Ocena wykorzystania technologii informacyjnych wśród rodziców dzieci ze schorzeniami przewlekłymi

Assessment of the use of information technologies among parents of children afflicted with chronic diseasesIntroduction and aim of the study:The support to patients with chronic conditions is an important aspect of development of e‑health systems. And yet, information about acceptance and skills related to the use of information technologies (IT) among potential end-users is scarce. The objective of this study was assessment of the use of computer and the Internet both for general and health-related activities in the group of parents of children suffering from chronic medical conditions.Material and methods: The survey was prepared and performed in the group of 120 parents accompanying their children during outpatient visits to speciality polyclinic (response rate 90.8%).Results: The mean age of respondents was 40.9 years; 82.6% of them were women. The use of computers was declared by 88.1% and the Internet by 80.7% of the respondents. The Internet was one of main sources of health-related information for 77.1% of them. Checking of procedures recommended by a physician and obtaining advice from other parents were indicated most frequently among health-related activities performed online (56,8% and 53,5% respectively). Use of the Internet depended on age, education and place of residence of respondents. These factors did not have impact on accepting of the Internet as one of the main sources of health-related informationConclusions: The parents of children suffering from chronic conditions more frequently use IT for general and health-related purposes than general population. Although they reveal relatively high satisfaction, there are still areas of care which could benefit from introduction of e‑health tools. However, there are still areas which could be supported or enhanced with e‑health solutions

Clinical value of serum eosinophilic cationic protein assessment in children with inflammatory bowel disease

Introduction: Eosinophils contribute to the pathogenesis of inflammatory bowel disease (IBD) in the intestine. Eosinophilic cationic protein (ECP) is one of the most important eosinophilic specific mediators released during activation. The aim of the study was to evaluate the clinical value of serum ECP determination in children with active and inactive IBD and its correlation with disease activity. Material and methods: There were 125 children with IBD (63 with Crohn’s disease - CD, 44 with ulcerative colitis - UC, 18 indeterminate colitis - IC) enrolled in the study. Among them 83 children were in the active phase of the disease, while the remaining 42 were in remission. The control group consisted of 56 healthy children. The ECP was assessed three times in children with active IBD, at baseline and after 2 and 6 weeks of treatment and once in children with inactive IBD and controls using fluoroenzymeimmunoassays. Results: We found elevated ECP at baseline in the total active IBD group when compared to the inactive IBD and control groups, decreasing during treatment. Serum ECP was also elevated in the active UC and CD groups when compared to the inactive UC and CD groups, and correlated with clinical UC and CD activity (R = 0.57 and R = 0.52, p < 0.05, respectively) and duration of the clinical manifestation in UC (R = 0.62, p < 0.05) but not with the disease location in the gastrointestinal tract, or endoscopic and histopathological activity. Conclusions: Evaluation of serum ECP in children with IBD may be useful in disease activity assessment at onset and during the treatment

Impact of biological treatment on intestinal microbiom in children with Crohn's disease

Crohn’s disease (CD) is a chronic, inflammatory illness of the digestive tract, characterized by alternating periods of remission and recurrence. The pathogenesis of CD is still unclear but probably is a result of a complex interaction between immunological, genetic and microbiological disorders. In recent years, there has been an increasing extent of evidence that gut microbiota plays a very important role in the pathogenesis of CD. Currently, the most effective treatment is biological therapy using anti-TNF monoclonal antibodies. It is interesting whether biological drugs resulting in fast remission, contributes to the normalization of the gut microbiota. Due to the fact that the children’s population is a significant percentage of all patients with CD, it is important to pay close attention to the problem of microbiological disorders in this age group. The aim of this study was to investigate whether there are quantitative changes of chosen bacteria species and fungi of the genus Candida in children with Crohn's disease relative to healthy children and assesment of quantitative changes in patients after biological treatment. In the group of children with Crohn’s disease, the numbers in Candida were significantly higher (9.74×1017 CFU/g) than in the control group (9.35×1010 CFU/g, p = 0.011). Biological therapy led to a significant reduction in the amount Candida (5.91×1011) and was comparable with the number in the control group. In the case of bacteria, we observed an increase in S. marcescens (3,4×108) in the patients group compared to the controls (1,85×108) and an increase in L. fermentum (2,34×1010) in relation to healthy children (3,31×108, p = 0,048) Biological treatment had an impact on the decrease in L. fermentum (4,76×109, p = 0.05)

Awareness of smoking in adolescents with inflammatory bowel disease

Introduction and objectives. Inflammatory bowel disease (IBD) is long life disease that results from an interaction between a polygenetic predisposition and environmental factors, including smoking. The aim of this study was to evaluate beliefs about and awareness of smoking among adolescents with IBD compared to healthy controls. Materials and method. Patients with IBD, Crohn’s disease (CD) and ulcerative colitis (UC), and healthy controls were asked to complete a questionnaire on demographic data and smoking status. The questionnaire also included data on beliefs and awareness of smoking-related health effects, including effects on IBD. Results. A total of 139 IBD patients and 108 controls were enrolled in the study. Of the IBD patients, 17/139 (12.2%) were smokers compared to 18/108 (16.7%) of controls (p=0.3). Patients with IBD were nine times more likely to be everyday smokers than occasional smokers (OR=9.2, 95% CI: 1.9- 45.1, p=0.004). No difference was found between patients with CD and UC in their answers to the question of whether “smoking increases the risk for surgery in your type of IBD” (17/28 (60.7%) vs. 10/29 (34.5%), respectively (p=0.047). More patients with CD than UC were aware of the risks of smoking on their disease: extra-intestinal manifestations and disease exacerbation, OR=11.3 (95% CI: 4.1 – 30.9; p=0.000) and OR=19.3 (95% CI: 6.7 – 55.1; p=0.000), respectively. Conclusions. The data obtained demonstrated that adolescents with CD are much more aware of the role of smoking on CD than are their peers with UC; however, this awareness is still unsatisfactory. Therefore, there is an unmet need to implement better anti-smoking strategies for this group of patients

Serum concentrations of fibrosis markers in children with inflammatory bowel disease

Background and study aims: The aim of the study was to assess the usefulness of serum concentrations of YKL-40/ CHI3L1 (a 40-kilodalton glycoprotein also referred to as chitinase 3 like- 1 - CHI3L1) and PIIINP (N-terminal propeptide of type III procollagen), markers of fibrosis, in the monitoring of inflammatory processes and fibrosis in children with inflammatory bowel disease (IBD). Patients and methods: In 60 patients (41 with Crohn’s disease (CD), 19 with ulcerative colitis (UC)) concentrations of investigated parameters were measured at baseline (day 0), after 3 and after 6-8 weeks of pharmacological treatment. Results: PIIINP concentrations were significantly higher in CD patients compared to UC (baseline results: median concentrations 1013.73 vs 78.30 ng/mL; P = 0.06 for the Kruskall-Wallis test; results at 6-8 weeks: 1076.48 vs 53.10 ng/mL, P = 0.01). Fibrosis was clearly present in patients with CD and its severity increased (reflected by both YKL-40/ CHI3L1 and PIIINP concentrations) in 6–8 weeks of follow up, regardless of the treatment used during that time. In patients with UC the levels of YKL-40/CHI3L1 and PIIINP were lower at baseline and further decreased after 6–8 weeks (median concentrations were respectively: 39.5 ng/mL vs 24.7 ng/mL and 78.3 ng/mL vs 53.1 ng/mL). Conclusion: Fibrosis was more severe in CD than in UC patients. The marker that more accurately reflected these differences was PIIINP

A role of hydrogen peroxide producing commensal bacteria present in colon of adolescents with inflammatory bowel disease in perpetuation of the inflammatory process

Bacteria in the gut play a central role in the initiation and progress of inflammatory bowel disease (IBD). This study was prepared to elucidate the role in the inflammatory process of the bacterial species which are able to produce hydrogen peroxide, present in samples taken from colon lesions in adolescents with inflammatory bowel disease. Fifty eight adolescents were enrolled into the study from January 2004 to October 2006 in Cracow, Poland. Biopsies and stool samples were collected. Bacteriological examinations and measurements of hydrogen peroxide production by enterococci, streptococci and lactobacilli were performed. For the first time it has been shown here that HP producing bacteria may contribute to increased amounts of hydrogen peroxide in the inflamed mucosa of Crohn’s disease and ulcerative colitis patients. Moreover, we have been able to demonstrate an increase of total populations of aerobic bacteria but not anaerobes in the studied samples of mucosa of adolescents with inflammatory bowel disease which is an indirect evidence of higher oxygen tension present in inflamed tissues in IBD. We have also been able to demonstrate the direct relationship between presence of blood in stools of IBD adolescents and increased populations of Enterobacteriaceae but not streptococci in samples of colon mucosa. It is, therefore, possible that different products of Enterobacteriaceae and especially their lipopolysaccharides may also contribute to perpetuation of the chronic colon inflammation

Changes in the intestinal microbiota are seen following treatment with infliximab in children with crohn's disease

The aim of the study was to determine the impact of biological treatment with tumor necrosis factor α antibodies (anti-TNF-α) on the intestinal microbiome of children with severe Crohn’s disease (CD) and to evaluate the differences in the intestinal microbiome between patients treated with biological therapy and healthy children. Microbiota composition was analyzed by 16S next-generation sequencing (NGS) and microbial profiles were compared between studied groups. Fifty-four samples (from 18 patients before and after anti-TNF-α induction therapy and 18 healthy children) were used in the sequencing analysis. Shannon’s diversity index (p = 0.003, adj. p = 0.010) and observed operational taxonomic units (OTUs) (p = 0.007, adj. p = 0.015) were different between controls and patients with prior therapy for CD. Statistically significant dissimilarities between beta diversity metrics, indicating distinct community composition across groups, were observed in patients with CD before and after therapy. We did not observe any differences between controls and patients with CD after therapy. Core microbiome analysis at species level showed that 32 species were present only in patients with CD but not in controls. The results show that biological treatment is associated with changes in the intestinal microbiome of patients with CD: these changes result in an intestinal microbiome pattern similar to that seen in healthy children. Long-term observation is necessary to determine whether treatment can lead to full restoration of a healthy-like microbiome