Wpływ wybranych czynników na intensywność bólu lędźwiowego odcinka kręgosłupa w ciągu sześciu miesięcy od wystąpienia dolegliwości

Introduction. Low-back pain (LBP), resulting from a slipped disc, exerts a long-lasting and irritating impact on all aspects of human life.Aim. The study aimed at assessing the effect of selected factors on the severity of pain measured on the Visual Analo­gue Scale (VAS) in patients who were treated conservatively due to a slipped disc in the lumbar section of the spine.Material and Methods. A total of 400 patients of the Outpatient Neurosurgical Clinic at the St. Lukas Regional Hospital in Tarnow, Poland, were involved in the survey. The observations (weight status and pain intensity) were conducted twice: when the problems appeared and after 6 months.Results. Obese and overweight individuals (79.5%) and the ones with android adiposity (86%) were most numerously represented in the research groups. The most severe low-back and leg pain in surveys one and two was repor­ted by obese patients and the ones who belonged to the group of senior participants.Conclusions. Conservative treatment combined with pro-health instructions brought the greatest subjective pain relief. The worst effects were achieved by obese patients. (JNNN 2015;4(1):24–29)Wstęp. Ból lędźwiowego odcinka kręgosłupa spowodowany dyskopatią wywiera długotrwały negatywny wpływ na wszystkie aspekty życia.Cel. Ocena wpływu wybranych czynników na nasilenie bólu mierzonego na wizualnej skali analogowej (VAS) u pacjentów, którzy byli leczeni zachowawczo z powodu dyskopatii w odcinku lędźwiowym kręgosłupa.Materiał i metody. Badaniom poddano łącznie 400 pacjentów Poradni Neurochirurgicznej Szpitala Świętego Łukasza w Tarnowie, w Polsce. Obserwacja (ocena stanu odżywienia i intensywności bólu) była prowadzona dwukrotnie: w momencie pojawienia się dolegliwości i po sześciu miesiącach.Wyniki. Osoby z nadwagą lub otyłością (79,5%) i z androgenicznym typem budowy ciała (86%) były najliczniej reprezentowane w grupach badanych. Największe nasilenie bólu w kręgosłupie i kończynach dolnych zarówno w pierwszym, jak i drugim badaniu zanotowano u osób z otyłością i osób z najstarszej grupy wiekowej.Wnioski. Największą subiektywną ulgę w bólu przyniosło połączenie leczenia zachowawczego z edukacją prozdrowotną. Najgorsze efekty uzyskano u pacjentów otyłych. (PNN 2015;4(1):24–29

Nowości pediatryczne na 9. Kongresie ECCO 2014 w Kopenhadze

W dniach 22–24 lutego bieżącego roku w Kopenhadze odbyła się coroczna konferencja Europejskiej Organizacji ds. Nieswoistych Chorób Zapalnych Jelit (ECCO). W tym roku zaprezentowane zostały nowy konsensus pediatryczny, który jest efektem dwuletniej pracy grupy roboczej, a także wiele streszczeń na sesji plakatowej. Celem artykułu jest przedstawienie i krótkie omówienie najciekawszych zagadnień pediatrycznych z kongresu

Czy mikroskopowe zapalenie jelita grubego należy do nieswoistych chorób zapalnych jelit?

Najnowszy konsensus histopatologiczny Europejskiej Organizacji ds. nieswoistych chorób zapalnych jelit (ECCO), wydany w 2013 roku, obejmuje opis i wytyczne diagnozowania mikroskopowego zapalenia jelita grubego (MZJG). W związku z tym powstaje pytanie, czy MZJG należy zaliczyć do nieswoistych chorób zapalnych jelit, wraz z chorobą Leśniowskiego-Crohna oraz wrzodziejącym zapaleniem jelita grubego. Zagadnienie to było również dyskutowane podczas 9. Kongresu ECCO, który odbył się w Kopenhadze w lutym 2014 roku

Methanogenic Archaea in the Pediatric Inflammatory Bowel Disease in Relation to Disease Type and Activity

The inflammatory bowel disease (IBD) is associated with gut microbiota dysbiosis; however, studies on methanogens—especially those focused on children—are extremely limited. The aim of this study was to determine the abundance of total methanogenic archaea and their three subgroups: Methanobrevibacter (Mb.) smithii, Methanosphaera (Ms.) stadtmanae, and Methanomassiliicoccales, in the feces of children with both active and inactive Crohn’s disease (CD) and ulcerative colitis (UC). The results of a quantitative real-time PCR were cross-referenced with the disease type (CD vs. UC) and activity assessed with the use of Pediatric Crohn’s Disease Activity Index (PCDAI) and Pediatric Ulcerative Colitis Activity Index (PUCAI) indices, and fecal calprotectin (FCP) concentration, and compared with controls. There was a significant decrease in the number of total methanogens in CD and UC compared to controls. The prevalence of total methanogens was also lower in UC compared to controls. Furthermore, patients from the inactive UC group were colonized by a lower number of Mb. smithii, and demonstrated the most pronounced positive correlation between the number of Ms. stadtmanae and the FCP concentration. Our results demonstrate that gut methanogens are related to the type and activity of pediatric IBD

Demographic characteristics of children with early clinical manifestation of inflammatory bowel disease

Abstract Introduction: Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), is a chronic condition of the colon and small intestine. The disease is common in young people (children and young adults), but it is rare in children younger than five years of age. Therefore, IBD developing during the first years of life (under the age of 5) is known as an early-onset IBD (EO-IBD), and it is considered to be a specific entity with a distinct phenotype. However, the available data on that issue are still insufficient. Aim: To determine the characteristics and clinical course of children with early-onset IBD. Material and methods: We performed a retrospective database analysis of 47 infants younger than 5 years old diagnosed with IBD. Patient's demographic data, including age, sex, and age at disease onset, were collected in 6 paediatric hospitals in Poland. Disease location was established on the basis of the review of all endoscopic, colonoscopic, histopathological, and radiological records. All possible complications were reported, as well as any treatment and its efficacy. Since the diagnosis was established all patients have been on follow up. Results: Among 47 children registered in the database, 23 (49%) had a diagnosis of CD, 16 (34%) had UC, and 8 (17%) had IC (indeterminate colitis). The mean age at diagnosis was 28.5 ±27.5 months; 57.4% were male. The most common location/type of disease was ileocolonic disease (L3). The most common complication of IBD was anaemia, found in 30 (63.8%) children. The observed course of the disease was either severe or moderate. In 4 children younger than 2 years old, surgery was performed. Conclusions: Inflammatory bowel disease in children younger than 5 years old includes UC, CD, and a relatively high proportion of IC. In early-onset IBD severe and moderate course of the disease is usually observed. Disease manifestation in these patients is predominantly ileocolonic

The potential of dietary treatment in patients with glycogen storage disease type IV

There is paucity of literature on dietary treatment in glycogen storage disease (GSD) type IV and formal guidelines are not available. Traditionally, liver transplantation was considered the only treatment option for GSD IV. In light of the success of dietary treatment for the other hepatic forms of GSD, we have initiated this observational study to assess the outcomes of medical diets, which limit the accumulation of glycogen. Clinical, dietary, laboratory, and imaging data for 15 GSD IV patients from three centres are presented. Medical diets may have the potential to delay or prevent liver transplantation, improve growth and normalize serum aminotransferases. Individual care plans aim to avoid both hyperglycaemia, hypoglycaemia and/or hyperketosis, to minimize glycogen accumulation and catabolism, respectively. Multidisciplinary monitoring includes balancing between traditional markers of metabolic control (ie, growth, liver size, serum aminotransferases, glucose homeostasis, lactate, and ketones), liver function (ie, synthesis, bile flow and detoxification of protein), and symptoms and signs of portal hypertension

Rodzina w zdrowiu i w chorobie. Wybrane aspekty opieki nad przewlekle chorym

Praca recenzowana / peer-reviewed pape

Zagrożenia zdrowotne wśród dzieci i młodzieży. T. 3

Praca recenzowana / Peer-reviewed pape

Long Term Follow-Up of Polish Patients with Isovaleric Aciduria. Clinical and Molecular Delineation of Isovaleric Aciduria

Isovaleric acidemia (IVA) is an autosomal recessive leucine inborn error of metabolism caused by isovaleryl-CoA dehydrogenase deficiency. The disease has various courses, from severe ones manifesting in newborns to the intermittent form with first manifestation in children and adults. The aim of this study was to analyze clinical and neurological outcomes in Polish patients with IVA. Ten patients diagnosed and treated in The Children’s Memorial Health Institute were included in the study. The diagnosis was based on tandem MS (increased level of C5 acylcarnitine) and urine GCMS (increased isovalerylglycine, and 3-hydroxyisovaleric acid). Molecular analysis was performed in seven patients (70%) leading to the detection of pathogenic variants in the IVD gene in all of them. A retrospective analysis of patients’ medical records included: demographics, symptoms at diagnosis, medical management, and biochemical and clinical outcomes following therapy. The median follow-up time (median; Q1–Q2) was 2.5 years (1.5–9.0) for newborn screening (NBS) and family screening (FS) children, and 17 years (5.0–20) for symptomatic patients. Five patients were in a good clinical state, four children presented mild neurological symptoms, and one—severely delayed child. In the IVD gene, five known and two novel variants (p.466C>G, c.1132G>A) were identified. Molecular analysis was performed in seven patients leading to identification of biallelic pathogenic variants in the IVD gene in all of them. We can conclude that long-term clinical and neurological outcomes of patients with IVA were satisfactory as a result of an early diagnosis and proper management. Although early treatment did not prevent decompensations, they were milder in these patients