Przegla̜d Gastroenterologiczny最新文献

{"title":"Exploring new noninvasive parameters to predict oesophageal varices in patients with NAFLD-associated compensated liver cirrhosis.","authors":"Adnan Agha, Andrea Pasta, Francesco Calabrese, Eram Anwar, Mazin Taha, Virgie G Pedo, Ghada S M Al-Bluwi, Edoardo G Giannini","doi":"10.5114/pg.2024.139210","DOIUrl":"10.5114/pg.2024.139210","url":null,"abstract":"<p><strong>Introduction: </strong>Nonalcoholic fatty liver disease is a leading cause of liver cirrhosis and portal hypertension, which can be complicated by oesophageal varices and variceal bleeding. Screening for oesophageal varices is essential for initiating bleeding prophylaxis. Several noninvasive parameters for predicting oesophageal varices have been suggested (e.g., Baveno VI, expanded Baveno VI, and platelet count/spleen diameter ratio), although with variable efficacy in patients with nonalcoholic fatty liver disease.</p><p><strong>Aim: </strong>This study aimed to compare the non-invasive predictors of oesophageal varices.</p><p><strong>Material and methods: </strong>We retrospectively analyzed the medical records of patients with nonalcoholic fatty liver disease-related compensated liver disease who underwent screening endoscopy at a tertiary care unit in United Arab Emirates. The accuracy of the established (Baveno VI and expanded Baveno VI) and newly devised (platelet count)/(spleen diameter) + liver stiffness × (40 - albumin) noninvasive parameters in predicting oesophageal varices and the presence of large oesophageal varices was assessed in our population.</p><p><strong>Results: </strong>We found that the (platelet count)/(spleen diameter) + liver stiffness × (40 - albumin) formula had a higher accuracy than both Baveno VI (<i>p</i> = 0.030) and expanded Baveno VI criteria (<i>p</i> = 0.050) in predicting the presence of oesophageal varices. The (platelet count)/(spleen diameter) + liver stiffness × (40 - albumin) formula was associated with a higher number of spared endoscopies than Baveno VI (<i>n</i> = 16, 21.9%) and expanded Baveno VI (<i>n</i> = 9, 12.3%) criteria.</p><p><strong>Conclusions: </strong>The new formula could provide superior predictive value than the currently practiced noninvasive predictors of oesophageal varices. However, large-scale studies are warranted to confirm its predictive performance in patients with nonalcoholic fatty liver and other etiologies of chronic liver disease.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 1","pages":"48-54"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low blood orexin concentration as a predictor of increased nutritional risk and all-cause mortality after surgery for colorectal cancer.","authors":"Krzysztof Tojek, Damian Czarnecki, Marcin Ziólkowski, Małgorzata Michalska, Ewa Żekanowska, Natalia Mysiak, Łukasz Wołowiec, Jacek Budzyński","doi":"10.5114/pg.2025.148513","DOIUrl":"10.5114/pg.2025.148513","url":null,"abstract":"<p><strong>Introduction: </strong>Orexin regulates food intake, as well as the development and progression of neoplasms.</p><p><strong>Aim: </strong>The aim of this study was to determine associations between nutritional risk and status and neoplasm stage and prognosis in patients who underwent surgery for colorectal cancer (CRC).</p><p><strong>Material and methods: </strong>In 84 consecutive patients undergoing surgery for CRC, serum orexin, nutritional risk and body composition (assessed by bioelectrical impedance analysis and cross-sectional area determined using abdominal CT) were evaluated before the operation and 3 months after the surgery. The long-term follow-up lasted 1296.0 ±617.7 days.</p><p><strong>Results: </strong>Compared to CRC patients with a serum orexin concentration lower than the cutoff value (197.9 pg/ml) determined in ROC curve analysis in prediction of all-cause mortality during long-term follow-up, those with orexin concentrations equal to or higher than the cutoff value were, at baseline and at the 3-month visit, more likely to have a lower score on the nutritional NRS2002 and a higher score on functional scales, greater handgrip strength, and higher skeletal muscle mass, and were less likely to suffer perioperative complications and all-cause mortality (OR = 0.34; 95% CI: 0.13-0.89; <i>p</i> = 0.026) during the follow-up period. No statistically significant differences in tumor size, histopathological grade or clinical stage were found between CRC patient groups divided according to orexin blood concentration.</p><p><strong>Conclusions: </strong>Serum orexin concentrations were found to be statistically significantly associated with patients' nutritional risk and status before surgery and at a 3-month follow-up visit, and with all-cause mortality during the 3.6-year follow-up.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 1","pages":"62-70"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probiotic use reduces the incidence of antibiotic-associated diarrhea among adult patients: a meta-analysis.","authors":"Henry Wanyama, Tayyab S Akhtar, Sameen Abbas","doi":"10.5114/pg.2025.148486","DOIUrl":"10.5114/pg.2025.148486","url":null,"abstract":"<p><strong>Introduction: </strong>Probiotics potentially mitigate diarrhea incidence and severity, but their effectiveness in antibiotic-associated diarrhea (AAD) remains debated.</p><p><strong>Aim: </strong>This meta-analysis aimed to enhance evidence on probiotic use for AAD.Methods: A systematic search of randomized controlled trials (RCTs) from 2010 to 2023 in PubMed, EMBASE, Scopus, and Google Scholar was conducted. Eligible studies underwent risk assessment with the RoB-2 tool and data extraction using the random effects model. Subgroup analyses evaluated age, sample size, and probiotic strains' influence.</p><p><strong>Results: </strong>Fifteen trials with 7427 participants were included. Overall quality was moderate. Pooled analysis favored probiotics, reducing AAD incidence by 40% (RR = 0.60, 95% CI: 0.43-0.82). This effect was consistent across subgroup analyses. Multistrain probiotics showed superior protection (RR = 0.40 vs. 0.9 or 0.6 for dual or single strains).</p><p><strong>Conclusions: </strong>This review suggests that probiotics, especially multistrain combinations, mitigate AAD incidence. Future large-scale RCTs will address heterogeneity.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 1","pages":"5-16"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric hepatic encephalopathy score (PHES) - when, how, why, and why not: a guide for the unfamiliar.","authors":"Nikola Mumdzhiev, Rumen V Tenev, Mariana P Radicheva","doi":"10.5114/pg.2024.145382","DOIUrl":"10.5114/pg.2024.145382","url":null,"abstract":"<p><p>Psychometric hepatic encephalopathy score (PHES) has established itself as one of the most used tests for detecting minimal hepatic encephalopathy. To use it in a certain population one needs to determine what the norms are, and have a proper set of inclusion and especially exclusion criteria. When performing the test (either for validating or as a search tool) authors may benefit from a little guidance. All the 5 tests - DST (Digital Symbol test), Number Connection Test A (NCT A), Number Connection Test B (NCT B), Serial Dotting Test (SDT), Line Drawing Test (LDT) - have certain parameters to follow. In time, deviations have appeared, and comparability between different samples has become somehow limited. As new tests are emerging, and in order to compare, one must be familiar with the tests' variants, benefits, and limitations.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 1","pages":"31-35"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Celiac disease and human gut microbiota - how can we study the composition of microorganisms?","authors":"Wiktor Szczuciński, Dominika Salamon, Anna Sopel, Tomasz Gosiewski","doi":"10.5114/pg.2024.139574","DOIUrl":"10.5114/pg.2024.139574","url":null,"abstract":"<p><p>Celiac disease is an autoimmune disorder induced by consumption of gluten protein present in foods such as wheat and rye. In recent years there has been increasing evidence that changes in composition of gut microbiota may play a significant role in the pathogenesis of celiac disease. Multiple methods of bacterial identification may be used to find microbiota changes characteristic for celiac disease, and the latest methods such as next generation sequencing offer new possibilities of detecting previously unknown bacterial groups that may play a role in the occurrence of celiac disease. This review focuses on multiple methods of identifying bacterial gut microbiome and presents results of recent studies exploring the link between gut microbiota composition and celiac disease.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 1","pages":"17-30"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should physicians prescribe probiotics alongside antibiotics? A practical perspective.","authors":"Wojciech Marlicz, Grażyna Rydzewska","doi":"10.5114/pg.2025.148588","DOIUrl":"10.5114/pg.2025.148588","url":null,"abstract":"","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 1","pages":"1-4"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of physical activity on symptoms of irritable bowel syndrome.","authors":"Elżbieta Poniewierka, Ewa Szura, Petr Valach","doi":"10.5114/pg.2025.152029","DOIUrl":"10.5114/pg.2025.152029","url":null,"abstract":"<p><strong>Introduction: </strong>Rapid urbanization and constant technological progress contribute to a change in lifestyle in terms of physical activity. Lack of free time and reluctance to engage in physical activity may lead to impaired functioning of internal organs, including the digestive system.</p><p><strong>Aim: </strong>In the present study, by creating an exercise regimen, an attempt was made to demonstrate the impact of this activity on the symptoms of patients with irritable bowel syndrome (IBS).</p><p><strong>Material and methods: </strong>Forty-one women with diagnosed irritable bowel syndrome were included in the study. To assess the effectiveness of the method used, the validated IBS-SSS questionnaire was used. The study used an original training programme based on fitness lessons, yoga positions improving intestinal motility and relaxation techniques: autogenic training developed by Schultz and progressive muscle relaxation developed by Jacobson. Twenty-nine women completed the entire 2-month training cycle, in line with the assumptions of the study. The following methods were used: <i>t</i>-test for dependent samples, Wilcoxon pairwise order test, McNemar's χ² test and Spearman's <i>R</i> correlation coefficient.</p><p><strong>Results: </strong>It was found that nearly 80% of the study participants experienced abdominal pain before participating in the study. The training cycle caused pain in 52% of the surveyed women. The intensity of pain in the subjects decreased by 20%. After the study, the incidence of flatulence decreased by 38% and the severity of flatulence by 30%.</p><p><strong>Conclusions: </strong>The relationship between physical activity and the severity of symptoms of irritable bowel syndrome in the surveyed women was confirmed. The study group of women showed a reduction in IBS-related symptoms after 8 weeks of training.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 2","pages":"173-177"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of early and long-term clinical outcomes in obstructed proximal and distal colon cancers undergoing emergent surgery.","authors":"Ulaş Aday, Abdulkadir Akbaş, Hikmet Özesmer, Hasan Akkoç","doi":"10.5114/pg.2024.145475","DOIUrl":"10.5114/pg.2024.145475","url":null,"abstract":"<p><strong>Introduction: </strong>Studies comparing proximal and distal colon tumours undergoing emergent surgery for obstruction are limited.</p><p><strong>Aim: </strong>The purpose of our study was to compare the clinical and oncological outcomes of patients with proximal and distal colon cancer, who underwent emergent surgery for obstruction.</p><p><strong>Material and methods: </strong>From January 2012 to June 2022, patients with colon cancer presenting with obstruction and undergoing emergent surgery were analysed. The 2 groups were defined as proximal and distal according to the tumour location with respect to the splenic flexure. Postoperative early and long-term clinical and oncological outcomes were analysed.</p><p><strong>Results: </strong>Of the 118 patients included in the study, there were 46 patients (38.9%) in the proximal group and 72 patients (61.1%) in the distal group. Single-session surgery including resection and anastomosis was performed on 31 (67.4%) and 29 (40.3%) patients in the proximal and distal groups, respectively (<i>p</i> = 0.007). The global mortality rate was 11%, and there was no difference between the groups. Five-year survival was similar in the proximal and distal groups, being 80.4% and 68.1%, respectively. In the analysis of patients who did not develop early mortality and underwent R0 resection, 3-year disease-free survival was 89.5% in the proximal group and 81.5% in the distal group; the difference was not significant (<i>p</i> = 0.165).</p><p><strong>Conclusions: </strong>Mortality is high in emergent surgeries for obstructed proximal and distal colon cancers. If curative resection is achieved, oncological results are good and tumour localisation does not affect survival.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 1","pages":"71-77"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connection of vitamin D levels in blood serum with <i>Helicobacter pylori</i> infection in paediatric patients.","authors":"Kairat Rysbekov, Sagira Abdrakhmanova, Rashida Satybaeva, Dmitry Babenko, Zhanat Abdikadyr","doi":"10.5114/pg.2024.146213","DOIUrl":"10.5114/pg.2024.146213","url":null,"abstract":"<p><strong>Introduction: </strong><i>Helicobacter pylori</i> is a globally prevalent infection, particularly in developing countries, with significant implications for gastrointestinal health in children. Recent studies suggest a potential link between vitamin D and its metabolites in enhancing the effectiveness of <i>H. pylori</i> eradication therapies through their bactericidal properties.</p><p><strong>Aim: </strong>To investigate the correlation between the vitamin D levels and their influence on clinical management and treatment results of children patients, tested for <i>H. pylori</i>.</p><p><strong>Material and methods: </strong>The study was conducted on a cohort of 128 paediatric patients. They were divided into 2 groups, depending on whether positive (first group - A) or negative (second group - B) for <i>H. pylori</i>. To determine vitamin D levels, venous blood was taken from all participants from both groups. Group 1 included patients whose indexes were up to 10 ng/ml; Group 2 included patients whose indexes were from 10 ng/ml to 20 ng/ml; Group 3 levels were from 20 ng/ml to 30 ng/ml; and Group 4 indexes were over 30 ng/ml. The efficiency of the <i>H. pylori</i> eradication scheme in participants of these groups was evaluated.</p><p><strong>Results: </strong>The mean values in Group A were higher than those in Group B: 17.1 and 14.9, respectively, <i>p</i>-value 0.03. <i>Helicobacter pylori</i> prevalence was higher in participants with vitamin D levels below 30 ng/ml. As a result of the study, it was established that vitamin D levels below 30 ng/ml in blood serum could be a predisposing factor in the spread of <i>H. pylori</i> in paediatric patients. At the same time, different levels of deficiency below 30 ng/ml did not affect the frequency of <i>H. pylori</i> infection.</p><p><strong>Conclusions: </strong>The obtained data can be used in developing guidelines for clinical management of children patients who are primarily diagnosed with <i>H. pylori</i> and require eradication therapy.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 1","pages":"84-91"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A proposed comprehensive model of care for inflammatory bowel disease in Poland.","authors":"Grażyna Rydzewska, Piotr Eder, Maciej Gonciarz, Magdalena Kaniewska, Maria Kłopocka, Ewa Małecka-Wojciesko, Jarosław Reguła","doi":"10.5114/pg.2025.151866","DOIUrl":"10.5114/pg.2025.151866","url":null,"abstract":"<p><p>Epidemiological data of the Polish healthcare model of care indicate that the current management of inflammatory bowel disease (IBD) requires improvements in clinical practice and service organization. Integrated care models for patients with IBD, particularly those centred on a multidisciplinary team, offer a promising approach to improving outcomes, reducing admissions, and rationalizing resources. The coordination of specialists, nurses, dietitians, psychologists, and other professionals within a single reference unit could strengthen continuity of care with primary care providers and enable treatment strategies to be tailored to individual needs. In addition, education and ongoing support foster greater patient involvement, potentially lowering relapse rates and enhancing quality of life. These models, with reforms in care provision and quality measurement based on digital solutions, can reduce fragmentation and alleviate burdens on both patients and the healthcare system. Thus, integrated care represents an evolution in IBD management, benefiting all stakeholders in the healthcare continuum.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":"20 2","pages":"142-147"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}