Przegla̜d Gastroenterologiczny最新文献

Introduction: Ingestion of foreign bodies is a significant problem among children, which necessitates early intervention and may lead to serious morbidity and even mortality.

Aim: To estimate the pattern of foreign body ingestion among children and identify the role of management and its outcomes in relation to the type and site of foreign bodies.

Material and methods: Our study was carried out on patients who attended the Emergency Department of the Rapareen Teaching Hospital for Paediatrics in Erbil city and were referred to the Paediatric Gastroenterology Unit during between March 2019 and January 2023. All clinical and demographic data were entered and then analysed using SPSS.

Results: Fifty-four patients visited or were admitted to the Rapareen Hospital Emergency Department with a history of ingestion of foreign bodies, with a median age of 4 years (mean age: 4.14 ±2.15 years) and a nearly equal male-to-female ratio (1.16 : 1). Most of the foreign bodies were radiopaque, and the majority were located in the oesophagus at the time of initial presentation. Disc batteries (27.8%) were the commonest foreign body, followed by coins (20.4%), of which 66.7% were retrieved endoscopically, while 4 patients needed surgical intervention. Cross-tabulation reveals a significant association between the site of materials and the early presentation, type of object, and outcome. Also, a significant association was established between the type of foreign body and gender, age, time of presentation, and outcome.

Conclusions: The button battery was the most common foreign body ingested among the children, and the majority were located in the oesophagus and extracted by endoscopy.

Introduction: Common clinical problems are frequently seen in medical students. Gastroesophageal reflux disease (GERD) is increasingly seen in clinics and is taken seriously into consideration; from this point, we start discussing this disorder. The most important part is to find out the prevalence of GERD among medical students and determine the most dominant risk factors that affect the prognosis of the disease.

Aim: We aim at getting enough information about the best lifestyle modifications to alleviate symptoms.

Material and methods: This was a cross-sectional study conducted on medical students in Jordan through a well- structured questionnaire to assess the frequency of symptoms and if there are specific risk factors for medical students.

Results: The prevalence of GERD in medical students was found to be 42.3%, and of these 36% also had associated heartburn symptoms. The potential risk factors were psychological stress and bad dietary habits. Personal life stress was found to be the main cause of stress (65%). GERD patients had sleep problems which had a troublesome impact on them.

Conclusions: GERD symptoms are frequently encountered among the population, with increased prevalence in medical students. The most common symptom was heartburn. However, most of the students were asymptomatic. Multiple potential risk factors were identified including psychological stress and bad dietary habits.

Introduction: Decreased bone mineral density (BMD) is one of the most frequent extraintestinal symptoms of celiac disease (CD).

Aim: The study aimed to investigate BMD, body composition, 25(OH)D, and ionised calcium blood parameters, and to compare them between women with CD and healthy individuals.

Material and methods: The study covered 30 adult women with CD and 28 healthy controls. Densitometric measurements of the lumbar spine (L1-L4) and femoral neck (FN) were conducted using dual-energy X-ray absorptiometry (DXA). Body mass was measured with the use of the bioimpedance method. Furthermore, serum 25(OH)D and ionised calcium concentration were determined. All patients completed a questionnaire referring to vitamin D and calcium supplementation.

Results: Significant differences were found between the groups for body mass, body mass index (BMI), BMD, T-score, and Z-score of the FN, BMD, and T-score of the L1-L4, and 25(OH)D concentration. Osteopaenia affected 23.33% (n = 7) and 36.67% (n = 11) of patients in the FN and L1-L4, respectively, and osteoporosis in L1-L4 affected 13.33% (n = 4) of patients with CD. There were no cases of osteoporosis in FN. CD patients more often declared vitamin D and calcium supplementation than healthy participants. None of the patients reported a history of fractures.

Conclusions: Although patients with CD more often declare supplementing vitamin D and calcium, the prevalence of osteopaenia and osteoporosis is higher in this group compared to healthy controls. At the same time, patients with CD present with lower body mass, BMI, fat tissue, muscle mass, and fat-free mass and higher 25(OH)D concentration.

Introduction: Inflammatory bowel diseases (IBD) are characterised by chronic inflammation of the gastrointestinal tract. There aetiopathogenesis has not yet been fully elucidated. Faecalibacterium prausnitzii is one of the most abundant in human gut, and it is found in about 5% of the gut microbiota.

Aim: To study the role of F. prausnitzii in Egyptian patients with ulcerative colitis (UC) and Crohn's disease (CD) and to assess its relationship with the disease activity.

Material and methods: This study includes 80 patients divided as follows: group I: 30 patients with UC; group II: 30 patients with CD; and group III: 20 healthy patients as control. DNA execration was performed using a faecal extraction kit and quantitative SYBR green real time PCR to identify the core of F. prausnitzii.

Results: In group 1 of UC patients, the level of bacteria was reduced by a mean of 1.68E-01, and in the control group by a mean of 2.72E-01 (p ₂ = 0.004, significant). Regarding F. prausnitzii in UC patients according to Mayo score, in severe patients the level of bacteria was reduced significantly by a median of 4.80E-02. Regarding F. prausnitzii in group 2 of CD, the level of bacteria was significantly reduced by mean of 1.70E-01, and in the control group by a mean of 2.72E-01 (p ₃ = 0.037, significant).

Conclusions: There was a significant difference between CD and UC patients and the control group in F. prausnitzii. There was a significant reduction in the level of F. prausnitzii in severe UC cases.

Introduction: Haemorrhoidal disease is one of the most common nowadays. It is often associated with a sedentary lifestyle. The leading cause of its development is also a functional disorder of the intestine and chronic constipation. To date, there is a steady growth rate of this disease, leading to its "rejuvenation". The current stage of development indicates the need for further improvement of surgical treatment and optimisation of patient management methods and the creation of uniform standards of care for this contingent of patients.

Aim: To evaluate the clinical effectiveness of the use of platelet-rich plasma therapy and the biologically active substance "ozoyl" in the treatment of haemorrhoidal disease.

Material and methods: The main group included 100 patients with chronic haemorrhoids who were operated on in the period from March 2021 to March 2022. For this group, autoplasma was used during surgery, and an ozoyl-based drug in the postoperative period. The remaining 100 participants of this study, assigned to the control group, underwent a conventional haemorrhoidectomy operation and standard patient management using a hydrophilic ointment based on chloramphenicol.

Results: After the conducted clinical studies, it was established that in the main group, the pain syndrome decreased by about 30%, considering the period from the first day of the postoperative period compared to the control group. The postoperative wound healed in the main group in the third week after the operation, unlike the control group, in which this event was noted in the fourth week. The patients did not complain during the examination 3 months later.

Conclusions: This study is of practical significance because haemorrhoidal disease today has a high prevalence, and an integrated approach is required for the treatment of such patients. Ozoyl is a powerful cell and tissue repairer.

Introduction: The leaves and seeds of Urtica dioica (UD) are used in folk treatments for many diseases. Anticarcinogenic, anti-inflammatory, antioxidant, and antiallergenic properties of UD have been reported.

Aim: To uncover the effects of nettle seed (Urtica dioica; UD) extract on body weight gain in rats on a high-fat diet (HFD).

Material and methods: Male Wistar albino rats (n = 32) were divided into 4 groups, comprising a control group, a group that received a HFD (HFD group), a group that received UD extracts (UD group), and a group that received a HFD as well as UD extracts (HFD + UD group). UD extracts were given a daily dose of 300 mg/kg of body weight orally for 75 days.

Results: The HFD led to weight gain that was partially moderated by the UD extract. Histopathological findings in the HFD + UD group were uniformly significantly lower than those in the HFD group. Serum alanine transaminase, alanine aminotransferase, triglyceride, and low-density lipoprotein levels were significantly higher in the HFD group than in the HFD + UD group, and the HDL levels were lower in the HFD group than in the control group and the HFD + UD group.

Conclusions: The cholesterol levels were discovered to be highest in the HFD + UD group. Therefore, it was concluded that the UD extract did not completely protect the rats against body weight gain.

Introduction: In recent years, the issue of widespread increased body weight in combination with blood glycaemic changes in the able-bodied population of Kazakhstan has become especially acute, which in turn leads to dangerous complications and an increased burden on the country's healthcare structures.

Aim: To investigate the effectiveness of early prevention of overweight, obesity, and carbohydrate metabolism disorders in the able-bodied workers at an industrial facility in Kazakhstan.Material and methods: The study was conducted in 2019-2021 using elements of both empirical (observation, comparison, measurement) and theoretical (analysis and synthesis, statistical processing of results with the calculation of the reliability criterion) models of scientific knowledge.

Results: The factors that have a correlation with this pathology and the strength of their interaction have been studied. New approaches to primary prevention have been developed, and algorithms have been formulated not only for the early detection of pathologies but also for the most effective and efficient methods of combating the occurrence of such pathologies in the population.

Conclusions: To prevent the further spread of the phenomenon of overweight among workers in the industrial sector of Kazakhstan, the following measures are necessary: daily walking (more than 10,000 steps), dosed physical activity in the form of cardio and swimming, and nutrition correction (Mediterranean diet) with alcohol restriction. This prevention significantly reduces body weight and optimizes carbohydrate metabolism.

Introduction: Ophthalmological manifestations (O-EIM) are one of the extraintestinal manifestations (EIM) of inflammatory bowel disease (IBD), although their frequency and potential relationship with disease activity and treatment remain underestimated.

Aim: The aim of this screening questionnaire was to assess the number of EIM, including O-EIM, among patients with IBD.

Material and methods: 436 patients with IBD and 102 patients without IBD were included in this single-centre retrospective study. The questionnaire consisted of questions regarding the frequency of EIM, including confirmed O-EIM and ophthalmological symptoms which had not been confirmed by an ophthalmologist.

Results: EIM were present in 48.6% of cases; O-EIM were declared by 8.9% (uveitis 3.9% + episcleritis 4.8% + scleritis 0.2%) of the IBD patients. About half (50.7%) of them reported ophthalmological symptoms in the last 3 months, but only 30.5% reported consulting with an ophthalmologist. The multivariable logistic regression indicated some coexisting EIM (anaemia and axial/non-axial spondyloarthropathy), the use of certain medications (steroids, thiopurines, and methotrexate), smoking, family history of glaucoma, and spending more time in front of a computer screen as being linked with ophthalmological involvement among IBD patients.

Conclusions: EIM, including O-EIM, are a common problem in patients with IBD. The presence of ophthalmological symptoms and the lack of follow-up with an ophthalmologist make it difficult to correctly estimate the true number of IBD patients experiencing O-EIM. Therefore, patients with IBD should be routinely referred for ophthalmological evaluation.

Introduction: Periampullary diverticulum (PAD) is frequently discovered in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). Studies have yielded conflicting results regarding its impact on the technical success of ERCP and post-ERCP complications.

Aim: This study aims to assess the success and safety of ERCP in patients with PAD.

Material and methods: This study included 400 patients who underwent ERCP for common bile duct (CBD) stones. Patients were classified into the PAD group (200 patients) and the non-PAD group (200 patients). Within the PAD group, patients were further subclassified into three types based on the location of the papilla. The study compared the two groups in terms of technical success and ERCP complications.

Results: The success rate of cannulation using selective techniques, needle-knife precut, or trans-pancreatic sphincterotomy was 88%, 7.5%, and 4.5%, respectively, for the PAD group and 81%, 9.5%, and 9.5%, respectively, for the non-PAD group (p = 0.099). Complete CBD clearance was achieved in 85% of the PAD group and 84% of the non-PAD group (p = 0.782). The rate of post-ERCP complications was similar in both groups (p = 0.371). Periampullary diverticulum type 1 was associated with more challenging cannulation (p < 0.001), a lower rate of complete CBD clearance (p < 0.001), and a higher rate of post-ERCP pancreatitis (p = 0.002) compared to other types.

Conclusions: The presence of PAD does not hinder the technical success of ERCP and is not associated with a higher frequency of post-ERCP complications.