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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 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.)

Assessment of the entire surface of the mucosa of the diagnosed area is one of the key factors for high quality endoscopy. This is not obtainable without special preparation for endoscopy. Nationwide educational actions dedicated to informing patients how to prepare the bowel for colonoscopy have resulted in increased rate of detected pathological structures, clinically silent precancerous lesions in particular. Special pharmacological products for adequate colon preparation are available. Endoscopists are required to assess how well the colon was prepared for the procedure and include this information in their endoscopy report. The results of such efforts are already demonstrated by the decrease in the rate of colon cancer incidence and, most importantly, mortality. However, a similar effort is lacking as regards adequate preparation for gastroscopy despite it being the most common endoscopic examination. Generally, the required preparation for upper digestive tract endoscopy is limited to fasting for four to six hours before the procedure. Assessment of mucosa visibility is not required as an integral part of the gastroscopy report. This may be the reason for the low rate of early detection of gastric cancer and the high incidence of interval gastric cancer. Detection of advanced cancer results in low 5-year survival rates, with treatment mostly relying on extensive surgery. There are many publications available on premedication with simple mucolytic and anti-foaming agents for the detection of early precancerous lesions in the stomach, the bulk of them from the Far East, where gastric preparation for upper endoscopy is a routine procedure. [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 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.)

Autoimmune pancreatitis constantly belongs to diseases which often causes significant diagnostic problem and often runs out with surgical intervention as considered to be a pancreatic cancer. Important although usually underestimated problems are polyglandular syndromes, which may consist of autoimmune pancreatitis (AIP) problem as well. This case report is an example of autoimmune polyglandular syndrome (APS), which was connected with the surgical treatment with biliary bypass anastomosis because of the unresectable lesion in the head of pancreas. The definite remission of the pancreatic lesion finally came after a steroid therapy. Differentiation between neoplastic and inflammatory pancreatic tumors very often remains a serious clinical problem. On grounds of imaging and cytopathology exams it is often difficult to decide about the nature of a lesion. The negative result of cytopathological biopsy examination does not finally settle straightforward diagnosis. Diagnostic problems affect also autoimmune pancreatitis. It is worth to undertake attempts to differentiate pancreatic lesions especially in cases of concomitance with other autoimmune polyglandular syndromes. That is because it is connected with completely different treatment and outcome. We should remember about diagnostic criteria of autoimmune pancreatitis. Appropriate diagnosis for patients with AIP gives them a chance to avoid serious surgical resection and possible complications., (© 2016 MEDPRESS.)

Hereditary pancreatitis (HP) is a rare, heterogeneous familial disease and should be suspected in any patient who has suffered at least two attacks of acute pancreatitis for which there is no underlying cause and unexplained chronic pancreatitis with a family history in a first- or second degree relative. with an early onset, mostly during childhood. Genetic factors have been implied in cases of familial chronic pancreatitis. The most common are mutations of the PRSS1 gene on the long arm of the chromosome 7, encoding for the cationic trypsinogen. The inheritance pattern is autosomal dominant with an incomplete penetrance (80%). The inflammation results in repeated DNA damage, error-prone repair mechanisms and the progressive accumulation of genetic mutations. Risk of pancreatic adenocarcinoma is a major concern of many patients with hereditary chronic pancreatitis, but the individual risk is poorly defined. Better risk models of pancreatic cancer in individual patients based on etiology of pancreatitis, family history, genetics, smoking, alcohol, diabetes and the patient's age are needed., (© 2016 MEDPRESS.)

Background: Short-term administration of Galactosamine to experimental animals causes liver damage and acute liver failure (ALF), as well as acute renal failure in some cases. The aim of our study was to describe kidney disorders that developed in the course of galactosamine-induced liver failure., Material and Methods: Sprague-Dawley rats were randomly divided into 2 groups: a study group administered galactosamine intraperitoneally and a control group administered saline., Results: All the animals in the study group developed liver damage and failure within 48 h, with significant increase of alanine (p<0.001), aspartate aminotransferases (p<0.0001), bilirubin (p<0.004), and ammonia (p<0.005) and decrease of albumin (p<0.001) concentrations. Acute renal failure was observed in all test animals, with a significant increase in creatinine (p<0.001) and urea (p<0.001) concentrations and a decrease in creatinine clearance (p<0.0012). Moreover, osmotic clearance (p<0.001), daily natriuresis (p<0.003), and fractional sodium excretion (p<0.016) decreased significantly in this group of animals. The ratio of urine osmolality to serum osmolality did not change. Histopathology of the liver revealed massive necrosis of hepatocytes, whereas renal histopathology showed no changes., Conclusions: Acute renal failure that developed in the course of galactosamine-induced ALF was of a functional nature, with the kidneys retaining the ability to concentrate urine and retain sodium, and there were no renal changes in the histopathological examination. It seems that the experimental model of ALF induced by galactosamine can be viewed as a model of hepatorenal syndrome that occurs in the course of acute damage and liver failure.

Aim: To evaluate the effect of nitric oxide (NO) on the development and degree of liver failure in an animal model of acute hepatic failure (AHF)., Methods: An experimental rat model of galactosamine-induced AHF was used. An inhibitor of NO synthase, nitroarginine methyl ester, or an NO donor, arginine, were administered at various doses prior to or after the induction of AHF., Results: All tested groups developed AHF. Following inhibition of the endogenous NO pathway, most liver parameters improved, regardless of the inhibitor dose before the induction of liver damage, and depending on the inhibitor dose after liver damage. Prophylactic administration of the inhibitor was more effective in improving liver function parameters than administration of the inhibitor after liver damage. An attempt to activate the endogenous NO pathway prior to the induction of liver damage did not change the observed liver function parameters. Stimulation of the endogenous NO pathway after liver damage, regardless of the NO donor dose used, improved most liver function parameters., Conclusion: The endogenous NO pathway plays an important role in the development of experimental galactosamine-induced AHF.

Groove pancreatitis is an uncommon type of chronic pancreatitis. Most patients with groove pancreatitis are middle-aged men, smokers with excessive alcohol consumption. The describing patient is male admitted to hospital for fourth time during last six months because of recurrent abdominal pain, vomiting and lost weight. He has abused an alcohol in the history. The preliminary diagnosis of chronic pancreatitis was made. During hospitalization it was ordinated spasmolitic and analgesic therapy, antibiotic and enteral nutrition. The result of the implemented conservative therapy was successful, but the symptoms recurrented in very short period of time. Due to lack of long term improvement, patient was treated by pancreatoduodenectomy (Whipple's operation). The postoperative material was assessed by the patologist, and it was described focal chronic inflammation of the head of pancreas with fibrosis involving the wall of the duodenum. To diagnose groove pancreatitis in this case many diagnostic test, including endoscopy, imaging were required, but the histopathology was crucial. The patients should be diagnosed very carefully, because of the risk of the overlook of the cancer, which can be very similar in symptoms. The operation is recommended therapy in situation when improvement is short-period, with frequent recurrences or additional examination are uncertain.

Successful Crohn's disease conservative treatment is often associated with use of few, sometimes new drugs. Their clinical use apart from inflammatory process decrease is associated with some risk. In the paper we report a case of 23-year-old woman suffering from Crohn's disease treated successfully with anti-TNF antibodies. Apart from successful anti-inflammatory there were observed not symptomatic perforation of the alimentary tract. Patients treated with strong anti-inflammatory drugs require especially careful monitoring also because of possibility of occurrence of not symptomatic life-threatening conditions.

The Aim: Non-erosive reflux disease is presented in reflux diseases classifications not adequately Many esophageal lesions were described in different endoscopic techniques but not one classification was proposed. In many patients with signs of prolonged gastro-esophageal reflux in endoscopic assessment pale mucosa above gastro-esophageal junction was observed. In some patients color of esophagus in distal part becomes white and grey. We decided to check what histological lesions appear in all endoscopically visible lesions., Material and Methods: We analyzed 29 patients with chronic reflux disease and with endoscopic assessment of upper alimentary tract in which white color was observed in distal part of esophagus was observed. Biopses were taken from sites at least 2 cm from Z-line. Endoscopic assessment was performed by one endoscopist specialized in reflux disease. Biopsies were assessed by one pathologist specialized in upper alimentary tract diseases assessment., Results: In all cases biopsies taken from distal esophageal, white-coloured mucosa were assessed by pathologist as esophagitis caused by gastro-esophageal reflux., Conclusions: White color of the distal part of esophagus in patients with chronic reflux disease is unanimously associated with microscopic lesions associated with reflux disease.

Technology development in data processing in ultrasonography let new imaging method feasible. New method of imaging is elastography (elastosonography, ultrasonographic elastography). It relays on the presumption that pathologically changed tissues have different elasticity and change their shape in different way than health tissue. Elastography is used in lesions in alimentary tract diagnostics. Sensitivity and specificity in malignant lesions differentiation is 85% and 90%. In elastography there is used conventional ultrasonography device that is equipped with additional transformator that is located in probe. Examination is performed with multiple pressing the organ. Imaging is acquired in real-time regime they are colour-coded and they are created during compression. As a result of computer analysis images are generated in two colours. On the basis of character of normal and increased rigidity images were classified in five point scale from one to five. Indication to elastography is suspicion of malignant lesions in traditional ultrasonography and monitoring of liver cirrhosis and fibrosis. More trials are required to evaluate this method more reliably. Then it could be recommended for everyday clinical use.

Non-erosive gastroesophageal reflux disease (NERD) is still underappreciated type of gastroesophageal reflux disease (GERD). It is not a homogenous group of patients with real reflux, oversensitivity of esophagus and functional dyspepsia. Nowadays often in classifications of GERD patients with NERD are omitted. Many endoscopic lesions are found in esophagus in NERD, especially color change of mucosa. Erythrema is nowadays taken into account. Unequivocal are also opinions about histological image. Many histological lesions are found but not a specific lesions were typified. Probably it is the best to associate NERD with clinical symptoms, endoscopic and histological image.

Crohn disease treatment is a considerable challenge for a medical doctor. Gaining clinical remission is not enough. The important factor taken into account in treatment is gaining clinical remission and complete mucosal healing. Treatment useful in mucosal healing consists of immunosupresants as azathioprine, 6-markaptopurin, methotrexate and biological treatment. Important factors influencing mucosal healing is choice of medical treatment and its proper timing. More aggressive treatment in top-down scheme appears to be more successful in this aspekt than classical treatment with use of steroids. This data requires verification with more clinical trials.

Unlabelled: Inflammatory bowel diseases including ulcerative colitis are associated with prolonged inflammatory process, that is dependent on cytokine production. Among them crucial role plays tumor necrosis factor TNF-alpha. There is proven association between single nucleotyde polimorphism and ability to produce cytokines., Aim: We analyzed association between TNF-alpha (-308) promoter polymorphism and extension of lesions in ulcerative colitis. TNF-alpha (-308) promoter polymorphism., Materials and Methods: Analysis was performed using polymerase chain reaction with sequence specific primers method (PCR-SSP) in 48 patients suffering from ulcerative colitis and association between TNF-alpha (-308) promoter polymorphism and ulcerative colitis macroscopic lesions classified according Montreal classification was investigated., Results: No statistically significant association among groups of patients and TNF-alpha (-308) promoter polymorphism was observed. More cases of TNF-alpha (-308) promoter polymorphism associated with low TNF-alpha production were observed in patients with E2 and E3 lesions according to Montreal classification. CONCLUSIONS. There is no direct association between TNF-alpha (-308) promoter polymorphism and ulcerative colitis macroscopic inflammatory lesions evaluated on basis of Montreal classification. There is statistically irrelevant tendency of more cases of pancolitis in group of patient with TNF-alpha (-308) promoter polymorphism associated with low TNF-alpha production.

The rising incidence of alimentary tract diseases forces imaging metod development. Developing radiologic diagnostics changed imaging methods role and increased quality demand. X-ray based methods are still used in diagnosing many illnesses. Basic abdominal x-ray in nightshift condition is necessary to diagnose perforation or obstruction. Ultrasonographic, computed tomography and magnetic resonance imaging methods are the most important nowadays. The most popular and non-invasive method of imaging is ultrasonography. It is irreplaceable thanks to its availability and precision diagnosing many internal organs. One of the newest method is magnetic resonance and imaging in all possible scans. Complimentary method is computed tomography. It is based on human body layers analysis. Method is based on x-rays and assessing all tissues absorption. It can produce three dimensional imaging. The newest software can produce virtual imaging of all body cavities as well as colon. Basic and highly specialistic methods should be carefully planned in diagnostic-therapeutic process. In decision making what method should be used, medical doctor and patient should take part, taking into account all indication and cotraindications as well as method limitations.

Gastrology development is based on quick advancement in the area of imaging methods, especially radiologic and endoscopic methods. Currently, there is possibility of imaging the whole gastrointestinal tract with endoscopic methods as well as double-balloon method and endoscopic capsule. Those two latter methods allow the intestine examination that was out of the range of classic endoscopic methods. Radiologic methods as X-ray methods, ultrasonography, computed tomography, magnetic resonance and virtual colonoscopy are great assets for every Igastroenterologists. Apart from diagnostic value important there is a significant asset of endoscopic methods namely possiblility of curative procedure as polypectomy or bleeding treatment. The method that combine radiological and endoscpic method is endoscopic retrograde cholangiopancreatography (ERCP) and endosonography (EUS). ERCP allows the diagnosis establishing as well as decide to perform curative treatment. EUS is a combination of endoscopic method and ultrasonographic imaging. It allows the imaging of the tissues deep into the wall of gastrointestinal tract. Having such broad imaging methods we have to remember that very important for method efficacy and safety is proper qualification and preparation of the patient for that procedure.