Przegla̜d Gastroenterologiczny最新文献

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: 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.

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: Pancreaticoduodenectomy is a major procedure. Delayed gastric emptying (DGE) is a frequent postoperative complication that is attributed to several factors.

Aim: To investigate the probable association between perineural infiltrations and DGE, and the effects on overall survival.

Material and methods: A total of 123 patients who underwent pancreaticoduodenectomy were enrolled in the study. Factors like the presence of perineural infiltrations and post-operative DGE along with age, gender, presence of postoperative fistula, and grade of fistula and postoperative haemorrhage were analysed, and survival analyses were conducted.

Results: The presence of perineural infiltrations is statistically associated with DGE occurrence (p = 0.01). Moreover, the occurrence of DGE is statistically associated with male gender (p = 0.001), worse grade of postoperative fistula (p < 0.01), and the presence of postoperative haemorrhage (p = 0.03). There was no statistical association between the presence of perineural infiltrations and the other factors. Cox regression and Kaplan-Meier survival analyses showed that increased overall survival is associated with low age (p = 0.018 and p = 0.028, respectively), absence of perineural infiltrations (p = 0.005 and p = 0.003, respectively), better grade of postoperative fistula (p < 0.001), and absence of postoperative haemorrhage (p < 0.001). Multivariate analysis showed that independent prognostic factors for survival prognosis are perineural infiltrations, age, the presence of postoperative pancreatic fistula, and the presence of postoperative haemorrhage.

Conclusions: This is the first study that proves a statistically significant association between the presence of perineural infiltrations and the occurrence of DGE. Moreover, perineural infiltrations are an important independent prognostic factor for overall survival, along with other clinical factors.

Introduction: Because not all liver dysfunction patients are suitable for transplantations and there is a shortage of grafts, liver support therapies have gained interest. In this regard, extracorporeal albumin dialysis devices such as single-pass albumin dialysis (SPAD), Prometheus, and molecular adsorbent recycling system (MARS) have been valuable in supplementing standard medical therapy (SMT). However, the efficacy and safety of these devices is often questioned.Aim: We performed a systematic review to summarize the efficacy and safety of MARS, SPAD, and Prometheus as supportive treatments for liver dysfunction.

Material and methods: PubMed, Medline, Cochrane Library, Web of Science, and Google Scholar electronic databases were extensively searched for all randomized trials published in English. In addition, meta-analytic analyses were performed with Review Manager software, and Cochrane's risk of bias tool embedded in this software was used for bias assessment.

Results: Twelve trials including a total of 653 patients were eligible for inclusion. Subgroup analyses of data from these trials revealed that MARS and Prometheus were associated with significant removal of bilirubin (MD = -5.14 mg/dl; 95% CI: -7.26 - -3.02; p < 0.00001 and MD = -8.11 mg/dl; 95% CI: -12.40 - -3.82; p = 0.0002, respectively) but not bile acids and ammonia when compared to SMT. Furthermore, MARS was as effective as Prometheus and SPAD in the reduction of bilirubin (MD = 2.98 mg/dl; 95% CI: -4.26 - 10.22; p = 0.42 and MD = 0.67 mg/dl; 95% CI: -2.22 - 3.56; p = 0.65), bile acids (MD = -17.06 µmol/l; 95% CI: -64.33 - 30.20; p = 0.48 and MD = 16.21 µmol/l; 95% CI: -17.26 - 49.68; p = 0.34), and ammonia (MD = 26 µmol/l; 95% CI: -12.44 - 64.44; p = 0.18). In addition, MARS had a considerable effect in improving hepatic encephalopathy (HE) (RR = 1.54; 95% CI: 1.15-2.05; p = 0.004). However, neither MARS nor Prometheus had a mortality benefit compared to SMTRR (0.86; 95% CI: 0.71-1.03; p = 0.11 and RR = 0.87; 95% CI: 0.66-1.14; p = 0.31, respectively).

Conclusions: MARS, SPAD, and Prometheus, as liver support therapies, are equally effective in reducing albumin-bound and water-soluble substances. Moreover, MARS is associated with HE improvement. However, none of the therapies was associated with a significant reduction in mortality or adverse events.

Introduction: Inflammatory bowel disease (IBD) can affect mental health. There is no evidence that stress is a direct cause of the disease. Most IBD patients describe an emotional impact, mainly feelings of depression and anxiety. Many questionnaires are used to assess anxiety in those patients, including SCL-90.

Aim: To investigate the correlation between mental and psychological status to disease activity in patients with inflammatory bowel disease using 90-Item Symptom Checklist (SCL-90 R) questionnaire.

Material and methods: The study included 100 patients (50 Crohn's disease (CD) patients - 50 ulcerative colitis (UC) patients). Detailed history taking, systemic physical examination, laboratory investigations, colonoscopy, and the SCL-90-R symptom checklist - a self-report psychometric instrument (questionnaire) for each patient.

Results: The mean age of Crohn's disease patients was 24.2 ±3.6 years. In ulcerative colitis the mean age was 28.5 ±7.3 years. No age or gender relation could be detected with the SCL-90 score in both groups. Our study showed a direct correlation of CD disease activity (CDAI) and endoscopic activity (SES) according to the SCL-90 R questionnaire. There was direct correlation of UC disease activity (SCCAI) and endoscopic activity (UCEIS) according to the SCL-90 R questionnaire.

Conclusions: There is a direct correlation between disease activity and endoscopic activity in UC and CD according to the SCL-90 R questionnaire.

Since the beginning of the COVID-19 pandemic in 2020, the safety of those with compromised immune systems and chronic disease has been of particular concern for health care providers. Inflammatory bowel diseases (IBD) are chronic, incurable conditions of digestive system with unknown aetiology, but one of the causes is disordered immune response. Medical therapies most frequently used in IBD are immune suppressing or modifying with the rising use of biologic treatment. All these aspects make patients with Crohn's disease and ulcerative colitis a group of particular risk. Therefore, the aim of this review is to discuss potential mechanisms, risks, and management of patients with IBD during COVID-19 pandemic.