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Gasiorowska A.,University of Lodz | Talar-Wojnarowska R.,University of Lodz | Lapienis M.,Oddzial Otolaryngologiczny Szpitala | Schmidt J.,Oddzial Otolaryngologiczny Szpitala | And 2 more authors.
Przeglad Gastroenterologiczny | Year: 2012

Introduction: Combined multichannel intraluminal impedance and pH-metry (MII-pH) is a technique that enables monitoring of gastroesophageal reflux disease (GERD) independently of its acidity. Aim: To investigate the utility of MII-pH testing among patients with suspected GERD with atypical symptoms. Material and methods: Thirty-two consecutive patients underwent gastroscopy and MII-pH testing to evaluate the cause of atypical symptoms presumed due to GERD. Among them, 19 patients with unexplained chronic cough, sore throat, globus and hoarse voice were included in group 1 - laryngological symptoms. Videolaryngoscopic examination was used to document reflux-related laryngitis. Group 2 - miscellaneous symptoms - included 13 patients with nausea, chronic burning in the mouth and throat, belching, dyspnoea, wheezing and upper abdominal discomfort. Results: In group 1, with laryngological symptoms, 32%, 16%, and 16% of patients were found to have symptoms of acid reflux, non-acid reflux or both, respectively. Eight patients (42%), who did not show any changes in videolaryngoscopy, had MII-pH documented acid reflux. Application of MII-pH allowed the relation between laryngeal symptoms and acid reflux to be confirmed in 1/3 of all examined patients. In group 2, with miscellaneous symptoms, acid reflux was found in 3 patients (23%) and non-acid GER in 2 patients (15%). The majority of patients (62%) from the group with miscellaneous symptoms did not have GER. Conclusions: MII-pH testing is useful in determining whether gastroesophageal reflux occurs in patients with atypical symptoms. MII-pH testing was useful in redirecting the management of patients who did not have reflux as the cause of their symptoms. Source


Gasiorowska A.,University of Lodz | Talar-Wojnarowska R.,University of Lodz | Czupryniak L.,Klinika Chorob Wewnetrznych i Diabetologii | Smolarz B.,Laboratorium Genetyki Molekularnej | And 3 more authors.
Przeglad Gastroenterologiczny | Year: 2010

Introduction: In previous investigations, the N34S mutation of the serine protease inhibitor, Kazal type 1 (SPINK1) has been reported to have a connection with idiopathic and hereditary chronic pancreatitis, but the association between SPINK1 mutations and the incidence of chronic pancreatitis in alcoholics has been controversial. Additionally, it remains unknown whether the SPINK1 mutations have an impact on the clinical course of CP. No association between SPINK1 mutations and sporadic pancreatic cancer has been found. Aim: To determine the frequency of SPINK1 mutation in patients with alcoholic chronic pancreatitis (ACP), idiopathic chronic pancreatitis (ICP) and pancreatic cancer (PC). We also reviewed the clinical data of CP patients and analysed the differences of the clinical course of CP between patients with and without SPINK1 mutation. Material and methods: The diagnosis of CP was based on clinical examinations, ultrasound (US), computed tomography (CT) and endoscopic ultrasonography (EUS). DNA was isolated from 33 patients with ACP, 14 patients with ICP and 24 patients with PC. Forty-six healthy individuals were enrolled as controls. The N34S mutation of SPINK1 was detected with PCR-RFLP. Results: Among the CP group, in 6 patients (18%) with ACP and 4 patients (28.6%) with idiopathic CP, N34S mutation of SPINK1 was detected. The frequency of SPINK1 mutation was significantly higher (p < 0.024) than in controls (6.5%); OR was 5.733 (95% CI 1.218-26.959). No relations were detected between presence of this mutation and demographic data, as well as other clinical features of the CP patients. Among patients with a pancreatic cancer, the N34S mutation was present in 1 patient (4%). There was no difference in the frequency of the N34S mutation between patients with pancreatic cancer and controls (p = 0.687, OR 0.623, 95% CI 0.085-4.696). Conclusions: These preliminary data suggest the high incidence of N34S SPINK1 mutation in the Polish population generally, as well as in ICP. It may be speculated that this mutation contributes to the development of chronic pancreatitis in patients with alcohol overindulgence. Further studies are needed to explore the role of SPINK1 in the carcinogenesis of pancreatic cancer. Source


Juruc A.,Klinika Chorob Wewnetrznych i Diabetologii | Pisarczyk-Wiza D.,Klinika Chorob Wewnetrznych i Diabetologii | Wierusz-Wysocka B.,Klinika Chorob Wewnetrznych i Diabetologii
Diabetologia Kliniczna | Year: 2014

Modern diabetic treatment of diabetes requires implementation of lifestyle changes, including modification of dietary habits. Nowadays there is a significant progress in therapies for patients with, that may favor greater liberty in eating behaviors. Diets that were used in order to improve metabolic control were changed. Modern treatment of diabetes by intensive functional insulin therapy allows much greater flexibility in eating habits and increases the variety in acceptable food products in comparison to more conventional insulin therapies. Thanks to this therapy, the change in patient's lifestyle caused by diabetes can be less visible and unpleasant. In spite of the progress in diabetic treatment, reaching a proper metabolic control is still a very difficult problem for a large number of patients. On the other hand, however, changing eating habits, including greater amount of fiber and low glycaemic index, is widely recommended in order to prevent the rate of development of chronic complications of diabetes. The aim of this article is to review current knowledge about diet and eating behaviors and its role in metabolic control and prevention of long term complications in type 1 diabetic patients. Source

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