Search results

1

The influence of socio-demographic and clinical factors on the process of acceptance of the disease among patients with ulcerative colitis

100%

Chrobak-Bień J., Gawor A., Paplaczyk M., Małecka-Panas E., Gąsiorowska A.

Polish Journal of Surgery

|

2018

|

vol. 90(6)

6-12

EN

Ulcerative colitis (UC) is a kind of inflammatory bowel disease involving rectal mucosa, or the rectum with colon, resulting in ulcerations in some cases. It is incurable and varies with periods of exacerbation and remission. The disease affects mainly population of highly-developed European or North American nations. It can relatively rarely be observed in South America, Asia and Africa. It is estimated that morbidity and incidence in those regions is about 10 times lower than in Europe and North America [1,2]. The incidence of UC in Europe is approximately 10 new cases per 100,000 people annually [3]. In Poland, epidemiology assessment is difficult due to a lack of reliable statistics. In Lower Silesia, 840 hospitalizations for UC on average are registered annually [4,5]. In UC pathogenesis, genetic, environmental and immunologic factors play an important role. UC can occur at any age, however, the peak incidence is observed between ages 20 and 40 and over 65 [6]. UC is incurable and accompanies the patient through the rest of his/her life. It varies with periods of exacerbation and remission, which impair everyday activities and lower patient’s quality of life. As a consequence, the patient generally feels bad, which is not only caused by gastrointestinal symptoms but also by emotional and psychological issues [7]. Nowadays, a clear tendency can be observed in medicine to include health and disease-related issues in biopsychosocial context, including social and psychological factors affecting the course of the disease. The assessment of such factors brings up a broader perspective on patient’s health problems [8]. Adjustment to the disease is important in many chronic diseases, which demand a change of the patient’s attitude and taking aspects such as acceptance of one’s disease into consideration [9]. The term ‘acceptance’ denotes adopting an opinion, judgment, belief, behavior, favorable attitude or to give a consent [10]. Accepting one’s disease means adjusting to limitations posed by it and accepting the associated disability. The consequences include accepting the limitations, not being self-sufficient, dependence on others and low self-esteem [11]. In a chronic and difficult therapeutic process, medical staff play the key role, in addition to other patient’s support. Bonding with other patients is an important regulating factor in the emotional sphere, while psychological counseling can turn out beneficial in accepting one’s new difficult life situation. The aim of the study was to evaluate the acceptance of the disease in patients with ulcerative colitis with respect to selected socio-demographic and clinical variables.

2

Restorative Proctocolectomy for Emergency Cases of Ulcerative Colitis

80%

Hermann J., Sękowska M., Drews M.

Polish Journal of Surgery

|

2007

|

vol. 79

|

issue 4

265-268

EN

Restorative proctocolectomy was performed for urgent indications in three stages and for elective purposes in two stages for ulcerative colitis (UC). Since the three-step procedure makes enormous demands on the patients, there was an attempt to introduce a primary pouch anal anastomosis for urgent indications in selected cases.The aim of the study was to compare early complications in patients after having undergone Hartmann's procedure with those that had restorative proctocolectomy for urgent indications in UC, based on the authors' experience and the literature.Material and methods. The medical records of 211 patients who underwent an operation for UC in this clinic from 1996 through 2005 were retrospectively evaluated. There were 107 (51%) males and 104 (49%) females in this study; the mean age was 38 years. The median duration of disease was 3 years.Results. An operation was performed in 77 (36%) patients for urgent indications. Finally, the study was entered by 60 (28%) patients after exclusion of the high-risk patients. All the patients were divided into two groups. The first group consisted of 25 (42%) patients who underwent the Hartmann's procedure, whereas the second group comprised 35 (58%) patients who had the pouch operation. There was no postoperative mortality in the surveyed group. Respiratory failure occurred in 6 (24%) patients after Hartmann's operation and in 5 (14%) patients who underwent the pouch procedure. Intra-abdominal sepsis developed in 3 (12%) patients after colectomy and in 5 (14%) after pouch-anal anastomosis. Wound dehiscence was present in 2 (8%) patients undergoing Hartmann's operation and in 3 (9%) after the pouch procedure. Bowel obstruction occurred in 1 patient after the former operation and in 2 (6%) patients after the latter one. Wound infection was diagnosed in 5 (20%) patients after colectomy and in 7 (20%) after proctocolectomy. Differences between the investigated groups of patients were not statistically significant.Results. The three-stage procedure with Hartmann's colectomy is the treatment of choice for urgent indications in UC.Primary restorative proctocolectomy is performed for urgent indications in acute UC in selected group of patients without septic signs due to a similar morbidity as the group of patients who had Hartmann's procedure.

3

Quality of Life Considering Patients with Chronic Inflammatory Bowel Diseases - Natural and Parenteral Nutrition

80%

Raczkowska A., Ławiński M., Gradowska A., Zielińska-Borkowska U.

Polish Journal of Surgery

|

2015

|

vol. 86

|

issue 9

410-417

EN

One of the elements of treatment considering inflammatory bowel diseases is nutritional therapy. The duration of the above-mentioned depends on the prevalence of such symptoms as fever, bowel move-ments, length of the functioning gastrointestinal tract, stoma and intestinal fistula presence. Nutritional therapy is an essential element of successful treatment alongside pharmacological, surgical, and biological therapy, as well as other methods. Crohn's disease and ulcerative colitis considered as chronic diseases, lead towards physical and biopsychosocial disability, being responsible for the reduction in the quality of life. The aim of the study was to determine the quality of life after surgical procedures in case of patients diagnosed with Crohn's disease and ulcerative colitis, subjected to natural and parenteral nutrition. Material and methods. The study group comprised 52 patients from the Department of Gastroen-terology, Military Medical Institute, and Department of Surgery and Clinical Nutrition, Clinical Hospital in Warsaw. The study was performed between October, 2011 and April, 2012. The World Health Organization Quality of Life Instrument - Bref (WHOQOL-BREF) questionnaire was used to deter-mine the patients’ quality of life. conclusions. A lower quality of life was observed in case of patients subjected to parenteral nutrition, poor education, disease symptoms exacerbation, in the majority-rural inhabitants. The quality of life does not depend on gender, type of disease, family status, and additional medical care.

4

Hybrid Procedures of Restorative Proctocolectomy with Ileal Pouch Anal Anastomosis for Large Bowel Disorders

80%

Nowobilski W., Folwarski M., Dobosz M.

Polish Journal of Surgery

|

2011

|

vol. 83

|

issue 10

537-540

EN

The aim of the study was to describe the authors' experience in performing laparoscopic restorative proctocolectomy with the formation of an intestinal reservoir of the J-pouch type, anal anastomosis and protective ileostomy.Material and methods. Between 2004 and 2011, a total of 23 patients underwent laparoscopic restorative proctocolectomy with the formation of an intestinal reservoir of the J-pouch type, anal anastomosis and protective ileostomy for ulcerative colitis (n = 17) or familial adenomatous polyposis (n = 6). A statistical analysis of the treatment outcomes was performed.Results. No intraoperative complications were observed and none of the patients required conversion or blood transfusions. The mean duration of the procedure was 4.08 hours (2.5-6.0 hours). The mean duration of hospitalization was 15.4 days (8-24 days). We observed three major postoperative complications requiring intervention: two cases of small bowel obstruction (one due to postoperative adhesions and the other due to volvulus) and one case of infection of the surgical and ostomy wound healed following ileostomy closure.Conclusions. For such extensive procedures as restorative proctocolectomy, laparoscopic techniques prove safe and are characterised by a better patient acceptance thanks to the low invasiveness and good cosmetic effects. The technological progress and the increasing experience in performing laparoscopy provide more and more arguments to support the selection of this method as the preferred method of treatment.

5

Sexual activity in patients after proctocolectomy with ileal pouch-anal anastomosis

80%

Kluska P., Dzika-Andrysiak K., Mik M., Zelga P., Włodarczyk M., Kujawski R., Dziki Ł., Dziki A., Trzciński R.

Polish Journal of Surgery

|

2021

|

vol. 93

|

issue 1

19-24

EN

Introduction: Proctocolectomy with ileal pouch-anal anastomosis is the gold standard in the surgical treatment of patients with ulcerative colitis, familial adenomatous polyposis and other colorectal diseases requiring colectomy. The treatment consists in removing the large intestine and creating an intestinal reservoir from the last ileum loop and then anastomosing the intestinal reservoir with the anal canal. Like any surgical procedure, RPC-IPAA also carries the risk of complications, both early and late. Late postoperative complications include sexual dysfunction. Aim: The main goal of the following work is to assess the quality of life and sexual activity in patients having undergone the RPC-IPAA procedure at the General and Colorectal Surgery Clinic. Material and methods: The study group consisted of patients aged 19–79 who had been subjected to RPC-IPAA procedures at the General and Colorectal Surgery Clinic in years 2010–2019. The study was conducted on the basis of a survey consisting of 50 questions about the social and mental condition, medical history and previous treatment as well as the quality of sexual life before and after surgery. The scale used for the assessment of the quality of sex life consisted of 5 grades: very low, low, medium, high, very high. Thirty subjects (21 men and 9 women) took part in the survey. Ulcerative colitis (86.6%) was the most common reason for qualification for restorative proctectomy among the examined patients; less common reasons included familial adenomatous polyposis (13.3%) and synchronous colorectal cancer (3.3%). A vast majority of the surgeries had been performed after 10 years’ duration of ulcerative colitis, and the intestinal reservoir had been functioning for over a year at the time of the examination. In addition, the effect of taking steroids and the impact of early postoperative complications on the quality of sex life of patients was assessed. Results: High or very high sexual activity before surgery was reported by 46% of patients whereas low or very low quality was reported by 13%. The rest of the responders assessed their pre-operative sexual activity as average. After surgery, 23% of patients rated their sexual activity as high or very high while 36.6% of patients rated it as low or very low (P = 0.07). It was also noted that taking corticosteroids before surgery decreased the quality of sex life after surgery (P = 0.07 for activity, P = 0.04 for quality). None of the women surveyed used artificial moisturizing of intimate places during sex. Only 1 person stated that they started using artificial moisturization of intimate places after the procedure (P = 0.5). None of the men surveyed had used pharmacological agents to help them obtain an erection before surgery while as many as 33% of responders reported the need for their use after surgery (P = 0.008). Other postoperative sexual dysfunctions were also registered, such as dyspareunia (13.3%), sensory disorder within the intimate region, fecal incontinence, and urinary incontinence. Conclusions: To sum up, sexual activity and quality of sexual life deteriorated after RPC-IPAA in our patients.

6

Multifocal colorectal cancer in ulcerative colitis patient with sclerosing cholangitis – case report

80%

Kosmowska A., Krokowicz P., Nelke M.

Polish Journal of Surgery

|

2020

|

vol. 92(6)

51-54

EN

Introduction: U lcerative colitis (CU) is an inflammatory disease predisposing to colorectal cancer. Colorectal cancer in ulcerative colitis is more often metachronous or synchronous. Case report: In this case report we present a patient with multifocal colorectal cancer in the course of CU and operative treatment that was implemented. Additionallyprimary sclerosing cholangitis was diagnosed in this patient post-operatively.

7

Transforming growth factor β1 protein and mRNA levels in inflammatory bowel diseases: towards solving the contradictions by longitudinal assessment of the protein and mRNA amounts

80%

Liberek A., Kmieć Z., Wierzbicki P., Jakóbkiewicz-Banecka J., Liberek T., Łuczak G., Plata-Nazar K., Słomińska-Frączek M., Kaszubowska L., Gabig-Cimińska M., Węgrzyn A.

|

2013

|

vol. 60

|

issue 4

683-688

EN

Previously published studies on levels of the transforming growth factor-β1 (TGF-β1) protein and mRNA of the corresponding gene in patients suffering from inflammatory bowel diseases (IBD) gave varying results, leading to contradictory conclusions. To solve the contradictions, we aimed to assess longitudinally TGF-β1 protein and mRNA levels at different stages of the disease in children suffering from IBD. The study group consisted of 19 pediatric patients with IBD at the age between 3.5 and 18.4 years. The control group consisted of 42 children aged between 2.0 and 18.0 years. The plasma TGF-β1 concentration was measured with ELISA. mRNA levels of the TGF-β1 gene isolated from samples of the intestinal tissue were assessed by reverse transcription and real-time PCR. Levels of TGF-β1 protein in plasma and corresponding mRNA in intestinal tissue were significantly higher in IBD patients than in controls. TGF-β1 and corresponding transcripts were also more abundant in plasma and intestinal tissue, respectively, in patients at the active stage of the disease than during remission. In every single IBD patient, plasma TGF-β1 level and mRNA level in intestinal tissue was higher at the active stage of the disease than during remission. Levels of TGF-β1 and corresponding mRNA are elevated during the active stage of IBD but not during the remission. Longitudinal assessment of this cytokine in a single patient may help to monitor the clinical course of IBD.

8

Higher Apoptosis Index and Proliferation Index in Colonocytes of Patients with Ulcerative Colitis in Remission

80%

Buczyński J., Spychalski M., Ławska-Wierzchniewska A., Dziki A.

Polish Journal of Surgery

|

2012

|

vol. 84

|

issue 6

271-275

EN

Ulcerative colitis (UC) is a inflammatory disease of large bowel. The amount of people suffering from UC increases from year to year. Pathogenesis of this affection is still not entirely clear. Mechanisms of proliferation and apoptosis in colonocytes in the course of the disease are defectedThe aim of the study was to assess the rate of proliferation and intensity of apoptosis in colonocytes in patients with diagnose UC.Material and methods. Colon pathological samples taken from patients with diagnosed ulceraive colitis were examined. Patients were in both clinical and endoscopic remission and were treated with mesalazin. They were patient of Department of General and Colorectal Surgery. To estimate proliferation index dye with monoclonal antibody against Ki67. To determine apoptosis level immunohistochemistry with antybody against Bax was used.Results. Average Ki-67 in the test group was 42,13%, the largest value amounted to 57% and the lowest of 33%. Average value of Bax was 1.47 and ranged between 0-3. High index of bax appear not only in the bottom of the crypt, but also at their outlet.Conclusions. In ulecerative colitis genetic and immunological disturbances occur despite treatment. Mesalazine acting only on certain routes associated with the UC holds the remission, without, however "the molecular remission". Thus, it appears that the results of our research are another proof of the necessary caution in weaning support treatment.

9

Ileal-Pouch-Anal Anastomosis After Restorative Proctocolectomy in Patients With Ulcerative Colitis or Familial Adenomatous Polyposis - 11 Years of Experience

80%

Bednarz W., Olewiński R., Woldan J.

Polish Journal of Surgery

|

2007

|

vol. 79

|

issue 5

362-367

EN

Restorative proctocolectomy is the "gold standard" in surgical treatment for ulcerative colitis and familial adenomatous polyposis. The two alternative techniques of ileal-pouch-anal anastomosis include handmade and double line stapled suture.The aim of the study was to analyze postoperative complications and functional results of the two types of anastomosis.Material and methods. The study group consisted of 108 patients operated between 1994 and 2005 for ulcerative colitis (n=97) or familial adenomatous polyposis (n=11). Stapled anastomosis was performed in 88 (81.5%) cases and hand-made suture was performed in 20 (18.5%) cases.Results. No significant differences between the two anastomotic techniques were found in terms of postoperative complications and late functional results.Conclusions. The low rate of complications and well-accepted functional outcomes prove that restorative proctocolectomy is a safe surgical procedure that can be offered to patients with ulcerative colitis or familial adenomatous polyposis. Double line stapled suture should be the preferred method of ilealpouch-anal anastomosis, however, the hand-made suture remains its valuable alternative and may be considered in selected cases.

10

Diagnosis and treatment difficulties in 18-year-old male patient with hereditary hemochromatosis, chronic hepatitis B, Gilbert syndrome and ulcerative colitis

80%

Sikorska K., Liberek A., Romanowski T., Szlagatys-Sidorkiewicz A., Landowski P., Bielawski K.

|

EN

Among possible causes of chronic hepatitis in adolescents most common are infections, autoimmune disorders and metabolic diseases. Thus, diagnostic procedures should be multidirectional. This study reports diagnosis and treatment difficulties in an 18-year-old male patient with hereditary hemochromatosis (HH), ulcerative colitis (UC), chronic hepatitis B (CHB) and Gilbert syndrome. The presented case illustrates problems in diagnostics related to the presence of numerous disease conditions in one patient. It should be taken into consideration that these diseases coexisting in one patient can mutually affect their symptoms creating specific diagnostic difficulties.

11

Surgery for Inflammatory Bowel Disease in Children and Adolescents

80%

Meissner W., Szabłoński W., Krokowicz P., Ignyś I., Szmeja J., Drews M.

Polish Journal of Surgery

|

2007

|

vol. 79

|

issue 1

36-41

EN

Recent decades have seen a constant rise in the incidence of IBD in both adults and children. Despite considerable progress in the pharmacological treatment of this disease, surgery has become the more frequently used treatment modality in younger patients. In the presence of massive haemorrhage, free perforation, fulminate colitis or acute obstruction, only surgical intervention has a chance of saving the patient's life.The aim of the study was to present the results of surgical treatment of IBD in children and adolescents who were operated on in a department which copes with "adult surgery" in its everyday practice.Materials and methods. 235 patients were operated on for IBD in the years 1998-2005. There were 18 (7,66%) children in this group, 10 girls and 8 boys. 12 patients were diagnosed with ulcerative colitis (66.7 %) and (6) patients were diagnosed with Crohn's disease (33.3%). The age of the patients ranged from 12 to 17 years (mean 15.6). Among the 18 children, 10 (55.6%) were operated on for elective reasons and 8 (44.4%) of the interventions were emergencies (three perforations, two obstructions, one acute haemorrhage and one fulminate colitis). In all cases of ulcerative colitis, a two-step restorative proctocolectomy with J pouch anal anastomosis was performed. Patients with Crohn's disease were treated by limited (sparing)[it seems that either limited or sparing works here, pick one] bowel resection and/or strictureplasty.Results. There were no postoperative deaths in the study group. Postoperative complications were observed in 6 (33.3%) patients, the complications were ileus in 3 patients (1 patient demanded relaparotomy), pneumonia in 2 patients and wound suppuration with subsequent dehiscence in 1 patient. In one patient treated preoperatively with large doses of Imuran, the postoperative histology revealed a malignant lymphoma. Hospital stays ranged from 8 to 19 days (mean 12 days).Conclusions. Surgery for IBD in children and adolescents has become a widely accepted method, and it is often the only treatment modality that offers a chance of a cure. Restorative proctocolectomy should be considered earlier in many cases of younger patients with ulcerative colitis, prior to conservative treatment, as imunosupression and steroid therapy in particular produce undesired side effects. A consulting surgeon should be involved in the treatment of younger patients with IBD at a much earlier stage of therapy than is currently practiced.

12

Association of the-801G/A Polymorphism ofCXCL12Gene with the Risk of Inflammatory Bowel Diseases Development in a Polish Population

70%

Mrowicki J., Przybyłowska K., Dziki Ł., Sygut A., Wiśniewska-Jarosińska M., Chojnacki J., Dziki A., Majsterek I.

Polish Journal of Surgery

|

2011

|

vol. 83

|

issue 6

334-338

EN

Inflammatory bowel diseases (IBDs), mainly ulcerative colitis (UC) and Crohn's disease (CD), are characterized by chronic and idiopathic inflammatory conditions of gastrointestinal tract that are immunologically mediated. Stromal cell-derived factor 1 (CXCL12) has been demonstrated to be involved in the pathophysiology of IBD.The aim of the study was to investigate whether the CXCL12 -G/A polymorphism (rs1801157) is associated to IBD in a sample of Polish population.Material and methods. A total of 188 patients with IBD including 103 patients with CU and 72 patients with CD and 184 controls were enrolled in the study. Both groups came from the Polish population. The G/A polymorphism of CXCL12 was determined by PCR-RFLP analysis.Results. There was no association between G/A polymorphism at position -801 promoter region of CXCL12 gene and increased risk of IBD. The study population was not found a difference in genotype distribution between the control group and with both CD and CU patients.Conclusions. These results suggest that G/A polymorphism at position -801 promoter region of CXCL12 gene relates neither to the risk of the development of inflammatory bowel disease nor to the clinical subtypes of IBD in the Polish population. Whether this polymorphism truly contributes to disease susceptibility needs to be further addressed, and should stimulate additional studies in other populations.

13

The Impact of the Nutritional State of Patients on the Results of the Surgical Treatment of Ulcerative Colitis

70%

Skowrońska-Piekarska U., Matysiak K., Sowińska A.

|

vol. 85

|

issue 8

424-432

EN

A variety of mechanisms have been proposed to explain the malnutrition and body mass loss in UC patients. The aim of the study trial was a nutritional state assessment of 347 UC patients, admitted for surgical treatment, and the evaluation of the impact of this state on the postoperative course in this group of patients. Material and methods. We referred the results of nutritional state assessment to the length of time of postoperative hospitalization of patients. Results. Through application of the Kruskal-Wallis test we found statistically significant, but weakly expressed, differences between the values of nutritional state parameters and period of hospitalization of patients. The applied U Mann-Whitney test, with statistically significant results with p <0.05, showed statistically significant differences between cured and dead subgroups in: 1) loss of body mass in 6 months before hospitalization (p = 0.000033), 2) hemoglobin level (p = 0.006676), 3) total lymphocyte count (TLC) (p = 0.025242), 4) total serum protein level (p = 0.003485), 5) serum albumin level (p =0.00165). Differences in BMI values were statistically negligible (p = 0.969397). Conclusions. The body mass loss in 6 months before admission, total lymphocyte count and serum albumin level are the reference parameters of the nutritional state of UC patients on admission to surgery

14

Transcriptional changes between uninflamed ulcerative colitis and familial adenomatous polyposis pouch mucosa can be attributed to an altered immune response

70%

Paziewska A., Horbacka K., Goryca K., Mikula M., Jarosz D., Dabrowska M., Krokowicz P., Karon J., Ostrowski J.

|

2015

|

vol. 62

|

issue 1

69-75

EN

A total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is considered the surgery of choice for definitive management of familial adenomatous polyposis (FAP) and some patients with ulcerative colitis (UC). However, this surgical treatment is often associated with pouchitis, a long-term complication that occurs mostly in UC patients. The purpose of this study was to better define the molecular background of pouchitis. A microarray-based survey was performed using pouch mucosal samples collected from 28 and 8 patients undergoing surgery for UC and FAP, respectively. There were 4,770 genes that significantly differentiated uninflamed from inflamed mucosal samples, and their functional features were represented mostly by metabolic and cell proliferation pathways. In contrast, functional analyses of aberrantly expressed genes between UC and FAP samples, irrespective of mucosal inflammation status, revealed multiple pathways and terms that were linked to changes in immune response. Interestingly, the comparison of uninflamed UC and FAP samples identified a set of 29 altered probe sets, including an inflammation-related transcript encoding a Charcot-Leyden crystal (CLC) protein. The most distinct changes in gene expression profiles differentiating uninflamed UC and FAP pouch mucosal samples were attributed to the Gene Ontology category innate immune response. Our study confirmed that alterations in immune responses can be found between patients who underwent surgery for UC and FAP, independent of the pouch inflammation status. This observation may be important when managing IPAA patients.

15

Intestinal Pouch Complications in Patients Who Underwent Restorative Proctocolectomy for Ulcerative Colitis and Familial Adenomatous Polyposis in 1985-2008

70%

Burdyński R., Banasiewicz T., Marciniak R., Biczysko M., Szmeja J., Paszkowski J., Grochowalski M., Maik J., Majewski P., Krokowicz P., Drews M.

Polish Journal of Surgery

|

2011

|

vol. 83

|

issue 3

161-170

EN

Restorative proctocolectomy is considered a surgical treatment of choice in ulcerative colitis (UC) and familial adenomatous polyposis (FAP).The aim of the study was to evaluate postoperative complications in patients who underwent surgery for familial adenomatous polyposis and ulcerative colitis, on the basis of a retrospective data analysis.Material and methods. Data of 138 patients after restorative proctocolectomy performed between 1985 and 2008 were collected at routine follow-up visits in 2004-2008. We evaluated the presence of pouchitis, the degree of ileal pouch mucosa atrophy, the presence of ileal pouch mucosal metaplasia, the presence of ileal pouch malignancies, the necessity for diverting ileostomy, the necessity for pouch resection, and severe faecal incontinence.Results. Complications were observed in 45 (32.4%) patients. Thirty-seven patients developed pouchitis (26.6%). Low-degree dysplasia, severe dysplasia or malignancies were observed in total in 20 patients (14.4%). Six (4.3%) operated patients developed other analysed complications.Conclusions. The most common complications of restorative proctocolectomy were dysplasia and pouchitis. The most common complication in patients operated for UC was pouchitis. The low observed incidence of intestinal pouchitis may be attributed to the implemented prophylaxis of inflammation. Dysplasia was the most common complication in patients undergoing proctocolectomy for FAP. Due to an increased risk of dysplastic lesions as compared with UC patients, careful endoscopic follow-up examinations are obligatory in this patient group. Other analysed complications were uncommon and were mostly a consequence of chronic pouchitis. Clinical symptoms of pouch-related problems were similar in both analysed groups.

16

Relative homogeneity of oral bacterial flora in Crohn’s disease compared to ulcerative colitis and its connections with antioxidant defense — preliminary report

70%

Szczeklik K., Owczarek D., Cibor D., Cześnikiewicz-Guzik M., Krzyściak P., Krawczyk A., Mach T., Karczewska E., Krzyściak W.

Folia Medica Cracoviensia

|

2019

|

vol. 59

|

issue 1

17

Serum concentrations of fibrosis markers in children with inflammatory bowel disease

70%

Pieczarkowski S., Kowalska-Duplaga K., Kwinta P., Wędrychowicz A., Tomasik P., Stochel-Gaudyn A., Fyderek K., Pieczarkowski S., Kowalska-Duplaga K., Kwinta P., Wędrychowicz A., Tomasik P., Stochel-Gaudyn A., Fyderek K.

Folia Medica Cracoviensia

|

2020

|

vol. 60

|

issue 1

18

Comparison of fecal pyruvate kinase isoform M2 and calprotectin in assessment of pediatric inflammatory bowel disease severity and activity

61%

Czub E., Nowak J., Szaflarska-Poplawska A., Grzybowska-Chlebowczyk U., Landowski P., Moczko J., Adamczak D., Mankowski P., Banasiewicz T., Plawski A., Walkowiak J.

|

2014

|

vol. 61

|

issue 1

99-102

EN

Aims: Accurate assessment of inflammatory bowel disease (IBD) activity is the cornerstone of effective therapy. Fecal M2 isoform of pyruvate kinase (M2-PK) and fecal calprotectin (FC) are noninvasive markers of mucosal inflammation in IBD. The aim of this study was to compare performance of M2-PK and FC in assessment of pediatric ulcerative colitis (UC) and Crohn's disease (CD) severity and activity. Materials and methods: 121 patients with IBD, including 75 with UC and 46 with CD were recruited. Control group consisted of 35 healthy children (HS). Patients were assigned to groups depending on disease severity and activity. M2-PK and calprotectin concentration were determined in stool samples using ELISA. Areas under receiver operating characteristic curves (AUC) for FC and M2-PK with cut-off level at which M2-PK specificity was matching FC specificity were calculated and compared. Results: Performance of M2-PK at identifying patients with IBD, UC and CD among HS was inferior to FC. The differences in AUC were respectively: -0.10 (95% confidence interval [CI] [-0.13-(-0.06)], p<0.0001), -0.14 (95% CI [-0.19-(-0.09)], p<0.0001) and -0.03 (95% CI [-0.05-(-0.001)], p<0.02). M2-PK was inferior to FC in discriminating patients with mild UC from those with HS (AUC difference -0.23, 95% CI [-0.31-(-0.15)], p<0.0001). Conclusions: FC reflects pediatric IBD severity and activity better than M2-PK. This difference is particularly pronounced when identifying patients with mild UC and UC in remission.

19

Podstawowe objawy i różnicowanie nieswoistych chorób zapalnych jelit

51%

Wojtuń S., Gil J., Szwed Ł., Dyrla P.

Pediatria i Medycyna Rodzinna

|

2014

|

vol. 10

|

issue 1

61-66

EN

Ulcerative colitis (colitis ulcerosa, CU) and Crohn’s disease belong to a group of nonspecific inflammatory bowel diseases characterized by chronicity and unknown aetiology. Due to their heterogeneous pathogeneses, their clinical pictures and clinical courses vary. This results in diagnostic difficulties that are encountered despite the availability of a number of specialized tests in contemporary medicine. It is known that a condition necessary to establish a definitive diagnosis is to confirm the presence of a nonspecific inflammatory bowel disease in a histopathological examination, but laboratory tests are helpful in the initial diagnosis and demonstrate the extent and severity of the inflammatory process. C-reactive protein is the indicator of the inflammatory process, and anaemia that occurs in ulcerative colitis is due to both the chronicity of the disease and iron deficiency secondary to blood loss. Laboratory diagnosis is also applicable in the evaluation of parenteral complications concerning the liver, bile ducts, and osteoporosis. Abnormal liver function tests are frequent in inflammatory bowel diseases and may be caused by an ongoing inflammatory process typical of these diseases as well as by the pharmacological treatment implemented. Although new methods, such as computed tomography, magnetic resonance imaging and positron emission tomography, are used in diagnosing gastrointestinal diseases, endoscopy with histopathological analysis of the collected samples still is (and will be for a long time) a primary diagnostic method in the process of diagnosing, monitoring the course of treatment and oncological surveillance.

PL

Wrzodziejące zapalenie jelita grubego i choroba Leśniowskiego-Crohna należą do grupy nieswoistych chorób zapalnych jelit o przewlekłym przebiegu i nieznanej etiologii. Z uwagi na niejednorodną patogenezę mają zróżnicowany obraz i przebieg kliniczny, co powoduje trudności diagnostyczne pomimo dostępności wielu wielospecjalistycznych badań. Wiadomo, że warunkiem koniecznym ustalenia ostatecznego rozpoznania jest potwierdzenie nieswoistej choroby zapalnej jelit w badaniu endoskopowym i histopatologicznym, niemniej jednak badania laboratoryjne są pomocne we wstępnej diagnostyce i odzwierciedlają zasięg oraz nasilenie procesu zapalnego. Białko C-reaktywne stanowi wykładnik procesu zapalnego, a występująca we wrzodziejącym zapaleniu jelita grubego niedokrwistość jest wynikiem zarówno przewlekłości choroby, jak i niedoboru żelaza wtórnego do utraty krwi. Diagnostyka laboratoryjna ma również zastosowanie w ocenie powikłań pozajelitowych dotyczących wątroby i dróg żółciowych, a także osteoporozy. Nieprawidłowe wyniki prób wątrobowych są częste w chorobach zapalnych jelit i mogą być spowodowane procesem zapalnym typowym dla tych chorób, ale też stosowanym leczeniem farmakologicznym. Chociaż powstają nowe metody wykorzystywane w diagnostyce przewodu pokarmowego, takie jak tomografia komputerowa, rezonans magnetyczny, pozytronowa tomografia emisyjna, to jednak badanie endoskopowe z oceną histopatologiczną pobranych wycinków jest (i jeszcze długo będzie) podstawową metodą diagnostyczną w rozpoznawaniu, monitorowaniu leczenia oraz nadzorze onkologicznym.

20

The therapeutic potential of short-chain fatty acids enemas in inflammatory bowel diseases: a systematic review

51%

Kaczmarek N., Kokot M., Makarewicz A., Glapa-Nowak A., Nowak J. K., Jamka M., Walkowiak J.

Farmacja Polska

|

2020

|

vol. 76

|

issue 5

297-304

PL

Sugeruje się, że krótkołańcuchowe kwasy tłuszczowe (SCFA) mogą redukować nasilenie objawów klinicznych, poprawiać wyniki badania endoskopowego i histopatologicznego u pacjentów z nieswoistymi chorobami zapalnymi jelit (IBD). Jednakże, pomimo obiecujących badań in vitro, wyniki badań przeprowadzonych w modelu zwierzęcym oraz randomizowanych badań kontrolowanych (RCT) są niejednoznaczne. Celem tego przeglądu systematycznego była ocena skuteczności SCFA podawanych doodbytniczo u pacjentów z IBD. Wyszukiwanie elektroniczne przeprowadzono w następujących bazach danych: PubMed, Scopus, Web of Science i Cochrane. Kryteria włączenia badań oryginalnych do przeglądu systematycznego obejmowały: 1) rodzaj badań: równoległe lub krzyżowe RCT; 2) język: artykuły w języku angielskim; 3) rodzaj interwencji: SCFA podawane doodbytniczo; 4) populacja badana: pacjenci z wrzodziejącym zapaleniem jelita grubego lub chorobą Leśniowskiego-Crohna, niezależnie od płci, wieku, pochodzenia etnicznego, lokalizacji badania i wielkości próby. Jako punkty końcowe przyjęto wpływ podaży SCFA na wskaźnik aktywności choroby (DAI) oraz wyniki badań endoskopowych i histopatologicznych. Do analizy zakwalifikowano 4 badania obejmujące łącznie 187 pacjentów z IBD. W 2 badaniach oceniano wpływ SCFA na DAI, w 4 badaniach – na wyniki badania endoskopowego i histopatologicznego. Nie stwierdzono istotnych różnic pomiędzy grupą interwencyjną a grupą kontrolną w zakresie wpływu na jakikolwiek analizowany parametr. W 2 badaniach wykazano istotny spadek DAI po okresie interwencji, zarówno w grupie SCFA, jak i w grupie kontrolnej. Podobnie, w 4 badaniach odnotowano statystycznie istotne różnice między wynikami endoskopowymi przed i po interwencji w grupie SCFA. Jednakże, w 3 badaniach podobny efekt zaobserwowano w grupie kontrolnej. Poza tym, w 3 badaniach nie zaobserwowano wpływu SCFA na wyniki histopatologiczne. Podsumowując, brak jest dowodów na skuteczność SCFA podawanych doodbytniczo u pacjentów z IBD.

EN

It has been suggested that short-chain fatty acid (SCFA) enemas might improve clinical, endoscopic and histological scores in patients with inflammatory bowel disease. However, despite the promising results of in vitro studies, the findings of animal studies and randomised controlled trials are inconclusive. Therefore, this review aimed to assess the efficacy of SCFA enemas in patients with inflammatory bowel diseases. Electronic searches were performed in PubMed, Scopus, Web of Science and Cochrane databases. Original studies were included in this systematic review if they met the following inclusion criteria: 1) types of studies: parallel or crossover randomised controlled trials; 2) language: articles published in English; 3) types of interventions: SCFA enemas; 4) population: studies conducted in subjects with ulcerative colitis or Crohn’s disease of either gender and any age and without restrictions based on the ethnicity of study participants, location of study or sample size. The outcomes included the effect of SCFA enemas on disease activity index (DAI), endoscopic and histological scores. In total, four studies enrolling 187 patients with inflammatory bowel diseases were included in this systematic review. Two studies assessed the effect of SCFA enemas on DAI. Four studies evaluated the effect of SCFA therapy on the endoscopic score and the histological score. There were no significant differences between the SCFA groups and the control groups regarding the impact on any analysed parameter. Two studies demonstrated a statistically significant decrease in DAI after the intervention period, both in the SCFA groups and the control groups. Similarly, statistically significant differences between pre- and post-intervention endoscopic scores in the SCFA groups were reported in four studies. However, in three studies, a similar effect was demonstrated in the control groups. Besides, in three studies no effect of SCFA enemas on the histological score was observed. In conclusion, there is no evidence for the effectiveness of SCFA enemas in patients with inflammatory bowel diseases.

Refine search results

The influence of socio-demographic and clinical factors on the process of acceptance of the disease among patients with ulcerative colitis

Restorative Proctocolectomy for Emergency Cases of Ulcerative Colitis

Quality of Life Considering Patients with Chronic Inflammatory Bowel Diseases - Natural and Parenteral Nutrition

Hybrid Procedures of Restorative Proctocolectomy with Ileal Pouch Anal Anastomosis for Large Bowel Disorders

Sexual activity in patients after proctocolectomy with ileal pouch-anal anastomosis

Multifocal colorectal cancer in ulcerative colitis patient with sclerosing cholangitis – case report

Transforming growth factor β1 protein and mRNA levels in inflammatory bowel diseases: towards solving the contradictions by longitudinal assessment of the protein and mRNA amounts

Higher Apoptosis Index and Proliferation Index in Colonocytes of Patients with Ulcerative Colitis in Remission

Ileal-Pouch-Anal Anastomosis After Restorative Proctocolectomy in Patients With Ulcerative Colitis or Familial Adenomatous Polyposis - 11 Years of Experience

Diagnosis and treatment difficulties in 18-year-old male patient with hereditary hemochromatosis, chronic hepatitis B, Gilbert syndrome and ulcerative colitis

Surgery for Inflammatory Bowel Disease in Children and Adolescents

Association of the-801G/A Polymorphism ofCXCL12Gene with the Risk of Inflammatory Bowel Diseases Development in a Polish Population

The Impact of the Nutritional State of Patients on the Results of the Surgical Treatment of Ulcerative Colitis

Transcriptional changes between uninflamed ulcerative colitis and familial adenomatous polyposis pouch mucosa can be attributed to an altered immune response

Intestinal Pouch Complications in Patients Who Underwent Restorative Proctocolectomy for Ulcerative Colitis and Familial Adenomatous Polyposis in 1985-2008

Relative homogeneity of oral bacterial flora in Crohn’s disease compared to ulcerative colitis and its connections with antioxidant defense — preliminary report

Serum concentrations of fibrosis markers in children with inflammatory bowel disease

Comparison of fecal pyruvate kinase isoform M2 and calprotectin in assessment of pediatric inflammatory bowel disease severity and activity

Podstawowe objawy i różnicowanie nieswoistych chorób zapalnych jelit

The therapeutic potential of short-chain fatty acids enemas in inflammatory bowel diseases: a systematic review