Przegla̜d Gastroenterologiczny最新文献

Inflammatory bowel diseases (IBD) are chronic intestinal conditions of multifactorial aetiology including genetic susceptibility, immunological impairment, dysbiosis, and environmental factors. The diagnosis is based on both clinical and endoscopic features, wherein histopathological evaluation remains a gold diagnostic standard. However, fast, reliable, and non-invasive biological markers have been used for years for diagnosis as well as for disease activity monitoring. Currently, commonly used faecal calprotectin is the only biomarker approved and recommended by the European Crohn's and Colitis Organization (ECCO). Nonetheless, other biological markers discriminating between functional and organic bowel conditions have been widely studied. Therefore, the aim of this manuscript was to review new potential biomarkers of inflammation in IBD. The aim of this study was to review currently available biomarkers of intestinal inflammation and increased gut permeability in IBD.

Introduction: Retrospective exploratory analysis to identify biomarker pairs in the AVAGAST Phase III study.

Aim: The main hypothesis of this retrospective exploratory biomarker analysis is the identification of dichotomization levels based on optimal selection driven by the predictive value of single biomarkers. The outcome of interest optimization might unveil additional treatment benefits. Furthermore, testing the biomarker pairs at their optimal cut-off selection might provide the predictive score candidates.

Material and methods: 712 plasma 92% and 727 plasma 94% tumor samples of all patients were using Cox model by identifying optimal dichotomization to maximize treatment benefit. A quadrant analysis grouped biomarker pairs into subsets yielded the best clinical benefit. Candidate biomarker score using the nested 2-fold cross-validation method was used to adjust the optimal cut-off selection.

Results: Patients with lower VEGF-R1 at optimal cut-off with low IHER2G showed significant improvement in PFS - first line (HR = 0.62; 95% CI: 0.50 to 0.78). The interaction p-value of the biomarker pair was adjusted at 0.0147094.

Conclusions: The predictive biomarker is a potential candidate for PFS - first line in patients with advanced gastric cancer treated with Bevacizumab.

Introduction: Cirrhosis is a common liver disease, which is characterized by life-limiting complications. In cirrhosis, liver ACE2 mRNA levels were 34-times upregulated, ACE2 protein 97-times upregulated, and ACE2 receptors increased in 80% of hepatocytes. Increased ACE2 receptor sensitizes hepatocytes to COVID-19.

Aim: To evaluate the applications of cirrhosis patients to the Emergency Department before and after the pandemic.

Material and methods: The study was conducted retrospectively in a single centre on cirrhotic patients who applied to the Emergency Department in a 2-year period. The obtained data were compared with the laboratory values of the patients: the severity of cirrhosis, the reasons for applying to the Emergency Department, hospitalization/discharge status, and pre-pandemic and pandemic period values. The mortality of the patients was recorded.

Results: The biochemical values, CTP score, and complications of cirrhosis patients deteriorated during the pandemic period, which contributed to the increase in mortality and that the CTP score and its complications worsened, which contributed to the increase in mortality. COVID-19 positivity contributes to the progression of the CTP score, but it is not directly associated with mortality.

Conclusions: We think that new treatment protocols should be included in the guidelines to minimize the effects of this type of viral infection on the liver.

Introduction: Gastrointestinal-specific anxiety (GSA) is considered as an important factor in the course of irritable bowel syndrome (IBS). GSA may be evaluated by the visceral sensitivity index (VSI).

Aim: To translate original English version of the VSI into Ukrainian language (VSI-UA) and then to test its validity and reliability in patients with IBS.

Material and methods: 108 patients of both sexes, aged 18-44 years, with IBS were assessed by the VSI-UA, Patient Health Questionnaire-9 (PHQ-9), Beck's Depression Inventory (BDI), and the Hospital Anxiety and Depression Scale: depression (HADS-Dep) and anxiety (HADS-Anx). Reliability was checked by Cronbach's α and test-retest method with calculation of the intraclass correlation coefficient (ICC). Content validity was assessed by calculation of the content validity ratio (CVR) and content validity index (CVI). The construct validity was assessed by estimating Pearson`s correlation between VSI-UA, PHQ-9, BDI, HADS-Anx, and HADS-Dep.

Results: Cronbach's α for VSI-UA was 0.84; the ICC between the first measurement and the one repeated 4 weeks after administration of VSI-UA was 0.92 (95% CI: 0.87-0.95). The calculated CVR for each item of the VSI-UA was higher than the critical value of 0.56, and the CVI was 0.94. A moderate positive correlation was found between VSI-UA and PHQ-9 (r = 0.65), BDI (r = 0.69), HADS-Anx (r = 0.61), and HADS-Dep (r = 0.48); p < 0.05 in all correlations.

Conclusions: VSI-UA is a reliable and valid tool for the assessment of GSA in Ukrainian-language patients with IBS, and it could be implemented in routine clinical practice to manage patients with IBS.

Introduction: Around 200,000 new cases of pancreatic cancer are diagnosed yearly worldwide. It is the fourth most common cause of cancer deaths. Pancreatic cancer has a high mortality rate due to unspecific symptoms being responsible for late diagnosis.

Aim: In this study, the authors analysed selected nutritional parameters and the severity of anaemia in patients diagnosed with pancreatic head cancer.

Material and methods: Data were collected upon admission to the 2^nd Clinical Department of General, Gastrointestinal, and Oncological Surgery in the University Clinical Hospital in Bialystok, Poland and retrospectively with the help of correctly collected anamnesis.

Results: It has been shown that most patients with pancreatic cancer are malnourished at the time of diagnosis. Body mass index (BMI) is the least valuable parameter primarily. Weight loss has been determined to be the most accurate predictor of the patient's metabolic status, although it should never be the only parameter. Although these factors do not suggest an inflammatory process, serum protein levels and albumin concentration should be considered.

Conclusions: When assessing the nutritional status of patients with pancreatic cancer, many predictive factors should be considered. BMI seems to be the least accurate parameter for assessing nutritional status in patients diagnosed with cancer. However, when combined with weight loss and serum albumin levels, it can be quite useful as a prognostic factor.