Przegla̜d Gastroenterologiczny最新文献

Introduction: It is known that the virus SARS-CoV-2 can attack the gastrointestinal (GI) tract and induce gastroenteritis. This can trigger a wide variety of disorders of gut-brain interaction (DGBIs) or functional gastrointestinal disorders (FGIDs), including post-infectious dyspepsia, which remains underestimated.

Aim: To estimate the prevalence of dyspeptic symptoms following COVID-19, immediately after discharge and 3, 6, and 9 months after hospitalization.

Material and methods: A prospective, single-centre evaluation of questions regarding functional dyspepsia (FD) as assessed by the Gastroduodenal Module of ROME IV Diagnostic Questionnaire for Adult FGIDs among 320 patients who had had COVID-19.

Results: The FD ROME IV criteria were met at the respective time-points by 0.0% (0), 4.8% (12), 3.2% (8), and 3.2% (8) of cases. However, the presence of GI symptoms that suggested FD but did not meet the timeframe ROME IV criteria for FD were found in 9.6% (24), 23.5% (59), 20.7% (52), and 20.7% (52) of cases, respectively.

Conclusions: The presence and persistence of gastrointestinal dyspeptic symptoms following COVID-19 is a significant problem. The timeframe of the Rome IV criteria may underestimate the number of patients with persistent dyspeptic symptoms following COVID-19 disease.

Burnout is common among physicians; it severely alters their health and has a negative impact on functioning of healthcare systems. Hypertension, increased cortisol levels, maladaptive behaviors with negative social consequences, and suboptimal quality of care have been associated with healthcare providers' burnout. As the number of patients with cancers, psychiatric and neurodegenerative disorders will rise, we need new solutions to maintain physicians' health and, therefore, quality of care. Coping strategies before the COVID-19 pandemic seem ineffective in scaling all the deficits of the global healthcare systems. Examples of new initiatives include new collaborative projects, such as COH-FIT (The Collaborative Outcomes study on Health and Functioning during Infection Times - https://www.coh-fit.com), which aims to collect global data and understand the impact of the COVID-19 pandemic on physical and mental health in order to identify various coping strategies for patients and healthcare workers during infection times, or MEMO (Minimizing Error, Maximizing Outcome), funded by the Agency of Healthcare Research and Quality (AHRQ). Others: i) Rome Foundation GastroPsych undertake efforts dedicated to the science and practice of psychogastroenterology, a burgeoning field with roots in behavioral intervention, cognitive science and experimental psychology focused on fostering the professional growth and collaboration of those engaged in medical practices, or ii) World Gastroenterology Organisation (WGO), Train The Trainers (TTT) program including a new topic of the impact of burnout on career longevity in order to foster strategies for staying healthy and increasing career satisfaction. There is a need for continuous development of digital technologies (e.g. training simulators, telemedicine, robots and artificial intelligence). Their implementation into medical practice is inevitable. Now more than ever, there is a need for a new spirit in healthcare. Together with others in the field, we believe this article is a desperate call for maximizing the use of novel technologies supported by collaborative interactions among healthcare providers and medical professionals of diverse medical fields.

Introduction: Evidence regarding the association between diabetes mellitus (DM) and cholelithiasis is still inconsistent.

Aim: To examine the association between diabetes and gallstones and the commonly associated factors in a nationwide population-based cohort investigation.

Material and methods: The demographic and outcome variable data were extracted from the National Health and Nutrition Examination Survey (NHANES) database for the years 2017-2018.

Results: A total of 5376 individuals were included in the final analysis, with a mean age of 51.3 ±17.8 years. Females constituted 51.5% of the included individuals, and the overall mean body mass index (BMI) was 29.8 ±7.4 kg/m². The prevalence of diabetes was 16.2% among the included individuals, with a mean age of 50.6 ±13.6 years at diagnosis of diabetes, and only 4.5% were taking insulin. The prevalence of cholelithiasis was 11.2%, with a mean age of 44.4 ±16.1 years at diagnosis, and 11.3% had previous cholecystectomy (gallbladder surgery.) There was a significant increase in gallstone rates among diabetic patients as compared to non-diabetics in the unadjusted (OR = 2.30; 95% CI: 1.89-2.79; p < 0.001) and adjusted (OR = 1.52; 95% CI: 1.20-1.92; p < 0.001) models. Moreover, this association was not time-dependent where the "age when first told you had diabetes" did not show a significant influence on the gallstone rate, whether in unadjusted (OR = 1.01; 95% CI: 1.00-1.02; p = 0.221) or adjusted (OR = 1.01; 95% CI: 0.99-1.03; p = 0.395) models. Furthermore, insulin usage was found to be a significant predictor of cholelithiasis, whether in unadjusted (OR = 2.39; 95% CI: 1.74-3.28; p < 0.001) or adjusted (OR = 1.52; 95% CI: 1.05-2.19; p = 0.026) models.

Conclusions: DM and insulin therapy are possible risk factors for developing cholelithiasis.

Introduction: There are many studies on the influence of psychological factors in the appearance of symptoms and their treatment among gastroenterological patients. It is increasingly indicated that these factors are of great importance also for the quality of life of people struggling with a chronic disease.

Aim: To evaluate personality traits and emotional disorders in female patients with gastrointestinal conditions such as functional dyspepsia (FD), irritable bowel syndrome (IBS), or inflammatory bowel disease (IBD).

Material and methods: The sample of 28 patients was verified in terms of the disease using the GAST questionnaire and assessed by personality questionnaires and psychological tests: the Spielberger State-Trait Anxiety Inventory (STAI), EAS Temperament Survey, Eysenck Personality Inventory (EPQ-R), Coping Inventory for Stressful Situations (CISS); Beliefs about Pain Control Questionnaire (BPCQ), General Self-efficacy Scale (GSES), and Satisfaction with Life Scale (SWLS).

Results: The control group was recruited from female university students declaring full health. The conducted statistical analysis showed that there is a significant relationship between personality traits, psychological predispositions, and both the experience of illness and satisfaction with life among this specific group of patients.

Conclusions: This pilot study demonstrated the need for a personalized approach to gastroenterological patients, also based on their personality characteristics. Such an approach may increase the effectiveness of therapy and bring benefits in long-term treatment.

[This corrects the article DOI: 10.5114/pg.2023.125882.].

Introduction: The incidence of lactose intolerance in irritable bowel syndrome (IBS) varies in the literature (27-72%). Primary adult lactase deficiency (adult type hypolactasia) is the most common type of primary enzyme deficiency. Complaints related to lactose intolerance may overlap with the symptoms of IBS.

Aim: To assess the prevalence of primary hypolactasia in patients with IBS.

Material and methods: The study included 56 patients with IBS diagnosed based on the Rome III criteria and 23 healthy people. All study participants completed a questionnaire on IBS symptoms and lactose intolerance, and they underwent a hydrogen breath test (HBT) with lactose. In the group of patients with positive results of HBT, the polymorphism C/T -13910 and G/A -22018 in the promoter of the LCT gene encoding lactase was determined.

Results: Lactase deficiency was diagnosed in HBT in 34 (60.7%) patients with IBS and in the control group - in 10 (43.5%). Primary adult type hypolactasia was confirmed in 78.9% (n = 30; 79.3% in the study group; 77.8% in the control group). There were no statistically significant differences in the occurrence of LCT gene polymorphisms in particular IBS subtypes. Adult type hypolactasia was significantly more common in patients with severe than moderate and mild enzyme deficiency in HBT (p < 0.05).

Conclusions: The incidence of lactase deficiency in IBS patients is not different from that found in healthy subjects. Nevertheless, irrespective of the IBS subtype, lactose intolerance may pose additional issues in patients with IBS and requires the targeted treatment.

Colorectal cancer is one of the most prevalent types of cancer, with histopathologic examination of biopsied tissue samples remaining the gold standard for diagnosis. During the past years, artificial intelligence (AI) has steadily found its way into the field of medicine and pathology, especially with the introduction of whole slide imaging (WSI). The main outcome of interest was the composite balanced accuracy (ACC) as well as the F1 score. The average reported ACC from the collected studies was 95.8 ±3.8%. Reported F1 scores reached as high as 0.975, with an average of 89.7 ±9.8%, indicating that existing deep learning algorithms can achieve in silico distinction between malignant and benign. Overall, the available state-of-the-art algorithms are non-inferior to pathologists for image analysis and classification tasks. However, due to their inherent uniqueness in their training and lack of widely accepted external validation datasets, their generalization potential is still limited.