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Crohn's disease is a chronic inflammatory disease that affects the full length of the digestive tract. The precise aetiology is still unknown, but genetic, environmental, and immunologic factors are involved. The aim of this article is to summarize the current susceptibility genes and gene polymorphisms involved in the disease pathogenesis and clinical course. In recent studies an association was found between FUT2, ATG16L-1, IL-10, TLR, and NOD2 gene mutations and Crohn's disease. Each of them may affect the disease at a different stage of immune response, are involved in bacterial identification, or are related to bacterial dysbiosis. We present their effect of disease susceptibility, age of onset, severity, risk of surgery, and concomitant infections. Further research in this area may prove useful in early diagnosis, prognosis, and treatment of Crohn's disease. [ABSTRACT FROM AUTHOR]

Copyright of Paediatrics & Family Medicine / Pediatria i Medycyna Rodzinna is the property of Medical Communications Sp. z o.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Forum Zaburzen Metabolicznych is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Polish Journal of Wound Management / Leczenie Ran is the property of Evereth Publishing Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Despite progress in the pharmacological treatment of inflammatory bowel diseases (IBD), surgery is still an integral part of the treatment of ulcerative colitis and Crohn's disease. The probability of adverse effects of the procedure in this group of patients is related to the specificity of IBD and depends on modifiable and non-modifiable risk factors. Optimization of health must therefore rely on a multi-directional and individualized approach to a patient. Proper preparation of the patient for surgery consisting in nutritional and psychological support, improvement of physical efficiency and encouragement to give up addictions can bring a real benefit in improving the treatment results. The paper discusses the principles, benefits and limitations of the use of elements of prehabilitation in the surgical treatment of patients with IBD. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Laboratory Diagnostics / Diagnostyka Laboratoryjna is the property of Index Copernicus International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The prevalence of Crohn's disease amounts to 5.9 cases per 100,000 population. Complications such as intestinal strictures usually occur within a long course of Crohn's disease. Intestinal resection for stricture does not prevent a stricture recurrence and the need for repeated resections, which in turn leads to the formation of short intestine syndrome. The advantage of endoscopic balloon dilatation is organ preservation and a quick clinical therapeutic effiect. However, the frequency of recurrences after conventional endoscopic balloon dilatation of the intestinal stricture in Crohn's disease is still at a relatively high level and amounts to 59%, which justifies the need to improve the endoscopic dilatation technique. Aim: The aim of this study to improve the treatment effectiveness for intestinal strictures in Crohn's disease using endoscopic balloon dilatation combined with prednisolone injection in the stricture area. Materials and methods: Endoscopic treatment for intestinal strictures in Crohn's disease was performed in 64 patients. Depending on the endoscopic technique, patients were randomized into 2 groups. The first group consisted of 32 (50%) patients who underwent conventional endoscopic balloon dilatation of strictured areas. The second group consisted of 32 (50%) patients in whom an endoscopic balloon dilatation in combination with submucosal injection of prednisolone to the area of stricture after dilatation was performed. Patient groups were comparable in age, sex and length of stricture. Results and conclusions: The results showed that endoscopic balloon dilatation with administration of 40 mg of prednisolone in group II patients was more effective compared to conventional balloon dilatation. The recurrence rate was reduced from 34.4% to 9.3%. The risk of recurrence of intestinal stricture in group I during the first year of observation was found to be 4.5 times higher - HR = 4.5 (1.6-12.9); P = 0.010. The effectiveness of advanced endoscopic balloon dilatation for intestinal strictures was confirmed by colonoscopy with patomorphological examination of the intestinal mucosa 6 months after dilation in patients of both groups. [ABSTRACT FROM AUTHOR]

Wstęp. Choroba Leśniowskiego-Crohna jest chorobą zapalną jelit o nieznanej etiologii. Rozpoznana zostaje najczęściej u dzieci oraz nastolatków. Do objawów charakterystycznych dla choroby należą bóle brzucha, oddawanie biegunkowych stolców często z obecnością patologicznych domieszek: krwi, ropy czy śluzu, a także ubytek masy ciała. Podstawowym krokiem w procesie terapeutycznym jest nawodnienie dziecka drogą dożylną lub doustną, włączenie farmakoterapii oraz leczenia żywieniowego. Celem wdrożonej terapii jest utrzymanie pacjenta w jak najdłużej trwającej remisji. Cel. Praca ma na celu ukazać problemy opiekuńcze oraz terapeutyczne u dziecka z zaostrzeniem choroby Leśniowskiego-Crohna w warunkach szpitalnych oraz zadania personelu pielęgniarskiego wobec tego pacjenta. Prezentacja przypadku. Pacjentka lat 15 w drugiej dobie hospitalizacji przyjęta w oddział z podejrzeniem zaostrzenia choroby Leśniowskiego-Crohna. Pacjentka zgłasza liczne biegunki (od 10 do 15 wypróżnień na dobę) oraz ból brzucha. Przy przyjęciu temperatura ciała pacjentki wynosiła 38,4°C. Dziewczyna oraz jej rodzice wykazują deficyt wiedzy na temat choroby oraz postępowania w przypadku jej zaostrzenia. Wnioski. Bardzo ważnym aspektem w leczeniu choroby Leśniowskiego-Crohna u opisanej pacjentki jest stosowanie się do zaleceń żywieniowych oraz systematyczne przyjmowanie zleconych środków farmakologicznych. Całkowite wyleczenie choroby nie jest możliwe, lecz podjęte działania w walce z chorobą pozwalają na uzyskanie długiej remisji i zmniejszenie ryzyka wystąpienia jej poważnych powikłań.

Copyright of Folia Cardiologica is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. Mycobacterium avium spp. paratuberculosis (MAP) is a bacterial germ and the etiologic agent in paratuberculosis also known as Johne's disease, a debilitating disease seen in animals. MAP is one of the triggers in the development of Crohn's disease in humans. Therefore the presence of these microorganisms in the environment and their prevalence in farm animals in relation to Crohn's disease is a new area of research. To date, it has not been evaluated in Poland. Material and methods. The materials for this study consisted of 14,468 samples of bovine serum across Poland. Determination of anti-MAP antibody levels was performed using an immunoenzymatic Paratuberculosis Screening Ab Test p/n P07130-5® (IDEXX, Westbrook, Maine 04092, United States). Results. The study consisted of 14,468 samples of bovine serum. Anti-MAP antibodies were identified in 349 cattle sera. Conclusions. Successful paratuberculosis screening programs can lead to a reduction of MAP in animal products. As the role of MAP in Crohn's disease is not fully understood, future research should be conducted to address this knowledge gap and avoid a potential zoonotic public health problem. [ABSTRACT FROM AUTHOR]

Wstęp. Choroba Leśniowskiego – Crohna należy do grupy nieswoistych zapaleń jelit. Najczęściej jest diagnozowana u dzieci i młodzieży. Zapewnienie dziecku multidyscyplinarnej opieki, w tym pielęgniarskiej jest kluczowe, aby jak najszybciej poprawić stan pacjenta i doprowadzić do remisji choroby. Cel. Celem pracy jest analiza postępowania pielęgniarskiego w opiece nad dzieckiem z chorobą Leśniowskiego – Crohna. Materiał i metody. W pracy dokonano analizy literatury poświęconej chorobie Leśniowskiego – Crohna oraz zadań sprawowanych przez pielęgniarkę w opiece nad pacjentem pediatrycznym z tą jednostką chorobową. Przegląd. Na występowanie choroby Leśniowskiego – Crohna ma wpływ szereg czynników. Ważnym aspektem leczenia jest określenie stopnia zaawansowania choroby oraz dobranie zindywidualizowanej terapii. Wnioski. Choroba Leśniowskiego – Crohna istotnie wpływa na jakość życia dziecka. Istotnym elementem w pracy pielęgniarki sprawującej opiekę nad dzieckiem z chorobą Leśniowskiego – Crohna jest udzielanie wsparcia, a także edukacja młodocianego pacjenta oraz jego rodziców.

Copyright of General Medicine & Health Sciences / Medycyna Ogólna i Nauki o Zdrowiu is the property of Witold Chodzki Institute of Rural Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Advances in Biochemistry / Postepy Biochemii is the property of Polish Biochemical Society / Acta Biochimica Polonica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Crohn's disease and ulcerative colitis are the most common representatives of non-specific inflammatory bowel diseases. It is a group of chronic diseases of multifactorial and not fully understood aetiology. The characteristic gastro-intestinal symptoms may be accompanied by numerous extraintestinal manifestations. Skin lesions are observed in more than half of patients with inflammatory bowel diseases. Their appearance sometimes precedes development of typical abdominal symptoms. Therefore, the awareness of skin manifestations occurring in the course of inflammatory bowel diseases may contribute to early diagnosis and implementation of therapy. [ABSTRACT FROM AUTHOR]

Copyright of Advances in Biochemistry / Postepy Biochemii is the property of Polish Biochemical Society / Acta Biochimica Polonica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Advances in Biochemistry / Postepy Biochemii is the property of Polish Biochemical Society / Acta Biochimica Polonica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Advances in Biochemistry / Postepy Biochemii is the property of Polish Biochemical Society / Acta Biochimica Polonica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Inflammatory bowel disease (IBD) is a group of chronic digestive system conditions which significantly influence the everyday life of patients. Exhausting intestinal discomfort might cause a strong feeling of distress and lowers the quality of life. This study was based on the question: how are the sense of coherence, social support, socio-demographic variables and the duration of disease related to the quality of life of individuals suffering from IBD. Materials and methods: Thirty-nine individuals suffering from IBD were examined: 21 with ulcerative colitis, 17 with Crohn's disease and 1 with microscopic colitis. The participants completed a socio-demographic survey, and Life Orientation Questionnaire (SOC-29) and Berlin Social Support Scales (BSSS) questionnaires. The quality of life was examined by the Functional Assessment of Cancer Therapy-Gastric (FACT-Ga) questionnaire. Results: The overall rate of the sense of coherence with its components and the available instrumental and emotional support was found to be significantly connected to the patients' quality of life. The level of education differentiated the examined patients in terms of the quality of life. Conclusions: Psychological resources can play a significant role in the assessment of the impact of chronic disease on patients' everyday life. It is important to focus on their importance in raising the quality of life of the patients. [ABSTRACT FROM AUTHOR]

Gram-positive bacteria are the most common cause of skin and tissue infections. This paper reports the case of a patient with Crohn's disease who has been treated with dalbavancin for an infected perianal abscess. During the treatment process, there was no possibility of surgical drainage or bacteriological testing. [ABSTRACT FROM AUTHOR]

Introduction: Crohn's disease is a chronic condition that affects the functioning and life of the patients. Quality of life of patients affected by the disease is of particular importance because it allows better functioning in all dimensions of life. It is essential to identify the numerous factors that affect the patients' of quality of life. Aim of the research: To search for medical factors that influence the quality of life of patients affected by Crohn's disease. Material and methods: The study was conducted using a diagnostic survey. The study group comprised 100 adult patients with Crohn's disease hospitalised in the Gastroenterology Clinic of the Autonomous Public Hospital Complex No.1 of Pomeranian Medical University in Szczecin. The study was conducted in accordance with the Declaration of Helsinki. The standardised quality of life questionnaire SF-36v2 and an original questionnaire were used. The collected data were statistically analysed. Results: The analysis demonstrated a statistically significant effect of disease duration on quality of life as regards social functioning and mental health (p < 0.05). The course of the disease was found to affect all domains and dimensions of quality of life (p < 0.05). Treatment modality had a statistically significant influence only on the domain of physical functioning (p < 0.05). The number of hospitalisations in the year preceding the study was found to have a significant effect only on particular domains (p < 0.05). Conclusions: The course of the disease had the most significant effect on the quality of life of patients with Crohn's disease. Other significant factors are determining the tailored method of treatment and disease duration. [ABSTRACT FROM AUTHOR]

Wrzodziejące zapalenie jelita grubego i choroba Leśniowskiego-Crohna należą do grupy nieswoistych chorób zapalnych jelit o przewlekłym przebiegu i nieznanej etiologii. Z uwagi na niejednorodną patogenezę mają zróżnicowany obraz i przebieg kliniczny, co powoduje trudności diagnostyczne pomimo dostępności wielu wielospecjalistycznych badań. Wiadomo, że warunkiem koniecznym ustalenia ostatecznego rozpoznania jest potwierdzenie nieswoistej choroby zapalnej jelit w badaniu endoskopowym i histopatologicznym, niemniej jednak badania laboratoryjne są pomocne we wstępnej diagnostyce i odzwierciedlają zasięg oraz nasilenie procesu zapalnego. Białko C-reaktywne stanowi wykładnik procesu zapalnego, a występująca we wrzodziejącym zapaleniu jelita grubego niedokrwistość jest wynikiem zarówno przewlekłości choroby, jak i niedoboru żelaza wtórnego do utraty krwi. Diagnostyka laboratoryjna ma również zastosowanie w ocenie powikłań pozajelitowych dotyczących wątroby i dróg żółciowych, a także osteoporozy. Nieprawidłowe wyniki prób wątrobowych są częste w chorobach zapalnych jelit i mogą być spowodowane procesem zapalnym typowym dla tych chorób, ale też stosowanym leczeniem farmakologicznym. Chociaż powstają nowe metody wykorzystywane w diagnostyce przewodu pokarmowego, takie jak tomografia komputerowa, rezonans magnetyczny, pozytronowa tomografia emisyjna, to jednak badanie endoskopowe z oceną histopatologiczną pobranych wycinków jest (i jeszcze długo będzie) podstawową metodą diagnostyczną w rozpoznawaniu, monitorowaniu leczenia oraz nadzorze onkologicznym.

Introduction: Retroperitoneal abscesses are a relatively uncommon complication of diseases of various abdominal viscera, e.g. acute retrocoecal appendicitis or Crohn's disease. Case report: The paper reports the case of a 37-year-old patient suffering from Crohn's disease, in whom an abscess developed in the right retroperitoneal space, causing compression on the right ureter and penetrating into the right hip joint. The patient was admitted to hospital in a serious clinical state, with impending sepsis. The diagnosis was made based on abdominal computed tomography. The patient was immediately operated on, and the operation consisted in the resection of the involved part of the jejunum and caecum, followed by the evacuation and drainage of the abscess. Post-operative course was complicated by the occurrence of a mixed, partially mechanical and paralytic obstruction, and anastomotic leakage. At the second operation, a loop jejunostomy was performed, resulting in the stabilization of the abdominal disease. Unfortunately, the hip joint abscess was not evacuated at the right moment, resulting in the joint's destruction, requiring the third (orthopaedic) operation -- resection of the femoral head. The patient eventually recovered from abdominal disease complication, but was severely injured and will need a hip joint alloplasty. [ABSTRACT FROM AUTHOR]

Copyright of Polish Nursing / Pielegniarstwo Polskie is the property of Poznan University of Medical Sciences Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Polish Nursing / Pielegniarstwo Polskie is the property of Poznan University of Medical Sciences Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Paediatrics & Family Medicine / Pediatria i Medycyna Rodzinna is the property of Medical Communications Sp. z o.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Do nieswoistych zapaleń jelit zaliczamy wrzodziejące zapalenie jelita grubego i chorobę Leśniowskiego-Crohna. Ponieważ szczyt zapadalności na te choroby przypada między 15. a 35. rokiem życia, a więc dotyczy osób w okresie prokreacyjnym, rodzi się szereg pytań i wątpliwości na temat wpływu tych schorzeń oraz ich leczenia na płodność, a także przebieg ciąży, porodu i ewentualne bezpieczeństwo późniejszego karmienia piersią. W opracowaniu zostały przedstawione zasady leczenia nieswoistych zapaleń jelit u mężczyzn oraz u kobiet planujących posiadanie potomstwa, jak również kobiet będących w ciąży i karmiących. Należy podkreślić, że sam fakt rozpoznania nieswoistych chorób zapalnych jelit nie jest bezpośrednim przeciwwskazaniem do zajścia w ciążę. Ciąża nie stanowi również wskazania do przerwania leczenia tych chorób, tj. nieswoistych zapaleń jelit, gdyż zaostrzenie ich przebiegu wiąże się z większym ryzykiem dla potomstwa w porównaniu z niebezpieczeństwem wynikają- cym z wdrożenia nawet agresywnego, a skutecznego leczenia. Aktywacja tych chorób zwiększa zarówno ryzyko poronień, jak i porodów przedwczesnych oraz wewnątrzmacicznego obumarcia płodu. Nieprzerwana farmakoterapia nieswoistych zapaleń jelit środkami niemającymi działania karcynogennego ma istotny wpływ na urodzenie zdrowego dziecka. Optymalnym czasem do zajścia w ciążę w takim przypadku jest okres po trwającej przynajmniej 3 miesiące remisji choroby. W okresie planowania ciąży zaleca się suplementację kwasu foliowego.

Choroba Leśniowskiego-Crohna jest przewlekłym schorzeniem, które może dotyczyć dowolnego odcinka przewodu pokarmowego (najczęściej końcowego odcinka jelita cienkiego), powodującym znaczne obniżenie jakości życia oraz upośledzenie sprawności chorego. Najczęstsze objawy to ból brzucha, biegunka, krew w stolcu, badalny (często tkliwy) opór w jamie brzusznej, utrata masy ciała, osłabienie, stany podgorączkowe i gorączka. Często towarzyszą im zmiany okolicy odbytowej – przetoki, szczeliny i ropnie, a także przetoki jelitowo-skórne. Rozpoznanie opiera się na endoskopii z pobraniem wycinków, histopatologii oraz metodach radiologicznych z użyciem kontrastu. Pomimo coraz lepszego rozpoznawania i łatwiejszego dostępu do diagnostyki część przypadków jest diagnozowana w trakcie zabiegu z powodu niedrożności lub mylnie rozpoznanego zapalenia wyrostka robaczkowego. W leczeniu najczęściej stosuje się preparaty 5-aminosalicylanów, glikokortykosteroidy oraz tiopuryny. Obecnie w Polsce zarejestrowane są dwa przeciwciała anty-TNF-α, stosowane w terapii biologicznej. Leczenie metodami klasycznymi oraz lekami biologicznymi nie zawsze pozwala uniknąć interwencji chirurgicznej. Zdłuż- szej obserwacji wynika, że większość chorych przechodzi przynajmniej jeden zabieg operacyjny. Nowe doniesienia coraz śmielej wskazują na celowość wczesnego włączania terapii biologicznej i immunosupresyjnej (strategia top-down). Choć szansa zmiany przebiegu choroby w wyniku agresywnego leczenia od momentu rozpoznania jest kusząca, ze względu na możliwość wystąpienia powikłań takiej terapii, zwłaszcza infekcyjnych, należy zachować ostrożność, dopóki nie będziemy mieli więcej danych. Powikłania te wymuszają również, aby leczeniem tym zajmowały się ośrodki referencyjne, mające duże doświadczenie w tej dziedzinie.

Koarktacja aorty (CoA) jest to zwężenie światła aorty umiejscowione najczęściej poniżej odejścia lewej tętnicy pod obojczykowej. Występuje z częstością 5-7,5% wszystkich wad wrodzonych serca i dwu-, trzykrotnie częściej u chłopców niż u dziewcząt. Koarktacja aorty jest najczęstszą wadą układu sercowo-naczyniowego u pacjentek z zespołem Turnera. Wada może mieć charakter izolowany lub występować w skojarzeniu z innymi wadami, zwłaszcza dwupłatkową zastawką aorty. Najbardziej typowym objawem CoA jest wzrost ciśnienia na kończynach górnych, a jego obniżenie na kończynach dolnych. Nadciśnienie tętnicze obserwuje się głównie u dzieci starszych, podczas gdy u niemowląt mogą wcześnie rozwinąć się objawy niewydolności krążenia. Badanie echokardiograficzne jest podstawową metodą w diagnostyce koarktacji aorty, ale bardziej precyzyjną ocenę wady można uzyskać w badaniach angiograficznych CT lub MR. Postępowanie lecznicze w CoA zależy od wieku pacjenta, objawów klinicznych, typu wady oraz wad towarzyszących. W leczeniu operacyjnym stosowane są różne metody, np. zespolenie koniec do końca, poszerzenie zwężonego odcinka z wykorzystaniem łaty z własnej tętnicy podobojczykowej czy tworzywa sztucznego. Alternatywą dla operacji chirurgicznej są metody leczenia interwencyjnego (angioplastyka balonowa, implantacja stanu), szczególnie w przypadku nawrotów zwężenia. W niniejszej pracy prezentujemy przypadek nieopisywanego dotąd w piśmiennictwie współistnienia koarktacji aorty, choroby trzewnej i choroby Leśniowskiego-Crohna. Jest to jednocześnie przykład późnego rozpoznania wady układu sercowo-naczyniowego u 13-letniego chłopca.

Copyright of Polish Journal of Wound Management / Leczenie Ran is the property of Evereth Publishing Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Anti-tumor necrosis factor α (anti-TNF-α) antibodies are used to treat immune-mediated inflammatory diseases (IMID), which include inflammatory bowel diseases or psoriasis. In the group of adverse events induced by anti-TNF agents we can observe psoriatic lesions. Case report. We present two women who in the course of therapy of Crohn's disease with adalimumab (ADA) developed psoriasis. Diagnosis was based on the clinical picture and confirmed by histopathological examination. In the first case, treatment with ADA was continued and topical therapy was started, with a good effect. The second patient abandoned ADA therapy and the skin lesions resolved due to the external treatment, too. Conclusions. The comorbidity of IMID creates therapeutic difficulties and requires further study to elucidate pathophysiology of these diseases, as well as to clarify the mechanism of action of anti-TNF agents. [ABSTRACT FROM AUTHOR]

Inflammatory bowel diseases (IBD) are a group of chronic gastrointestinal disorders with alternating relapses and remissions. Two main types within IBD can be distinguished: Crohn's disease and ulcerative colitis. Considering the epidemiological, immunological and genetic data, it was concluded that IBD possess multifactorial etiology, where genetic and environmental factors form the immunological background for the disease. In this review we discuss the most important genes and their protein products in IBD etiology and their impact on IBD pharmacotherapy [ABSTRACT FROM AUTHOR]

Erythema dyschromicum perstans (EDP; ang. ashy dermatosis) jest rzadkim, łagodnym, nabytym schorzeniem skóry charakteryzującym się obecnością plam hiperpigmentacyjnych. Przyczyny EDP nie są znane, chociaż opisywano związek dermatozy z lekami, czynnikami toksycznymi, jak również schorzeniami internistycznymi. Cel pracy. Przedstawienie nieopisywanego dotychczas związku między EDP a chorobą Leśniowskiego-Crohna leczoną infliksymabem. Opis przypadku. Prezentujemy przypadek 15-letniego chłopca, u którego podczas terapii infliksymabem z powodu choroby Leśniowskiego- Crohna obserwowano pojawienie się asymptomatycznych plam hiperpigmentacyjnych. Na podstawie obrazu klinicznego i histopatologicznego rozpoznano EDP. Wnioski. Erythema dyschromicum perstans może mieć związek z chorobą Leśniowskiego-Crohna lub infliksymabem. [ABSTRACT FROM AUTHOR]

In this paper a review of the researches on the role of Escherichia coli strain Nissle 1917 (EcN) in gastrointestinal diseases was presented. EcN is a non-pathogenic strain of the Enterobacteriaceae family, which has probiotic properties. In a number of studies conducted among humans and experimental animals the application of EcN in treatment of gastrointestinal diseases was observed. Most studies about EcN has been devoted to this organism efficacy in ulcerative colitis treatment. Comparable results were obtained, by citied authors, in the treatment (sustaining remission) of EcN and mesalazine in ulcerative colitis. Moreover, this probiotic therapy, compared to placebo, contributes to obtaining a faster remission and improvement of intestinal histopathology. The use of EcN in Crohn's disease has not been the subject of as many studies as in the case of ulcerative colitis. Assessing the importance of EcN in treatment of other gastrointestinal disorders, authors of the studies observed, that in patients with irritable bowel syndrome, who receiving this probiotic there was a pain, nausea and bloating reduction. In studies conducted among children a positive impact of EcN in prevention and treatment of diarrhea was demonstrated. Similar results were obtained in studies conducted in experimental animals. Based on the presented review it can be concluded that the strain of Escherichia coli Nissle 1917 is useful in treatment of gastrointestinal diseases, especially in treatment of ulcerative colitis. This probiotic may constitute a part of treatment of irritable bowel syndrome and diarrhea. The effectiveness of this strain in treatment of Crohn's disease is not clearly established and further research are require. [ABSTRACT FROM AUTHOR]

Introduction: Non-specific inflammatory bowel diseases (IBD) and periodontitis are multifactoria diseases. The immune response plays a significant role in their onset and course. The aim of the study was to asses the periodontium in a group of patients diagnosed with non-specific IBD, including Crohn's disease and colitis ulcerosa (CU). Materials and methods: 75 patients hospitalized due to IBD were examined using a periodontal probe and a dental mirror; periodontal indexes including plaque index (PI) and bleeding on probing (BOP pocket depths (PD) and clinical attachment loss (CAL) were measured. CAL was used for diagnosis o periodontitis. Additionally, the activity of a periodontal disease was assessed using the Offenbacher scale Results: The average plaque index was 50.15%, average BOP 9.7%, average PD: 1.55 mm, average CAL: 0.45 mm. Chronic periodontitis was diagnosed in 96% of patients (72 individuals), of whom 27% had a generalized form of periodontitis, which occurred more often in the Crohn's disease group than in the CU group. In 69% of patients a localized form was diagnosed. Three people were diagnosed as healthy. The assessment of periodontium was performed with reference to gastroenterological dia gnosis and applied immunotherapy. Conclusions: Periodontitis and gingivitis were more often present in the Crohn's disease group than in the CU group. Compared to available research, the study group of patients demonstrated a highe plaque index but lower PD and BOP indexes. [ABSTRACT FROM AUTHOR]

Introduction: Many of the diseases may have their manifestations in the oral cavity. A typical example of them are inflammatory bowel diseases (IBD). Typical systemic symptoms for IBD are: abdominal pain, diarrhea, rectal bleeding, loss of weight and signs of malnutrition. Crohn's disease (CD), as more severe is more frequently observed in the oral cavity of patients, especially at the exacerbation of the disease. These symptoms may precede and resemble other symptoms. Oral mucosa changes typically include: buccal cobblestoning, orofacial granulomatosis, lip swelling, hyperplastic changes, aphthae, cheilitis, stomatitis, changes of mucosa coloration, taste disorders and lichen planus. The changes may be caused by malnutrition, but also may have their cause in incorrect function of autoimmune system (aphthae, buccal cobblestoning), or have genetic origin (geographic tongue). Aim of the study was to estimate the frequency of different types of oral cavity changes in patients suffering from Crohn's disease and to assess whether their nature and occurrence depends on the localization of the disease in the gastrointestinal tract in CD patients. Material and methods: In 18patients with CD (8 female, 10 male, mean age 36.3±12.4 years), hospitalized due to exacerbation of the disease in the Department and Clinic of Gastroenterology and Hepatology of the Silesian Piasts Medical University in Wrocław, Poland, dental examination was performed. The patients were chosen randomly. The localization of the disease in the gut was confirmed with endoscopic examination (gastro- and colonoscopy) and CT enteroclysis. Results: Among the patients, the disease was localized in the large bowel in 11of them, while the small bowel was affected in 15 individuals. Oral mucosa changes appeared in 14out of 18 cases. None of the patients had more than 4 different lesions in the oral cavity. The most common were buccal cobblestoning (6 patients), recurrent aphthae (6) and lingua scrotalis (4). In 4 patients with CD no changes were observed. Surprisingly, the patients with localization of CD in the small intestine suffered from rarer oral manifestations of CD. Ten of 14 patients with any oral cavity changes had their disease localized in the large intestine. All the patients with aphthae had at least the large bowel involved. Conclusions: Oral mucosa changes occur in patients with CD very often, more frequently at the exacerbation of the disease. Changes at Crohn's disease can have immunologic (eg. aphthae, buccal cobblestoning) or genetic background (eg. lingua scrotalis) but also malnutrition observed in the course of CD may be an independent cause of changes in the oral cavity (lack of folic acid resulting from diet and abnormal absorption of vitamin B12 ). Immune and hereditary nature of the oral changes may explain their frequent occurrence in patients with large bowel localization of the disease. [ABSTRACT FROM AUTHOR]

Introduction: Computed tomography (CT) enteroclysis is the double contrast exam with the use of multidetector CT, which has replaced conventional enteroclysis in the examination of the small bowel. The aim of the study is presentation of the authors' own experience in the use of CT enteroclysis in children with inflammatory bowel diseases (IBD). Material and methods: CT enteroclysis was performed in 17 children suspected of IBD: Crohn's disease (CD), n=7; ulcerative colitis (UC), n=5; indeterminate colitis (IC), n=5. In all patients volume challenge of 1500-2000 ml of enteral contrast agents (0.5% methylcellulose and gastrografin) was administered to the small bowel through the nasojejunal catheter placed beyond the ligament of Treitz and the intravenous contrast medium was given. Next, CT images were obtained. Results: In all patients with CD enteroclysis depicted abnormalities in the small intestine such as inflammatory changes in the distal part of ileum with narrowing of its lumen. Additionally in one patient with CD two fistulae were detected, which were not visualized in small-bowel follow-through exam. In children with initially diagnosed UC, enteroclysis did not reveal any pathological changes, which finally confirmed the diagnosis. There were no abnormalities in children with IC, moreover in one patient with IC enteroclysis excluded changes seen initially in small-bowel follow-through exam. During examination transient abdominal pain, nausea and abdominal bloating were observed in 7 patients. The remaining children tolerated contrast agents well. The average time of duration of the exam was 38±12 minutes. Conclusions: CT enteroclysis is the thorough radiological technique for evaluation of the small intestine, which improves diagnostic methods and treatment of IBD. The side-effects seen during enteroclysis do not affect the technical value of the exam. [ABSTRACT FROM AUTHOR]

First European Crohn's and Colitis Organization (ECCO) consensus regarding definition, diagnosis, management and special situations in Crohn's disease (CD) was published in 2006. At the beginning of 2010 new consensus was published, updated due to the new evidence. The paper discusses the differences between ECCO consensus from 2006 and 2010. A basic examination for establishing the diagnosis of CD is ileocolonoscopy with the biopsies of the terminal ileum and colon. MR and CT enterography or enteroclysis are recommended for small bowel evaluation. Faecal calprotectin and lactoferrin may be used in the initial assessment of patients with the suspicion of CD. Major change regarding the therapy is an increase of the number of indications for anti-TNF treatment, It seems that currently available anti-TNF agents have similar efficacy and safety profile. Thus, the choice of medication depends on the cost, availability, route of delivery, patient's decision and national recommendations. [ABSTRACT FROM AUTHOR]

Many papers describing the unknown mechanism of Leśniowski-Crohn disease implicate bacteria as a possible factor inducing immunological disorders in the intestinal mucosa. Many species of bacteria are considered to be responsible for the immunological disorders in Leśniowski-Crohn's disease, but Escherichia coil bacilli and Mycobacterium paratuberculosis are the most commonly investigated species. E. coli are the most prevalent among microaerophilic and anaerobic bacteria in the bowels of patients with chronic as well as early Leśniowski-Crohn disease. Antigens of E. coli have been detected in 70% of samples obtained from mucosa of patients with Leśniowski-Crohn disease. The bacilli were also isolated from macrophages residing in the lamina propria of intestinal mucosa of patients with the disease. Serological investigations have revealed that E. coli specific antibodies are present at higher levels in patients with Leśniowski-Crohn than in healthy controls. [ABSTRACT FROM AUTHOR]

Crohn's disease is one of the chronic inflammatory bowel diseases. In the course of this inflammatory process among other factors pro-inflammatory cytokines have a great significance. The drugs blocking biological effects of cytokines could be a new approach to the treatment of the disease. In the paper a review of therapeutic efficacy of the anti-TNF-α drugs (infliximab, adalimumab) has been made. Additionally, a potential possibilities of using other pro-inflammatory cytokines as a drug targets have been indicated. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease due to its multifactorial and still not clear etiology is a difficult treatment target. There is no medication leading to a constant remission. Many new therapeutical methods are still under investigation, except for the well known biological methods such as tumor necrosis factor α (TNF-α). Inhibitors and some investigations relating to interleukins appear to be new options such as adhesion molecules inhibitors (natalizumab, MLN-02, Alicaforsen), helminth ova therapy (stimulates a response of Th2 that can inhibit or modify a response of Th1 to other antigens), probiotics, leukocytapheresis (removes activated immunological cells from blood, changes the level of pro-inflammatory and anti-inflammatory agents), autologous haematopoietic stem cell transplantation, immunostimulation, growth factors, and gene therapy. In this paper the review of trials regarding the above-mentioned methods was performed. Among them the most promising treatment options seem to be leukocytapheresis and growth factors, especially epidermal growth factor (EGF) that can lead to a remission rate of above 80%. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, a steady increase in the incidence of inflammatory bowel disease (IBD) can be observed, especially in the developed and urbanized countries. In etiopathogenesis of the disease, the genetic, environmental, immunological, bacterial, and psychosomatic factors have been taken into account, among others. Aim of study: This paper attempts to assess body build of patients with IBD: ulcerative colitis (UC) and Crohn's disease (CD). Material and methods: The following indicators were used for anthropometric analysis: height, body weight, chest circumference, body mass index (BMI), and Rohrer index. Results: The differences in body weight, chest circumference, BMI, and Rohrer index are statistically significant and indicate that patients with CD have statistically lower values of the studied parameters. Only with respect to height, no statistically significant difference was observed in the two studied groups of patients. Conclusions: Statistically, patients with CD have lower body weight, smaller chest circumference, lower BMI, and lower Rohrer index in comparison with patients with UC. [ABSTRACT FROM AUTHOR]

Introduction: Inflammatory bowel diseases (IBD) can be divided into Crohn's disease (CD) and ulcerative colitis (UC). In CD inflammation can occur in the whole gastrointestinal (GI) tract. Extra-intestinal symptoms also occur. Many studies prove that CD is genetically determined. Aim of study: The aim of this study was to define if DLG5 113 G>A (R30Q), CARD15/NOD2 2827 C>G (G908R) and OCTN1 1672 C>T (F503L) polymorphisms are related to localization of the disease or extra-intestinal symptoms occurence. Material and methods: DNA was collected from 98 adult patients with CD (50 women and 48 men) and from a population group of 132 individuals. Sequence analysis was run using a pyrosequencing method. Symptoms from the GI tract were divided into: those observed in the small intestine, colon, perianal region as well as those from mouth, esophagus, stomach and duodenum. Extra-intestinal symptoms were grouped into: artrithis, iritis, stomatitis aphtosa, erythema nodosum, primary sclerosing cholangitis (PSC), and elevated body temperature. Results and conclusions: CG genotype in CARD15/NOD2 G908R was observed more frequently among the patients than in the population group (14.29% and 3.94%, respectively). As to the DLG5 R30Q gene, genotype AG and AA was observed more frequently in the population group. From all CD patients that had CG genotype in G908R, 85.71% also had genotype GG in R30Q; remaining 14.29% had AG (at least one allele G in all cases). In OCTN1 F503L gene, genotypes AG and AA were slightly more frequent in the patient group than in the population group. CD patients with CG genotype in G908R always had intestinal symptoms, and in 28.57% of cases the disease affected both small intestine and colon. Arthritis occurred in 71.43% of patients with CG genotype in G908R. [ABSTRACT FROM AUTHOR]

Dalziel, in 1913, basing on the clinical and histopatological similarities, compared Crohn's disease with cattle Johne's disease caused by mycobacteria. Since that year the consideration about the part of mycobacteria in inflammatory bowel diseases regularly has been coming back in scientific discussions. The numerous trials were conducted to evidence the role of Mycobacterium avium subspecies paratuberculosis in the pathogenesis of Crohn's disease, but until now it hasn't been proved if mycobacteria are Crohn's disease causing agent or have no connection to it. Basing on DNA isolated from mycobacteria found in bowels of patients suffering from Crohn's disease or living mycobacteria obtained from Crohn's patients it becomes clearly apparent that they are only casual microorganisms, which come to human bowels with water and food. There is almost the same number of arguments for MAP's participation in Crohn's disease as counter-arguments. [ABSTRACT FROM AUTHOR]

Discovery of gene CARD15 has initiated an intensive searching of new genes, which can be associated with the susceptibility to inflammatory bowel disease, and has resulted in finding genes described as IBD2, IBD3, IBD4, IBD5, IBD6 and others. The consequences of the genetic research are studies aiming to find their clinical meaning, e.g. relation between genotype and phenotype in Crohn's disease (CD) and prognostic value, e.g. predicting the effects of treatment. The biggest number of studies concern gene CARD15. Our paper describes the clinical meaning of gene CARD15 and other susceptibility genes to CD. [ABSTRACT FROM AUTHOR]

Endometriosis is a common condition in many women of the child-bearing age. It affects approximately 8-15% of the menstruating female population. Usually endometriosis can be found in the peritoneal cavity. Ectopic foci can be located in a number of other organs, such as the lung, gall bladder, retroperitoneal space, stomach, small and large intestine and pancreas. It is found beyond the peritoneal cavity in 0.2% of the population. Endometriotic foci in the colon have already been discussed, however, there is a rare type of this condition that imitates Crohn's disease. This paper presents a long-term disease which was diagnosed and treated as Crohn's disease. In the third year of treatment, colonic endometriosis was diagnosed correctly. [ABSTRACT FROM AUTHOR]

The highest incidence of inflammatory bowel diseases (IBD) is observed in countries with high socioeconomic rates. Urbanization and good hygienic standards seem to promote higher IBD occurrence. In the last decades, a noticeably higher rate of IBD occurrence can be spotted in countries where social changes related to a western lifestyle took place. A large number of epidemiological studies have shown that people brought up in good sanitary standards were diagnosed with IBD more frequently. One of the ways to explain this phenomenon is the hygiene hypothesis, which implicates that the lack of exposition to germs during childhood years can be linked with the lack of ability to form a proper immunological response to common germs. There is, however, a large amount of studies that do not confirm this hypothesis. A further investigation of this problem is likely to provide us with an explanation why the IBD morbidity in many countries is increasing and may also help with forming proper recommendations how to prevent and treat this disease. [ABSTRACT FROM AUTHOR]

Urological complications associated with inflammatory bowel disease occur in almost 25% of patients, but renal parenchymatitis is rare. IgA nephropathy is the most common form of the primary glomerulonephritis. It can be also observed, however, as a secondary disease in association with such digestive system conditions as liver diseases, celiac disease, the Crohn's disease (CD) or colitis ulcerosa. The joint pathomechanism of these disorders is still a subject of studies. We present the case of a 15-year-old boy with severe CD who developed the extra-intestinal symptoms in a form of an erythema nodosum as well as of erythrocyturia and proteinuria during the first aggravation of the disease. The CD had been diagnosed when the boy was 13 years old, inflammatory lesions covered the upper and lower parts of the digestive system. The disease activity was assessed on the PCDAI (pediatric Crohn's disease activity index) scale at 52.5 points (severe disease). The child was treated with steroids and azathioprine, then, due to no response, the boy was treated biologically with infliximab. Consequently, full clinical remission and partial healing of the intestinal mucosa was obtained. Withdrawal of the biological treatment resulted in the primary disease aggravation accompanied by the full manifestation in the digestive system, massive changes in the form of the erythema nodosum on both shanks as well as by erythrocyturia and proteinuria. In the course of differential diagnosis based on the renal biopsy the IgA nephropathy was diagnosed. The biological treatment and the administration of angiotensin converting enzyme inhibitors were resumed which resulted in the abating of the CD intestinal and extra-intestinal symptoms. [ABSTRACT FROM AUTHOR]