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Abstract Crohn’s disease (CD) may affect the entire gastrointestinal tract including its upper part. However, this aspect is poorly addressed in scientific literature and considered a rare finding. Here we aimed to prospectively investigate the prevalence, characteristics and clinical significance of upper gastrointestinal tract involvement in patients with CD, with particular focus on stomach bamboo joint-like appearance (BJA), Helicobacter pylori status and presence of microscopic changes. 375 prospectively recruited patients were included. In CD patients the prevalence of gastric and duodenal, but not esophageal, mucosal lesions, such as gastric mucosal inflammation, duodenal edema, ulcerations, and duodenal bulb deformation was significantly higher (at least p

Celem niniejszego artykułu jest przedstawienie prawnokarnej ochrony Prezydenta Rzeczypospo­litej Polskiej przed zachowaniami wyczerpującymi znamiona czynnej napaści. Asumpt do podjęcia studiów nad przywołanym problemem stanowiło jego relatywnie niewyczerpujące omówienie w dotychczasowym piśmien­nictwie. W tekście zaprezentowano racje, które skłoniły ustawodawcę do objęcia taką ochroną głowę państwa polskiego. Dokonano również względnie kompletnego omówienia struktury przestępstwa penalizowanego w art. 135 § 1 Kodeksu karnego. Na potrzeby rozważań posłużono się metodą dogmatycznoprawną. Na pod­stawie poczynionych ustaleń stwierdzono, że polski ustawodawca to Prezydentowi przyznaje najszerszy zakres ochrony przed czynną napaścią spośród katalogu wszystkich funkcjonariuszy publicznych. Dalsze istnienie tej regulacji, pomimo nielicznych stanowisk kontestujących, uznać należy za pożądane. Warte podkreślenia jest też to, że chroni ona nie tyle samą osobę sprawującą urząd prezydencki, co stoi na straży godności i majestatu Rze­czypospolitej Polskiej, której najwyższym przedstawicielem jest, zgodnie z Konstytucją RP, Prezydent. Z tychże racji wywodzić należy uzasadnienie dla dalszej penalizacji tego występku w polskim prawie karnym.

Abstract The gastric microbiota in Crohn’s disease (CD) has not been studied. The purpose of the study was to evaluate differences of stomach microbiota between CD patients and controls. DNA was extracted from gastric mucosal and fluid samples, from 24 CD patients and 19 controls. 16S rRNA gene sequencing identified 1511 operational taxonomic units (OTUs), of which 239 passed the low abundance and low variance filters. All but one CD patients were HP negative. Fifteen bacterial phyla were identified in at least one mucosal or fluid site. Of these, Bacteroidota and Firmicutes accounted for 70% of all phyla. Proteobacteria, Actinobacteriota, and Fusobacteriota combined accounted for 27%. There was significant difference in the relative abundance of Bacteroidota, Proteobacteria, Fusobacteriota, and Campilobacterota between CD patients and controls only in gastric corpus samples. In gastric liquid, there was a significant difference only in Actinobacteriota. Pairwise comparison identified 67 differentially abundant OTUs in at least one site. Of these, 13 were present in more than one comparison, and four differentiating OTUs (Neisseriaceae, Neisseria, Absconditabacteriales, and Microbacteriaceae) were identified at all tested sites. The results reveal significant changes in gastric microbial profiles (beta diversity, phylum, and individual taxa levels) between H. pylori-negative CD patients and controls.

A growing number of studies indicate the potential involvement of various populations of bone marrow-derived stem cells (BMSCs) in tissue repair. However, the mobilization of BMSCs to the peripheral blood (PB) in acute and chronic pancreatitis (AP and CP) has not been investigated. A total of 78 patients were assigned into AP, CP, and healthy control groups in this study. Using flow cytometry, we found that VSELs, EPCs, and CD133+SCs were mobilized to the PB of patients with both AP and CP. Interestingly, AP and CP patients exhibited lower absolute number of circulating MSCs in the PB compared to healthy individuals. SC mobilization to the PB was more evident in patients with AP than CP and in patients with moderate/severe AP than mild AP. Using ELISA, we found a significantly increased HGF concentration in the PB of patients with AP and SDF1α in the PB of patients with CP. We noted a significant positive correlation between SDF1α concentration and the mobilized population of CD133+SCs in AP and between C5a and the mobilized population of VSELs moderate/severe AP. Thus, bone marrow-derived SCs may play a role in the regeneration of pancreatic tissue in both AP and CP, and mobilization of VSELs to the PB depends on the severity of AP.

Mediastinal pseudocysts are a rare complication of acute pancreatitis. Lack of uniform treatment standards makes the management of this condition a clinical challenge. We report the case of a 43-year-old patient who presented with a left pleural effusion. Pleural fluid revealed a high amylase concentration consistent with a pancreaticopleural fistula. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a disruption of the pancreatic duct with free outflow of contrast medium into the thoracic cavity. A pancreatic stent was placed. The second day after the ERCP, the patient developed septic shock and was admitted to the intensive care unit. Computed tomography (CT) revealed mediastinal pseudocysts and bilateral pleural effusions. After bilateral drainage of the pleural cavities, the patient improved clinically, and a follow-up CT scan showed that the fluid collection and pseudocysts had resolved. We discuss the optimal strategies for diagnosing and treating patients with pancreatic thoracic pseudocysts and fistulas, as well as review the management of these conditions.

BACKGROUND/AIMS: Recent experimental studies have suggested that various cytokines may be important players in the development and progression of pancreatic cancer. However, these findings have not yet been verified in a clinical setting. METHODS: In this study, we examined the levels of a broad panel of cytokines, including interleukin (IL)-1, IL-6, IL-8, IL-10, IL-12, IL-17, and IL-23, as well as tumor necrosis factor alpha (TNFα) and granulocyte-colony stimulating factor (G-CSF) in patients with pancreatic adenocarcinoma (n=43), other pancreatic malignancies (neuroendocrine [n=10] and solid pseudopapillary tumors [n=3]), and healthy individuals (n=41). RESULTS: We found that there were higher levels of IL-6, IL-8, IL-10 and TNFα in patients with pancreatic cancer compared to healthy controls (for all, at least p

This study explores the generalization of heterogeneous medical data for monitoring anomalies and changes over time using fuzzy intervals. The most important feature of these intervals is saving the parameter value as a membership function from the interval [0, 1]. An example illustrating this method is the blood count parameters of an oncological patient recorded for three years with a monthly frequency. Over 20 typical measurements of these features are considered, and eight with the highest variance are selected. The registration of the overall picture of changes, a synthesis of eight fuzzy intervals, allowed for observing a systematic improvement in health. This approach allows the doctor to take a holistic view of the patient’s health (based on blood tests), avoiding the dilemma of which parameters are less and which are more important. The Mamdani fuzzy inference system was used to assess the patient’s health status. The study presents the actual results of medical measurements, and the GitHub repository contains measurement data.