Epidemiology of inflammatory bowel disease among children in Poland. A prospective, population-based, 2-year study, 2002-2004.

BACKGROUND/AIMS: The incidence of pediatric inflammatory bowel disease (IBD) in Western countries is on the rise. No prospective studies have been conducted on the epidemiology of pediatric IBD in Poland. The aim of the study was to define the characteristics of new pediatric IBD and assess the incidence of new IBD among children in Poland between 2002 and 2004. METHODS: Patient records from 24 pediatric gastroenterology centers servicing the whole population of Poland were collected. IBD diagnosis was based on clinical, radiological, endoscopic and histological features. RESULTS: There were 491 new IBD patients, representing an overall incidence of IBD of 2.7 cases/100,000 children/year. The incidence of Crohn's disease (CD) was 0.6, ulcerative colitis (UC) 1.3, and indeterminate colitis (IC) 0.8. The age-related incidence of IBD was 1.8 in the 0- to 10-year-old age group, rising to 3.7 for the 11- to 18-year age group. CONCLUSIONS: The overall incidence of IBD (as well as CD, UC and IC) in Poland is lower than that in Western countries. The relative contribution of UC and IC to the overall IBD incidence is higher in Poland than in most Western countries. These findings may suggest a tendency towards under- or misdiagnosis.

[Detrusor pseudohyperactivity syndrome in children with constipation]. / Zespól rzekomej nadreaktywnosci wypieracza u dzieci z zapaciami.

THE AIM OF THE STUDY: was the evaluation of dependencies occurring between constipation and observed nocturia, pressing tenesmus and daytime urinary incontinence. MATERIAL AND METHODS: the studies were conducted in 51 children aged between 3 and 17 years including 25 girls and 26 boys hospitalized in the Clinical Department because of nocturia, pressing tenesmus and daytime urinary incontinence. In all children a complex diagnostic work up of the urinary system and the lower segment of alimentary tract was performed. Results of the examinations were compared to the control group. RESULTS: analysis of the results of the conducted examinations indicates that the overblown rectal ampulla, through the pressure exerted on the urinary bladder, seemingly decreases its volume causing the occurrence of pressing tenesmus, nocturia and daytime urinary incontinence. This process leads to the formation of detrusor hyperactivity syndrome characterized by: chronic constipation, increase of miction frequency and simultaneous decrease of volume of each portion of urine, nocturia and/or daytime urinary incontinence. CONCLUSIONS: chronic constipation disturbs the functional-morphological equilibrium between the end segment of alimentary tract and the urinary bladder. By influencing the process of filling and accumulation of urine in the bladder they lead to the formation of detrusor hyperactivity syndrome.

[Assessment of postvaccinal response in children past pertussis]. / Ocena odpowiedzi poszczepiennej u dzieci, które przebyly krztusiec.

In the nineties, despite high percentage of vaccination of children, from 86% to 99% dependently on the region, there came to the increase of whooping cough cases. Until then infants and children to the age of 5 years suffered from this disease, whereas in the last decade the number of cases increased mainly among children over 5 years of age, who were subjected to full cycle of vaccination against whooping cough. Searching for the causes of such epidemiologic situation the following suggestions have been given: change of the bacteria antigenicity, the phenomenon of postvaccinal immunity extinction, immune system mechanisms disorders and groundless excuse from vaccination. The study estimates parameters of postvaccinal response to immunization with selected vaccines in children post whooping cough.

[Neutrophils and selected cytokines in ulcerative colitis pathomechanism]. / Udzial neutrofilów i wybranych cytokin w patomechanizmie wrzodziejacego zapalenia jelita grubego.

The aim of the study was to assess receptor CD11b and CD62L expression on neutrophils and IL-1beta, IL-6 and IL-8 level in children with ulcerative colitis. Thirty children aged 8-17 years were included in the study. The investigations were performed in the acute phase, prior to the treatment and during remission, 2 months after clinical improvement was obtained. The control group consisted of 12 children with chronic obstipation. IL-1beta, IL-6 and IL-8 serum level and receptor CD11b expression, especially on resting neutrophils, in children with severe and moderate course of the disease were statistically significantly higher; whereas CD62L expression was significantly lower in comparison with the controls and got back to normal during remission. Increased IL-1beta level was observed only in children with severe disease course. In children with mild process the results of the investigations were similar to the control group. In children with severe disease activity the proinflammatory cytokines levels in serum were elevated. The neutrophils in children with severe course of the disease manifested priming in peripheral blood before leaving the circulation.

[Mucus physicochemical properties in children with ulcerative colitis]. / Wlasciwosci fizykochemiczne sluzu u dzieci z wrzodziejacym zapaleniem jelita grubego.

The aim of the study was to estimate colonic mucus physicochemical state in children with ulcerative colitis. Investigations were performed in 36 children, aged 10-17 years, allotted into three groups dependently on the severity of the disease. The severity of the disease was estimated basing on Truelove-Witts criteria. Mucus analysis was performed with polyacrylamide gel electrophoresis (SDS-PAGE), electron paramagnetic resonance (EPR) and spectrophotometric method. Mucus fraction dissolved in normal saline was subject of investigations. Protein content was determined in this fraction with Lowry's method. The obtained results demonstrated different mucus solubility dependent on the severity of the disease. Mucus protein concentration increased whereas mucus viscosity decreased with the severity of the disease. Colonic mucus physicochemical properties change dependently on the disease severity. Determination of soluble protein fraction in mucus may be a useful marker in the estimation of the disease severity.

[Probiotics--an alternative for antibiotics?]. / Probiotyki--alternatywa dla antybiotyków?

The condition and function of gastrointestinal (GI) tract are essential to our well being. Probiotics are defined as the microbial food supplements, which beneficially affect the host by improving its intestinal microbial balance. Probiotics are the functional food ingredients. They are used therapeutically to improve lactose tolerance and to prevent diarrhoea (especially viral diarrhoea in infants, antibiotic-associated diarrhoea, Clostridium difficile-associated diarrhoea and traveler's diarrhoea). Clinical studies suggest that probiotics might be useful in stimulation of the immune system, prevention of allergic diseases, control of GI tract inflammatory diseases and cancer prevention. Probiotic microbial species act by changing the composition of the gut microbionta. The use of non-digestible oligosaccharides (prebiotics) can fortify intestinal microflora and stimulate their growth. This review encompasses information regarding probiotic strains, prebiotics and commercially products (functional food), which can be useful in improving our health.