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The Helicobacter pylori status of the population of Eastern European countries has not been explored despite the high incidence of peptic ulcer disease and gastric cancer observed in these countries. A seroprevalence study has been performed in Wroclaw, a city of Lower Silesia, Poland, to provide insight into this question. Sera were collected to obtain 50 subjects per 5 yr increment of age. A second generation ELISA kit with a high sensitivity and specificity was used. The results plotted by year of birth show a very high prevalence of H. pylori infection in all adults groups born before 1970 (80-100% positive). In the younger age groups, a dramatic decrease was observed. Because it is now known that most H. pylori infections are acquired in childhood (cohort effect), it can be predicted that the infection rate in the adult population will be much lower in the future compared with that presently observed, and it can be expected that evolution in H. pylori prevalence will have an impact on the rate of gastroduodenai diseases in Poland. Because of the high prevalence, it was not possible to identify risk factors for infection in this population. [ABSTRACT FROM AUTHOR]

Presents several abstracts on alimentary tract and abdominal organs. 'Endoscopic brush cytology of upper gastrointestinal tract lesions'; 'An evaluation of colorectal cytology'; 'DNA analysis in samples of FNA from liver masses.'

Background: Vedolizumab is a gut-selective anti-lymphocyte trafficking agent used to treat ulcerative colitis (UC) and Crohn's disease., Objectives: We aimed to evaluate the effectiveness, safety, and durability of the therapeutic effect of vedolizumab after treatment discontinuation in a real-world cohort of patients with UC treated in Poland., Design: This was a multicenter, prospective study involving patients with moderate to severely active UC from 12 centers in Poland who qualified for reimbursed treatment with vedolizumab between February and November 2019., Methods: The primary endpoints were clinical response (⩾2-point improvement from baseline on partial Mayo score) and clinical remission (partial Mayo score 0-1), including steroid-free remission, at week 54. Other outcomes included response durability at 26 weeks after treatment discontinuation, identification of predictors of response and remission, and safety assessment., Results: In all, 100 patients with UC were enrolled (55 biologic naïve and 45 biologic exposed). At baseline, 68% of patients were on corticosteroids and 45% on immunomodulators. Clinical response was observed in 62% of patients, clinical remission in 50%, and steroid-free remission in 42.6% at week 54. Within 26 weeks after treatment discontinuation, 37% of patients who maintained response by week 54 relapsed. The decreased number of liquid stools and rectal bleeding and endoscopic response at week 14 were predictive factors for response at week 54. Time from diagnosis ranging 2-5 years, decreased stool frequency, and non-concomitant use of corticosteroids at baseline and at week 14 were predictive factors for remission at week 54. Partial Mayo score < 3 with no subscale score > 1 at week 54 was a predictive factor for durable response after treatment discontinuation. The rate of serious adverse events related to treatment was 3.63 per 100 patient-years., Conclusion: Vedolizumab is effective and safe in UC treatment in Polish patients. However, the relapse rate after the treatment cessation was high., Registration: ENCePP (EUPAS34119)., Competing Interests: Piotr Eder received lecture fees and/or travel grants from Takeda, Ferring, Astellas, Pfizer, and Janssen. Maria Kłopocka has received payment for lectures from Janssen, Takeda, Ferring, Alfa-Sigma, and Pharmabest and travel/accommodation/meeting expenses from Ferring, Janssen, Takeda, Alfa-Sigma, and Pharmabest. Renata Talar-Wojnarowska received lecture fees and/or travel grants from Abbvie, Alfasigma, Astellas, Ferring, Janssen, Pfizer, and Takeda. Rafał Filip served as a speaker for Gramineer International AB, Egis, Ferring, Janssen, and Takeda; received investigational grants from Gramineer International AB, and Egis; and received support for traveling and congress assistance from MSD, Abbvie, Egis, Takeda, and Ferring. Katarzyna Waszak received payment for travel/accommodation/meeting expenses from Janssen-Cilag, Pfizer, Pro.Med.CS, Samsung Bioepis, and Takeda Pharma. Kamila Stawczyk-Eder received travel grants and lecture fees from Janssen, Pfizer, and Takeda. Ariel Liebert received payment for lectures from Janssen, Takeda, Egis, Abbvie, and Pharmabest, and travel/accommodation/meeting expenses from Janssen, Takeda, Egis, and Abbvie. Hubert Zatorski gave scientific advice to Takeda. Anna Solarska-Półchłopek received lecture fees and travel grants from Janssen. Aleksandra Kaczka received lecture fee(s)/travel/accommodation/meeting expenses from Takeda, Janssen-Cilag, Biogen, Astellas, and Alfa-Sigma. Krzysztof Wojciechowski and Szymon Drygała are permanent employees of Takeda Pharma sp. z o.o. Krzysztof Wojciechowski is now an employee of: Independent Public Health Care Center in Tarczyn, Warszawska 42, Tarczyn, Poland. Edyta Zagórowicz received lecture fees from Janssen, Sandoz, Ferring, and Pfizer; consultancy fees from Pfizer, Janssen, and Takeda; and other compensations from Takeda and Janssen. The remaining authors disclose no conflicts of interest., (© The Author(s), 2023.)

Bad breath is a clinical symptom encountered by doctors of various specialties in their daily practice. The symptom causes lower self-esteem and a negative perception of the patient by society, and consequently personal and social isolation. Bad breath can be an early manifestation of many systemic diseases. Because its causes are numerous, it is important to properly diagnose the condition and apply the appropriate treatment. The aim of the study was to present the gastroenterological aspect of halitosis on the basis of available literature reports., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Termedia.)

Inflammatory bowel diseases (IBD) are chronic and relapsing disorders usually requiring numerous medical imaging. IBD patients might be exposed to a large dose of radiation. As a cumulative effective dose (CED) ≥ 50 mSv is considered significant for stochastic risks of cancer, it is important to monitor the radiation exposure of IBD patients. In the present work, we aimed to quantify the mean CED in IBD patients and identify factors associated with exposure to high doses of diagnostic radiation. A retrospective chart view of patients with IBD hospitalized between 2015 and 2019 was performed. A total of 65 patients with Crohn's disease (CD) and 98 patients with ulcerative colitis (UC) were selected. Of all imaging studies performed, 73% were with doses of ionizing radiation. Mean CED (SD) amounted to 19.20 (15.64) millisieverts (mSv) and 6.66 (12.39) mSv, respectively, in patients with CD and UC ( p < 0.00001). Only 1.84% of the patients received CED ≥ 50 mSv. We identified three factors associated with CED in the IBD patients: number of surgical procedures, and number and length of hospitalization. CD patients with strictures or penetrating disease and UC patients with extensive colitis were more likely to receive higher radiation doses.

P-glycoprotein encoded by the ABCB1 gene constitutes a molecular barrier in the small and large bowel epithelium, and its different expression may influence susceptibility to inflammatory bowel disease (IBD). We aimed to assess the contribution of the C3435T polymorphism to disease risk in the Polish population. A total of 100 patients (50 Crohn's disease (CD), 50 ulcerative colitis (UC)) and 100 healthy controls were genotyped for the single nucleotide polymorphism (SNP) C3435T by using the PCR-RFLP method. Patients were classified on the basis of disease phenotype and the specific treatment used. A meta-analysis was carried out of our results and those from previously published Polish studies. There was no significant difference in allele and genotype frequencies in IBD patients compared with controls. For CD patients, a lower frequency of TT genotype in those with colonic disease, a lower frequency of T allele, and a higher frequency of C allele in those with luminal disease were observed, whereas for UC patients, a lower frequency of CT genotype was observed in those with left-sided colitis. A meta-analysis showed a tendency towards higher prevalence of CC genotype in UC cases. These results indicate that the C3435T variants may confer a risk for UC and influence disease behaviour.

Inflammatory bowel disease (IBD) is a chronic condition affecting primarily the gastrointestinal tract and characterized by growing incidence worldwide. Complex diagnostic process of IBD as well as evaluation of disease activity and intestinal complications that are crucial for the therapeutic decisions, require repetitive, invasive, expensive, time-consuming and poorly tolerated tests. In contrast to endoscopy and computed tomography, ultrasound elastography (UE) is non-invasive, non-radiating and non-contrasting dependent tool which might be utilized in IBD patients for the assessment of the intestinal changes. Therefore, we performed the systematic review to evaluate the possible application of the ultrasound elastography for assessment of the intestinal changes in IBD. After the search of three databases: PubMed, World of Knowledge and Scopus, we identified 12 papers which were included in the final analysis. The majority of the studies were focused on the evaluation of the symptomatic ileal/ileocolonic strictures in Crohn's disease patients that required surgical resection. Only one study concerned ulcerative colitis. The authors evaluated different UE techniques: strain elastography (SE), acoustic radiation force impulse (ARFI) and shear wave elastography (SWE). Results were expressed with semi-quantitative color mapping and strain measurement. Histological scores of inflammation and fibrosis in Crohn's disease were used as a reference test in the majority of studies. Ultrasound elastography seems to be a promising novel imaging technique supporting evaluation of the intestinal strictures in Crohn's disease patients in respect to fibrosis detection as well as differentiation between fibrosis and inflammation. However, further research is needed to establish the position of ultrasound elastography in IBD management.

Background: Vedolizumab, a humanized antibody targeting the α 4 β 7 integrin, was proven to be effective in the treatment of moderate-to-severe ulcerative colitis (UC) in randomized clinical trials. The aim of the POLONEZ study is to determine the demographic and clinical characteristics of the patients with UC treated with vedolizumab within the scope of the National Drug Program in Poland and to assess the real-world effectiveness and safety of vedolizumab in the study population. Here we report the demographic and clinical characteristics of these patients., Methods: This prospective study included adult patients eligible for UC treatment with vedolizumab who were recruited from 12 centers in Poland between February and November 2019. Collected data included sex, age, disease duration, presence of extraintestinal manifestations or comorbidities, status of previous biologic treatment, and current concomitant treatment. Disease extent was determined according to the Montreal classification, and disease activity was measured with the Mayo Score., Results: A total of 100 (55 biologic-naïve and 45 biologic-exposed) patients were enrolled in the study (51% female, median age 35 years). Among biologic-exposed patients (mostly infliximab-treated), 57% had failed to respond to the therapy. The disease duration was significantly shorter in biologic-naïve (median 5 years) than in biologic-exposed (8 years, p  = 0.004) or biofailure patients (7 years, p  = 0.04). In the overall population the median Total Mayo Score was 10. Disease extent and activity were similar between the subgroups., Conclusions: Our study indicates that patients treated with vedolizumab in Poland receive the drug relatively early after UC diagnosis, but their disease is advanced. More than half of the patients had not been treated with biologic drugs before initiating vedolizumab. The study was registered in ENCePP database (EUPAS34119)., Lay Summary: Characteristics of patients treated for ulcerative colitis with vedolizumab in Poland Treatment of moderate-to-severe ulcerative colitis (UC) with the integrin antagonist vedolizumab became available within the Polish National Drug Program (NDP) in 2018. In this study, for the first time, we provide detailed demographic and clinical characteristics of 100 patients (median age 35 years, 51% female) treated with vedolizumab in Poland, of whom 55 were biologic-naïve and 45 biologic-exposed. The median duration of disease was 6 years. The disease duration was shorter in biologic-naïve than in biologic-exposed patients. Most patients were affected by extensive colitis (52%) or left-sided colitis (42%). Median disease activity was 10 according to the Total Mayo Score. Sixty-eight patients received concomitant systemic corticosteroids and 45 patients received immunomodulators. Our findings indicate that Polish patients receiving vedolizumab have a high disease activity and are treated relatively early after UC diagnosis. This might be due to the criteria for inclusion of a patient in the NDP., Competing Interests: Conflict of interest statement: Piotr Eder received lecture fees and/or travel grants from Takeda, Ferring, Astellas, Pfizer, and Janssen. Kamila Stawczyk-Eder received travel grants and lecture fees from Janssen, Pfizer, and Takeda. Renata Talar-Wojnarowska received lecture fees and/or travel grants from Abbvie, Astellas, Ferring, Janssen, and Takeda. Hubert Zatorski gave scientific advice to Takeda. Anna Solarska-Półchłopek received lecture fees and travel grants from Janssen. Rafał Filip served as a speaker for Gramineer International AB, Egis, Ferring, Janssen, and Takeda; received investigational grants from Gramineer International AB, and Egis; and received support for traveling and congress assistance from MSD, Abbvie, Egis, Takeda, and Ferring. Maria Kłopocka has received payment for lectures from Janssen, Takeda, Ferring, Alfa-Sigma, and Pharmabest and travel/accommodation/meeting expenses from Ferring, Janssen, Takeda, Alfa-Sigma, and Pharmabest. Ariel Liebert received payment for lectures from Janssen, Takeda, Egis, Abbvie, and Pharmabest and travel/accommodation/meeting expenses from Janssen, Takeda, Egis, and Abbvie. Aleksandra Kaczka received lecture fee(s)/travel/accommodation/meeting expenses from Takeda, Janssen‑Cilag, Biogen, Astellas, and Alfa-Sigma. Krzysztof Wojciechowski and Szymon Drygała are permanent employees of Takeda Pharma Sp.z.o.o. Edyta Zagórowicz received lecture fees from Janssen, Sandoz, Ferring, and Pfizer; consultancy fees from Pfizer, Janssen, and Takeda; and other compensations from Takeda and Janssen. The remaining authors disclose no conflicts of interest., (© The Author(s), 2021.)

Background and Aims: Adenoma detection rate (ADR) in colon cancer screening is most important for cancer prophylaxis. This work is the first three-armed randomised controlled clinical trial aimed at comparing a head-to-head setting standard colonoscopy (SC) with Endocuff-assisted colonoscopy (EC) and cap-assisted colonoscopy (CAC) for improvement of ADR., Methods: Patients from Poland and Germany with independent indication for colonoscopy were randomised into three arms of this trial: EC, CAC and SC. Exclusion criteria were age <18 years, active Crohn's disease or ulcerative colitis, known stenosis and post-colonic resection status., Results: A total of 585 patients (195 SC, 189 EC and 186 CAC) were enrolled in this study. Indications were not different between the groups (colorectal cancer screening 51%, diagnostic colonoscopy in 31% and post-polypectomy follow-up in 18%; p = 0.94). Withdrawal time was a mean of 7 min in all groups (p = 0.658), and bowel preparation did not differ between the groups. The time to reach the caecum was significantly reduced when using the cap (a mean of 6 min for CAC vs. 7 min for SC; p = 0.0001). There was no significant difference in the primary outcome of the ADR between the groups (EC 32%, CAC 30%, SC 30%; p = 0.815). EC proved to be superior (EC vs. SC) in the sigmoid colon and transverse colon for polyp detection., Conclusion: The use of EC increased the total number of polyps seen during colonoscopy. In contrast to recent studies, no significant improvement of the ADR was detected., (© 2020 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology.)

Diabetes is a metabolic disease leading to the development of numerous health complications. In developed countries, it is the main cause of blindness, end-stage renal disease, and non-traumatic amputation of the lower limbs. Neuropathy is the most common chronic complication of diabetes. A long-term course of a metabolically unbalanced disease causing damage to the autonomic nervous system of the digestive tract results in the development of many complications, such as intensification of gastro-oesophageal reflux disease, gastroparesis, chronic diarrhoea or faecal incontinence., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2020 Termedia Sp. z o. o.)

Background: Non-alcoholic fatty liver disease (NAFLD) is becoming the most common cause of chronic liver disease worldwide, affecting up to 30% of population. Non-alcoholic fatty liver disease can lead to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma. Age, obesity, insulin resistance, type 2 diabetes, and dyslipidemia are important risk factors for developing hepatic steatosis. Concomitant diseases, especially cardiovascular, are discussed as important causes of death in NAFLD patients., Objectives: The objective of this study was to conduct a retrospective comparison of the frequency of concomitant diseases in NAFLD patients and controls, especially metabolic syndrome and cardiovascular disease (CVD)., Material and Methods: A total of 1,058 (558 NAFLD patients and 500 controls). Diagnosis of NAFLD was established with ultrasound examination in the absence of other causes of fatty liver. The control group included patients with no history of liver disease, normal liver image in ultrasound examination and normal liver laboratory tests., Results: Overweight and/or obesity were diagnosed in 80.8% of patients in the study group and 40.8% in the controls (p < 0.001). Metabolic syndrome was present in 48.7% patients in the study group compared with 14.4% controls, (p < 0.001). In the study group, we found higher prevalence of hypertension (56.1% vs 37%; p < 0.001), type 2 diabetes mellitus (24.4% vs 8.6%; p < 0.001), decreased concentration of serum HDL (35.1% vs 19.5%; p < 0.001), elevated serum triglycerides (36.5% vs 15.4%; p < 0.001). Cardiovascular disease was found in 13.6% of individuals in the study group and in 15% controls (NS, p = 0.32). The most frequent concomitant gastrointestinal disease present in the study group was gastroesophageal reflux disease (GERD) (31.9% vs 22.8%; p < 0.001) followed by colonic diverticulosis (23.7% vs 15.8%; p < 0.005)., Conclusions: Metabolic syndrome with its components is more common in NAFLD patients compared to matched controls. Additionally, NAFLD patients are more often affected by GERD and colonic diverticulosis but not by CVD.

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease which becomes a rapidly growing health problem in the Western countries. The development of the disease is most often connected to obesity. NAFLD is also considered as the hepatic manifestation of metabolic syndrome. Transforming growth factor b1 (TGF-b1) plays an important role in the pathogenesis of liver fibrosis, being involved in activation of hepatic stellate cells, stimulation of collagen gene transcription, and suppression of matrix metalloproteinase expression. The objective of the study was to evaluate by immunohistochemistry the expression of TGF-b1 in the liver tissue of NAFLD patients and correlate it with anthropometric, biochemical and routine histological parameters., Material and Methods: The study group consisted of 48 patients with diagnosed NAFLD. Liver steatosis, NAFLD Activity Score (NAS) and METAVIR score of fibrosis were evaluated in liver biopsies. The immunoreactivity of TGF-b1 was evaluated semi-quantitatively separately in portal, septal, lobular hepatocytic and lobular sinu-soidal liver compartments. The results were analyzed in regard to patients' clinical and biochemical parameters., Results: Neither steatosis nor NAS correlated with TGF-b1 expression in any liver compartment, whereas METAVIR score of fibrosis was associated with increased immunoreactivity of TGF-b1 in most of the studied liver compartments. TGF-b1 immunoreactivity showed positive correlation with patients' age and its expression in septal compartment disclosed positive correlation with body mass index, and waist and hip circumference. Hyaluronic acid serum level was positively and iron concentration was negatively associated with TGF-b1 ex-pression in the selected consecutive liver compartments., Conclusions: The immunohistochemical expression of TGF-b1 may be complementary to routine methods of liver fibrosis evaluation.

Aim: Multi-organ dysfunction often complicates the natural course of acute heart failure (AHF) and identifies patients with poor prognosis. The MELD score (Model of End-Stage Liver Dysfunction) combines data reflecting liver and kidney function, which makes it a potentially useful tool for the assessment of patients with AHF. The aim of this study was to assess the prognostic utility of the MELD score in patients with AHF., Methods and Results: The MELD score was calculated on admission and during hospital stay (days 2-3) using a formula that does not take into account the international normalized ratio (MELD XI). The study population consisted of 203 AHF patients (mean age 65 ± 12 years, 76% male). The mean MELD XI score was -14.8 ± 4.5 points on admission and 13.9 ± 4.3 points during hospitalization. Contributors of elevated MELD XI score at baseline and during hospital stay were isolated increase in creatinine in 22-25%, isolated increase in bilirubin in 17-19%, and abnormal values of both in 40-46% of patients. During 1-year follow-up, 67 (33%) patients died. After adjustment for well-established prognosticators, MELD XI score at baseline and during hospital stay were significant predictors of poor outcome [hazard ratio (95% confidence interval): 1.11 (1.05-1.2) and 1.14 (1.09-1.2), respectively, P < 0.001]. An increase in the MELD XI score during hospital stay occurred in 31% of patients and was related to increased risk of death at 1 year [1.97 (1.2-3.2), P < 0.005]., Conclusions: Impairment of hepato-renal function defined by the MELD XI score is common and carries unfavourable prognosis in AHF patients., (© 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.)

One of the susceptibility genes in Crohn's disease (CD) is CARD15. Our study examined the relationship between peripheral CARD15 expression and phenotype and duration of CD, treatment methods and inflammatory indices. Sixty patients with CD and 30 healthy volunteers as controls were enrolled in the study. Total RNA was isolated from peripheral blood mononuclear cells (PBMCs) with E.Z.N.A. Total RNA Kit (Omega Bio-tek) then quantitative real-time PCR was performed on the ABI Prism 7900 HT Real-Time PCR System. CARD15 gene expression in PBMCs in CD was significantly higher than in the control group. The highest level of gene expression was found in CD patients in the fourth decade of life. The mRNA level of the CARD15 gene was higher in patients with disease duration between 12 and 60 months. A positive correlation was found between erythrocyte sedimentation rate (ESR) and gene expression level. Gene expression increased with increasing level of C-reactive protein and ESR, but it was not statistically significant. CARD15 expression significantly decreased in CD patients treated with anti-TNFα agents compared to azathioprine or steroid treatment groups. Expression of the CARD15 gene in Crohn›s disease is higher than in healthy individuals. Disease duration and age of patients seem to be the most important factors influencing CARD15 expression.

Background: Non-alcoholic fatty liver disease (NAFLD) is a very common chronic liver condition which may potentially develop into fibrosis and cirrhosis. Liver biopsy is still the gold standard for liver fibrosis detection in these patients. However, non-invasive tools for liver assessment in NAFLD patients, like the (13)C-methacetin breath test, may be useful., Objectives: The aim of the study was to evaluate the utility of the (13)C-methacetin breath test in NAFLD patients, especially in predicting significant fibrosis., Material and Methods: Thirty three patients (24 male and 9 female (average age 47.9)) with histologically proven NAFLD had the (13)C-methacetin breath test performed., Results: Different forms of NAFLD were found during the histology phase, from simple steatosis to advanced fibrosis. Simple steatosis (SS) was found in 18 subjects (54.5%), in another 15 (45.5%) signs of inflammation and fibrosis (NASH) were observed. However, more than half of the patients with liver fibrosis had only minimal changes described (0/1). The sensitivity of the test was highest for cumulative recovery after 10 min of the test and for a combination of two parameters (the cumulative recovery after 40 min and the time of maximal momentary recovery). The positive predictive value was low for all the parameters under consideration, but the negative predictive value was over 0.8 in significant fibrosis detection., Conclusions: The (13)C-methacetin breath test could be a promising noninvasive tool for excluding at least F1 fibrosis in NAFLD patients.

Introduction: In recent years the failure of standard therapy for Helicobacter pylori infections has been observed, which results primarily from the increasing resistance of H. pylori strains to antibiotics. The aim of the study was to estimate the prevalence of antimicrobial resistance of H. pylori strains isolated from adult symptomatic patients with primary infection in the Lower Silesia Region in Poland., Material and Methods: One hundred and seventy-eight adults aged 19-89 years with dyspeptic symptoms suggesting gastroduodenal pathology were enrolled in the study. The study was performed in the years 2008-2011. Fifty H. pylori strains were isolated from gastric biopsy samples of examined patients. Antimicrobial susceptibility to 6 drugs (amoxicillin (AM), clarithromycin (CH), metronidazole (MZ), tetracycline (TC), levofloxacin (LEV), and rifabutin (RB)) was tested by the gradient-diffusion method (E-test method)., Results: The incidence of H. pylori infection among examined patients was 35%. From 50 isolated H. pylori strains, 24% showed resistance to CH, 42% to MZ and 8% to LEV alone. Multidrug resistance was detected in 26% of strains, whereas 20% of isolates were resistant to MZ and CH. Examined strains were fully susceptible to AM, TC and RB., Conclusions: Resistance to clarithromycin strains isolated from adults of the Lower Silesia Region in Poland is high and is almost always associated with resistance to metronidazole (CH + MZ). It is necessary to continuously monitor H. pylori resistance to drugs used in therapy, especially to clarithromycin. Verification of the existing recommendations of eradication therapy is also needed.

The resistance of microorganisms to antibiotics has become a serious issue in recent years in the therapy of bacterial infections. This problem also concerns the treatment of infections caused by Helicobacter pylori strains. The aim of this study was to evaluate the frequency of primary resistance of H. pylori strains isolated from children and adults. The subject of the research was 105 strains of H. pylori isolated from children and 60 strains from adults in the Lower Silesia Region in the years 2008-2011. Antimicrobial susceptibility to the following antibiotics was assessed: amoxicillin (AC), clarithromycin (CH), metronidazole (MZ), tetracycline (TC), levofloxacin (LEV) and rifabutin (RB). Among the strains isolated from children, 33.3% were resistant to CH, 44.8% to MZ whereas 1.9% of strains were resistant simultaneously to CH, MZ and LEV. Among 60 strains isolated from adults, 23.3% were resistant to CH, 66.7% to MZ, and 6.7% to LEV. Moreover, 16 multidrug resistant strains were isolated from adults, including 12 resistant to CH and MZ, 3 to MZ and LEV, and 1 to CH, MZ and LEV. All examined strains were susceptible to AC, TC and RB. The high incidence of resistance to CH and MZ suggests that standard triple therapies may not be useful as first-line treatment in Poland without earlier susceptibility testing.

Colorectal cancer is one of the most common malignancies in Europe and North America. Colonoscopy done every 10 years beginning at age 50 is the preferred method of screening. In Poland and some other countries examinations are offered to subjects free of charge. However, as well as direct medical costs there are direct non-medical costs, which include the cost of transportation and costs related to caregivers' time, and indirect costs, which are costs related to patients' time. These costs essentially augment the total societal costs of colonoscopy.

Anemia is one of the most common extraintestinal symptoms of inflammatory bowel disease (IBD). The pathophysiology of anemia in IBD is complex. It may be developed in the course of inflammation, intestinal bleeding or disorders of iron absorption. Hepcidin, discovered in the year 2000, is an endogenous peptide responsible for iron homeostasis. Recent data suggests that hepcidin is a major mediator of anemia and plays a central role in iron homeostasis and metabolism. This paper presents information about hepcidin structure and function, mechanisms of the regulation of the synthesis and current data about the role of this hormone in IBD-related anemia. Assessment of hepcidin levels in patients with IBD may become a key element in the treatment of anemia in the near future.

H. pylori was isolated from the gastric mucosa in 1140 (52.4%) cases out of 2177 subjects receiving endoscopic examination because of gastric and/or duodenal diseases. The frequency of H. pylori isolation amounted to 38.1% in children and 57.4% in adults. The frequency of H. pylori isolation was the highest in duodenal ulcer disease (76%) and the lowest in subjects with normal gastric mucosa (10% and 20% in children and adults, respectively). Elevated levels of IgA anti-H. pylori antibodies were found in children (93%) and adults (97%) with H. pylori-positive isolates, as well as in children (20%) and adults (26%) with normal gastric mucosa and H. pylori-negative isolates. The frequency of H. pylori infection was found to increase with patient's age, and was the highest in patients aged between 31 and 50 years.

The study involved 196 H. pylori strains and 196 serum samples taken from the same patients. H. pylori strains were investigated for the production of vacuolating cytotoxin. Antibodies to the vacuolating cytotoxin produced by H. pylori were detected in the sera samples by neutralisation assay (on Intestine 407 cells) and ELISA. Of the 196 H. pylori strains tested, 80 (40.8%) were found to express vacuolating cytotoxic activity. The titres of cytotoxic nonconcentrated broth culture filtrates ranged from 1:2 to 1:128. The vacuolating assay was positive in 37.1% strains isolated from children, and in 50% strains isolated from adults. Cytotoxin-positive H. pylori strains were found more frequently in duodenal ulcer (71%) than in chronic gastritis (35.2%) patients, and this difference was statistically significant p < 0.05. Neutralising antibodies to vacuolating cytotoxin were present in 51% and 49% of the serum samples tested by neutralisation and ELISA, respectively. Duodenal ulcer patients had antibodies to vacuolating cytotoxin more frequently (p < 0.05) than chronic gastritis patients. Antibodies to cytotoxin were detected in the serum samples from patients infected by cytotoxic (100%) and noncytotoxic (18%) H. pylori strains.

The study involved 196 H. pylori strains and 196 serum samples taken from the same patients. H. pylori strains were investigated for the production of vacuolating cytotoxin. Antibodies to the vacuolating cytotoxin produced by H. pylori were detected in the sera samples by neutralisation assay (on Intestine 407 cells) and ELISA. Of the 196 H. pylori strains tested, 80 (40.8%) were found to express vacuolating cytotoxic activity. The titres of vacuolating cytotoxic were ranged from 1:2 to 1:128. The vacuolating assay was positive in 37.1% strains isolated from children, and in 50% strains isolated from adults. Cytotoxin-positive H. pylori strains were found more frequently in duodenal ulcer (71%) than in chronic gastritis (35.2%) patients, and this difference was statistically significant p<0.05. Neutralising antibodies to vacuolating cytotoxin were present in 51% and 49% of the serum samples tested by neutralisation and ELISA, respectively. Duodenal ulcer patients had antibodies to vacuolating cytotoxin more frequently (p<0.05) than chronic gastritis patients. Antibodies to cytotoxin were detected in 100% of the serum samples from patients infected by cytotoxic H. pylori strains. This suggests that the presence of anticytotoxic antibodies in the serum samples may be regarded as a sensitive indicator of infection by cytotoxic H. pylori strains.

In older patients involution processes are observed. Frequency of H. pylori infection has been related of histopathological changes of gastric mucosa in patients over 65 yrs old. In 73% of analyzed patients gastritis atrophica has been documented.

Broth culture supernatants from 14 (34%) out of the 41 H. pylori strains tested, induced vacuolization in Intestine 407 cells in titers ranging from 1:2 to 1:64. 20% of H. pylori strains isolated from children and 42% of strains isolated from adults expressed vacuolating activity. Serum antibody to cytotoxin produced by H. pylori was detected with a neutralization assay. Anticytotoxic antibodies were present in all sera from patients infected with cytotoxic H. pylori strains. The toxin-neutralizing activity of sera from individuals infected with H. pylori suggests that the cytotoxin is produced in vivo.

Treatment with the proton pump inhibitor (omeprazole) and single antibiotic (amoxycillin), two synergistic compounds, can cure Helicobacter pylori (H. pylori) infection, but this therapy is not as effective as had been expected. However, some studies show promising results. The aim of our study was to evaluate the effect of two weeks dual-therapy with omeprazole (O) and amoxycillin (A) on gastric (GU) and duodenal ulcer (DU) patients: ulcer healing, eradication of the H. pylori and recurrence rate of the ulcer. We studied 216 patients (aged 18-70) endoscopically proven GU (58 patients) and DU (158 patients). Rapid urease test from the two antrum biopses and two antral and two corporeal biopses using Giemsa stain method for confirmation of the H. pylori infection were used. The patients were treated with omeprazole 20 mg BID and amoxycillin 1.0 g BID for 2 weeks and investigated every 4 months during 2 years. Clearance effect of Hp infection was achieved in 65.1% GU and 66.4% DU patients. Eradication ("check point" after 4 months) in 43% DU and 56.6% GU patients was confirmed. Reinfection rate was found in 16% during 2 years. We conclude--dual-therapy (O and A) is not sufficiently effective to be recommended as an anti-H. pylori treatment. H. pylori eradication prevents recurrence of peptic ulcer and is an important issue in attempts to achieve permanent ulcer healing.

In order to find an objective marker of disease intensity, neutrophil elastase activity was determined in patients with ulcerative colitis. The study included 41 patients with ulcerative colitis who were divided into two groups depending on tge stage of the disease on the basis of the activity index according to Maier et al. The obtained results of studies were compared a group of 18 healthy persons. The values of neutrophil elastase activity in the patients and in the control group were subjected to statistical analysis. It was found that neutrophil elastase activity in the patients with high degree of disease intensity was lower than that in the patients with low degree of disease intensity and in healthy subjects. The obtained differences were statistically significant. From the results of the study the conclusion was drawn that the neutrophil elastase activity may be an indicator of ulcerative colitis activity.

The purpose of the work was a comparison of the incidence of Helicobacter pylori (HP) infections in persons with dyspeptic symptoms of non-ulcer dyspepsia (NUD) character in relation to the presence or absence of duodenogastric reflux (DGR). The study included 80 patients aged from 17 to 80 years, 21 males and 59 females. In all studied patients endoscopy of upper digestive tract segment was performed with biopsy specimen taking for microbiological investigations. From each patient two biopsy specimens were taken from the prepyloric part and the fundus. The specimens were subjected to a microbiological analysis using the rapid urease test, culturing, and direct preparation. The presence of duodenogastric reflux was evaluated during endoscopy. In persons with diagnosed NUD and duodenogastric reflux, lower incidence of HP infections was found than in patients with the same diagnosis but without the reflux.