Metabolic syndrome in overweight or obese children and adolescents based on own material Abstract Key words.

OBJECTIVE: Aim: To assess the prevalence of metabolic syndrome (MS) components in overweight or obese children and adolescents, as well as analyze the risk factors of its occurrence. PATIENTS AND METHODS: Material and methods: The study was conducted in a group of 70 children and adolescents aged 5-18 hospitalized in the Department of Gastroenterology, Allergology and Pediatrics, Polish Mother's Memorial Hospital - Research Institute in Lodz (Poland) based on the results of medical histories, physical examination, biochemical investigation, and calculation of the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index. RESULTS: Results: MS was diagnosed in 14 children (20%). The most common abnormalities besides obesity included: decreased High Density Lipoprotein Cholesterol (HDL-C) levels (n=13, 92.9%), increased triglycerides (TG) concentrations (n=10, 71.4%) and arterial hypertension (n=10, 71,4%). Among all the children, insulin resistance was diagnosed in 29 subjects (41.4%). The results of univariate logistic regression showed that the occurrence of lipid disorders, obesity, hypertension and diabetes in their parents, as well as the duration of pregnancy, birth weight, or breastfeeding were not associated with the risk of MS development in the subjects (p>0.05). However, in the study group, 92.9% of subjects had one or more particular risk factor for MS development. CONCLUSION: Conclusions: Besides visceral obesity, lipid disorders were the most frequently observed components of MS in the subjects analyzed, which may have prognostic significance. The occurrence of one or more MS risk factors in almost all of the children studied indicates the increased risk of cardiovascular diseases in the studied group in the future.

[The participation of some innate immunological defense components in children with chronic gastritis associated H. pylori infection in ultrastructure and function of the mast cells aspects]. / Udzial niektórych elementów odpornosci wrodzonej w zapaleniu blony sluzowej zoladka z zakaieniem H. pylori u dzieci w aspekcie ultrastruktury i funkcji komórki tucznej.

UNLABELLED: It has been clearly established that Helicobacter pyloni (H. pylori) play an important role in the pathogenesis of some chronic diseases of upper gastrointestinal tract. A lot of attention to the complicated immunological processes induced by the infection was paid. The clinical outcome of the damage of gastric mucosa by H. pylori depends on the type and the intensification of these processes. During many years the acquired (specific) immunological response on the infection was analyzed by scientists, but much more researches on innate defense was done lately The mast cells constitute some important parts of the immunological innate defense. H. pylori colonization of gastric mucosal surface elicits a conspicuous infiltration comprising of lymphocytes, and plasma cells as well as neutrophils, eosinophils, macrophages and the granule cells of connective fissue. Some difficulties with the mastocytes visualization in conventional histological slides in light microscope caused so far the little attention of their participation in chronic gastritis. The aim of the study was the assessment of the mastocytes participation in the infiltration of immunological cells induced by H. pylonri in chronic gastritis. MATERIAL AND METHODS: The subjects were twenty dyspeptic children aged 9-17 years underwent upper GI endoscopy procedure. Twelve children were H. pylori positive. Remaining eight children H. pylori negative composed a control group. Gastric antrum and corpus tissue specimens in the conventional (light) and electron microscopy were examined. The specimens intended for electron microscope assessment were fixed in the solution of 1% glutaraldehyde and 2.5% paraformaldehyde at 40 C (pH 7.4) for 24 hours, and postfixed in 2% osmium tetroxide at the same conditions. Ultrathin sections were contrasted with uranyl acetate and lead citrate. Results. Ultrastructural analysis revealed two distinct, morphological forms of mast cells in gastric mucosa. All mast cells contained multiple granules with fine-grained material but their appearance was distinct in both types of these cells. Statistical analysis revealed that the count of mast cells in gastric mucosa was increased in H. pylori positive when compared with H. pylori negative children. It was also affirmed that in specimens from H. pylori infected children mast cells more frequently were seen in the gastric epithelium.

[Accidental ingestion of two magnets--aggresive or prolonged approach?]. / Przypadkowe polkniqcie magnesów--postepowanie naglace czy odroczone?

Accidental ingestion of foreign bodies is a common pediatric problem. Non-sharp items like coins, jewelry, pieces of toys are most frequently found among swallowed objects. They usually pass through a child's digestive system without health consequences (40-90% of reported cases). Approximately 10% of children require endoscopic intervention and 1-3% undergoes a surgical treatment. Authors present a unique health hazard caused by multiple magnet ingestion and general management in these cases of this specific foreign body presence. A 6 y.o. boy, in excellent health has been admitted G.I. Dept. presenting a history of accidental ingestion of two magnets (size 1.5 x 0.5 cm) 4 days prior to hospitalization. On admission patient presented no symptoms of foreign body in GI tract, however his WBC was 15000/mm3, ESR-22mm. Foreign bodies have been removed under general anesthesia using endoscopic technique. Endoscopic view of the esophagus region from which magnet has been removed at first might have been identify as a perforation of the esophageal wall. Chest X-ray has not revealed symptoms of pneumothorax, as well as the contrast radiologic study showed symptoms of upper GI tract perforation. Conservative treatment has been administered. Patient has been discharged home with no complaints in general and local good condition. Ingestion of more than one magnets is an strong indication for an immediate endoscopic intervention. Such an algorithm is strongly advocated to prevent of lesion formation in the soft tissues located between two objects with paramagnetic properties which may cause ischemic necrosis and perforation of the GI tract wall.