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Bukowski JS, Jankowski J, Bałut D, Kozieł S, Pertkiewicz J, Banaszkiewicz A. Ansa pancreatica as a rare cause of pancreatitis: A review of case reports. Pancreatology 2024:S1424-3903(24)00071-1. [PMID: 38519392 DOI: 10.1016/j.pan.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/14/2024] [Accepted: 03/17/2024] [Indexed: 03/24/2024]
Affiliation(s)
- Jan Stanisław Bukowski
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Jan Jankowski
- Students' Scientific Group GEKON, Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland; Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
| | - Daniel Bałut
- Students' Scientific Group GEKON, Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Sławomir Kozieł
- Department of General and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Jan Pertkiewicz
- Department of General and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
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Dembiński Ł, Grzybowska-Chlebowczyk U, Toporowska-Kowalska E, Walkowiak J, Gładysiewicz B, Dądalski M, Korczowski B, Czkwianianc E, Zagierski M, Jarocka-Cyrta E, Soroczyńska-Wrzyszcz A, Pytrus T, Krawiec P, Banaszkiewicz A. Pediatric endoscopy in times of pandemic: A nationwide retrospective analysis. J Infect Public Health 2024; 17:396-400. [PMID: 38246113 DOI: 10.1016/j.jiph.2023.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/16/2023] [Accepted: 12/31/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Gastrointestinal endoscopy is a procedure that carries an increased risk of transmission of SARS-CoV-2 infection to medical staff. In patients, COVID-19 is a risk factor for adverse events of medical procedures. This study analyzed the real-life risk of, and factors contributing to, infection transmission to endoscopic personnel, and possible adverse events of the endoscopy procedure and anesthesia in children with COVID-19. METHODS Nationwide retrospective analysis of medical records of children with confirmed SARS-CoV-2 infection who underwent gastrointestinal endoscopy in Poland between February 2020 and February 2022. RESULTS Fifty-eight patients were included in the analysis, 35% of whom had COVID-19 symptoms at the time of endoscopy. The dominant indications for endoscopy were foreign body or corrosive substance ingestion and gastrointestinal bleeding. Nine cases of virus transmission were registered among endoscopic personnel. In all of these cases, the endoscopy team was unaware of the patient's infection (p < 0.01), although symptoms were present in 78% of the children. Lack of use of personal protective equipment was the strongest predictor of SARS-CoV-2 transmission (p < 0.01). The risk of infection was not statistically significantly dependent on the method of anesthesia, intubation or the type of endoscopy. No statistically significant correlation was found between symptomatic infection and adverse events of endoscopy or anesthesia occurrence. There was one reported anesthesia-related adverse event involving extubation difficulties due to worsening respiratory infection symptoms. CONCLUSIONS The risk of transmitting SARS-CoV-2 to endoscopic personnel during procedures in children is low and depends on compliance with infection prevention and control measures. Performing gastrointestinal endoscopy in children with COVID-19 does not appear to be associated with an increased risk of adverse events.
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Affiliation(s)
- Łukasz Dembiński
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland.
| | | | - Ewa Toporowska-Kowalska
- Department of Pediatric Allergology, Gastroenterology and Nutrition, Medical University of Lodz, Lodz, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Beata Gładysiewicz
- Department of Gastroenterology and Hepatology, Pediatrics Clinic, Regional Polyclinical Hospital, Kielce, Poland
| | - Maciej Dądalski
- Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | - Bartosz Korczowski
- Department of Pediatrics and Pediatric Gastroenterology, Institute of Medical Sciences, Medical College, University of Rzeszów, Rzeszów, Poland
| | - Elżbieta Czkwianianc
- Department of Gastroenterology, Allergology and Pediatrics, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Maciej Zagierski
- Department of Pediatrics, Gastroenterology, Allergology and Nutrition, Medical University of Gdańsk, Gdańsk, Poland
| | - Elżbieta Jarocka-Cyrta
- Department of Clinical Pediatrics, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Provincial Specialist Children's Hospital, Olsztyn, Poland
| | | | - Tomasz Pytrus
- Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Wroclaw, Poland
| | - Paulina Krawiec
- Department of Pediatrics and Gastroenterology, Medical University of Lublin, Lublin, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
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Dembiński Ł, Dziekiewicz M, Banasiuk M, Banaszkiewicz A. Pediatric Gastrointestinal Stromal Tumor. J Pediatr Gastroenterol Nutr 2023; 77:e48. [PMID: 37195885 DOI: 10.1097/mpg.0000000000003831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Affiliation(s)
- Łukasz Dembiński
- From the Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Warsaw, Poland
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Daniluk U, Krawiec P, Pac-Kożuchowska E, Dembiński Ł, Bukowski JS, Banaszkiewicz A, Woźniuk-Kaźmierczak A, Czkwianianc E, Brylak J, Walkowiak J, Borys-Iwanicka A, Kofla-Dłubacz A, Pytrus T, Zdanowicz K, Lebensztejn DM. Pancreatic Involvement in the Course of Inflammatory Bowel Disease in Children-A Multi-Center Study. J Clin Med 2023; 12:4174. [PMID: 37445210 DOI: 10.3390/jcm12134174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
The coexistence of inflammatory bowel disease (IBD) with pancreatic pathology is rare in children. A retrospective analysis of data from 1538 children diagnosed with IBD in 2014-2021 was conducted to determine the frequency and causes of pancreatitis and asymptomatic hyperlipasemia (HL) or hyperamylasemia (HA) in this group of patients. Among the 176 children (11.4%) with pancreatic involvement (PI), acute pancreatitis (AP) was diagnosed in 77 children (43.8%), and HA or HL was observed in 88 children (50.0%). Only a few patients were diagnosed with autoimmune or chronic pancreatitis (6.2%). PI was observed at the time of the IBD diagnosis in 26.1% of the cases. A total of 54.5% of the patients had moderate to severe IBD, and 96% had colonic involvement at the time of diagnosis of PI. Idiopathic PI was the most common (57%), followed by drug-induced PI (37%) and azathioprine (AZA). In patients with AZA-induced AP, the successful introduction of 6-mercaptopurine (6-MP) to therapy was noted in 62.5% of the children. Our results suggest that routine monitoring of pancreatic enzymes in patients with IBD should be performed, especially after the initiation of the AZA treatment. The presence of transient HA/HL in IBD does not necessarily indicate pancreatic pathology.
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Affiliation(s)
- Urszula Daniluk
- Department of Pediatrics, Gastroenterology, Hepatology, Nutrition, Allergology and Pulmonology, Medical University of Bialystok, 15-274 Bialystok, Poland
| | - Paulina Krawiec
- Department of Pediatrics and Gastroenterology, Medical University of Lublin, 20-059 Lublin, Poland
| | - Elżbieta Pac-Kożuchowska
- Department of Pediatrics and Gastroenterology, Medical University of Lublin, 20-059 Lublin, Poland
| | - Łukasz Dembiński
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Jan Stanisław Bukowski
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna Woźniuk-Kaźmierczak
- Department of Gastroenterology, Allergology and Pediatrics, Polish Mother's Memorial Hospital-Research Institute, 93-338 Lodz, Poland
| | - Elżbieta Czkwianianc
- Department of Gastroenterology, Allergology and Pediatrics, Polish Mother's Memorial Hospital-Research Institute, 93-338 Lodz, Poland
| | - Jan Brylak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 60-572 Poznan, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 60-572 Poznan, Poland
| | - Agnieszka Borys-Iwanicka
- 2nd Clinical Department of Pediatrics, Gastroenterology and Nutrition, Medical University of Wroclaw, 50-369 Wroclaw, Poland
| | - Anna Kofla-Dłubacz
- 2nd Clinical Department of Pediatrics, Gastroenterology and Nutrition, Medical University of Wroclaw, 50-369 Wroclaw, Poland
| | - Tomasz Pytrus
- 2nd Clinical Department of Pediatrics, Gastroenterology and Nutrition, Medical University of Wroclaw, 50-369 Wroclaw, Poland
| | - Katarzyna Zdanowicz
- Department of Pediatrics, Gastroenterology, Hepatology, Nutrition, Allergology and Pulmonology, Medical University of Bialystok, 15-274 Bialystok, Poland
| | - Dariusz Marek Lebensztejn
- Department of Pediatrics, Gastroenterology, Hepatology, Nutrition, Allergology and Pulmonology, Medical University of Bialystok, 15-274 Bialystok, Poland
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Banaszkiewicz A, Bukowski J, Pertkiewicz J, Dembiński Ł, Kluczewska E, Kwiecień J. Ansa Pancreatica. J Pediatr Gastroenterol Nutr 2023; 76:e45. [PMID: 36417399 DOI: 10.1097/mpg.0000000000003665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Aleksandra Banaszkiewicz
- From the Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Jan Bukowski
- From the Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Jan Pertkiewicz
- the Department of General and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Łukasz Dembiński
- From the Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Kluczewska
- the Department of Radiology and Radiodiagnostics in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jarosław Kwiecień
- the Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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Dziekiewicz M, Marczak H, Banasiuk M, Aksionchyk M, Krenke K, Banaszkiewicz A. Characteristics of gastroesophageal reflux disease in children with interstitial lung disease. Pediatr Pulmonol 2023; 58:171-177. [PMID: 36196557 DOI: 10.1002/ppul.26176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 09/10/2022] [Accepted: 09/28/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Childhood interstitial lung disease (chILD) is a rare group of respiratory tract disorders. One of the factors suggested to be associated with its etiopathogenesis is microaspiration related to gastroesophageal reflux disease (GERD). The aim of the present study was to determine the frequency and characteristics of GERD in children with chILD, with a particular focus on proximal GER episodes. METHODS This was a prospective cross-sectional study. Consecutive patients with chILD underwent 24-h multichannel intraluminal pH-impedance monitoring. Different types of gastroesophageal reflux episodes (GER) were recorded and compared with regard to the GERD diagnosis. RESULTS Sixty-two children (median age of 1.22 years) were included. GERD was diagnosed in 20 (32.3%) of them. The GERD (+) and GERD (-) subgroups differed mainly in their esophageal exposure to acid content (2.9 vs. 1.0%, p = 0.02) and bolus exposure (3.0 vs. 1.4%, p < 0.0001), as well as total number of GER (72.5 vs. 42.0 p = 0.0004), acid GER (35.5 vs. 15.0 p = 0.004), and acid proximal GER (21.0 vs. 12.0 p = 0.02). There were no differences in the number of proximal GER comparing GERD (+) and GERD (-) subgroups. CONCLUSIONS The frequency of GERD seems to be relatively high in the population of children with chILD used in this study. However, it has not demonstrated an association between proximal GER and GERD diagnosis in chILD, which casts uncertainty over the microaspiration theory proposed to link the two diseases. The latter conclusion, however, needs to be confirmed using more accurate aspiration assessment methods.
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Affiliation(s)
- Marcin Dziekiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Honorata Marczak
- Department of Pediatric Pneumology and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Banasiuk
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Marina Aksionchyk
- Department of Pediatric Gastroenterology, Diagnostic Division, Republican Scientific and Practical Center for Pediatric Surgery, Minsk, Belarus
| | - Katarzyna Krenke
- Department of Pediatric Pneumology and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
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Rybak K, Warchoł A, Drobczyński Ł, Banaszkiewicz A. Metronidazole-Induced Encephalopathy in a 16-Year-Old Girl with Crohn’s Disease: Case Report and Review of the Pediatric Literature. Children 2022; 9:children9091408. [PMID: 36138717 PMCID: PMC9497710 DOI: 10.3390/children9091408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 11/29/2022]
Abstract
Metronidazole-induced encephalopathy (MIE) is a rare and unpredictable complication that is most commonly reported in adults. Here, we present the case of MIE in a patient treated with rectal, oral, and intravenous metronidazole. This is the first case of MIE reported after suppositories. A 16-year-old girl with Crohn’s disease treated with mesalazine and exclusive enteral nutrition was operated on due to perianal fistulas and abscesses. She received oral metronidazole for 25 days and rectal metronidazole for 15 days as an adjuvant before surgery. Moreover, 2.5 g of intravenous metronidazole was administrated during the perioperative period. The second day after the surgery, symptoms of cerebellar syndrome appeared. She presented with an inability to coordinate balance and gait. Although she showed accurate verbal responses, her speech was slow, slurred, and scanning. The finger–nose test was positive. The T2-weighted magnetic resonance imaging revealed an increased symmetrical signal within the dentate nuclei of the cerebellum and in the corpus callosum. The changes were characterized by restricted diffusion. Based on the clinical picture and magnetic resonance imaging findings, MIE was diagnosed. Treatment with metronidazole was discontinued. The cumulative dose of metronidazole that she received for 29 days was 54 g: 38 g p.o., 13.5 g p.r., and 2.5 g i,v. The first symptoms appeared on the 28th day of antibiotic therapy after receiving 52 g of metronidazole. The neurological symptoms resolved after six days; however, three days after the resolution, paresthesia appeared in the distal phalanges of both feet and lasted for approximately two months. Our report highlights that neurologic symptoms related to metronidazole treatment should raise the suspicion of MIE.
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Affiliation(s)
- Karolina Rybak
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warsaw, Poland
- Correspondence:
| | - Aleksandra Warchoł
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Łukasz Drobczyński
- Department of Pediatric Radiology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warsaw, Poland
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Glapa-Nowak A, Szczepanik M, Banaszkiewicz A, Kwiecień J, Szaflarska-Popławska A, Grzybowska-Chlebowczyk U, Osiecki M, Kierkuś J, Dziekiewicz M, Walkowiak J. C-Reactive Protein/Albumin Ratio at Diagnosis of Pediatric Inflammatory Bowel Disease: A Retrospective Multi-Center Study. Med Sci Monit 2022; 28:e937842. [PMID: 36101481 PMCID: PMC9484282 DOI: 10.12659/msm.937842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background This study aimed to evaluate the C-reactive protein-to-albumin (CRP/albumin) ratio at diagnosis of pediatric inflammatory bowel disease (IBD). Material/Methods Serum CRP/albumin ratio was calculated for patients with Crohn’s disease (CD; n=186) and ulcerative colitis (UC; n=159) aged 3–18 years. Results Patients with CD differed in CRP/albumin ratio at diagnosis in groups with quiescent, mild, moderate, and severe disease (P=0.011). CRP/albumin ratio at diagnosis was significant in differentiating patients with severe CD from quiescent disease at diagnosis (area under the curve (AUC)=0.94, odds ratio (OR)=63.4, 95% confidence interval (CI) 7.1–569.1, P<0.0001). CRP/albumin ratio at diagnosis could moderately differentiate penetrating from non-penetrating disease behavior in CD at diagnosis (AUC=0.73, OR=6.3, 95% CI 2.0–19.3, P<0.001). Furthermore, CRP/albumin ratio at diagnosis weakly differentiated IBD patients in need of biological treatment in a step-up procedure (AUC=0.58, OR=2.1, 95% CI 1.3–3.4, P=0.022) and in need of surgery (AUC=0.63, OR=3.1, 95% CI 1.4–7.2, P=0.006). For the IBD, CRP/albumin ratio at diagnosis was weakly correlated with age at first immunosuppressive treatment (rho=0.20, P=0.018), time from diagnosis to first biological treatment (rho=−0.37, P<0.001), days spent in hospital (rho=0.26, P=0.007), number of severe relapses (rho=0.31, P=0.001), and Pediatric Crohn’s Disease Activity Index (rho=0.38, P=0.002). Conclusions The present findings add to previous studies carried out in adult patients and show that the CRP/albumin ratio at diagnosis was not significantly associated with the course of either CD or UC in children. However, CRP/albumin ratio could differentiate patients with severe CD from those with quiescent disease.
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Affiliation(s)
- Aleksandra Glapa-Nowak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, Poznań, Poland
| | - Mariusz Szczepanik
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, Poznań, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Jarosław Kwiecień
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Anna Szaflarska-Popławska
- Department of Pediatric Endoscopy and Gastrointestinal Function Testing, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | | | - Marcin Osiecki
- Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | - Jarosław Kierkuś
- Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | - Marcin Dziekiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, Poznań, Poland
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Dybska E, Nowak JK, Banaszkiewicz A, Szaflarska-Popławska A, Kierkuś J, Kwiecień J, Grzybowska-Chlebowczyk U, Walkowiak J. Methylation of RUNX3 Promoter 2 in the Whole Blood of Children with Ulcerative Colitis. Genes (Basel) 2022; 13:genes13091568. [PMID: 36140736 PMCID: PMC9498668 DOI: 10.3390/genes13091568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/22/2022] [Accepted: 08/30/2022] [Indexed: 12/03/2022] Open
Abstract
Ulcerative colitis (UC) results from a complex interplay between the environment, gut microbiota, host genetics, and immunity. Runt-related transcription factor 3 (RUNX3) regulates Th1/Th2 balance and, thus, the synthesis of cytokines and inflammation. We aimed to analyze the dependence of RUNX3 promoter 2 (P2) methylation level on: age, sex, body mass index (BMI), C-reactive protein (CRP), serum albumin, disease duration, Pediatric Ulcerative Colitis Activity Index (PUCAI), the Paris classification, and exposure to medications. This multicenter, cross-sectional study recruited hospitalized children with UC. Methylation of RUNX3 P2 was measured with methylation-sensitive restriction enzymes in the whole blood DNA. Sixty-four children were enrolled, with a mean age of 14.5 ± 2.8 years. Half of them were female (51.6%), and the average BMI Z-score was −0.44 ± 1.14. The mean methylation of RUNX3 P2 was 54.1 ± 13.3%. The methylation level of RUNX3 P2 did not correlate with age, sex, nutritional status, CRP, albumin, PUCAI, or the extent of colitis (Paris E1–E4). RUNX3 P2 methylation did not differ between patients recruited within two and a half months of diagnosis and children who had UC for at least a year. Current or past exposure to biologics, immunosuppressants, or steroids was not associated with RUNX3 P2 methylation. Methylation of RUNX3 promoter 2 in whole blood DNA does not seem to be associated with the characteristics of UC in children.
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Affiliation(s)
- Emilia Dybska
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 60-572 Poznan, Poland
| | - Jan Krzysztof Nowak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 60-572 Poznan, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna Szaflarska-Popławska
- Department of Pediatric Endoscopy and Gastrointestinal Function Testing, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-094 Bydgoszcz, Poland
| | - Jarosław Kierkuś
- Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland
| | - Jarosław Kwiecień
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland
| | - Urszula Grzybowska-Chlebowczyk
- Department of Pediatrics, Faculty of Medical Sciences, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 60-572 Poznan, Poland
- Correspondence:
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Banasiuk M, Dziekiewicz M, Dobrowolska M, Skowrońska B, Dembiński Ł, Banaszkiewicz A. Three-dimensional High-resolution Anorectal Manometry in Children With Non-retentive Fecal Incontinence. J Neurogastroenterol Motil 2022; 28:303-311. [PMID: 35362455 PMCID: PMC8978114 DOI: 10.5056/jnm20216] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 04/14/2021] [Accepted: 05/07/2021] [Indexed: 12/30/2022] Open
Abstract
Background/Aims Three-dimensional high-resolution anorectal manometry (3D-HRAM) is a precise tool to assess the function of the anorectum. Our aim is to evaluate children diagnosed with non-retentive fecal incontinence (NRFI) using 3D-HRAM. Methods In all children diagnosed with NRFI, manometric parameters and 3-dimensional reconstructions of the anal canal subdivided into 8 segments were recorded. All data were compared to raw data that were obtained from asymptomatic children, collected in our laboratory and published previously (C group). Results Forty children (31 male; median age, 8 years; range, 5-17) were prospectively included in the study. Comparison of the NRFI group and C group revealed lower values of mean resting pressure (74.4 mmHg vs 89.2 mmHg, P < 0.001) and maximum squeeze pressure (182 mmHg vs 208.5 mmHg, P = 0.018) in the NRFI group. In the NRFI group, the thresholds of sensation, urge and discomfort (40 cm3, 70 cm3, and 140 cm3, respectively) were significantly higher than those in the C group (20 cm3, 30 cm3, and 85 cm3, respectively; P < 0.001). In the NRFI group, 62.5% presented a mean resting pressure above the fifth percentile, and 82.5% of patients presented a maximum squeeze pressure above the fifth percentile. The comparisons between segments obtained from these patients and those obtained from the C group revealed several segments with significantly decreased pressure values in the NRFI group. Conclusions Our study demonstrated lower pressure parameters in children with NRFI. In patients with normal resting pressures, 3D-HRAM may reveal segments with decreased pressures, which may play a potential role in the pathomechanism of incontinence.
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Affiliation(s)
- Marcin Banasiuk
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Poland
| | - Marcin Dziekiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Poland
| | - Magdalena Dobrowolska
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Poland
| | - Barbara Skowrońska
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Poland
| | - Łukasz Dembiński
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Poland
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Nowak JK, Glapa-Nowak A, Banaszkiewicz A, Iwańczak B, Kwiecień J, Szaflarska-Popławska A, Grzybowska-Chlebowczyk U, Osiecki M, Kierkuś J, Hołubiec M, Chanaj-Kaczmarek J, Radzikowski A, Walkowiak J. HLA-DQA1*05 Associates with Extensive Ulcerative Colitis at Diagnosis: An Observational Study in Children. Genes (Basel) 2021; 12:genes12121934. [PMID: 34946883 PMCID: PMC8701736 DOI: 10.3390/genes12121934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/27/2021] [Accepted: 11/28/2021] [Indexed: 12/22/2022] Open
Abstract
The human leukocyte antigen (HLA) allele group HLA-DQA1*05 predisposes to ulcerative colitis (UC) and is associated with the development of antibodies against infliximab in patients with inflammatory bowel disease (IBD). Therefore, we hypothesized that the presence of HLA-DQA1*05 correlates with characteristics of pediatric IBD. Within a multi-center cohort in Poland, the phenotype at diagnosis and worst flare was established and HLA-DQA1*05 status was assessed enabling genotype-phenotype analyses. HLA-DQA1*05 was present in 221 (55.1%) out of 401 children with IBD (UC n = 188, Crohn's disease n = 213). In UC, the presence of HLA-DQA1*05 was moderately associated with a large extent of colonic inflammation at diagnosis (E4 55% more frequent in HLA-DQA1*05-positive patients, p = 0.012). PUCAI at diagnosis (p = 0.078) and the time from UC diagnosis to the first administration of biologic treatment (p = 0.054) did not differ depending on HLA-DQA1*05 status. The number of days of hospitalization for exacerbation was analyzed in 98 patients for whom sufficient follow-up was available and did not differ depending on HLA-DQA1*05 carriership (p = 0.066). HLA-DQA1*05 carriers with CD were less likely to present with both stenosing and penetrating disease (B2B3, p = 0.048) and to have active disease proximal to the ligament of Treitz (L4a) at the worst flare (p = 0.046). Future research focusing on explaining and preventing anti-TNF immunogenicity should take into account that ADA may develop not only as an isolated reaction to anti-TNF exposure but also as a consequence of intrinsic differences in the early course of UC.
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Affiliation(s)
- Jan Krzysztof Nowak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, Szpitalna 27/33, 60-572 Poznań, Poland; (J.K.N.); (A.G.-N.); (M.H.)
| | - Aleksandra Glapa-Nowak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, Szpitalna 27/33, 60-572 Poznań, Poland; (J.K.N.); (A.G.-N.); (M.H.)
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warszawa, Poland; (A.B.); (A.R.)
| | - Barbara Iwańczak
- Department and Clinic of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, 50-367 Wrocław, Poland;
| | - Jarosław Kwiecień
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland;
| | - Anna Szaflarska-Popławska
- Department of Pediatric Endoscopy and Gastrointestinal Function Testing, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-067 Bydgoszcz, Poland;
| | - Urszula Grzybowska-Chlebowczyk
- Department of Pediatrics, Faculty of Medical Sciences, Medical University of Silesia in Katowice, 40-055 Katowice, Poland;
| | - Marcin Osiecki
- The Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (M.O.); (J.K.)
| | - Jarosław Kierkuś
- The Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (M.O.); (J.K.)
| | - Magdalena Hołubiec
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, Szpitalna 27/33, 60-572 Poznań, Poland; (J.K.N.); (A.G.-N.); (M.H.)
| | - Justyna Chanaj-Kaczmarek
- Department of Pharmacognosy, Poznan University of Medical Sciences, 4 Święcickiego Street, 60-781 Poznan, Poland;
| | - Andrzej Radzikowski
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warszawa, Poland; (A.B.); (A.R.)
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, Szpitalna 27/33, 60-572 Poznań, Poland; (J.K.N.); (A.G.-N.); (M.H.)
- Correspondence:
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12
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Weterle-Smolińska K, Dziekiewicz M, Liber A, Banasiuk M, Wolańczyk T, Szymańska U, Banaszkiewicz A. Frequency of gastroesophageal reflux disease in adolescent girls with anorexia nervosa. Psychiatr Pol 2021; 55:1093-1100. [PMID: 34997745 DOI: 10.12740/pp/onlinefirst/118269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The aim of the study was to assess the incidence of gastroesophageal reflux disease (GERD) in young females with anorexia nervosa (AN). METHODS Participation in the study was proposed to young females with AN aged 12-18 who were hospitalized in the Department of Child Psychiatry, Medical University of Warsaw. Exclusion criteria were psychiatric disorders other than AN and treatment with prokinetic drugs and/or antacids (such as proton pump inhibitors or histamine receptor antagonists) in the last 2 weeks prior to the study. Patients were interviewed for gastrointestinal symptoms that can be related to GERD. Anthropometric measurements were obtained to assess the nutritional condition of the patients, and all of them were subjected to 24-hour pH-impedance monitoring. The pH-impedance recording was considered abnormal when the total number of reflux episodes exceeded 70 and/or the overall esophageal acid exposure time exceeded 6%. RESULTS 23 female patients with AN were included in the study. They reported numerous symptoms, e.g., epigastric pain, nausea, vomiting, heartburn, chest pain, or excessive belching. However, only 2 of them (8.7%) were diagnosed with GERD on the basis of 24-hour pH-impedance monitoring. Both were suffering from a restrictive subtype of anorexia. CONCLUSIONS Even if numerous gastrointestinal symptoms indicative of GERD are reported by patients with AN, diagnosis of the disease in this group should not be based on symptoms, but it should be confirmed in an objective examination, preferably pH-impedance test.
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Affiliation(s)
| | - Marcin Dziekiewicz
- Warszawski Uniwersytet Medyczny, Klinika Gastroenterologii i Żywienia Dzieci
| | - Anna Liber
- Warszawski Uniwersytet Medyczny, Klinika Gastroenterologii i Żywienia Dzieci
| | - Marcin Banasiuk
- Warszawski Uniwersytet Medyczny, Klinika Gastroenterologii i Żywienia Dzieci
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13
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Dembiński Ł, Banaszkiewicz A, Dereń K, Pituch-Zdanowska A, Jackowska T, Walkowiak J, Mazur A. Exploring Physicians' Perspectives on the Introduction of Complementary Foods to Infants and Toddlers. Nutrients 2021; 13:3559. [PMID: 34684560 PMCID: PMC8541593 DOI: 10.3390/nu13103559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/06/2021] [Accepted: 10/09/2021] [Indexed: 11/28/2022] Open
Abstract
Complementary feeding is the subject of many recommendations regarding the benefits of its use, illustrating its crucial impact on further health. However, it still poses a significant problem for caregivers, and thus for doctors. This survey focused on nutritional problems faced by the parents of infants and toddlers, as well as how physicians deal with these problems. Based on the responses from 303 doctors, it was determined that the time and sequence of introducing complementary foods raise the greatest doubts in parents. This study also found that at least one-third of pediatricians experience difficulties in providing effective nutritional counseling. Increasing the nutritional awareness of physicians can allow them to provide more appropriate support to parents.
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Affiliation(s)
- Łukasz Dembiński
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warsaw, Poland; (A.B.); (A.P.-Z.)
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warsaw, Poland; (A.B.); (A.P.-Z.)
| | - Katarzyna Dereń
- College of Medical Sciences, University of Rzeszow, 35-310 Rzeszów, Poland; (K.D.); (A.M.)
| | - Aleksandra Pituch-Zdanowska
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warsaw, Poland; (A.B.); (A.P.-Z.)
| | - Teresa Jackowska
- Department of Pediatrics, Center of Postgraduate Medical Education, 01-813 Warsaw, Poland;
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 60-572 Poznan, Poland;
| | - Artur Mazur
- College of Medical Sciences, University of Rzeszow, 35-310 Rzeszów, Poland; (K.D.); (A.M.)
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14
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Załęski A, Banasiuk M, Sokół-Łupińska K, Karolewska-Bochenek K, Banaszkiewicz A. Correlation of clinical symptoms, endoscopic features and density of oesophageal eosinophilia in children with newly-diagnosed eosinophilic esophagitis. Ann Agric Environ Med 2021; 28:404-408. [PMID: 34558261 DOI: 10.26444/aaem/127180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION AND OBJECTIVE Eosinophilic esophagitis (EoE) is an inflammatory immune-mediated oesophageal disease of growing prevalence. The aim of this study is to characterise the clinical symptoms, endoscopic features and histological findings, as well as their possible correlations, in newly-diagnosed EoE paediatric patients. MATERIAL AND METHODS Between 2009-2018, the clinical records of patients diagnosed with EoE at the Paediatric Hospital in Warsaw, Poland, were retrospectively reviewed. Inclusion criteria were upper gastrointestinal tract symptoms in association with oesophageal mucosal biopsy specimens containing not less than 15 intraepithelial eosinophils per hpf. The prevalence and the possible correlations between symptoms, endoscopic features and the density of eosinophilic infiltration were analysed; the medical history of the comorbidities were also assessed. RESULTS The study included 47 children (median age 9.5 years). The most common clinical symptoms were abdominal pain (53%) and GERD-like symptoms (26%). The most common macroscopic changes were white plaques and exudates in 47% and furrows in 34%. A macroscopically normal oesophagus was observed in 28% of the children. The median number of eosinophils was estimated to be 45 eosinophils/hpf (IQR: 30-60), and no significant differences were found between the density of eosinophil infiltration and clinical symptoms or endoscopic features. Moreover, 70% of the children had a history of an allergy disease, older children (>3 years) tended to have pollen allergy more often than younger children (p<0.05). CONCLUSIONS The density of oesophageal eosinophilia does not correlate with symptoms or endoscopic findings in children with newl-diagnosed EoE.
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Affiliation(s)
- Andrzej Załęski
- Department of Infectious Diseases, Tropical Diseases and Hepatology, Medical University, Warsaw, Poland
| | - Marcin Banasiuk
- Department of Paediatric Gastroenterology and Nutrition, Medical University, Warsaw, Poland
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15
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Banasiuk M, Dobrowolska M, Skowronska B, Konys J, Chorazyk A, Szudejko E, Banaszkiewicz A. Three-dimensional high-resolution anorectal manometry: cut-off values for diagnosis of dyssynergic defecation in children. Eur Rev Med Pharmacol Sci 2021; 25:5199-5207. [PMID: 34486694 DOI: 10.26355/eurrev_202108_26533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Dyssynergic defecation (DD) may be one of the most important causes of constipation, but its diagnostic criteria have not been formally validated in children. This study aims to evaluate constipated children with 3DHRAM (three-dimensional high-resolution anorectal manometry) and determine a new pediatric cut-off for DD variables. PATIENTS AND METHODS 205 patients diagnosed with functional constipation (FC) based on Rome III criteria were prospectively enrolled. Data were compared to a historical control group (C). Initially, the diagnosis of DD was based on adult criteria and divided into 4 types. A new cut-off value for percent anal relaxation was determined based on ROC curve analysis. RESULTS The FC group presented significantly lower values of percent anal relaxation during straining compared to the C group (9.5% vs. 20%, respectively, p=0.03). Based on adult criteria, DD was found in 53% of the FC group and 46% of the C group (p=0.3), with type II occurring most frequently (35.8%). New cut-off value of 31% for percent anal relaxation in children was derived based on the ROC curve analysis. Based on this new cut-off value, DD was diagnosed in 69.3% of constipated children, with type IV occurring most frequently (28.9%). The analysis of segmental pressure showed significant influence of segments at the locations of the puborectalis muscle and external anal sphincter. CONCLUSIONS We found that during bear down maneuver the percent anal relaxation variable significantly differed between patients and controls. The higher cut-off value should be used when 3DHRAM and the standard four-type classification are used to diagnose DD in children.
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Affiliation(s)
- M Banasiuk
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland.
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16
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Witkowska-Krawczak E, Zapolska A, Banaszkiewicz A, Kucharska A. Recurrent gastrointestinal bleeding due to vascular malformations in a girl with Turner syndrome. Pediatr Endocrinol Diabetes Metab 2021; 27:43927. [PMID: 34431260 PMCID: PMC10228191 DOI: 10.5114/pedm.2021.105636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/06/2021] [Indexed: 11/17/2022]
Abstract
Turner syndrome (TS) is a genetic defect accompanied by gonadal dysgenesis, short stature, characteristic dysmorphic features, congenital heart and kidneys defects, and other diseases. One of the less common are vascular malformations in the gastrointestinal (GI) tract. They are asymptomatic in some patients, but can also cause GI bleeding. We present a description of a 12-year-old patient with TS and vascular malformations in the GI tract who was admitted to the hospital because of recurrent microcytic anemia. At the age of 15, she started estrogen therapy due to hypogonadism. Since then, the bleeding has stopped and the number of malformations on follow-up colonoscopy has been significantly decreased. In TS patients with iron deficiency anemia, the differential diagnostics should include vascular defects in the GI. There are evidences, that estrogen therapy may limit the number of lesions and reduce the risk of bleeding.
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Affiliation(s)
- Ewa Witkowska-Krawczak
- SKN of Pediatrics and Endocrinology at Department of Pediatrics and Endocrinology, Medical University of Warsaw, Poland
| | - Anna Zapolska
- SKN Gekon at Department of Gastroenterology and Nutrition of Children, Medical University of Warsaw, Poland
| | | | - Anna Kucharska
- Department of Pediatrics and Endocrinology, Medical University of Warsaw, Poland
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Banasiuk M, Dobrowolska ME, Skowrońska B, Konys J, Banaszkiewicz A. Comparison of Anorectal Function as Measured with High-Resolution and High-Definition Anorectal Manometry. Dig Dis 2021; 40:448-457. [PMID: 34515101 DOI: 10.1159/000518357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/07/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Anorectal manometry (ARM) provides comprehensive assessment of pressure activity in the rectum and anal canal. Absolute pressure values might depend on the catheter used. OBJECTIVE Our aim was to compare the results obtained by different anorectal catheters in children with functional anorectal disorders. METHODS Children diagnosed with functional defecation disorders based on the Rome IV criteria were prospectively enrolled. ARM was performed in the supine position successively using 2 different probes in each patient in random order. Resting, squeeze pressures, and bear-down maneuver variables obtained by high-resolution (2-dimensional [2D]) and high-definition (3-dimensional [3D]) catheters were compared. RESULTS We prospectively included 100 children {mean age 7.5 [standard deviation (SD) ± 4.3] years; 62 boys}. Mean resting pressures were significantly higher when measured with the 3D than with the 2D catheter (71 [SD ± 19.4] vs. 65 [SD ± 20.1] mm Hg, respectively; p = 0.000). Intrarectal pressure measured by 3D and 2D catheters was similar (35 vs. 39 mm Hg, respectively; p = 0.761), but the percent of anal relaxation appeared to be higher for the 3D than for the 2D probe (12 vs. 5%, respectively; p = 0.002). Dyssynergic defecation (DD) was diagnosed in 41/71 patients (57.7%) using the 3D probe and in 51/71 children (71.8%) using the 2D probe (p = 0.044). Cohen's kappa showed only fair agreement between the catheters (κ = 0.40) in diagnosis of DD. CONCLUSIONS Our study demonstrated significantly different values of pressures obtained with different types of catheters. Normal ranges for conventional manometry cannot be applied to high-resolution systems, and results obtained by different types of manometry cannot be compared without adjustments (NCT02812823).
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Affiliation(s)
- Marcin Banasiuk
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | | | - Barbara Skowrońska
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Justyna Konys
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
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18
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Dembiński Ł, Stelmaszczyk-Emmel A, Sznurkowska K, Szlagatys-Sidorkiewicz A, Radzikowski A, Banaszkiewicz A. Immunogenicity of cholera vaccination in children with inflammatory bowel disease. Hum Vaccin Immunother 2021; 17:2586-2592. [PMID: 33794737 PMCID: PMC8475559 DOI: 10.1080/21645515.2021.1884475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The cholera vaccine can protect patients with inflammatory bowel disease (IBD) against both cholera and travelers' diarrhea. However, both immunosuppressive treatment and IBD can affect its vaccine immunogenicity. The aim of this study was to assess the immunogenicity and safety of the cholera vaccine in children with IBD. Children older than 6 years with diagnosed IBD were enrolled in this multicenter study. All patients were administered two doses of the oral cholera vaccine (Dukoral®). Anti-cholera toxin B subunit IgA and IgG seroconversion rates were evaluated in a group with immunosuppressive (IS) treatment and a group without IS treatment (NIS). Immunogenicity was assessed in 70 children, 79% of whom received IS treatment. Post-vaccination seroconversion was displayed by 33% of children, for IgA, and 70% of children, for IgG. No statistically significant differences were found in the immune responses between the IS and NIS groups: 35% vs. 27% (p = .90), for IgA, and 68% vs. 80.0% (p = .16), for IgG, respectively. One case of IBD exacerbation after vaccination was reported. The oral cholera vaccine is safe. The immunogenicity of the oral cholera vaccine in children with IBD was lower than previously observed in healthy ones. The treatment type does not seem to affect the vaccine immunogenicity.
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Affiliation(s)
- Łukasz Dembiński
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Warsaw, Poland
- CONTACT Łukasz Dembiński ; Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Zwirki I Wigury 63A, Warsaw02-091, Poland
| | - Anna Stelmaszczyk-Emmel
- Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Sznurkowska
- Department of Pediatrics, Gastroenterology, Allergology and Nutrition, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Agnieszka Szlagatys-Sidorkiewicz
- Department of Pediatrics, Gastroenterology, Allergology and Nutrition, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Andrzej Radzikowski
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Warsaw, Poland
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Kowalska-Duplaga K, Gawlik-Scislo A, Krzesiek E, Jarocka-Cyrta E, Łazowska-Przeorek I, Duplaga M, Banaszkiewicz A. Determinants of disease-specific knowledge among children with inflammatory bowel disease and their parents: A multicentre study. World J Gastroenterol 2021; 27:4468-4480. [PMID: 34366617 PMCID: PMC8316911 DOI: 10.3748/wjg.v27.i27.4468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/02/2021] [Accepted: 07/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Disease knowledge is associated with increased treatment compliance and improvement of symptoms in inflammatory bowel disease (IBD). IBD-knowledge inventory device (IBD-KID) was developed and validated specifically as a tool to measure disease-related knowledge in children with IBD and their parents. AIM To prospectively assess the determinants of disease-related knowledge regarding paediatric IBD patients and their parents, using the IBD-KID. METHODS A questionnaire-based survey was carried out in paediatric patients and their parents. The determinants of patients' and parents' IBD-KID scores were assessed according to hierarchical linear regression models. RESULTS The study group consisted of 269 IBD patients and 298 parents. The patients' mean (standard deviation, SD) IBD-KID score was 10.87 (± 3.97), while the parents' was 11.95 (± 3.97). Both groups exhibited poor knowledge of the side effects of steroid therapy, the role of surgical treatment in IBD, dietary restrictions and the risks associated with the use of herbal medicines. The patients' IBD-KID scores were statistically associated with patient sex [B coefficient (standard error, SE) = 1.03 (0.44), P = 0.021] and patient age [B (SE) = 0.03 (0.01), P < 0.001]. The parents' IBD-KID scores were significantly related to patient age [B (SE) = 0.02 (0.01), P = 0.003], and treatment with immunosuppressive agent [B (SE) = 1.85 (0.48), P < 0.001]. The final models explained 26.9% of the variance of patients' IBD-KID scores and 18.5% of the variance of parents' scores. CONCLUSION The variables originating from parents' knowledge were significantly associated with patients' IBD-KID scores. The study results indicate the need to implement better education programmes for patients and parents.
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Affiliation(s)
- Kinga Kowalska-Duplaga
- Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University Medical College, Kraków 30-663, Poland
| | - Anita Gawlik-Scislo
- Children's Hospital of the Medical University of Warsaw, Medical University of Warsaw, Warsaw 02-091, Poland
| | - Elzbieta Krzesiek
- Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Wroclaw 50-369, Poland
| | | | - Izabella Łazowska-Przeorek
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw 02-091, Poland
| | - Mariusz Duplaga
- Department of Health Promotion and e-Health, Jagiellonian University Medical College, Kraków 31-066, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw 02-091, Poland
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20
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Dziekiewicz M, Mielus M, Lisowska A, Walkowiak J, Sands D, Radzikowski A, Banaszkiewicz A. Effect of omeprazole on symptoms of gastroesophageal reflux disease in children with cystic fibrosis. A randomized, double-blind, placebo-controlled trial. Eur Rev Med Pharmacol Sci 2021; 25:999-1005. [PMID: 33577055 DOI: 10.26355/eurrev_202101_24669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The incidence of gastroesophageal reflux disease (GERD) is higher in patients with cystic fibrosis (CF) than in the general population. While the relationship between GERD and its typical symptom, heartburn, is beyond doubt, its effect on cough or abdominal pain is unclear. In CF patients, in particular, it is often difficult to confirm the causal relationship between GERD and these symptoms. The aim of this trial was to evaluate the effect of omeprazole treatment of GERD on abdominal pain and cough, in children with CF. PATIENTS AND METHODS This was a multicentre, randomized, double-blind, placebo-controlled trial. All children aged 4-18 years underwent 24-hour multichannel intraluminal pH-impedance monitoring. The patients with diagnosed GERD were randomly assigned to receive omeprazole (20 mg twice daily for 12 weeks) or placebo. The severity of symptoms was assessed on visual analog scale. RESULTS 22 consecutive patients (median age 11.02± 3,67, range 6.4-17.0) were enrolled. A statistically significant reduction in abdominal pain and typical GERD symptoms, but not cough, was observed in both omeprazole (N=12) and placebo (N=10) groups. However, there were no statistically significant differences between the groups in the degree of reduction. We did not observe any differences between the groups in terms of adverse reactions. CONCLUSIONS Treatment of GERD in children with CF seems not to have a stronger effect than a placebo on the severity of cough and abdominal pain. Considering this, as well as the previously raised concerns about the impact of chronic proton pump inhibitor treatment on the course of CF, perhaps one should be more careful in intensively treating suspected atypical GERD symptoms in patients with CF.
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Affiliation(s)
- M Dziekiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland.
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21
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Talarek E, Warzecha J, Banasiuk M, Banaszkiewicz A. Influenza Vaccination Coverage and Intention to Receive Hypothetical Ebola and COVID-19 Vaccines among Medical Students. Vaccines (Basel) 2021; 9:709. [PMID: 34209128 PMCID: PMC8310166 DOI: 10.3390/vaccines9070709] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/20/2021] [Accepted: 06/24/2021] [Indexed: 12/16/2022] Open
Abstract
The study aimed to determine influenza vaccine uptake among medical students and their intention to receive a hypothetical Ebola or COVID-19 vaccine. This cross-sectional questionnaire-based study was performed in 2015 and 2020 on 675 medical students at the Medical University of Warsaw, Poland. In 2020, the influenza vaccination coverage was 36.5%, and students were almost five times more likely to be vaccinated than in 2015 (OR = 4.8; 95% CI: 3.1-7.5). In 2020, the survey was conducted during the first university campaign targeted at free influenza vaccinations for all students, as well as during the first lockdown in Poland due to the COVID-19 pandemic. In 2020, clinical students (4th-6th study year) were significantly more often vaccinated than preclinical students (p < 0.001), in contrast to 2015. A majority-67.0% and 94.6%-of students expressed their intention to receive a hypothetical Ebola or COVID-19 vaccine, respectively. Among the medical students, influenza vaccination status was a predictor of the intention to receive a COVID-19 vaccine. Influenza vaccine uptake among medical students has increased significantly, but it is still not optimal; thus, further educational efforts are needed to convince those who are hesitant regarding vaccines. A high number of students reported their intention to receive a COVID-19 vaccine, and it is crucial to support their positive attitude about it.
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Affiliation(s)
- Ewa Talarek
- Department of Children’s Infectious Diseases, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Joanna Warzecha
- University Children’s Hospital of Warsaw, 02-091 Warsaw, Poland;
| | - Marcin Banasiuk
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.B.); (A.B.)
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.B.); (A.B.)
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Abstract
Until now it has been Professor Elie Metchnikoff, a Russian researcher and scientist, who has been considered the discoverer of probiotics. In the early 20th century he associated the longevity and good health of Caucasian peasants with their consumption of a type of yoghurt containing strains of Lactobacillus acidophilus which were supposed to destroy the harmful microbiota of the intestines. However, at least a dozen years prior to Metchnikoff, a Polish doctor and scientist Dr. Józef Brudziński planned, conducted and described a study in which he applied a Bacillus lactis aërogenes suspension in treatment of infants with acute infectious diarrhoea. Here, we briefly characterise this study. Undoubtedly, apart from his fame as the neurologist who described meningeal symptoms, he deserves to be regarded as the true 'Father of probiotics'.
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Affiliation(s)
- R T Krawczyk
- University Children's Hospital of Warsaw, Warsaw, Poland
| | - A Banaszkiewicz
- Medical University of Warsaw, Department of Pediatric Gastroenterology and Nutrition, Żwirki i Wigury 63a, 02-091 Warsaw, Poland
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Glapa-Nowak A, Szczepanik M, Iwańczak B, Kwiecień J, Szaflarska-Popławska AB, Grzybowska-Chlebowczyk U, Osiecki M, Dziekiewicz M, Stawarski A, Kierkuś J, Banasiewicz T, Banaszkiewicz A, Walkowiak J. Apolipoprotein E variants correlate with the clinical presentation of paediatric inflammatory bowel disease: A cross-sectional study. World J Gastroenterol 2021; 27:1483-1496. [PMID: 33911469 PMCID: PMC8047531 DOI: 10.3748/wjg.v27.i14.1483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/17/2020] [Accepted: 02/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It has been suggested that apolipoprotein E (APOE) polymorphisms are associated with the risk of developing inflammatory bowel disease (IBD) and the early age of disease onset. However, there are no reports regarding the relationship with clinical characteristics and disease severity.
AIM To summarise that APOE polymorphisms are associated with the risk of developing IBD and the early age of disease onset.
METHODS In total, 406 patients aged 3-18 with IBD (192 had ulcerative colitis and 214 had Crohn’s disease) were genotyped using the TaqMan hydrolysis probe assay. Clinical expression was described at diagnosis and the worst flare by disease activity scales, albumin and C-reactive protein levels, localisation and behaviour (Paris classification). Systemic steroid intake with the total number of courses, immunosuppressive, biological, and surgical treatment with the time and age of the first intervention were determined. The total number of exacerbation-caused hospitalisations, the number of days spent in hospital due to exacerbation, the number of relapses, and severe relapses were also estimated.
RESULTS Ulcerative colitis patients with the APOEε4 allele had lower C-reactive protein values at diagnosis (P = 0.0435) and the worst flare (P = 0.0013) compared to patients with the APOEε2 allele and genotype APOEε3/ε3. Crohn’s disease patients with the APOEε2 allele scored lower on the Pediatric Crohn’s Disease Activity Index at diagnosis (P = 0.0204). IBD patients with APOEε2 allele spent fewer days in the hospital due to relapse (P = 0.0440).
CONCLUSION APOE polymorphisms are associated with the risk of developing IBD and the clinical expression of IBD. However, the clinical relevance of the differences identified is rather modest.
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Affiliation(s)
- Aleksandra Glapa-Nowak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, Poznań 60-572, Poland
| | - Mariusz Szczepanik
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, Poznań 60-572, Poland
| | - Barbara Iwańczak
- Department of Pediatrics, Medical University of Wroclaw, Wroclaw 50-369, Poland
| | - Jarosław Kwiecień
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze 41-800, Poland
| | | | - Urszula Grzybowska-Chlebowczyk
- Department of Pediatrics, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Katowice 40-752, Poland
| | - Marcin Osiecki
- Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, The Children’s Memorial Health Institute, Warsaw 04-730, Poland
| | - Marcin Dziekiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw 02-091, Poland
| | - Andrzej Stawarski
- Department and Clinic of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Wroclaw 50-369, Poland
| | - Jarosław Kierkuś
- Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, The Children’s Memorial Health Institute, Warsaw 04-730, Poland
| | - Tomasz Banasiewicz
- Chair and Department of General Surgery, Gastroenterological Surgical Oncology and Plastic Surgery, Poznań University of Medical Sciences, Poznań 60-355, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw 02-091, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, Poznań 60-572, Poland
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24
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Karolewska-Bochenek K, Lazowska-Przeorek I, Grzesiowski P, Dziekiewicz M, Dembinski L, Albrecht P, Radzikowski A, Banaszkiewicz A. Faecal Microbiota Transfer - a new concept for treating cytomegalovirus colitis in children with ulcerative colitis. Ann Agric Environ Med 2021; 28:56-60. [PMID: 33775068 DOI: 10.26444/aaem/118189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Cytomegalovirus (CMV) infection in patients with inflammatory bowel disease (IBD) is reactivated by the use of immunosuppressive drugs. CMV infection may produce IBD flares refractory to standard therapy. OBJECTIVE The aim of our study was to assess the efficacy and safety of faecal microbiota transplantation (FMT) for the treatment of CMV colitis in patients with ulcerative colitis (UC) flare. MATERIAL AND METHODS A total of 8 children, with mild to severe UC, positive for CMV PCR in colonic biopsies, received 50-100 ml FMT by nasogastric tube on 5 consecutive days in each of 2 weeks. During the study, the subjects were treated with 5ASA and FMT. Immunosuppressant therapy was withdrawn, when CMV colitis was diagnosed by positive DNA PCR in colonic tissues. The clinical response was defined as a decrease of Paediatric UC Activity Index by ≥20 points. RESULTS At the 6th week of the study, negative colonic CMV DNA PCR was measured after 10 infusions in 7/8 patients. For one boy, 20 infusions were administered to assess CMV elimination from colonic biopsies. A clinical response was observed in 3/8 patients, with clinical remission in 3/8 patients. Faecal calprotectin decreased significantly in 3 patients. CRP normalized in 2 patients after 6 weeks. No serious adverse effects were observed during and after infusions. CONCLUSIONS FMT seems to be an effective and safe treatment option for CMV colitis in children with UC. This is the first study to demonstrate the application of FMT as a new therapeutic option for CMV colitis.
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Affiliation(s)
| | | | - Pawel Grzesiowski
- School of Public Health, Centre of Postgraduate Medical Education, Preventive Medicine and Rehabilitation Centre, Foundation for Infection Prevention Institute, Warsaw, Poland
| | - Marcin Dziekiewicz
- Department of Paediatric Gastroenterology and Nutrition, Medical University, Warsaw, Poland
| | - Lukasz Dembinski
- Department of Paediatric Gastroenterology and Nutrition, Medical University, Warsaw, Poland
| | - Piotr Albrecht
- Department of Paediatric Gastroenterology and Nutrition, Medical University, Warsaw, Poland
| | - Andrzej Radzikowski
- Department of Paediatric Gastroenterology and Nutrition, Medical University, Warsaw, Poland
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25
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Talarek E, Chazan M, Winiarska P, Dembiński Ł, Sobierajski T, Banaszkiewicz A. How attitudes towards vaccination change in the face of an outbreak. Hum Vaccin Immunother 2021; 17:805-809. [PMID: 32873126 PMCID: PMC7993138 DOI: 10.1080/21645515.2020.1798152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/26/2020] [Accepted: 07/13/2020] [Indexed: 01/06/2023] Open
Abstract
Outbreaks of infectious diseases cause great fear and a desire to avoid infection. One of the most effective outbreak containment methods is vaccination. However, in order for this strategy to be effective, a majority of the susceptible population should be vaccinated in a short time. This may require changing the practice of immunization execution and changing attitudes toward vaccination. In the survey on the attitudes of Polish parents and guardians toward vaccinations, we asked about the acceptance of vaccination in places other than health-care facilities in both non-epidemic and epidemic conditions. The study was conducted using an anonymous questionnaire in two Warsaw hospitals between August 2018 and February 2019 and was addressed to parents and legal guardians of children. At the time of the survey, "epidemic" was a hypothetical term. Two hundred fifty respondents participated in the study. The pharmacy was the most accepted non-healthcare facility vaccination location, both normally and during an outbreak, with 54.4% (123/226) and 75.2% (170/226) of respondents finding pharmacies an acceptable location, respectively. A gas station had the lowest acceptance: 5.8% (13/226) and 28.8% (65/226), respectively. The only statistically significant demographic factors affecting acceptance of each vaccination location were male sex (p = .001) and higher education level (p = .001). Of those surveyed, 58.5% (131/224) would approve of vaccination in front of a hospital or outpatient clinic during an outbreak; 70.5% (43/61) of men versus 54.0% (88/163) of women, p = .026. In conclusion, during an outbreak, people would be more likely to accept vaccination at locations other than a health-care facility.
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Affiliation(s)
- Ewa Talarek
- Department of Children`s Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
- Regional Hospital of Infectious Diseases in Warsaw, Warsaw, Poland
| | - Magdalena Chazan
- Student Research Association at Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Paulina Winiarska
- Student Research Association at Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Łukasz Dembiński
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Sobierajski
- Institute of Applied Social Sciences, University of Warsaw, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
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26
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Banaszkiewicz A, Bola Ł, Matuszewski J, Szczepanik M, Kossowski B, Mostowski P, Rutkowski P, Śliwińska M, Jednoróg K, Emmorey K, Marchewka A. The role of the superior parietal lobule in lexical processing of sign language: Insights from fMRI and TMS. Cortex 2020; 135:240-254. [PMID: 33401098 DOI: 10.1016/j.cortex.2020.10.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/24/2020] [Accepted: 10/22/2020] [Indexed: 11/29/2022]
Abstract
There is strong evidence that neuronal bases for language processing are remarkably similar for sign and spoken languages. However, as meanings and linguistic structures of sign languages are coded in movement and space and decoded through vision, differences are also present, predominantly in occipitotemporal and parietal areas, such as superior parietal lobule (SPL). Whether the involvement of SPL reflects domain-general visuospatial attention or processes specific to sign language comprehension remains an open question. Here we conducted two experiments to investigate the role of SPL and the laterality of its engagement in sign language lexical processing. First, using unique longitudinal and between-group designs we mapped brain responses to sign language in hearing late learners and deaf signers. Second, using transcranial magnetic stimulation (TMS) in both groups we tested the behavioural relevance of SPL's engagement and its lateralisation during sign language comprehension. SPL activation in hearing participants was observed in the right hemisphere before and bilaterally after the sign language course. Additionally, after the course hearing learners exhibited greater activation in the occipital cortex and left SPL than deaf signers. TMS applied to the right SPL decreased accuracy in both hearing learners and deaf signers. Stimulation of the left SPL decreased accuracy only in hearing learners. Our results suggest that right SPL might be involved in visuospatial attention while left SPL might support phonological decoding of signs in non-proficient signers.
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Affiliation(s)
- A Banaszkiewicz
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - Ł Bola
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - J Matuszewski
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - M Szczepanik
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - B Kossowski
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - P Mostowski
- Section for Sign Linguistics, Faculty of Polish Studies, University of Warsaw, Warsaw, Poland
| | - P Rutkowski
- Section for Sign Linguistics, Faculty of Polish Studies, University of Warsaw, Warsaw, Poland
| | - M Śliwińska
- Department of Psychology, University of York, Heslington, UK
| | - K Jednoróg
- Laboratory of Language Neurobiology, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - K Emmorey
- Laboratory for Language and Cognitive Neuroscience, San Diego State University, San Diego, USA
| | - A Marchewka
- Laboratory of Brain Imaging, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland.
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27
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Glapa-Nowak A, Szczepanik M, Kwiecień J, Szaflarska-Popławska A, Flak-Wancerz A, Iwańczak B, Osiecki M, Kierkuś J, Pytrus T, Lebensztejn D, Banasiewicz T, Banaszkiewicz A, Walkowiak J. Insolation and Disease Severity in Paediatric Inflammatory Bowel Disease-A Multi-Centre Cross-Sectional Study. J Clin Med 2020; 9:jcm9123957. [PMID: 33297324 PMCID: PMC7762204 DOI: 10.3390/jcm9123957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/29/2020] [Accepted: 12/05/2020] [Indexed: 12/19/2022] Open
Abstract
This study was to investigate whether the clinical course of inflammatory bowel disease (IBD) in a Polish paediatric cohort fits a seasonal pattern and depends on insolation. Two hundred and fourteen patients diagnosed with Crohn's disease (CD) and 192 with ulcerative colitis (UC) aged from 3 to 18 years, were recruited in seven centres of similar latitude. The seasons were defined as winter (December-February), spring (March-May), summer (June-August), autumn (September-November). The year was also divided depending on insolation threshold (3.0 kWh/m2/day). Patients diagnosed with IBD when the isolation was >3 kWh/m2/day had poorer nutritional status than those diagnosed while insolation was below threshold (lower standardised BMI at diagnosis (-0.81 ([-1.34]-[-0.03]) vs. -0.52 ([-1.15]-0.15); p = 0.0320) and worst flare (-0.93 ([-1.37]-[-0.05]) vs. -0.66 ([-1.23]-0.17); p = 0.0344), with the need for more frequent biological treatment (45.5% vs. 32.7%, p = 0.0100). Patients diagnosed in winter were significantly younger at diagnosis (11.4 vs. 13.0; padj = 0.0180) and first immunosuppressive treatment (11.3 vs. 13.3; padj = 0.0109) than those diagnosed in other seasons. CD patients diagnosed in months with higher insolation spent more days in hospital than those diagnosed in months with lower insolation [4.6 (1.8-11.8) vs. 2.9 (1.3-6.2); p = 0.0482]. CD patients diagnosed in summer had significantly more concomitant diseases. In patients with CD, the occurrence of the worst flare was more frequent in autumn. Furthermore, the season of birth was associated with Pediatric Crohn's Disease Activity Index at worst flare and earlier surgery. In conclusion, several clinical parameters are associated with insolation, the season of diagnosis and season of birth in the clinical course of Crohn's disease.
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Affiliation(s)
- Aleksandra Glapa-Nowak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, 60-572 Poznan, Poland; (A.G.-N.); (M.S.)
| | - Mariusz Szczepanik
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, 60-572 Poznan, Poland; (A.G.-N.); (M.S.)
| | - Jarosław Kwiecień
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Katowice, Poland;
| | - Anna Szaflarska-Popławska
- Department of Pediatric Endoscopy and Gastrointestinal Function Testing, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-067 Bydgoszcz, Poland;
| | - Anna Flak-Wancerz
- Department of Pediatrics, Faculty of Medical Sciences, Medical University of Silesia in Katowice, 40-752 Katowice, Poland;
| | - Barbara Iwańczak
- Department and Clinic of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, 50-369 Wroclaw, Poland; (B.I.); (T.P.)
| | - Marcin Osiecki
- The Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (M.O.); (J.K.)
| | - Jarosław Kierkuś
- The Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (M.O.); (J.K.)
| | - Tomasz Pytrus
- Department and Clinic of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, 50-369 Wroclaw, Poland; (B.I.); (T.P.)
| | - Dariusz Lebensztejn
- Department of Pediatrics, Gastroenterology, Hepatology, Nutrition and Allergology, Medical University of Bialystok, 15-274 Bialystok, Poland;
| | - Tomasz Banasiewicz
- Department of General and Endocrine Surgery and Gastroenterological Oncology, Poznań University of Medical Sciences, 60-355 Poznan, Poland;
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, 60-572 Poznan, Poland; (A.G.-N.); (M.S.)
- Correspondence:
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28
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Dziekiewicz M, Cudejko R, Banasiuk M, Dembiński Ł, Skarżyński H, Radzikowski A, Banaszkiewicz A. Frequency of gastroesophageal reflux disease in children with adenoid hypertrophy. Int J Pediatr Otorhinolaryngol 2020; 138:110304. [PMID: 32828019 DOI: 10.1016/j.ijporl.2020.110304] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/01/2020] [Accepted: 08/04/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Recent studies have suggested that the reflux of gastric contents can cause adenoid hypertrophy (AH). The frequency of gastro-oesophageal reflux disease (GERD) in this AH population is unknown, but according to studies using pH-metry it may be as high as 65%. The aim of this study was to estimate the frequency of GERD among children with AH. METHODS This was a cross-sectional, multicentre, prospective study of children with AH selected for adenoidectomy. The diagnosis of AH was made by a single laryngologist using a flexible fiberscope. All children had 24-hr multichannel intraluminal pH-impedance (MII/pH) assessment. A GERD diagnosis was made using BioVIEW software analysis after manual review by a single investigator. RESULTS 38 consecutive patients (21 males, mean age 6.58 years) were enrolled in the study. GERD was diagnosed in 5 (13.2%) patients. A total of 1462 gastro-oesophageal reflux events (GERs) were detected by MII/pH and the majority (60.9%) were acidic. The only significant differences between the GERD-positive and GERD-negative groups were the total number of GERs, and the number of acid GERs. CONCLUSION It is first study using MII/pH to assess the frequency of GERD in children with AH. The data suggest that GERD in children with AH seems to be not as common as it was previously raised. Further studies are needed to confirm these results.
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Affiliation(s)
- Marcin Dziekiewicz
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Zwirki I, Wigury 63A, 02-091, Warsaw, Poland.
| | - Renata Cudejko
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Mokra 17, Kajetany, 05-830, Nadarzyn, Poland
| | - Marcin Banasiuk
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Zwirki I, Wigury 63A, 02-091, Warsaw, Poland
| | - Łukasz Dembiński
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Zwirki I, Wigury 63A, 02-091, Warsaw, Poland
| | - Henryk Skarżyński
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Mokra 17, Kajetany, 05-830, Nadarzyn, Poland
| | - Andrzej Radzikowski
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Zwirki I, Wigury 63A, 02-091, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Zwirki I, Wigury 63A, 02-091, Warsaw, Poland
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29
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Martinelli M, Giugliano FP, Strisciuglio C, Urbonas V, Serban DE, Banaszkiewicz A, Assa A, Hojsak I, Lerchova T, Navas-López VM, Romano C, Sladek M, Veres G, Aloi M, Kucinskiene R, Miele E. Vaccinations and Immunization Status in Pediatric Inflammatory Bowel Disease: A Multicenter Study From the Pediatric IBD Porto Group of the ESPGHAN. Inflamm Bowel Dis 2020; 26:1407-1414. [PMID: 31689349 DOI: 10.1093/ibd/izz264] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Vaccine-preventable diseases and opportunistic infections in pediatric inflammatory bowel disease (IBD) are increasingly recognized issues. The aims of this study were to evaluate vaccinations, immunization status, and consequent therapeutic management in children with IBD and to analyze the differences among patients diagnosed before (Group 1) and after June 2012 (Group 2). METHODS This was a multicenter, retrospective cohort investigation. Between July 2016 and July 2017, 430 children with IBD were enrolled in 13 centers. Diagnosis, therapeutic history, vaccinations, and immunization status screening at diagnosis and at immunosuppressant (IM)/biologic initiation and reasons for incomplete immunization were retrieved. RESULTS Vaccination rates at diagnosis were unsatisfactory for measles, mumps, and rubella (89.3%), Haemophilus influenzae (81.9%), meningococcus C (23.5%), chickenpox (18.4%), pneumococcus (18.6%), papillomavirus (5.9%), and rotavirus (1.9%). Complete immunization was recorded in 38/430 (8.8%) children, but specific vaccines were recommended in 79/430 patients (18.6%), without differences between the 2 groups. At IM start, 22% of children were tested for Epstein-Barr virus (EBV) status, with 96.2% of EBV-naïve patients starting azathioprine, without differences between Groups 1 and 2. Screening for latent tuberculosis (TB) before start of biologics was performed in 175/190 (92.1%), with up to 9 different screening strategies and numerous inconsistencies. CONCLUSIONS We demonstrated a poor immunization status at diagnosis in children with IBD, which was not followed by proper vaccination catch-up. EBV status before IM initiation and latent TB before biologics were not adequately assessed. Thus, the overall impact of the current guidelines seems unsatisfactory.
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Affiliation(s)
- Massimo Martinelli
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II," Napoli, Italy; Napoli, Italy
| | - Francesca Paola Giugliano
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II," Napoli, Italy; Napoli, Italy
| | - Caterina Strisciuglio
- Department of Woman, Child and General and Specialistic Surgery, University of Campania "Luigi Vanvitelli," Napoli, Italy
| | - Vaidotas Urbonas
- Vilnius University Clinic of Children's Diseases, Vilnius, Lithuania
| | - Daniela Elena Serban
- 2nd Department of Pediatrics, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Emergency Clinical Hospital for Children, Cluj-Napoca, Romania
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Amit Assa
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva, affiliated with the Sackler faculty of Medicine, Tel-Aviv University, Israel
| | - Iva Hojsak
- Referral Center for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, University J.J. Strossmayer, Osijek, Croatia
| | - Tereza Lerchova
- Pediatric Department of 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | | | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, University of Messina, Messina, Italy
| | - Małgorzata Sladek
- Department of Pediatrics, Gastroenterology and Nutrition Jagiellonian University Medical College, Kracow, Poland
| | - Gabor Veres
- Pediatric Institute, AOK, University of Debrecen, Debrecen, Hungary
| | - Marina Aloi
- Department of Pediatrics, Sapienza University, Rome, Italy
| | - Ruta Kucinskiene
- Department of Pediatrics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Erasmo Miele
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II," Napoli, Italy; Napoli, Italy
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Bieńkowska A, Osińska I, Nowosielska J, Leloch A, Gawrychowski K, Banaszkiewicz A, Małecki M. Pharmaceutical emulsion with increased viscosity for local use of glucocorticosteroids in the esophagus. Farm Pol 2020. [DOI: 10.32383/farmpol/121025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Dziekiewicz M, Kowalska-Duplaga K, Baranowska-Nowak M, Neścioruk M, Kuźniarski S, Banasiuk M, Banaszkiewicz A. Awareness of smoking in adolescents with inflammatory bowel disease. Ann Agric Environ Med 2020; 27:61-65. [PMID: 32208581 DOI: 10.26444/aaem/105821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
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. MATERIAL AND METHODS 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.
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Affiliation(s)
- Marcin Dziekiewicz
- Department of Paediatric Gastroenterology and Nutrition, Medical University, Warsaw, Poland
| | - Kinga Kowalska-Duplaga
- Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, Jagiellonian University, Kraków, Poland
| | - Marta Baranowska-Nowak
- Department of Paediatric Gastroenterology and Nutrition, Medical University, Warsaw, Poland
| | - Magdalena Neścioruk
- Department of Paediatric Gastroenterology and Nutrition, Medical University, Warsaw, Poland
| | - Stefan Kuźniarski
- Department of Paediatric Neurosurgery and Traumatology, Medical University, Warsaw, Poland
| | - Marcin Banasiuk
- Department of Paediatric Gastroenterology and Nutrition, Medical University, Warsaw, Poland
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Kowalska-Duplaga K, Baranowska-Nowak M, Nescioruk M, Banasiuk M, Karolewska-Bochenek K, Łazowska-Przeorek I, Radzikowski A, Banaszkiewicz A. Immunization Coverage in Children with Inflammatory Bowel Disease. Adv Exp Med Biol 2019; 1113:83-88. [PMID: 29429027 DOI: 10.1007/5584_2018_163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Patients suffering from inflammatory bowel diseases (IBD) are at increased risk of infections, mainly due to immunosuppressive treatment. Moreover, infections may cause flares of IBD. Vaccination is the most effective way of preventing many infections. The aim of this study was to evaluate the vaccination status of Polish children with IBD. Individual immunization cards of children with IBD and healthy controls were reviewed. Demographic data such as age, sex, and IBD history, including therapy type, were collected. We enrolled 267 children into the study, including 214 children with IBD and 53 controls. None of the children had completed the full up-to-date routine childhood immunization schedule recommended in Poland. Controls were more than 4 times more likely to be vaccinated than the IBD patients, with the vaccines that enjoy the insurance reimbursed (OR 4.1, 95% CI 2.2-7.9). In conclusion, the study demonstrates a poor vaccination status in children suffering from IBD.
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Affiliation(s)
- K Kowalska-Duplaga
- Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University Medical College, Cracow, Poland
| | - M Baranowska-Nowak
- Department of Pediatric Gastroenterology and Nutrition, Warsaw Medical University, Warsaw, Poland
| | - M Nescioruk
- Department of Pediatric Gastroenterology and Nutrition, Warsaw Medical University, Warsaw, Poland
| | - M Banasiuk
- Department of Pediatric Gastroenterology and Nutrition, Warsaw Medical University, Warsaw, Poland
| | - K Karolewska-Bochenek
- Department of Pediatric Gastroenterology and Nutrition, Warsaw Medical University, Warsaw, Poland
| | - I Łazowska-Przeorek
- Department of Pediatric Gastroenterology and Nutrition, Warsaw Medical University, Warsaw, Poland
| | - A Radzikowski
- Department of Pediatric Gastroenterology and Nutrition, Warsaw Medical University, Warsaw, Poland
| | - A Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Warsaw Medical University, Warsaw, Poland.
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Jaworska K, Konop M, Bielinska K, Hutsch T, Dziekiewicz M, Banaszkiewicz A, Ufnal M. Inflammatory bowel disease is associated with increased gut-to-blood penetration of short-chain fatty acids: A new, non-invasive marker of a functional intestinal lesion. Exp Physiol 2019; 104:1226-1236. [PMID: 31243807 DOI: 10.1113/ep087773] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 05/29/2019] [Indexed: 01/02/2023]
Abstract
NEW FINDINGS What is the central question of this study? 'Leaky gut' has been found in intestinal and extra-intestinal diseases. However, functional evaluation of intestinal permeability is not widely used as a diagnostic marker, possibly owing to significant limitations of currently used permeability assays. There is an unmet need for development of a new, non-invasive test to assess intestinal function. What is the main finding and its importance? We show that an increased blood-to-stool ratio of the concentration of gut bacteria-produced short-chain fatty acids may be used as a marker of gut permeability. Our findings lay the groundwork for establishing a new, non-invasive, risk-free diagnostic tool in diseases associated with intestinal barrier malfunction, such as inflammatory bowel disease. ABSTRACT Intestinal diseases, such as inflammatory bowel disease (IBD), are characterized by an impaired gut-blood barrier commonly referred to as 'leaky gut'. Therefore, functional evaluation of the gut-blood barrier is a promising diagnostic marker. We hypothesized that short-chain fatty acids (SCFAs) produced by gut bacteria might serve as a marker in IBD. Animal experiments were performed on male Sprague-Dawley rats with acetic acid-induced colitis and in sham control animals. The gut-blood barrier permeability was determined by assessing the ratios of the following: (i) portal blood concentration of SCFAs (Cp ) to faecal concentration of SCFAs (Cf ); (ii) systemic blood concentration of SCFAs (Cs ) to faecal concentration of SCFAs (Cf ); and (iii) Cp and Cs of fluorescein isothiocyanate (FITC)-dextran administered into the colon. As a clinical study, we evaluated Cs , Cf and the Cs /Cf ratio of SCFAs in six paediatric patients with IBD, assessed as mild/moderate/severe by the Paediatric Ulcerative Colitis Activity Index (PUCAI) and the Paediatric Crohn's Disease Activity Index (PCDAI) at the time of sample collection, and nine age-matched healthy control subjects. Rats with histologically confirmed IBD had significantly increased ratios of Cp /Cf and Cs /Cf for SCFAs. This was positively correlated with the plasma FITC-dextran concentration. Likewise, IBD patients showed a significantly higher Cs /Cf ratio for SCFAs, including acetic, valeric, isocaproic, caproic and propionic acids, in comparison to control subjects. In conclusion, in the rats and in paediatric patients with IBD we found an increased blood-to-stool ratio of SCFAs, suggesting an increased gut-to-blood penetration of SCFAs. These findings pave the way for a new, non-invasive diagnostic tool in IBD and other diseases accompanied by intestinal barrier malfunction.
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Affiliation(s)
- Kinga Jaworska
- Department of Experimental Physiology and Pathophysiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Marek Konop
- Department of Experimental Physiology and Pathophysiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Klaudia Bielinska
- Department of Experimental Physiology and Pathophysiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Hutsch
- Department of Experimental Physiology and Pathophysiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Dziekiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Ufnal
- Department of Experimental Physiology and Pathophysiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
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Pituch-Zdanowska A, Kowalska-Duplaga K, Jarocka-Cyrta E, Stawicka A, Dziekiewicz M, Banaszkiewicz A. Dietary Beliefs and Behaviors Among Parents of Children with Inflammatory Bowel Disease. J Med Food 2019; 22:817-822. [PMID: 31063436 DOI: 10.1089/jmf.2018.0206] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Diet is regarded as one of the important environmental factors triggering inflammatory bowel disease (IBD). Many IBD patients avoid numerous types of foods in fear of disease exacerbation. The aim of the study was to investigate dietary beliefs and food avoidance among pediatric patients with IBD. This questionnaire-based study was conducted in three University-affiliated children's hospitals in Poland. Data were collected from parents of children who were diagnosed with IBD. A total of 155 parents of IBD patients participated in the survey: 104 (67.1%) had a child with Crohn's disease and 51 (32.9%) with ulcerative colitis. Parents of older children and those with longer disease duration predicted diet being considered one of the causative agents of IBD, and differences were statistically significant (P = .01 and P = .04, respectively). Also, patients with a shorter history of disease rarely shared food with other family members (P = .02). In total, 61.5% of patients avoided some kind of food in fear of disease flares. In the parent's opinion, the food the children liked but avoided included fried dishes, sweets (e.g., chocolate, cookies, cakes, candies, jellies), and fast food. Due to their dietary beliefs, parents of children with IBD commonly introduced dietary restrictions for their offspring. Frequent and unjustified food avoidance may influence not only nutritional status but also general well-being of pediatric patients. Our results underscore the urgent need for IBD patients and parents of ill children to receive reliable dietary advice based on strong scientific evidence.
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Affiliation(s)
| | - Kinga Kowalska-Duplaga
- 2Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University Medical College, Cracow, Poland
| | - Elżbieta Jarocka-Cyrta
- 3Department of Pediatrics, Gastroenterology and Nutrition, Faculty of Medical Science University of Warmia and Mazury, Olsztyn, Poland
| | - Alicja Stawicka
- 1Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Dziekiewicz
- 1Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- 1Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
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Kucharska A, Józefczuk P, Ksiązyk M, Labochka D, Banaszkiewicz A. Gastrointestinal Vascular Malformations in Patients with Turner's Syndrome: A Systematic Review of Case Reports. Horm Res Paediatr 2018; 90:39-43. [PMID: 30041185 DOI: 10.1159/000490425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 05/18/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIM There is a paucity of data on gastrointestinal (GI) vascular abnormalities in patients with Turner's syndrome (TS). Therefore, this literature review aimed to characterize the nature of GI vascular malformations in patients with TS, their localization in the GI tract, and their clinical and laboratory manifestations. METHODS A systematic search for articles was conducted using Medline and Embase (until August 2017). A manual search of the references of the included papers was performed to identify any potential additional references. We also conducted a retrospective chart review of all patients with TS and GI bleeding who were hospitalized at our institution. RESULTS A total of 29 articles published between 1947 and 2015 that described 39 cases were reviewed. Additionally, we included 2 patients who were hospitalized at our institution. The median age of patients with TS was 15 years (range: 0.1-57 years). Iron deficiency anaemia (35/40), haematochezia (15/37), and melaena (14/36) were the most common symptoms. Abnormal GI vessels occurred throughout the entire bowel, with a predilection for the small intestine (72%, 29/40). The most common abnormal vessels (65%, 24/37) were telangiectasias and dilated veins. CONCLUSION Telangiectasias and dilated veins of the small intestine were the most commonly seen abnormal GI vessels in patients with TS.
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Affiliation(s)
- Anna Kucharska
- Department of Pediatrics and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Józefczuk
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Ksiązyk
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Dominika Labochka
- Department of Pediatrics and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
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Affiliation(s)
| | - Marcin Dziekiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
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Komarnicka J, Brzewski M, Banaszkiewicz A, Maciąg R, Krysiak R. Computed Tomography (CT) Angiography in Pre-Embolization Assessment of Location of Gastrointestinal Bleeding in Paediatric Patient with Granulomatosis with Polyangiitis (Wegener's Granulomatosis) - Case Report. Pol J Radiol 2017; 82:589-592. [PMID: 29662590 PMCID: PMC5894021 DOI: 10.12659/pjr.901282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 12/21/2016] [Indexed: 11/09/2022] Open
Abstract
Background Acute gastrointestinal bleeding is an emergency with a high morbidity and mortality. Early diagnosis and appropriate intervention can be lifesaving and can prevent long-term complications. Case Report In this case report, we discuss and illustrate the role of CT angiography in the evaluation of acute, active gastrointestinal haemorrhage and show its usefulness prior to embolization. We describe a 15-year-old girl with granulomatosis with polyangiitis, formerly known as Wegener's granulomatosis. Conclusions An accurate pre-embolization assessment of bleeding with CT angiography shortens the total diagnostic time, which results in prompt and more effective endovascular treatment.We describe the clinical presentation of our patient and present diagnostic and interventional radiologic findings.
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Affiliation(s)
- Justyna Komarnicka
- Department of Paediatric Radiology, Medical University of Warsaw, Warsaw, Poland
| | - Michał Brzewski
- Department of Paediatric Radiology, Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Paediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Rafał Maciąg
- 2 Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland
| | - Remigiusz Krysiak
- Department of Paediatric Radiology, Medical University of Warsaw, Warsaw, Poland
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Dembiński Ł, Klukowska A, Banaszkiewicz A. Haemophilia and inflammatory bowel disease: We still know very little. Haemophilia 2017; 23:e484-e486. [PMID: 28780768 DOI: 10.1111/hae.13314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Ł Dembiński
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Warsaw, Poland
| | - A Klukowska
- Department of Pediatrics, Hematology and Oncology, The Medical University of Warsaw, Poland, Warsaw, Poland
| | - A Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Warsaw, Poland
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Karolewska-Bochenek K, Grzesiowski P, Banaszkiewicz A, Gawronska A, Kotowska M, Dziekiewicz M, Albrecht P, Radzikowski A, Lazowska-Przeorek I. A Two-Week Fecal Microbiota Transplantation Course in Pediatric Patients with Inflammatory Bowel Disease. Adv Exp Med Biol 2017; 1047:81-87. [PMID: 29151253 DOI: 10.1007/5584_2017_123] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Dysbiosis plays a major role in the etiology of inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) is a new promising option for IBD treatment. We aimed to assess the effectiveness of a two-week FMT course in children with IBD. Ten patients, 10-17 years of age with moderate to severe IBD received a course of eight doses of freshly prepared FMT via a naso-duodenal tube or gastroscopy. All of the patients had pancolitis. There were eight cases of ulcerative colitis (UC) and two of Crohn's disease (CD). Disease activity was evaluated using the Pediatric UC Activity Index (PUCAI) and Pediatric CD Activity Index (PCDAI) for UC and CD, respectively, CRP, and fecal calprotectin on the day before the first infusion and then on the day before the next course of FMT. Clinical response, defined as a decrease of 15 points in either index, was observed in 9/10 patients (seven UC and two CD). Clinical remission, defined as a PCDAI score ≤ 10 and PUCAI score < 10 measured at the same time point, was observed in 3/8 UC patients and 2/2 CD patients. Side effects observed were self-limiting and benign. We conclude that a short, intensive course of FMT has a beneficial effect on UC and CD colitis. FMT was well-tolerated and safe. Nonetheless, an optimal protocol of FMT administration is crucial for treatment efficacy.
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Affiliation(s)
| | - Pawel Grzesiowski
- Preventive Medicine and Rehabilitation Center, Infection Prevention Institute, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Paediatric Gastroenterology and Nutrition, Warsaw Medical University, Warsaw, Poland
| | - Agnieszka Gawronska
- Department of Paediatric Gastroenterology and Nutrition, Warsaw Medical University, Warsaw, Poland
| | - Maria Kotowska
- Department of Paediatric Gastroenterology and Nutrition, Warsaw Medical University, Warsaw, Poland
| | - Marcin Dziekiewicz
- Department of Paediatric Gastroenterology and Nutrition, Warsaw Medical University, Warsaw, Poland
| | - Piotr Albrecht
- Department of Paediatric Gastroenterology and Nutrition, Warsaw Medical University, Warsaw, Poland
| | - Andrzej Radzikowski
- Department of Paediatric Gastroenterology and Nutrition, Warsaw Medical University, Warsaw, Poland
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Banaszkiewicz A, Banasiuk M, Szaflarska-Popławska A, Mantei A, Albrecht P. Letter: gastritis in paediatric patients with coeliac disease. Aliment Pharmacol Ther 2016; 44:1003-1004. [PMID: 27696481 DOI: 10.1111/apt.13789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- A Banaszkiewicz
- Department of Paediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Warsaw, Poland.
| | - M Banasiuk
- Department of Paediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Warsaw, Poland
| | - A Szaflarska-Popławska
- Department of Paediatric Endoscopy and Gastrointestinal Function Testing, Collegium Medicum Nicolaus Copernicus University, Bydgoszcz, Poland
| | - A Mantei
- Department of Paediatrics, Paediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk, Gdansk, Poland
| | - P Albrecht
- Department of Paediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Warsaw, Poland
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Banasiuk M, Banaszkiewicz A, Dziekiewicz M, Załęski A, Albrecht P. Values From Three-dimensional High-resolution Anorectal Manometry Analysis of Children Without Lower Gastrointestinal Symptoms. Clin Gastroenterol Hepatol 2016; 14:993-1000.e3. [PMID: 26820403 DOI: 10.1016/j.cgh.2016.01.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 01/08/2016] [Accepted: 01/12/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Three-dimensional high-resolution anorectal manometry (3DHRAM) provides a topographic image of pressure along the anal canal. We aimed to determine normal 3DHRAM values in children. METHODS We performed a prospective study of 61 children (34 male; mean age, 8.28 years) without any symptoms arising from the lower gastrointestinal tract who were evaluated at the Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Poland. Manometry procedures were performed by using a rigid probe without medication. Pressure within the anal canal and 3D images of sphincters were measured. If possible, squeeze pressure and thresholds of sensation were evaluated. The population was divided into age groups of <5 years, 5-8 years, 9-12 years, and older than 12 years. RESULTS The mean resting and squeeze sphincter pressures were 83 ± 23 mm Hg and 191 ± 64 mm Hg, respectively. The mean length of the anal canal was 2.62 ± 0.68 cm and correlated with age (r = 0.49, P < .0001). The mean rectal balloon volume to elicit rectoanal inhibitory reflex was 15.7 ± 10.9 cm(3). The first sensation, urge, and discomfort were observed at balloon volumes of 24.4 ± 23.98 cm(3), 45.9 ± 34.55 cm(3), and 91.6 ± 50.17 cm(3), respectively. The mean resting pressure of the puborectalis muscle was 69 ± 14 mm Hg, whereas the mean squeeze pressure was 124 ± 33 mm Hg. There was no statistically significant difference in pressure parameters between age groups. We observed a positive correlation between age and balloon volume needed to elicit discomfort (r = 0.49, P < .001). CONCLUSIONS In a prospective study, we determined normal values from 3DHRAM analysis of children without symptoms arising from the lower gastrointestinal tract. There were no significant differences in pressure results between children of different sexes or ages. ClinicalTrials.gov number: NCT02236507.
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Affiliation(s)
- Marcin Banasiuk
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland.
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Dziekiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Załęski
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland; Department of Pediatrics and Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Albrecht
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
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Banaszkiewicz A, Targonska B, Kowalska-Duplaga KI, Karolewska-Bochenek K, Sieczkowska A, Gawronska A, Grzybowska-Chlebowczyk U, Krzesiek E, Lazowska-Przeorek I, Kotowska M, Sienkiewicz E, Walkowiak J, Gregorek H, Radzikowski A, Albrecht P. Serotype-Specific Pneumococcal Status prior to PCV 13 Administration in Children and Adolescents with Inflammatory Bowel Disease. Pol J Microbiol 2016; 65:89-91. [DOI: 10.5604/17331331.1197279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Banasiuk M, Banaszkiewicz A, Piotrowski D, Albrecht P, Kamiński A, Radzikowski A. 3D high-definition manometry in evaluation of children after surgery for Hirschsprung's disease: A pilot study. Adv Med Sci 2016; 61:18-22. [PMID: 26344909 DOI: 10.1016/j.advms.2015.07.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 07/03/2015] [Accepted: 07/29/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Anorectal 3-dimensional high definition manometry (3D HRM) could be the best tool for postoperative assessment of restorative surgical procedures for Hirschsprung's disease. The aim of our study was to evaluate patients after surgery for Hirschsprung's disease using 3D HRM. MATERIALS AND METHODS Anorectal function was evaluated using solid state 3D HRM. We measured the length of the anal canal, mean resting squeeze pressures, the presence of rectoanal inhibitory reflex, cough reflex, ano-anal reflex and the bear down manoeuvre. RESULTS We studied 14 children operated on for Hirschsprung's disease. The mean values of pressure asymmetry were higher in patients after the Duhamel procedure than after the TEPT procedure (29.58% vs. 22.26% during resting and 26.1% vs. 14.01% during squeeze, respectively). No difference between the groups was observed in the measurement of all the manometric parameters except the presence of rectoanal inhibitory reflex (87.5% after TEPT vs. 33% after Duhamel). CONCLUSIONS Anorectal 3D HRM evaluation of patients with Hirschsprung's disease demonstrated that the asymmetry of the anal canal occurred in a similar percentage after both procedures.
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Sieczkowska J, Jarzębicka D, Banaszkiewicz A, Plocek A, Gawronska A, Toporowska-Kowalska E, Oracz G, Meglicka M, Kierkus J. Switching Between Infliximab Originator and Biosimilar in Paediatric Patients with Inflammatory Bowel Disease. Preliminary Observations. J Crohns Colitis 2016; 10:127-32. [PMID: 26721942 DOI: 10.1093/ecco-jcc/jjv233] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 12/14/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS The growing incidence of inflammatory bowel disease (IBD) in children necessitates the use of biological treatments. Recently, an infliximab biosimilar was authorized in the European Union, which may result in switching patients. We present our preliminary experiences with such switches. METHODS The prospective study included 32 paediatric patients diagnosed with Crohn's disease (CD) and 7 children with ulcerative colitis (UC) at 3 academic hospitals, who were switched from infliximab originator to its biosimilar (Remsima). Patient characteristics, disease severity, laboratory parameters and adverse events were recorded. Means, medians and ranges were calculated. RESULTS Mean age at diagnosis of CD and UC was 11.1 (2.7-15.3) and 12.3 years (8.5-14.8), respectively. Mean number of infliximab originator infusions before switching to the biosimilar was 9.9 (median 8, range 4-29) and 5.1 (5, 1-12) for the CD and UC group, respectively. Evaluation efficacy of last biosimilar doses of all patients revealed rates of clinical remission of 88 and 57% for CD and UC patients, respectively. Last follow-up assessment of patients who continued with biosimilar therapy showed that 16/20 (80%) CD patients and all 4 UC individuals were in remission. One infusion reaction to infliximab biosimilar was observed in a CD patient, which led to treatment discontinuation. The incidence of sporadic mild adverse events prior to and after switching did not differ significantly and was consistent with the safety profile of the infliximab molecule. CONCLUSION Switching from infliximab originator to its biosimilar seems to be a safe option in children with CD. After the switch the biosimilar was just as effective as the originator.
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Affiliation(s)
- J Sieczkowska
- Department of Gastroenterology, Hepatology, Nutrition and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | - D Jarzębicka
- Department of Gastroenterology, Hepatology, Nutrition and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | - A Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - A Plocek
- Department of Pediatric Allergology, Gastroenterology and Nutrition, Medical University of Lodz, Lodz, Poland
| | - A Gawronska
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - E Toporowska-Kowalska
- Department of Pediatric Allergology, Gastroenterology and Nutrition, Medical University of Lodz, Lodz, Poland
| | - G Oracz
- Department of Gastroenterology, Hepatology, Nutrition and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | - M Meglicka
- Department of Gastroenterology, Hepatology, Nutrition and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | - J Kierkus
- Department of Gastroenterology, Hepatology, Nutrition and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
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Ramotowska A, Groele L, Mytyk A, Banaszkiewicz A, Szypowska A. Continuous subcutaneous insulin infusion during total parenteral nutrition after gastroscopy complicated by duodenal intramural haematoma in a patient with type 1 diabetes - case repor. Pediatr Endocrinol Diabetes Metab 2016; 22:170-174. [PMID: 29073300 DOI: 10.18544/pedm-22.04.0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We present the course of the insulin therapy during total parenteral nutrition (TPN) after gastroscopy complicated by duodenal intramural haematoma, in a boy with type 1 diabetes treated with the insulin pump. There is a lack of guidelines regarding the insulin therapy during TPN in children. Additionally, duodenal intramural haematoma is a very rare complication of diagnostic gastroscopy. There are only few cases reported so far.
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Affiliation(s)
| | - Lidia Groele
- Department of Pediatrics, Warsaw Medical University
| | - Aleksandra Mytyk
- Klinika Gastroenterologii i Żywienia Dzieci, Warszawski Uniwersytet Medyczny
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Dziekiewicz MA, Banaszkiewicz A, Urzykowska A, Lisowska A, Rachel M, Sands D, Walkowiak J, Radzikowski A, Albrecht P. Gastroesophageal Reflux Disease in Children with Cystic Fibrosis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 873:1-7. [DOI: 10.1007/5584_2015_154] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Łazowska-Przeorek I, Kotowska M, Banasiuk M, Karolewska-Bochenek K, Banaszkiewicz A, Gawrońska A, Albrecht P. Value of Antral Nodularity for the Diagnosis of Helicobacter pylori Infection in Children. Med Sci Monit 2015; 21:1827-30. [PMID: 26105000 PMCID: PMC4484617 DOI: 10.12659/msm.893467] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background The aim of this study was to confirm the role of antral nodularity in the diagnosis of Helicobacter pylori (H. pylori) infection in children. Material/Methods This prospective study included 107 children (58 male; 54.2%), between the ages of 3 and 18 years, infected with H. pylori, which was confirmed if the patient had at least 2 of 4 positive test results (urea breath test, urease test in gastric biopsy, histopathology – positive hematoxylin and eosin and Giemsa staining, and/or monoclonal stool ELISA test – Amplified IDEIA™ Hp StAR™). The control group consisted of 234 children with abdominal pain, of similar age, in whom urease test in gastric tissue and histopathology were negative. In both groups, photographs of the gastric antrum taken during endoscopy were evaluated for nodularity by 3 independent endoscopists, blinded to the results of other tests. Sensitivity, specificity, and negative and positive predictive value of nodularity were assessed. Indication for upper endoscopy was chronic abdominal pain not considered to be functional. Results There were no statistical differences between groups regarding sex (chi-square test with Yates’s correction: p=0.8763) or age (mean ±SD) 11.77±3.49 and 12.43±3.32, study and control groups, respectively (Mann-Whitney test: p=0.1352). The sensitivity of the presence of nodularity as an indication of H. pylori infection was 91.6% and specificity was 91%. PPV of gastric nodularity was 81% and NPV was 96%. Conclusions Antral nodularity is reliable test. Physicians could start treatment of H. pylori infection whenever gastric nodularity is observed and the urease test result is positive, without waiting for histopathology results.
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Affiliation(s)
| | - Maria Kotowska
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Banasiuk
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | | | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Gawrońska
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Albrecht
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
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Czub E, Nowak JK, Moczko J, Mankowski P, Lisowska A, Banaszkiewicz A, Banasiewicz T, Walkowiak J. Fecal pyruvate kinase is not suitable for discrimination between inflammatory bowel disease exacerbation and acute gastroenteritis. Dev Period Med 2015; 19:167-173. [PMID: 26384117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION In inflammatory bowel diseases (IBD) diarrhea can be caused by exacerbation and/or infectious agents. Fecal calprotectin (FC) is a well-established biomarker of intestinal inflammation in IBD. However, its usefulness in depiction of IBD exacerbation from infectious diarrhea is limited. The value of fecal pyruvate kinase isoenzyme type 2 (M2-PK) in this application remains unknown. AIM To compare the performance of M2-PK and FC in discriminating between diarrhea caused by IBD and infectious agents. MATERIALS AND METHODS One hundred three patients were enrolled for the study, including 32 with ulcerative colitis (UC), 21 with Crohn's disease (CD), 29 with acute diarrhea caused by rotavirus (AD-RV), and 21 with acute diarrhea caused by Salmonella enteritidis (AD-SE). M2-PK and FC were measured using ELISA. Areas under receiver operating characteristic curves (AUCs), sensitivities and specificities for both tests in distinguishing between patient subgroups with moderate to severe UC and CD from AD-RV and AD-SE were calculated. RESULTS Differences in AUCs between M2-PK and FC for distinguishing UC [CD] from AD-RV were -0.06 (p < 0.028) [-0.10 (p < 0.0018)] and for differentiating UC [CD] from AD-SE were 0.03 (NS) [-0.19(p < 0.0011)].M2-PK sensitivities and specificities in distinguishing UC [CD] from AD-RV were 75.0%[71.4%] and 89.7% [89.7%] and for differentiation of UC [CD] from AD-SE were 56.3% [71.4%] and 95.2[57.1%]. CONCLUSIONS The performance of M2-PK in distinguishing between children with moderate-to-severe IBD and patients with infectious gastroenteritis was inferior to FC. Neither test had sensitivity ands pecificity sufficient for everyday clinical application.
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Affiliation(s)
- Elzbieta Czub
- Child and Mother Specialist Hospital in Poznan, Poland
| | - Jan K Nowak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Jerzy Moczko
- Department of Informatics and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Przemyslaw Mankowski
- Department of Pediatric Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Aleksandra Lisowska
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Banasiewicz
- Department of General, Gastroenterological and Endocrinological Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
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Banaszkiewicz A, Radzikowski A, Albrecht P. Immunisation in children and adolescents with inflammatory bowel disease. Adv Med Sci 2015; 60:144-7. [PMID: 25689276 DOI: 10.1016/j.advms.2014.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 11/27/2014] [Accepted: 11/28/2014] [Indexed: 10/24/2022]
Abstract
Inflammatory bowel disease (IBD) patients may be at a higher risk for developing infections due to underlying disease, malnutrition, surgery, or immunosuppressive therapy. Therefore, protecting this group against infections is of particular importance. Immunisation against vaccine-preventable diseases is strongly recommended. This article for the first time summarises data on immunogenicity and safety of vaccines in IBD children and provides an update on some important issues regarding immunisation in these group of children.
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Weterle- Smolińska K, Banasiuk M, Dziekiewicz M, Ciastoń M, Jagielska G, Banaszkiewicz A. Gastrointestinal motility disorders in patients with anorexia nervosa – a review of the literature. Psychiatr Pol 2015; 49:721-9. [DOI: 10.12740/pp/35482] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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