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Introduction: Over the years, advances in alpine ski equipment such as helmets, bindings, skis and boots have resulted in risk reduction, remodelling of injury patterns and mechanisms. Skiers’ injuries are currently about 1 to 5 per 1000 days spent in the snow per athlete. The most common area of the injury is the knee, especially ACL and MCL. Purpose of the work: The purpose of the work is analysis of literature on mechanism of knee ligaments injury and potential prevention intervention in alpine skiing. Methods and materials: The present study was based on available data collected in the PubMed and Google Scholar database. The study was conducted by reviewing keywords such as: “alpine skiing”, “ski bindings”, “alpine skiing injuries”, “ACL”. Results: Taking into consideration less advanced skiers, we can distinguish three types of injury mechanism: valgus-external rotation sequence, boot-induced anterior drawer mechanism and phantom-foot mechanism. Three mechanisms have been described for professional skiers: slip-catch, landing back-weighted and dynamic snowplow. Female skiers have a higher risk of ACl injury than male skiers. Conclusion: Most of the described injury mechanisms are linked with no releasing of bindings. The future injury prevention should concentrate on injury mechanisms using electronic sensors placed at skiers equipment. New micro-electronic technologies can help create mechatronic ski bindings.

Introduction and purpose: Premature Ovarian Insufficiency (POI) is a rare but serious disease diagnosed in about 1% of women before the age of 40. It is characterized by hypoestrogenism and an increase in the level of the follicle-stimulating hormone, which is associated with menstrual disorders, pregnancy failures and a reduced quality of life. The main causes of POI include a genetic background and autoimmune abnormalities, as well as increasingly jatrogenic factors. Care for patients is focused on hormone replacement therapy and infertility treatment. The aim of this review is to discuss current treatment methods, the impact of early diagnosis and the prevention of premature ovarian insufficiency, which affects the ability to have one's own offspring. The article also describes new methods of infertility treatment that are under investigation. Materials and methods: This literature review is based on articles published in the PubMed database from 2015 to 2022 using the following phrases: premature ovarian insufficiency, premature ovarian insufficiency stem cells State of knowledge: The only way to treat infertility in women with POI is egg donation. Currently, research is being conducted to achieve early diagnosis, introduce new treatment methods and reduce the number of iatrogenic forms of POI. Conclusion: The main problem for women diagnosed with POI is the difficulty or often impossibility of having their own children. Egg donation does not allow for the transfer of the patient's genetic material, and is also not available as a treatment option in some countries. For this reason, new methods for early diagnosis, treatment, and prevention of POI are being developed.

TOMASIK, Mikołaj, WARZYSZAK, Paweł, MAŁEK, Róża, MILCZEK, Maria, ŻOŁYNIAK, Wojciech, HAWRANIK, Izabela, NISKI, Szymon, ŻABA, Ziemowit, LISOWSKA, Aleksandra & SKRZYPEK, Mateusz. Ulcerative colitis – recent and potential methods of treatment - review.Journal of Education, Health and Sport. 2023;13(3):65-73. eISSN 2391-8306. DOIhttp://dx.doi.org/10.12775/JEHS.2023.13.03.009 https://apcz.umk.pl/JEHS/article/view/41482 https://zenodo.org/record/7542482 The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 21, 2021. No. 32343. Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences). Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 21 grudnia 2021 r. Lp. 32343. Posiada Unikatowy Identyfikator Czasopisma: 201159. Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu). © The Authors 2023; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 21.12.2022. Revised: 27.12.2022. Accepted: 17.01.2023. Ulcerative colitis – recent and potential methods of treatment - review Mikołaj Tomasik 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0002-5489-0059 https://orcid.org/0000-0002-5489-0059 mikolajt97@gmail.com Paweł Warzyszak 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0003-2023-7980 warzyszakpawel@gmail.com Róża Małek 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0003-3606-0067 https://orcid.org/my-orcid?orcid=0000-0003-3606-0067 rozamalek192@gmail.com Maria Milczek 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0002-4204-5632 https://orcid.org/0000-0002-4204-5632 Maria@milczek.com Wojciech Żołyniak Centrum Medyczne w Łańcucie Sp. z o.o. Ignacego Paderewskiego 5, 37-100 Łańcut 0000-0002-3709-4018 https://orcid.org/0000-0002-3709-4018 wojtesk995@gmail.com Izabela Hawranik 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0002-7329-8595 https://orcid.org/0000-0002-7329-8595 hawranik14@gmail.com Szymon Niski Wojewódzki Szpital Specjalistyczny im. Najświętszej Maryi Panny w Częstochowie Polskiego Czerwonego Krzyża 7, 42-200 Częstochowa 0000-0001-6295-5783 https://orcid.org/0000-0001-6295-5783 szymonniski96@gmail.com Ziemowit Żaba 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0001-9476-1166 https://orcid.org/0000-0001-9476-1166 piast753@gmail.com Aleksandra Lisowska Uniwersytet Medyczny w Lublinie 0000-0003-0009-8995 https://orcid.org/0000-0003-0009-8995 alisowska8@wp.pl Mateusz Skrzypek Uniwersytet Rzeszowski, Kolegium Nauk Medycznych 0000-0001-6767-3144 https://orcid.org/0000-0001-6767-3144 mati.skrzypek@gmail.com Abstract Introduction and purpose:Ulcerative colitis (UC, colitis ulcerosa) belongs to a group of inflammatory bowel diseases of unexplained etiology. It is a diffuse nonspecific inflammation of the mucosa of the rectum or rectum and colon, leading to ulceration in more severe cases. Despite a decline in the incidence of ulcerative colitis in developed countries, the prevalence continues to rise due to increasingly predominant benign course of the disease with a low mortality rate. The purpose of this review is to summarize latest directions and discoveries in research of ulcerative colitis. Materials and methods:This review is based on articles published in Pubmed between 2017 and 2022 by searching keywords ulcerative colitis treatment, ulcerative colitis guidelines. State of knowledge:Currently, many independent scientific societies represent a consensus position on the standard management of patients with UC, while recent therapeutic options are constantly emerging due to intensive research. These options require the involvement of multiple medical centers to determine their position in future guidelines. Conclusion: Although ulcerative colitis is a disease that is diagnosed and detected relatively easily, due to its chronic nature, relatively high prevalence in the population and lack of causal treatment options, it is an important direction for further research. Keywords:Ulcerative colitis; treatment. Abstrakt Wprowadzenie i cel pracy: Wrzodziejące zapalenie jelita grubego (WZJG, colitis ulcerosa) należy do grupy nieswoistych zapaleń jelit(NZJ) i polega ono na rozlanym nieswoistym zapaleniu błony śluzowej odbytnicy lub odbytnicy iokrężnicy, które wcięższych przypadkach prowadzić może do powstania owrzodzeń. Pomimo spadku zapadalności w krajach rozwiniętych, chorobowość nadal wykazuje tendencję wzrostową w związku ze stałym wzrostem odsetka łagodnego przebiegu choroby(o niskiej śmiertelności). Celem tego przeglądu jest podsumowanie najnowszych odkryć i trendów w leczeniu WZJG. Materiały i dowody: Ten przegląd literatury oparty jest na artykułach opublikowanych w bazie PubMed od 2017 do 2022 roku, przy użyciu następujących fraz: ulcerative colitis treatment, ulcerative colitis guidelines. Stan wiedzy: Obecnie wiele niezależnych od siebie towarzystw naukowych reprezentuje zgodne stanowisko co do standardowego postępowania z pacjentami chorymi na WZJG, natomiast w związku z intensywnymi badaniami stale pojawiają się nowe opcje terapeutyczne, które wymagają zaangażowania wielu ośrodków medycznych w celu określenia ich pozycji w przyszłych wytycznych. Podsumowanie:Chociaż wrzodziejące zapalenie jelita grubego jest chorobą stosunkowo łatwo rozpoznawaną i wykrywaną, to ze względu na swój przewlekły charakter, stosunkowo dużą częstość występowania w populacji oraz brak możliwości leczenia przyczynowego stanowi ważny kierunek dalszych badań. Słowa klucze: ulcerative colitis; treatment.

ŻABA, Ziemowit, LISOWSKA, Aleksandra, ŻOŁYNIAK, Wojciech, WARZYSZAK, Paweł, MAŁEK, Róża, MILCZEK, Maria, HAWRANIK, Izabela, TOMASIK, Mikołaj, NISKI, Szymon & SKRZYPEK, Mateusz. The effect of using chondroitin sulfate in osteoarthritis of the knee. Journal of Education, Health and Sport. 2023;13(2):235-241. eISSN 2391-8306. DOI https://dx.doi.org/10.12775/JEHS.2023.13.02.034 https://apcz.umk.pl/JEHS/article/view/41424 https://zenodo.org/record/7503907 The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 21, 2021. No. 32343. Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences). Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 21 grudnia 2021 r. Lp. 32343. Posiada Unikatowy Identyfikator Czasopisma: 201159. Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu). © The Authors 2023; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 16.12.2022. Revised: 21.12.2022. Accepted: 04.01.2023. The effect of using chondroitin sulfate in osteoarthritis of the knee Ziemowit Żaba 1 Wojskowy Szpital Kliniczny z Polikliniką SPZOZ w Lublinie ORCID 0000-0001-9476-1166 https://orcid.org/0000-0001-9476-1166 e-mail: piast753@gmail.com Aleksandra Lisowska Uniwersytet Medyczny w Lublinie ORCID 0000-0003-0009-8995 https://orcid.org/0000-0003-0009-8995 e-mail: alisowska8@wp.pl Wojciech Żołyniak Centrum Medyczne w Łańcucie Sp. z o.o. ORCID 0000-0002-3709-4018 https://orcid.org/0000-0002-3709-4018 e-mail: wojtesk995@gmail.com Paweł Warzyszak 1 Wojskowy Szpital Kliniczny z Polikliniką SPZOZ w Lublinie ORCID 0000-0003-2023-7980 https://orcid.org/0000-0003-2023-7980 e-mail: warzyszakpawel@gmail.com Róża Małek 1 Wojskowy Szpital Kliniczny z Polikliniką SPZOZ w Lublinie ORCID 0000-0003-3606-0067 https://orcid.org/0000-0003-3606-0067 e-mail: rozamalek192@gmail.com Maria Milczek 1 Wojskowy Szpital Kliniczny z Polikliniką SPZOZ w Lublinie ORCID 0000-0002-4204-5632 https://orcid.org/0000-0002-4204-5632 e-mail: Maria@milczek.com Izabela Hawranik 1 Wojskowy Szpital Kliniczny z Polikliniką SPZOZ w Lublinie ORCID 0000-0002-7329-8595 https://orcid.org/0000-0002-7329-8595 e-mail: hawranik14@gmail.com Mikołaj Tomasik 1 Wojskowy Szpital Kliniczny z Polikliniką SPZOZ w Lublinie ORCID 0000-0002-5489-0059 https://orcid.org/0000-0002-5489-0059 e-mail: mikolajt97@gmail.com Szymon Niski Wojewódzki Szpital Specjalistyczny im. Najświętszej Maryi Panny w Częstochowie ORCID 0000-0001-6295-5783 https://orcid.org/0000-0001-6295-5783 e-mail: szymonniski96@gmail.com Mateusz Skrzypek Uniwersytet Rzeszowski, Kolegium Nauk Medycznych ORCID0000-0001-6767-3144 https://orcid.org/0000-0001-6767-3144 e-mail: mati.skrzypek@gmail.com Abstract: Introduction: Osteoarthritis is the most common disease of the musculoskeletal system. It develops in the regulation of the quality and quantity of articular cartilage, which cushions the joint and improves the sliding of the articular surfaces. Chondroitin sulfate being a natural glycosaminoglycan is found in the cartilage and extracellular matrix. The European League Against Rheumatism (EULAR) recommends the use of chondroitin sulfate in the treatment of knee osteoarthritis. Objective: The purpose of our study was to present, based on the available literature, the latest reports on the effect of chondroitin sulfate in knee osteoarthritis Methods and materials: The present study was based on available data collected in the PubMed database and published between 2001 and 2022. The study was conducted by reviewing keywords such as:,,knee osteoarthritis”, ,,chondroitin sulfate”, ,,treatment” ,,diagnosis” State of knowledge: Joint cartilage is mainly composed of type II collagen, proteoglycans, chondrocytes and water. In healthy articular cartilage, the balance between the individual components is constantly maintained, thanks to which cartilage degradation is accompanied by its synthesis. The reviewed scientific papers evaluated the effect of chondroitin sulfate on pain in osteoarthritis. Summary: We found a large inconsistency between experimental protocols and study results. Therefore, comparing publications evaluating the actual effect of chondroitin sulfate on joint synovial tissues and biochemical markers is challenging. Additional studies are needed focusing on long-term treatment as well as evaluating their potential disease modifying effects. Keywords: Chondroitin sulfate, osteoarthritis, treatment, knee

WARZYSZAK, Paweł, MAŁEK, Róża, MILCZEK, Maria, ŻOŁYNIAK, Wojciech, TOMASIK, Mikołaj, HAWRANIK, Izabela, NISKI, Szymon, ŻABA, Ziemowit & LISOWSKA, Aleksandra. Psoriasis - a review of recent progress, characteristics, diagnostic management. Journal of Education, Health and Sport. 2023;13(2):149-155. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2023.13.02.021 https://apcz.umk.pl/JEHS/article/view/41225 https://zenodo.org/record/7485962 The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 21, 2021. No. 32343. Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences). Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 21 grudnia 2021 r. Lp. 32343. Posiada Unikatowy Identyfikator Czasopisma: 201159. Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu). © The Authors 2022; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 08.12.2022. Revised: 21.12.2022. Accepted: 27.12.2022. Psoriasis- a review of recent progress, characteristics, diagnostic management Paweł Warzyszak 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0003-2023-7980 warzyszakpawel@gmail.com Róża Małek 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0003-3606-0067 https://orcid.org/my-orcid?orcid=0000-0003-3606-0067 rozamalek192@gmail.com Maria Milczek 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0002-4204-5632 https://orcid.org/0000-0002-4204-5632 Maria@milczek.com Wojciech Żołyniak Centrum Medyczne w Łańcucie Sp. z o.o. Ignacego Paderewskiego 5, 37-100 Łańcut 0000-0002-3709-4018 https://orcid.org/0000-0002-3709-4018 wojtesk995@gmail.com Mikołaj Tomasik 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0002-5489-0059 https://orcid.org/0000-0002-5489-0059 mikolajt97@gmail.com Izabela Hawranik 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0002-7329-8595 https://orcid.org/0000-0002-7329-8595 hawranik14@gmail.com Szymon Niski Wojewódzki Szpital Specjalistyczny im. Najświętszej Maryi Panny w Częstochowie Polskiego Czerwonego Krzyża 7, 42-200 Częstochowa 0000-0001-6295-5783 https://orcid.org/0000-0001-6295-5783 szymonniski96@gmail.com Ziemowit Żaba 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0001-9476-1166 https://orcid.org/0000-0001-9476-1166 piast753@gmail.com Aleksandra Lisowska Uniwersytet Medyczny w Lublinie 0000-0003-0009-8995 https://orcid.org/0000-0003-0009-8995 alisowska8@wp.pl Abstract Introduction: Psoriasis is a common, chronic, systemic inflammatory disease with an immunological basis. It occurs in about 2% of people in Europe and North America. It is associated with an increased probability of obesity, diabetes, dyslipidemia, cardiovascular disease and inflammatory bowel disease. Objective: The purpose of this review is to analyze the latest information on the characteristics, diagnosis and treatment of patients with psoriasis. Materials and methods: The present study was based on available data collected in the PubMed database and published between 2001 and 2022. The study was conducted by reviewing keywords such as: "psoriasis"; "diagnosis"; "treatment"; "genetics"; "immunology"; "angiogenesis"; "keratinocytes" and "incidence." State of the knowledge: In the last decade, biologic drugs targeting tumor necrosis factor alpha, interleukin 23, interleukin 17 and interleukin 12 have been developed and approved for the treatment of psoriasis. These drugs have revolutionized the treatment and management of psoriasis. Summary: Over the past decade, there have been tremendous advances in knowledge about the pathogenesis of psoriasis. Discoveries on this background, have given rise to new biological therapies. Currently in clinical trials are substances such as, Janus kinase inhibitors and tyrosine kinase 2 inhibitors, which represent hope for the most affected patients. Unfortunately, our knowledge of the causes of psoriasis is still incomplete. This poses a challenge for further research and thus the creation of more therapeutic substances. Keywords: "psoriasis”; „therapy”; „pathogenesis&rdquo

Introduction: Wilms tumor is the most common occuring malignant tumor of kidney among children. Mostly appears in infants and young children. The main symptom is enlargement od the abdomen. It is often diagnosed incidentally during USG examination. Aim of the study: Summary of current knowledge on the pathogenesis, diagnosis, treatment and prognosis of Wilms Tumor. Methods and matherials: A review of the literaturę available in the PubMed data base, using the following keywords: :„Wilms Tumor”,„Wilms tumor genetics” State of knowledge: Wilms tumor appears more often among people with certain genetic syndromes. There are two to treat WT depending on the world region (SIOP, COG). According to SIOP, the diagnosis is made based on imaging. This is followed by neoadiuvant chemotherapy, and then it is surgically removed. According to COG, the first stage of treatment is surgical removal of the tumor, then chemotherapy. During chemotherapy, vincristine, actinomycin, doxodubicin are used in both schemes. Although both strategies differ in their pretreatment approach, they lead to similar overall survival rates. Conclusions:Despite already advanced treatment techniques for the tumor, and extensive knowledge about it, its pathogenesis still remains somewhat unknown. Increased understanding of the aberrant molecular pathways active in Wilms tumorigenesis has identified many potential targeted therapeutic approaches that could be applied in a clinical setting

Introduction: Nonbacterial prostatitis (CNP) also known as chronic pelvic pain syndrome (CPPS) is a condition with an incompletely understood etiology. Chronic prostatitis is diagnosed when symptoms of prostatitis persist for more than 3 months and it is difficult to treat. The causes are not fully understood. Among the many possible causes are stress, psycho-emotional disorders, hormonal disorders and autoimmune disorders. The main symptom is pain usually felt in the perineum, at the base of the penis, in the anal area, sometimes over the pubic symphysis. This pain can radiate to the penis and scrotum. Aim of the study: Summary of current knowledge on the treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Material and methods: Review of PubMed articles using the following keywords: “nonbacterial chronic prostatitis”, “abacterial chronic prostatitis” and “chronic pelvic pain syndrome”. Results: Complete cure in non-bacterial chronic prostatitis is rare. Due to the lack of knowledge of the cause of chronic prostatitis, there is no effective treatment for this disease. Although the pathogen is rarely found in the patients studied, many patients show improvement after antibiotic therapy. In addition, anti-inflammatory drugs, alpha blockers and neuromodulators are used. Physical therapy also has proven benefits in relieving symptoms. Conclusion: CNP is a frustrating disease for many doctors and patients. Although it is not yet completely understood, we have made significant progress in the evaluation and treatment of this disease over the past several decades. Physicians need to move away from outdated algorithms that often result in endless courses of antibiotics and embrace multimodal therapy, which provides better results than other treatment strategies.

Background Patients with cystic fibrosis (CF) are exposed to overlapping cardiovascular risk factors. We hypothesized that CF is characterized by increased arterial stiffness and greater intima-media thickness (IMT). Methods This cross-sectional study assessed the digital volume pulse arterial stiffness index (SIDVP) using photopletysmography, measured intima-media complex thickness (IMT) at the common carotid artery, and obtained an extended set of clinical and atherosclerosis-related laboratory parameters. Results Fifty-five patients with moderate-to-severe CF (mean age 26.3±8.6 years, BMI 20.3±3.1 kg/m2, FEV1 62±26%) and 51 healthy controls (25.1±4.4 years, BMI 21.7±3.0 kg/m2) entered the study. SIDVP was greater in pancreatic insufficient (PI), but not pancreatic sufficient (PS) CF patients compared with control (7.3±1.8 m/s vs 6.0±1.2 m/s; p=7.1 × 10−5). IMT was increased in PS (but not PI) participants relative to control (552±69 µm vs 456±95 µm, p=0.0011). SIDVP was also greater in PI than in PS patients (7.3±1.8 m/s vs 6.3±1.7 m/s, p=0.0232) and IMT was higher in PS compared with PI (552±69 µm vs 453±82 µm, p=0.0002). SIDVP independently associated with age, PI, the lack of liver cirrhosis, and with Pseudomonas aeruginosa colonization. PS was the only independent correlate of IMT in CF. Conclusions PI patients are at risk of developing general arterial stiffness. PS may relate to carotid IMT thickening, which underscores the need for further study that could lead to reconsideration of dietary guidance in PS CF.

MAŁEK, Róża, WARZYSZAK, Paweł, MILCZEK, Maria, ŻOŁYNIAK, Wojciech, TOMASIK, Mikołaj, HAWRANIK, Izabela, NISKI, Szymon, ŻABA, Ziemowit, LISOWSKA, Aleksandra & SKRZYPEK, Mateusz. Impact of physical activity in pregnant women on maternal health. Journal of Education, Health and Sport. 2023;13(1):319-325. eISSN 2391-8306. DOIhttp://dx.doi.org/10.12775/JEHS.2023.13.01.047 https://apcz.umk.pl/JEHS/article/view/41425 https://zenodo.org/record/7516696 The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 21, 2021. No. 32343. Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences). Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 21 grudnia 2021 r. Lp. 32343. Posiada Unikatowy Identyfikator Czasopisma: 201159. Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu). © The Authors 2023; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 28.11.2022. Revised: 15.12.2022. Accepted: 09.01.2023. Impact of physical activity in pregnant women on maternal health Róża Małek 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0003-3606-0067 https://orcid.org/0000-0003-3606-0067 rozamalek192@gmail.com Paweł Warzyszak 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0003-2023-7980 https://orcid.org/0000-0003-2023-7980 warzyszakpawel@gmail.com Maria Milczek 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0002-4204-5632 https://orcid.org/0000-0002-4204-5632 Maria@milczek.com Wojciech Żołyniak Centrum Medyczne w Łańcucie Sp. z o.o. Ignacego Paderewskiego 5, 37-100 Łańcut 0000-0002-3709-4018 https://orcid.org/0000-0002-3709-4018 wojtesk995@gmail.com Mikołaj Tomasik 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0002-5489-0059 https://orcid.org/0000-0002-5489-0059 mikolajt97@gmail.com Izabela Hawranik 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0002-7329-8595 https://orcid.org/0000-0002-7329-8595 hawranik14@gmail.com Szymon Niski Wojewódzki Szpital Specjalistyczny im. Najświętszej Maryi Panny w Częstochowie Polskiego Czerwonego Krzyża 7, 42-200 Częstochowa 0000-0001-6295-5783 https://orcid.org/0000-0001-6295-5783 szymonniski96@gmail.com Ziemowit Żaba 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0001-9476-1166 https://orcid.org/0000-0001-9476-1166 piast753@gmail.com Aleksandra Lisowska Uniwersytet Medyczny w Lublinie 0000-0003-0009-8995 https://orcid.org/0000-0003-0009-8995 alisowska8@wp.pl Mateusz Skrzypek Uniwersytet Rzeszowski, Kolegium Nauk Medycznych 0000-0001-6767-3144 https://orcid.org/0000-0001-6767-3144 mati.skrzypek@gmail.com Abstract Introduction:Pregnancy is an important period in a woman's life. One of the most essential things people can do to improve their health both physical and mental is taking regular physical exercise. Healthy people, people with chronic illnesses or disabilities as well as pregnant women benefit from regular physical activity. All pregnant women should be physically active, except in certain situations when there are medical contraindications. Objective of the study:The purpose of this study is to summarize the benefits of regular physical activity during pregnancy. Materials and methods:A review of the literature available on the PubMed database was carried out, the key words used were: ,,pregnancy,,, ,,physical activity,,, ,,gestational diabetes,,, ,,hypertension,,, ,,pre-eclampsia,,. Results:Physical activity increases the chance of a normal pregnancy and a successful outcome. In the absence of obstetric or medical contraindications, physical activity during pregnancy is desirable and advisable. Exercise results in fewer complications for both the pregnant woman and the newborn. Conclusions:The best results from physical activity in pregnancy are obtained when the pregnant woman exercises regularly, for example, 3 times a week for 30-60 minutes. It is advisable that for it to be regular aerobic training of moderate intensity of at least 150 minutes per week. Keywords:,,physical activity,,, ,,pregnancy,,, ,,gestational diabetes,,, ,,hypertension,,, ,,pre-eclampsia,, Abstrakt Wprowadzenie:Czas ciąży to ważny okres w życiu kobiety. Jedną z najważniejszych rzeczy, które ludzie mogą zrobić, aby poprawić swoje zdrowie zarówno to fizyczne, jak i psychiczne jest regularna aktywność fizyczna. Osoby zdrowe, osoby z przewlekłą chorobą, niepełnosprawnością, jak również kobiety w ciąży odnoszą korzyści z regularnej aktywności fizycznej. Wszystkie ciężarne powinny być aktywne fizycznie, poza niektórymi sytuacjami, kiedy to istnieją przeciwwskazania medyczne. Cel pracy:Celem pracy jest zestawienie korzyści, jakie wynikają z regularnej aktywności fizycznej w ciąży. Materiały i metody:Dokonano przeglądu literatury obecnej w bazie PubMed, używano słów kluczy: ,,ciąża,,, ,,aktywność fizyczna,,, ,,cukrzyca ciążowa,,, ,,nadciśnienie,,, ,,stan przedrzucawkowy,,. Wyniki:Aktywność fizyczna zwiększa szansę na prawidłowy przebieg ciąży oraz na pomyślne jej zakończenie. W przypadku braku przeciwwskazań położniczych lub medycznych aktywność fizyczna w ciąży jest pożądana i wskazana. Ćwiczenia powodują mniej komplikacji zarówno u ciężarnej jak też u noworodka. Systematyczna aktywność może nieść za sobą takie korzyści jak: redukcja stresu, zmniejszenie zmęczenia, spadek ryzyka depresji, poprawa jakości życia. Wnioski:Najlepsze rezultaty z aktywności fizycznej w ciąży są wtedy, kiedy ciężarna ćwiczy regularnie np. 3 razy w tygodniu po 30-60 minut. Wskazane jest aby był to regularny trening aerobowy o umiarkowanej intensywności minimum 150 minut tygodniowo. Słowa kluczowe:,,aktywność fizyczna,,, ,,ciąża,,, ,,cukrzyca ciążowa,,, ,,nadciśnienie,,, ,,stan przedrzucawkowy

SKRZYPEK, Mateusz, WARZYSZAK, Paweł, MAŁEK, Róża, MILCZEK, Maria, ŻOŁYNIAK, Wojciech, TOMASIK, Mikołaj, HAWRANIK, Izabela, NISKI, Szymon, ŻABA, Ziemowit & LISOWSKA, Aleksandra. Pathological conditions associated with hyperhomocysteinemia. Journal of Education, Health and Sport. 2023;13(2):222-228. eISSN 2391-8306. DOI https://dx.doi.org/10.12775/JEHS.2023.13.02.032 https://apcz.umk.pl/JEHS/article/view/41392 https://zenodo.org/record/7502077 The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 21, 2021. No. 32343. Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences). Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 21 grudnia 2021 r. Lp. 32343. Posiada Unikatowy Identyfikator Czasopisma: 201159. Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu). © The Authors 2023; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 14.12.2022. Revised: 21.12.2022. Accepted: 03.01.2023. Pathological conditions associated with hyperhomocysteinemia Mateusz Skrzypek Uniwersytet Rzeszowski, Kolegium Nauk Medycznych Aleja Kopisto 2a, 35-959 Rzeszów 0000-0001-6767-3144 https://orcid.org/0000-0001-6767-3144 mati.skrzypek@gmail.com Paweł Warzyszak 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0003-2023-7980 https://orcid.org/0000-0003-2023-7980 warzyszakpawel@gmail.com Róża Małek 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0003-3606-0067 https://orcid.org/0000-0003-3606-0067 rozamalek192@gmail.com Maria Milczek 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0002-4204-5632 https://orcid.org/0000-0002-4204-5632 Maria@milczek.com Wojciech Żołyniak Centrum Medyczne w Łańcucie Sp. z o.o. Ignacego Paderewskiego 5, 37-100 Łańcut 0000-0002-3709-4018 https://orcid.org/0000-0002-3709-4018 wojtesk995@gmail.com Mikołaj Tomasik 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0002-5489-0059 https://orcid.org/0000-0002-5489-0059 mikolajt97@gmail.com Izabela Hawranik 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0002-7329-8595 https://orcid.org/0000-0002-7329-8595 hawranik14@gmail.com Szymon Niski Wojewódzki Szpital Specjalistyczny im. Najświętszej Maryi Panny w Częstochowie Polskiego Czerwonego Krzyża 7, 42-200 Częstochowa 0000-0001-6295-5783 https://orcid.org/0000-0001-6295-5783 szymonniski96@gmail.com Ziemowit Żaba 1 Wojskowy Szpital Kliniczny w Lublinie Aleje Racławickie 23, 20-049 Lublin 0000-0001-9476-1166 https://orcid.org/0000-0001-9476-1166 piast753@gmail.com Aleksandra Lisowska Uniwersytet Medyczny w Lublinie 0000-0003-0009-8995 https://orcid.org/0000-0003-0009-8995 alisowska8@wp.pl Abstract The effect of excessive homocysteine concentration in human blood, on the cells and tissues of the body is very complex. The effect associated with the induction of oxidative stress and disruption of the biochemical balance of the intracellular space has a negative impact on the physiology of cells and the regularity of their functioning by changing their metabolism. This may result in the formation and development of atherosclerotic lesions, disorders in the coagulation system leading to thrombosis and, consequently, embolism, pathological changes in the central nervous system, which may translate into the formation of mental disorders, neurodegenerative diseases, depression and dementia. In addition, hyperhomocysteinemia affects the possible pathologies and complications of pregnancy associated with them, as well as the implications for fetal development if its aforementioned condition. The work presented here outlines the mechanisms that determine the formation of the aforementioned disease entities as a result of too much homocysteine and the clinical significance of these relationships. With the development of science and the increasing number of publications related to the impact of hyperhomocysteinemia on diverse disease entities, there are voices suggesting the inclusion of studies on homocysteine concentrations in body fluids in screening as risk factors for the development of these diseases or using them for their control and treatment. Keywords: "homocysteine”; „hyperhomocysteinemia”; „pathogenesis”; „diseases”; „thrombosis”.

The article includes an analysis involving the requirements for the adaptation of rolling stock for use by people with movement dysfunction. The requirements including construction and dimensions have been summarized and detailed conditions necessary to ensure the assumed level of travel comfort for people with reduced mobility with real examples of solutions used in currently operated railway vehicles. The focus was on the requirements set out in Regulation No 1300/2014 regarding technical design and construction solutions for adapting railways to the transport of disabled people, TSI PRM. Based on the collected material, an analysis of the compliance of the actual state with the theoretical one, included in the standard, was carried out. Elements designed and manufactured in a manner consistent with the recommendations contained in the standard, as well as those that require a re-analysis of rolling stock constructors, repair or necessary changes are indicated. The components analyzed included, among others, seating positions, movement zone - including internal and external doors, toilets or platforms enabling access to the interior of the vehicle The opinion of disabled people using rail transport was also included by conducting a survey and performing analysis and then interpretation of the data obtained. Basing on this analysis, solutions that will increase the comfort of travelling for people with disabilities have been proposed.

Rationing of nursing care (RNC) is characterized by the omission of any aspect of the required patient care, resulting in incomplete or delayed nursing activities. Oncology nurses are exposed to a very high psychological burden, which can lead to the development of professional burnout syndrome (PBS). The level of PBS might be related to life and job satisfaction. This study aimed to identify determinants affecting RNC and reveal the relationship between RNC, life and job satisfaction, and the PBS levels among oncology nurses. The sample was a hundred oncology nurses from four hospitals in Poland with a mean age of 43.26 ± 10.69 years. The study was conducted from March 2019 to February 2020. The self-administered sociodemographic questionnaire and validated scales determining missed nursing care, job and life satisfaction, and life orientation were used: Basel Extent of Rationing of Nursing Care-Revised (BERNCA-R), Satisfaction with Job Scale (SWJS), Satisfaction with Life Scale (SWLS), Life Orientation Test-Revised (LOT-R), and Maslach Burnout Inventory (MBI). The mean BERNCA score was 1.55 ± 0.15, which indicates the frequency of RNC was between “never” and “rarely”. The mean SWJS score was 11.71 ± 5.97, which showed that nurses were “dissatisfied” and “rather dissatisfied” with their job. A low SWLS score was reported by 59% of nurses, which means that more than half of the respondents described their life satisfaction as low. In LOT-R, 66% of nurses reported pessimistic and 31% neutral life orientation. The mean overall MBI score was 49.27 ± 19.76 points (EE = 63.56 ± 25.37, DEP = 37.2 ± 24.95, and lack of PA = 47.05 ± 22.04), which means that half of the nurses perceived burnout and half did not. Additionally, the higher the job satisfaction (SWJS), the more frequent the RNC (BERNCA) (p < 0.05). The greater the EE, the stronger the sense of lack of PA, and the higher the PBS (MBI) level, the less frequent the RNC (BERNCA). In conclusion, there is a phenomenon of omission of some aspects of care among oncology nurses, but it is not frequent and concerns areas not directly related to therapeutic tasks, but requiring effort and not resulting in quick noticeable effects. It depends only little on life satisfaction and more on job satisfaction and PBS level. The results may indicate the professionalism of Polish nurses, their responsibility towards their patients’ life and health, and the sense of mission that enables them to perform their duties regardless of the external and internal difficulties. The presence of the PBS phenomenon in oncology nurses highlights the need for continued research in this area.

The primary objective of the study is to compare the effect of endurance and endurance‑strength training on endothelial function in women with abdominal obesity. The secondary objectives include the assessment of the effect of both types of training on anthropometric, densitometric and biochemical parameters. In total, at least 100 women will be recruited for the study. The study population will be randomly divided into two groups according to the type of training: endurance and endurance‑strength training. During the 3-month of intervention, both groups will be performed three times a week training of an equal exercise volume and duration of 60 minutes. Before and after the intervention selected anthropometric and densitometric parameters will be measured and body composition will be analysed. In addition, biochemical parameters related to glucose and insulin homeostasis, lipid metabolism, antioxidant status, oxidative stress, inflammatory markers and endothelial function will be assessed.

Background The interest in cystic fibrosis (CF) dyslipidaemia as a potential risk factor for cardiovascular disease is increasing with patients' survival. This study aimed to investigate CF dyslipidaemia, its clinical correlates and links to oxidized low-density lipoprotein (oxLDL), adiponectin, and apolipoprotein E (APOE). Methods This cross-sectional study assessed clinical characteristics of CF, as well as the serum lipid profile, oxLDL, adiponectin, and APOE. Results In total, 108 CF subjects were enrolled in this study, with a median age of 22 years, BMI of 20.5 kg/m2, FEV1% of 61%, of which 81% were pancreatic insufficient (PI). Healthy subjects (HS; n = 51) were in similar age. Hypocholesterolaemia occurred in 31% of CF subjects and in no HS. Hypertriglyceridaemia concerned 21% of patients (HS: 8%, p = .04), and low HDL-C 45% (HS: 6%, p Conclusions CF dyslipidaemia is highly prevalent and heterogenous. The lipid profile weakly associates with the clinical characteristics of CF as well as oxLDL, adiponectin, and APOE. Further research is needed, especially regarding HDL function in CF, the causes of hypertriglyceridaemia, and the value of essential fatty acid supplementation for CF dyslipidaemia.

Background: Three main diagnostic types of osteoarthritic changes are distinguished in clinical and anthropological literature: osteophytes, porosity, and eburnation. The nature of the relationship between these changes and how lesions progress over time is still unclear. Aim: The aim of the present study is the analysis of the relationships between osteophytes, porosity, and eburnation based on skeletal material. Subjects and methods: The analysis employed the skeletal collection from Cedynia (199 individuals) from tenth to fourteenth-century Poland. Marginal osteophytes (OP), porosity (POR), and eburnation (EB) were examined on a shoulder, elbow, wrist, hip, knee, and ankle. Results: Osteophytes and porosity occurred independently of each other. Combinations of osteophytes and porosity (OP + POR) and osteophytes, porosity, and eburnation (OP + POR + EB) were rarely observed. Combinations of osteophytes and eburnation (OP + EB) or porosity and eburnation (POR + EB) were not found. There was a significant correlation between osteophytes and porosity in the scapula, proximal end of the ulna and proximal end of the femur. Osteophytes and eburnation were correlated at the distal end of the ulna. Porosity and eburnation were correlated at the distal end of the radius and distal end of the ulna. When all joints were considered together, all the types of osteoarthritic changes were correlated. However, the relationship between osteophytes and eburnation and between porosity and eburnation was only slightly significant. Osteophytes preceded porosity, but there were a few cases where more developed porosity accompanied less developed osteophytes. Conclusions: The findings indicate that correlations between osteoarthritic changes are weak, albeit statistically significant and further studies of the relationship between changes are necessary.

It is well known that rapeseed oil improves lipid profile and has antiatherosclerotic properties. Recently, amaranth oil has also become popular due to its potential health benefits. However, the effect of this oil on atherosclerosis markers in humans is not clear. Therefore, this study aimed to compare the effect of amaranth and rapeseed oils on selected atherosclerosis-related parameters in overweight and obese subjects. In this randomized cross-over study, 44 subjects were instructed to consume 20 mL of amaranth oil and rapeseed oil during two consecutive three-week intervention periods separated by a washout period of the same duration as the intervention. The outcome variables included changes in tumor necrosis factor-alpha, adiponectin, oxidized low-density lipoprotein, apolipoproteins (Apo) A1, B and E as well as glucose and insulin homeostasis markers. Compared to rapeseed oil, amaranth oil had a slight positive effect on adiponectin levels (mean (95% confidence interval): 0.55 (0.22–0.89) vs. -0.29 (−0.75–0.16), p = 0.0002) but negatively affected ApoB concentrations (0.05 (−0.01–0.11) vs. 0.03 (−0.07–0.00), p = 0.0004) and ApoB/A1 ratio (0.01 (−0.03–0.05) vs. −0.02 (−0.04–0.00), p = 0.0113). No differences between the other analyzed parameters were observed. In conclusion, amaranth oil does not have a greater beneficial effect on atherosclerosis markers than rapeseed oil. However, further studies with a longer intervention period are needed. The study was retrospectively registered with the German Clinical Trials Register within the number: DRKS00014046, date of registration: 3 May 2018.

Diagenetic alterations may limit the potential use of archaeological bones and teeth as a reliable source of information about the origin and movement of people and animals, their diet and the environment in which they lived. Fourier transform infrared spectroscopy (FTIR) has been widely applied to determine the overall state of preservation of ancient bones. Spectral data are commonly used to quantify two diagenetic indicators related to sample crystallinity: the splitting factor (SF), the hydrogen phosphate ion index (HPO4/PO4) and the width at 85% of the height of the 604 cm-1 peak (FW85%). The aim of the present work is to determine the presence of any difference in the value of SF, HPO4/PO4 and FW85% of the 604 cm−1 peak between tissues such as enamel, dentine and bone. This method has been applied to two different modern animals: sheep and pigs. The results obtained in this study demonstrate that enamel has significantly higher values of the SF and significantly lower values of HPO4/PO4 and FW85% in comparison to bone and dentine in both animal species. Moreover, enamel has been reported to show diversification of SF index across the investigated species, which is presumably related to different tooth development and mineralisation patterns in animals with different diets (i.e. herbivorous versus omnivorous). The present study demonstrates that due to the different biogenic chemical structure of bones and teeth, the SF and HPO4/PO4 reference ranges should be determined separately for each of the three tissues, and in the case of enamel also allowing for the analysed species.

The available data on the influence of liver cirrhosis on vitamin K status in CF patients is scarce. Therefore, the aims of the present study were to assess the prevalence of vitamin K deficiency in cirrhotic CF subjects and to determine whether it correlates with liver cirrhosis. The study group comprised of 27 CF patients with and 63 without liver cirrhosis. Vitamin K status was assessed using prothrombin induced by vitamin K absence (PIVKA-II) and the percentage of undercarboxylated osteocalcin (u-OC). PIVKA-II concentrations were higher in cirrhotic than in non-cirrhotic CF patients (median [1st-3rd quartile]: 3.2ng/ml [1.0-10.0] vs. 1.3ng/ml [0.2-2.6], p=0.0029). However, the differences in u-OC percentages between the studied groups did not reach the level of significance (49.4% [7.0-73.8] vs. 8.0% [2.6-59.1], p=0.0501). Based on multiple linear regression analysis the dose of vitamin K and F508del mutation were potentially defined as determinants of vitamin K deficiency. Liver cirrhosis was not documented to be an independent risk factor. In CF patients with liver cirrhosis vitamin K deficiency is not only more frequent, but also more severe. However, not liver cirrhosis, but the presence of a F508del CFTR mutation constitutes an independent risk factor for vitamin K deficiency.

The main objective of oxygen isotope analysis is to determine the probable place of origin of an individual or the reconstruction of migration paths. The research are methodologically based on referencing oxygen isotope ratios of apatite phosphates (δ18Op) to the range of environmental background δ18O, most frequently determined on the basis of precipitation. The present work is a response to the need for providing background for oxygen isotope studies on skeletons excavated in Poland. Currently there no monitoring of the isotope composition of precipitation water in Poland is conducted. For this reason, based on the data generated in the Online Isotopes In Precipitation Calculator (OIPC), a database was developed, containing δ18O levels in precipitation for locations in which exploration work was carried out in the archaeological fields from Poland. In total, 279 locations were analysed. The result of the data analysis was a complete isotope composition map for Poland with four zones distinguished by δ18Ow values. The observable differences in oxygen isotope composition of precipitation in Poland are sufficient to trace migrations of individuals and populations, although accurate only at the level of macroregions.

The article presents calculations of the theoretical efficiency of the spark ignition engine cycle. Calculations of the efficiency of the Otto cycle were carried out with the use of throttling to a certain value of manifold vacuum in relation to atmospheric pressure, which is to simulate the operation of a real engine in the partial load range. The determined efficiency is the benchmark for determining the efficiency of the same cycle with a decreasing of throttling by adding an inert gas in the form of argon. This approach, apart from limiting the pumping work in the comparative cycle, increases the isentropic exponent in the compression and expansion processes, and thus translates into an increase in the efficiency of the considered cycle. The calculations were performed for various ranges of throttling pressure with the use of air and air with argon addition. The results are compiled in the form of a 3D diagram, taking into account the limiting ranges of throttling pressures and maintaining the ratio of argon mass to air mass at a certain level not exceeding 20% of the air mass involved in the process. Up to about 5.4% increase in the cycle efficiency was observed with an argon addition of 20% by weight. The obtained results are the basis for conducting research on a real object.

Background At present, fecal elastase-1 ELISA determination is the most sensitive and specific tubeless pancreatic function test available. However, the results are not available the same day in routine clinical practice. This prospective study aims at evaluating the sensitivity and specificity of the Elastase-1 Quick™ Test by comparing the results with the ELISA test. Methods The study was composed of three groups: the screening-diagnosed cystic fibrosis (CF) patients (n=28), the screened, but non-CF subjects (n=36) and non-screened CF patients (n=62). Pancreatic status (normal vs abnormal) was evaluated using the Pancreas Elastase-1 Quick™ Test. Fecal elastase-1 concentration was determined with a commercially available ELISA kit, used as reference. The cut-off for abnormal results was set at Results The Pancreatic Elastase-1 Quick Test™ showed the following sensitivities and specificities in the studied groups: 92.8% and 96.6% in all subjects, 90.5% and 100% in screening samples, and 92.8 and 90.5% in CF patients. Conclusion Pancreatic Elastase-1 Quick Test™ proves to be a rapid and reliable option to qualitatively evaluate pancreatic function for diagnostic purposes in a clinical setting of CF care.

Background: Although the activity of the cytosolic hepatic enzyme phenylalanine hydroxylase is impaired in phenylketonuria (PKU), the microsomal function, necessary for the metabolism of xenobiotics, has never been assessed. The aim of the study was to assess the microsomal liver function in PKU patients by 13C-methacetin breath test (13C-MBT), which measures cytochrome P450 activity. Methods: Twenty patients with classical PKU, aged 15 - 34 years, were enrolled in the study. The control group comprised of 20 healthy subjects matched for age and sex. The 13C-MBT was performed in every subject at rest after an overnight fast. Results: The values of cumulative percentage dose recovery at 120 minutes of the test (CPDR median ) were significantly lower in the PKU group than in the control group (25.1 vs 32.8 ; P = 0.0067). The lower values of the maximum momentary 13C recovery (Dmax) were observed in the PKU group than in the control group (26.6 vs. 32.1 ; P = 0.0227). The values of time to reach Dmax (Tmax) did not differ (20 vs. 20 ; P = 0.8410). The values of CPDR, Dmax and Tmax were not different between the group with abnormal (> 10 mg/dL) and normal (< 10 mg/dL) Phe level (P = 0.2799; 0.7959; 0.4812, respectively). Conclusions: The present study demonstrates that the cytochrome P450 activity in PKU patients may be reduced. However, further research is required, particularly in regards to the effect that patient diet compliance has on the microsomal liver function.

Background. Conjugated linoleic acid (CLA) reduces body weight (BW), body fat mass (BFM), and in- creases or maintains lean body mass in animals. However, the results concerning the eff ect of CLA on weight reduction in humans are contradictory. The present study aimed to evaluate the eff ect of CLA supplementa- tion on the BW and anthropometric parameters (waist and hip circumferences) in overweight and obese adult women. Material and methods. A total of 74 subjects (BMI: 28-42 kg/m 2 ) were included in a double blind, placebo- controlled trial. Subjects were randomized into two groups, those supplemented with either 3.0 g/d CLA or with placebo (sunfl ower oil) for 12 weeks. Results. CLA signifi cantly decreased the hip circumferences compared to placebo (p = 0.016209), but had no eff ect on body weight, BMI, or waist circumference. The number of subjects with a reduction in hip circum- ference in the CLA group was signifi cantly larger compared to that in the placebo group (p = 0.0017; NNT = 2.65; CI (6.27-1.685)). Conclusions. In conclusion, our fi ndings do not support the hypothesis that 12 weeks CLA supplementation, as dosed in the present study, is eff ective for body weight reduction in overweight and obese women. How- ever, its local action in decreasing the hip circumference seems to be encouraging and suggests that CLA may represent an attractive dietary supplement.

Correct pH probe placement is vital for the precision of esophageal pH monitoring. This study aimed at finding the optimal formula for placement of pH probe in the locus proposed by the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition European Pediatric Impedance Working Group, that is, 2 vertebrae above the diaphragm. An analysis of data regarding 353 children ages 0-18 years in whom the position of the pH sensor was determined radiographically revealed that a mathematical formula (3.2 + 0.2 × body length or height, centimeter) could guide the probe to within 1/12 of thoracic spine length of the desired location in 71.7% of all of the patients.

The term constipation with regard to patients with a stoma is defined as impaired bowel movements associated with increased stool consistency or long periods without bowel movements that lead to discomfort, flatulence, and abdominal pain. Information about constipation in patients with a stoma is limited. A prospective, descriptive study was conducted among patients attending ostomy and proctology outpatient clinics in Poznan, Poland between January 2011 and December 2014 to assess the role of dietary and pharmacological strategies in the management of constipation in patients with a stoma. Patients were included if they experienced a 3-day period without bowel movements leading to abdominal discomfort and bloating. Patients who were terminally ill from neoplastic disease or could not provide informed consent for study participation were not eligible to participate. Patients underwent 3 evaluations 3 months apart: the first assessed problems with passing stool through the stoma, at which time patients were told to increase fiber and fluid intake. During the next 2 visits, patients were asked if their symptoms had improved. If dietary changes were not successful, first-line pharmacological interventions were suggested (laxatives, osmotic agents, and probiotics). If no improvement was reported during the third assessment, second line pharmacologic therapy (eg, stimulant laxatives) were prescribed. Of the 405 patients initially assessed for participation, 331 met the initial screening criteria and were scheduled for followup. Of those, 93 (28%) had constipation; 50 (15%) required a surgical referral for morphological stoma changes and 43 (12.9%) met the study inclusion criteria for dietary recommendations. Almost all (42) had a colostomy and most (28) had a history of stoma creation due to diverticular disease. Twenty-five (25) men and 18 women (average age 55.9 ± 9.3 years) received dietary recommendations during the first visit. Diet modifications were effective and sufficient to resolve the problem with constipation in more than half (24) of the patients. Among the remaining 19 patients, only 2 did not improve after using first-line or second-line pharmacological management strategies. One patient required emergency surgery due to complicated colonic diverticulosis (perforation). The results of this study suggest constipation among patients with a stoma can be associated with morphological stoma changes and in the absence of morphologic changes the majority of patients respond well to a change in diet. Additional studies are needed to increase understanding about the incidence and optimal management strategies of constipation in persons with a stoma.

Purpose A lower parasympathetic activity was described in patients with the gastroesophageal reflux disease. We aimed to determine whether gastroesophageal reflux (GER) episodes are associated with a short-term parasympathetic tone variability in children. Methods In order to address this question we performed simultaneous 24-h esophageal multichannel intraluminal impedance-pH and electrocardiographic monitoring in 16 children (age range 6–18 years), including 8 with asthma and 2 with gastroesophageal reflux disease. After describing duration, height, and acidity of 483 GER episodes we also measured parasympathetic-related heart rate variability parameters in 4 time periods: preceding, containing, following GER, and in-between GERs (control). High frequency (HF) power and root-mean square differences of successive R–R intervals (r-MSSD) were assessed in 2.5-min and 1-min periods, respectively. Results We did not identify the searched short-term parasympathetic tone changes. Conclusions In conclusion, GER episodes and their characteristics were not associated with short-term variability of parasympathetic activity in children.

OBJECTIVES New tools are needed in cystic fibrosis (CF) diagnostics in pancreatic-sufficient CF (PS-CF) patients. Secretin-enhanced magnetic resonance cholangiopancreatography (SE-MRCP) allows for improved assessment of the width of the pancreatic duct. METHODS Sixteen PS-CF patients and 17 healthy volunteers underwent SE-MRCP. The width of the pancreatic duct in the head, the body, and the tail of the pancreas was measured at the baseline and 1, 2, 3, 5, and 10 minutes after secretin administration. RESULTS The width of the pancreatic duct in the head of the pancreas did not differ between the groups at the baseline; after 10 minutes of secretin stimulation, it was smaller in PS-CF patients (median, 1.4 mm [first-third quartile, 1.3-2.0] vs 2.2 mm [1.7-2.4], P = 0.008). The area under the curve for discrimination between the 2 groups using this parameter was 0.77 (95% confidence interval, 0.60-0.93). CONCLUSIONS The SE-MRCP identified differences in the width of the pancreatic duct between PS-CF and healthy volunteers. Further improvements of the method are needed to augment its clinical utility.

BACKGROUND Ursodeoxycholic acid (UDCA) supplementation is recommended for cystic fibrosis (CF) patients with associated liver disease. However, its effect on fat digestion and absorption is not known. MATERIALS AND METHODS In 23 patients with mild liver involvement, a C-mixed triglyceride breath test was performed on UDCA supplementation (with and without pancreatic enzymes - standard and increased dose) and after 1 month of UDCA withdrawal. Cumulative percentage dose recovery [CPDR; median (interquartile range)] has been considered to reflect lipid digestion and absorption. RESULTS The enzyme supplementation resulted in a significant CPDR improvement [0% (0-0) vs. 4.6% (0.4-6.0); P

As decreased bone mineral density (BMD) is a common problem in cystic fibrosis (CF) and milk products may have pivotal dietary role affecting BMD, we aimed to assess the potential influence of adult-type hypolactasia (ATH) and lactose malabsorption (LM) on BMD in adolescent and young adult patients. In 95 CF pancreatic-insufficient patients aged 10–25 years (without liver cirrhosis, steatosis and cholestasis, diabetes mellitus, systemic glucocorticoid therapy), lumbar BMD, the nutritional status, pulmonary function, vitamin D3 concentration, calcium intake and single-nucleotide polymorphism upstream of the lactase gene were assessed. In subjects with the −13910 C/C genotype predisposing to ATH, the presence of LM was determined with the use of a hydrogen–methane breath test (BT). BMD and calcium intake were significantly lower in patients with the C/C genotype (P

In our previous study, we demonstrated that abstaining from meat, for 1 month, by healthy omnivores (lacto-ovovegetarian model) resulted in a statistical decrease in pancreatic secretion as measured by faecal elastase-1 output. However, no correlation between relative and non-relative changes of energy and nutrient consumption and pancreatic secretion was documented. Therefore, in the present study, we aimed to assess the changes of exocrine pancreatic secretion with a more restrictive dietetic modification, by applying a vegan diet. A total of twenty-one healthy omnivores (sixteen females and five males) participated in the prospective study lasting for 6 weeks. The nutrient intake and faecal output of pancreatic enzymes (elastase-1, chymotrypsin and lipase) were assessed twice during the study. Each assessment period lasted for 7 d: the first before the transition to the vegan diet (omnivore diet) and the second during the last week of the study (vegan diet). The dietary modification resulted in a significant decrease in faecal elastase-1 (P P P v.animal (P P

Streszczenie U chorych na mukowiscydoze moze wystąpic zarowno pierwotna, jak i wtorna nietolerancja laktozy, wymagające odmiennego postepowania terapeutycznego. Jednocześnie dolegliwości związane z nietolerancją laktozy mogą byc mylone z objawami klinicznymi podstawowej jednostki ze strony przewodu pokarmowego. Do tej pory nie ustalono jednoznacznie, czy czestośc wystepowania nietolerancji laktozy w mukowiscydozie jest wieksza niz w populacji osob zdrowych.

Background Most methods used for the assessment of severe steatorrhea in cystic fibrosis (CF) are sensitive. In fact, the tests show their usefulness in a borderline zone of the results. Yet, the existing data related to acid steatocrit (AS) are still contradictory. Therefore, in the present study we have aimed to assess CF patients without or with mild steatorhea (

Streszczenie Nietolerancja laktozy jest jednym z powszechniejszych problemow gastroenterologicznych, z jakim mają do czynienia lekarze pierwszego kontaktu. W zalezności od przyczyny mozna wyroznic jej trzy podstawowe postaci. Wrodzona nietolerancja laktozy to niezwykle rzadka, aczkolwiek groźna jednostka chorobowa. Objawy kliniczne pojawiają sie u noworodka po pierwszym podaniu mleka. Brak stosownego rozpoznania i/lub postepowania terapeutycznego moze prowadzic do zgonu. Wtorna nietolerancja laktozy towarzyszy chorobom przebiegającym z uszkodzeniem szczytowej cześci kosmkow jelitowych, gdzie umiejscowiona jest laktaza. Zaburzona tolerancja laktozy ma charakter odwracalny i ustepuje wraz z regeneracją śluzowki jelita. Najcześciej wystepuje pierwotna nietolerancja laktozy, związana z hipolaktazją typu doroslych. Jest to sytuacja fizjologiczna, a predyspozycje do jej wystąpienia są dziedziczone w sposob autosomalny recesywny. Dotyczy ona wiekszości populacji świata. Niezaleznie od podloza, objawy nietolerancji laktozy obejmują bol brzucha, biegunke, wzdecia, przelewania, kruczenie oraz oddawanie gazow, a ich pojawienie sie jest związane ze spozyciem produktow zawierających laktoze, glownie przetworow mlecznych. Metody diagnostyczne nietolerancji laktozy mozna podzielic na bezpośrednie i pośrednie. Do metod bezpośrednich zalicza sie pomiar aktywności laktazy w bioptacie jelita cienkiego. Wśrod metod pośrednich wyroznic mozna wodorowy/wodorowo-metanowy test oddechowy, test doustnego obciązenia laktozą, probe eliminacyjną, ocene pH stolca i badanie molekularne polimorfizmu genu laktazy. Ze wzgledu na wysoką czulośc i swoistośc oraz stosunkową latwośc wykonania, obecnie za zloty standard w diagnostyce nietolerancji laktozy uznaje sie wodorowy/wodorowo-metanowy test oddechowy.

Streszczenie Mukowiscydoza (cystic fibrosis – CF) jest najcześciej wystepującą w populacji kaukaskiej chorobą genetyczną o autosomalnym recesywnym typie dziedziczenia. Jej przyczyną są mutacje genu CFTR (Cystic Fibrosis Transmembrane Conductance Regulator), zlokalizowanego na dlugim ramieniu chromosomu 7. Produktem powyzszego genu jest bialko CFTR, spelniające role kanalu chlorkowego, ktore jest obecne na szczytowej powierzchni komorek nablonkowych wydzielania zewnetrznego. Efektem mutacji genu CFTR jest brak funkcjonalnego bialka, co w konsekwencji prowadzi do gromadzenia lepkiego śluzu w wielu narządach ukladu oddechowego i pokarmowego. Chorzy na CF są narazeni na niedobor witaminy K z powodu: zaburzen wchlaniania tluszczow (niewydolnośc zewnątrzwydzielnicza trzustki), chorob wątroby, czestych antybiotykoterapii oraz resekcji fragmentu jelita cienkiego w przebiegu niedrozności smolkowej. Witamina K jest kofaktorem posttranslacyjnej gamma-karboksylacji reszt kwasu glutaminowego do reszt kwasu gamma-karboksyglutaminowego. Do bialek zaleznych od witaminy K zalicza sie osteokalcyne, bialka C, S, Z oraz czynniki krzepniecia krwi: II, VII, IX, X. Z tego powodu odpowiada ona za utrzymanie hemostazy oraz mineralizacje koścca. W przypadku niedoboru witaminy K wyzej wymienione bialka wystepują w formach niekarboksylowanych i nie spelniają swojej biologicznej funkcji. Ich pojawienie sie jest natomiast czulym wskaźnikiem niedoboru powyzszej witaminy. Chorzy na CF są zdecydowanie bardziej narazeni na wystąpienie osteopenii spowodowanej dlugotrwalym niedoborem witaminy K niz koagulopatii. W świetle dostepnej wiedzy, jej suplementacja wydaje sie niezbedna.

Streszczenie Wprowadzenie Mukowiscydoza (CF) w klasycznej postaci objawia sie nawracającym zapaleniem oskrzeli i pluc, niewydolnością zewnątrzwydzielniczą trzustki, podwyzszonym stezeniem chlorkow w pocie oraz nieplodnością meską. U 85–90% chorych na CF niewydolnośc zewnątrzwydzielnicza trzustki przejawia sie jako biegunka tluszczowa. Pacjenci wymagają suplementacji enzymatycznej oraz monitorowania jej efektywności. Cel pracy Określenie przydatności oznaczania wskaźnika kwaśnego steatokrytu (KS) w ocenie wydalania tluszczow w stolcu u chorych na CF. Material i metody Badaniami objeto 34 chorych na CF w wieku 7–30 lat. U wszystkich badanych oceniono wydalanie tluszczow w stolcu oraz wartośc wskaźnika KS. Wyniki Stezenie tluszczu w stolcu wynosilo 0,8–9,9% (Xśr±SEM: 4,9 ± 0,5%), wydalanie tluszczu w stolcu 0,1–16,1 g/dobe (4,8 ± 0,8 g/d), a wartośc KS 3,6–35% (19,7 ± 1,9%). Wykazano wystepowanie statystycznie istotnej korelacji pomiedzy wartością wskaźnika KS a stezeniem tluszczu w stolcu (r = 0,607; p Wnioski Kwaśny steatokryt moze byc przydatną metodą szacunkowej oceny stezenia tluszczow w stolcu, nie nadaje sie natomiast do oceny dobowej utraty tluszczow w stolcu u chorych na mukowiscydoze wydolnych trzustkowo oraz niewydolnych poddanych suplementacji enzymatycznej.

Since the vegetarian diet lacks the substrate for pancreatic elastase-1 as an enzyme, a decreased secretion of this enzyme could be expected. We aimed therefore to assess the changes of exocrine pancreatic secretion in a prospective way in a group of healthy omnivores who modified their diet by abstaining from meat for 1 month. Twenty healthy omnivores (fourteen females and six males) were used in the study. The nutrient intake was assessed for 7 d before commencing the study (omnivore diet) and after 1 month of dietary modification (modified diet; meat excluded). Similarly, the faecal output of pancreatic enzymes (elastase-1, chymotrypsin and lipase) was assessed before and 1 month after the period of dietary modification. Statistical differences between two points of the assessment (paired data) were calculated with the use of the Wilcoxon rank test. The relationship between the changes of faecal enzyme output and the changes in nutrient intake was assessed using multiple regression analysis. The dietary changes resulted in statistically significant decrease of faecal elastase-1 output (P

Nadmierna kolonizacja gornego odcinka przewodu pokarmowego przez bakterie określana jako zespol jelitowego przerostu bakteryjnego moze istotnie wplywac na funkcje i morfologie przewodu pokarmowego u chorych na mukowiscydoze. Z dostepnych danych wynika, ze problem ten moze dotyczyc 30–50% pacjentow. Do typowych objawow powyzszego zespolu nalezą: dyskomfort i wzdecia brzucha, bebnica oraz oddawanie gazow. Zwazywszy na typową brzuszną manifestacje mukowiscydozy objawy te mogą pozostac niezauwazone, jednakze wspomniany zespol moze istotnie zaburzac procesy trawienia i wchlaniania. Istnieją doniesienia o związku jelitowego przerostu bakteryjnego ze stanem zapalnym w obrebie przewodu pokarmowego. Z kolei stan zapalny jelit moze wywierac wplyw na ekspresje genow odpowiedzialnych za wytwarzanie i sekrecje śluzu w przewodzie pokarmowym. Wlaściwa diagnostyka i redukcja nadmiernej liczby bakterii w jelicie cienkim moze miec korzystny wplyw na funkcje przewodu pokarmowego i stan ogolny chorych na mukowiscydoze.

In inflammatory bowel diseases (IBD) diarrhea can be caused by exacerbation and/or infectious agents. Fecal calprotectin (FC) is a well-established biomarker of intestinal inflammation in IBD. However, its usefulness in depiction of IBD exacerbation from infectious diarrhea is limited. The value of fecal pyruvate kinase isoenzyme type 2 (M2-PK) in this application remains unknown.To compare the performance of M2-PK and FC in discriminating between diarrhea caused by IBD and infectious agents.One hundred three patients were enrolled for the study, including 32 with ulcerative colitis (UC), 21 with Crohn's disease (CD), 29 with acute diarrhea caused by rotavirus (AD-RV), and 21 with acute diarrhea caused by Salmonella enteritidis (AD-SE). M2-PK and FC were measured using ELISA. Areas under receiver operating characteristic curves (AUCs), sensitivities and specificities for both tests in distinguishing between patient subgroups with moderate to severe UC and CD from AD-RV and AD-SE were calculated.Differences in AUCs between M2-PK and FC for distinguishing UC [CD] from AD-RV were -0.06 (p0.028) [-0.10 (p0.0018)] and for differentiating UC [CD] from AD-SE were 0.03 (NS) [-0.19(p0.0011)].M2-PK sensitivities and specificities in distinguishing UC [CD] from AD-RV were 75.0%[71.4%] and 89.7% [89.7%] and for differentiation of UC [CD] from AD-SE were 56.3% [71.4%] and 95.2[57.1%].The performance of M2-PK in distinguishing between children with moderate-to-severe IBD and patients with infectious gastroenteritis was inferior to FC. Neither test had sensitivity ands pecificity sufficient for everyday clinical application.

Green tea is known worldwide for its beneficial effects on human health. However, objective data evaluating this influence in humans is scarce. The aim of the study was to assess the impact of green tea extract (GTE) on starch digestion and absorption. The study comprised of 28 healthy volunteers, aged 19 to 28 years. In all subjects, a starch 13C breath test was performed twice. Subjects randomly ingested naturally 13C-abundant cornflakes during the GTE test (GTE 4 g) or placebo test. The cumulative percentage dose recovery (CPDR) was significantly lower for the GTE test than for the placebo test (median [interquartile range]: 11.4% [5.5–15.5] vs. 16.1% [12.7–19.5]; p = 0.003). Likewise, CPDR expressed per hour was considerably lower in each point of the measurement. In conclusion, a single dose of green tea extract taken with a test meal decreases starch digestion and absorption.

Previously published studies have indicated that gastroesophageal reflux (GER) disease is common in pediatric patients with cystic fibrosis. The aim of the present study was to get insight into the incidence of GER and to characterize the nature of reflux episodes in children with cystic fibrosis. This was a multicenter, prospective study of children with cystic fibrosis older than 18 months. Forty four consecutive patients (22 boys, mean age 10.4 ± 3.6, range 3.0–17.8 years) were enrolled into the study. All patients underwent 24 h pH-impedance monitoring. GER were classified according to the widely recognized criteria as an acid, weakly acid, weakly alkaline, or proximal. The pH-impedance trace was considered abnormal when acid exposure was >6 %. GER was diagnosed in 24/44 (54.5 %) children. A total of 1585 (median 35, range 7–128) reflux episodes were detected; 1199 (75.6 %) were acidic, 382 (24.1 %) weakly acidic, and 4 (0.3 %) weakly alkaline. Six hundred and ninety-one (43.6 %) reflux episodes reached the proximal esophagus. In 14/44 patients typical GER symptoms were present. We conclude that the incidence of GER in children with cystic fibrosis is very high. In the majority of patients typical GER symptoms are absent. Therefore, diagnostic procedures should be considered, regardless of lacking symptoms. Although acid reflux episodes predominate in children with cystic fibrosis, classical pH-metry may not constitute a sufficient diagnostic method in this population because of a relatively high number of proximal reflux episodes. Such episodes also indicate an increased risk for aspiration. The pH-impedance diagnostic measurement is advocated when suspecting GER in children with cystic fibrosis.

Objective Conjugated linoleic acid (CLA) is known as a potent agent for altering body weight and composition. However, its effect on the process digestion is still unknown. The aim of this study has been to elucidate the effect of 3 month supplementation with CLA on starch and fat digestion and absorption in humans. Research methods & procedures The study included 74 obese and overweight adults who were randomized to receive daily 3.0g CLA or sunflower oil as placebo for 3 months. Digestion and absorption of fat and starch was assessed using non-invasive breath tests with a stable lsupg13l/supgC isotope (cumulative percentage dose recovery - CPDR) before and after the supplementation period. To exclude the effect of oxidation, in addition total energy expenditure (TTE) was measured by lsupg13l/supgC bicarbonate breath test. Results The changes in CPDR values (∆CPDR medianlinterquartile rangeg) were not different between subjects from CLA group and placebo group (fat: -0.2 l-9.1 4.1g vs. 0.6 l-7.0 8.0g, pl0.4796; starch: -1.3 l-9.5 2.4g vs. -1.0 l-5.1 1.7g, pl0.5520, respectively). The incidence of negative and positive values of ∆CPDR was not different between groups [for fat: 53.1% vs 46.7%, RR 1.138, (95 % CI 0.689-1.882) and for starch: 67.7% vs 56.7%, RR 1.195, (95 % CI 0.804-1.777)]. The changes of TTE did not differ between CLA and placebo group (respectively 1 l48; 267g vs. -8 l-120;93g kcal; pl0.2728). Conclusion Supplementation of CLA for three months did not affect fat and starch digestion assessed by lsupg13l/supgC mixed triglyceride breath test and lsupg13l/supgC starch breath test.

The etiology of altered blood fatty acid (FA) composition in cystic fibrosis (CF) is understood only partially. We aimed to investigate the determinants of serum glycerophospholipids’ FAs in CF with regard to the highest number of FAs and in the largest cohort to date. The study comprised 172 CF patients and 30 healthy subjects (HS). We assessed Fas’ profile (gas chromatography/mass spectrometry), CF transmembrane conductance regulator (CFTR) genotype, spirometry, fecal elastase-1, body height and weight Z-scores, liver disease, diabetes and colonization by Pseudomonas aeruginosa. The amounts of saturated FAs (C14:0, C16:0) and monounsaturated FAs (C16:1n-7, C18:1n-9, C20:1n-9, C20:3n-9) were significantly higher in CF patients than in HS. C18:3n-6, C20:3n-6 and C22:4n-6 levels were also higher in CF, but C18:2n-6, C20:2n-6 and C20:4n-6, as well as C22:6n-3, were lower. In a multiple regression analysis, levels of seven FAs were predicted by various sets of factors that included age, genotype, forced expiratory volume in one second, pancreatic status and diabetes. FA composition abnormalities are highly prevalent in CF patients. They seem to be caused by both metabolic disturbances and independent clinical risk factors. Further research into the influence of CFTR mutations on fat metabolism and desaturases’ activity is warranted.