Biomedical subjects

Stanisław Wojtuń

Publications and source records attributed to Stanisław Wojtuń.

At least 19 recordsLinked to original sources

PubMed2004

[Inflammatory bowel diseases--pathogenesis and clinical symptoms].

The common factor of inflammatory bowel diseases is the unknown etiologic agent. It's suggested that it could be genetic predisposition, environment and immunologic factor. It seems probable that the etiology of these diseases has many sources but the pathogenesis is similar. Inflammatory bowel diseases etiology requires more research but the immunological system disturbances are out of the question. The most typical course of these diseases is the one with remissions and relapses. Clinical symptoms vary and depend on localization, phase and presence of complications. In this paper we present some basic information about epidemiology, pathogenesis and the clinical course of inflammatory bowel diseases.

Humans↗

PubMed2004

[Inflammatory bowel diseases--imaging diagnostics].

The basic diagnostic procedure in ulcerative colitis is an endoscopy of gastrointestinal tract. It allows the macroscopic evaluation as well as the specimen taking for histological assessment what is the basis for ultimate diagnosis. In case of Crohn's disease the radiological diagnostics is of equal importance as endoscope evaluation. The imaging of inflammatory changes in Crohn's disease still poses some difficulties, especially, that located in the small intestine. Lately, the range of accessible examinations has been wider. We have in disposal the ultrasonography, the computed tomography, the magnetic resonance imaging and the capsular endoscopy. All of them are of great use in the diagnosis of Crohn's disease. In case of microscopic colitis all the imaging diagnostics has no use. The only one mean to establish the diagnosis is a histological assessment. What is more, in the period of remission the colon tissue could be normal. In this paper we discussed the traditional and contemporary intestine imaging methods in inflammatory bowel diseases. The conclusion is that the further progress in science offers a better imaging and, what is even more important, the more efficient diagnostics and treatment of these diseases.

Humans↗

PubMed2004

[Histoclinic of nonspecific inflammatory bowel diseases].

In the paper pathomorphological indices of changes in inflammatory bowel lesions were presented. Additionally a clinicopathological correlation has been performed. The necessity of collaboration between gastroenterologist and pathomorphologist in diagnostic process of inflammatory bowel lesions has been indicated. The collaboration should mainly result from the lack of repeated morphological changes in most cases of inflammatory bowel lesions, but also from lack of specificity of signs and symptoms in these inflammations.

Humans↗

PubMed2004

[The conservative treatment of nonspecific inflammatory bowel diseases].

The treatment of inflammatory bowel diseases includes the nutritional management, the pharmacotherapy and the surgical treatment. The main aim of treatment is to achieve the remission, to prevent a relapse and to take a decision of surgical treatment. The treatment is introduced in the relevance to the intensification of disease. To assess properly the level of the intensification of disease there is a need of deep knowledge of clinical manifestations of the disease. In the treatment the corticosteroids, 5-aminosalicylic acid (5-ASA) or immunosuppressive treatment are used. Immunosuppressive treatment is now a widely accepted standard in Crohn's disease treatment. Some cases of Crohn's disease could be treated with anti-TNFalpha antibodies that successfully treat the relapses of disease. This treatment is especially well suited to cases that are not successfully treated with the standard pharmacological treatment. The nonsurgical treatment is successful in most cases. There are no standards of treatment of microscopic colitis. We usually start the treatment with 5-ASA and an antidiarrheal agent. In case of failure of this treatment we introduce corticosteroids. In this paper authors present basic information about the current state of knowledge about inflammatory bowel diseases treatment.

Anti-Inflammatory Agents↗

PubMed2004

[Immunotherapy of inflammatory bowel diseases].

Inflammatory bowel diseases (IBD), namely ulcerative colitis (UC) and Crohn's disease (CD) are chronic disorders which appear to be immunologically related. The basic therapeutic agents used in IBD treatment are 5-aminosalicilates and corticoids. In cases when this treatment is insufficient, immunosuppressive therapy is recommended. During an acute phase of the illness most useful is cyclosporine A and in the maintenance therapy, azathioprine and 6-mercaptopurine. Because of insufficiency of this classic therapy in many cases, the new, more useful and safe methods of IBD treatment are wanted. Permanent researches have been focused on immunological reactions. The most useful appear to be TNFalpha antagonists (oxpentifilline, infliximab, entanercept, onercept and thalidomide), anti alpha-4 integrin antibodies (natalizumab), IL-10, anti-CD4, IL-6, IL-12, IL-18, IFNgamma, IL-2R antibodies and others. The best clinical experiences are connected with CD treatment using infliximab (monoclonal, chimeric anti TNFalpha antibodies). Its position in IBD therapy appears to be established now, whereas the other methods are still experimental. Most of clinical and experimental data indicate that it is possible to cure severe IBD using agents which affect metabolism of the cytokine playing key role in pathogenesis of the illness. The modern immunotherapy will probably play important role in the future IBD treatment.

Humans↗

PubMed2004

[The role of proteasome in pathophysiology of cancer cachexia].

Cancer cachexia is a serious and life-treating syndrome that appears in most solid tumor patients. The syndrome is associated with anorexia, loss of protein mass, wasting of lipids, and disturbances of carbohydrate metabolism. Moreover, psychological distress and lower quality of life are often seen in patients with cancer cachexia. The latter is a multimodality process in which cytokine interactions, action of enzymes playing a key role in lipid metabolism, and activity of proteolytic proteinases are the complex net that are responsible for destruction of an organism suffering from cancer cachexia. Recently, it has been shown a growing role of ubiquitin-proteasome pathway in cachexia. Biochemical interactions are crucial for further study, mainly, when a novel target therapy appears to treat cancer in different modalities. In case of proteasome, PS-341 (bortezomib, Velcade) an inhibitor of proteasome is under investigation in clinical trials phase I.

Boronic Acids↗

PubMed2004

[An early diagnosis of colorectal cancer].

Colorectal cancer is still a huge challenge for modern oncology due to a number of patients. The malignant disease is associated with industrial countries and mostly occurs in Europe and United States. Despite screening programs there are a constant number of 30% patients who have advanced colorectal cancer that is clinically relevant. On the other hand, a body of evidence is accumulating on the molecular mechanisms that play a pivotal role in development of sporadic and hereditary kind of colorectal cancers. In this review we presented molecular mechanisms involved in development of colorectal cancer. Moreover, we described the results of screening programs used to detect an early stage of colorectal cancer and modern molecular techniques useful at the time of detection micrometastatic disease involving lymph nodes and bone marrow.

Biopsy↗

PubMed2004

[Possibilities and limitations of morphological diagnosis in early stages of colitis].

In the paper the most frequent difficulties in diagnosis of early stages of colitis has been presented. Also the most frequent sources of errors depending on methods of obtaining and fixing of material as well as diagnostic possibilities of various kinds of obtained biopsy material has been shown. The role of close cooperation between clinician and pathologist in the earliest stages of diagnostic efforts and final diagnosis has been emphasized.

Biopsy↗

PubMed2004

[Early diagnosis of colorectal cancer].

Colorectal cancer is the fourth most common cancer in the world and the second most common and most frequently mentioned cause of cancer death in Poland. Death from colorectal cancer can be reduced through early diagnosis. Currently there are several screening methods: faecal occult blood tests, sigmoidoscopy, colonoscopy, barium enema and emerging methods like virtual colonoscopy and faecal DNA testing. In this article we show the efficacy of these tests with respect to their sensitivity, specificity, costs and safety. Patients at high-risk of colorectal cancer were also considered. There is an urgent need to standardize the methods of diagnosis in patients at high-risk to increasing accessibility and quality of tests.

Biopsy↗

PubMed2004

[Ischaemic intestinal disease--still opened diagnostic clinical and pathomorphological problem].

Contemporary opinions on etiology and pathogenesis of ischaemic colitis have been presented. Diagnostic difficulties in endoscopic and pathologic examination of colonic ischaemic changes have also been discussed. Some aspects of differential diagnosis of ischaemic colitis has been discussed. The literature opinions and authors own experience indicate that ischaemic colitis is still serious histoclinical problem which could be resolved only if close cooperation of gastrologists and pathologists has been applied.

Algorithms↗

PubMed2004

[Irritable bowel syndrome--pathogenesis, management].

Irritable bowel syndrome creates many diagnostic and treatment difficulties in a general practitioner practice as well as in a specialist practice. Etiopathogenesis of this illness still elicit some controversy. In a diagnostic process, apart from an organic basis excluding, the most important is a medical history of a patient because of the fact that a right symptoms interpretation usually allows a correct diagnosis establishment. A treatment is in its premise a symptomatic treatment, is long-lasting and based on a mutual trust between a doctor and a patient. Basic information concerning this illness is presented in this article.

Antidepressive Agents↗

PubMed2004

[Antireflux endoscopic procedures].

In recent few years there took place a significant development of endoscopic antireflux procedures. There appeared a need for review of these procedures. There could be distinguished three basic directions in treatment; endoscopic sewing, injection and implantation technique based on administering polymer-based, biologically neutral substances and the technique based on applying radiation of radiowave length in the region of lower esophageal sphincter.

Endoscopy↗

PubMed2004

[The contemporary endoscopic methods of treatment of gastroesophageal reflux disease complications].

Gastroesophageal reflux disease (GERD) is one of the most common publication subjects in gastroenterology field for more than twenty years. The following article is a review of endoscopic methods of treatment of GERD complications. It is interesting that complications of disease are quite common despite the constant development of diagnostics and treatment methods. It is still common to diagnose the disease when the first manifestation is the esophagus constriction. The complication of GERD is the intestinal metaplasia and adenocarcinoma of the distal part of the esophagus. There are effective endoscopic methods of GERD complications treatment. The most effective are esophagus dilations and endoscopic pathological mucosae layer removal like photodynamic therapy, laser ablation, argon coagulation, multipolar coagulation or mucosectomy.

Endoscopy↗

PubMed2004

[Complications of endoscopic procedures].

Endoscopic procedures became the widely accepted standard diagnostic tool used in diagnostics and treatment of gastrointestinal tract diseases. There are complications associated these procedures are quite rare but can be very serious and even life-threatening. The following paper presents the current knowledge about the prevalence, risk factors and the character of these complications. We should distinguish complications connected with the upper GI endoscopy, complications of colonoscopy and complications connected with endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincteropapillotomy (ES) procedures.

Cholangiopancreatography, Endoscopic Retrograde↗

PubMed2004

[Peptic ulcer disease etiology, diagnosis and treatment].

Authors in this article present etiology, clinical manifestations, diagnostic procedures and treatment of peptic ulcer disease in children and adults. Increased gastric acid output, Helicobacter pylori, NSAIDs and stress are the basic risk factors in peptic ulcer disease. H. pylori infection is a widely known risk factor in peptic ulcer disease and influences diagnostic and treatment procedures. Primary ulcer disease concerns mainly duodenum and is accompanied by H. pylori infection. Gastroscopy and Helicobacter tests are the only reliable procedures to diagnose peptic ulcer disease. Nowadays the most important aim in peptic ulcer treatment is the H. pylori eradication. Therapy with two antibiotics and a protein pomp inhibitor eradicates the bacteria, treats the ulceration and lowers the number of ulcer recurrence. In non-infected H. pylori ulcers or in a long-term treatment protein pomp inhibitors and H2-inhibitors are effective as well in gastroprotective therapy.

Adult↗

PubMed2004

[Complication of NSAIDs treatment in gastrointestinal tract].

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the common medicaments administered to relieve pain and other inflammation symptoms. Apart from indisputable advantages, the use of these can cause the undesired complications especially concerning gastrointestinal tract. Some of them could be serious. The most disturbing is that some of the gastrointestinal tract damage done by NSAIDs is asymptomatic. It is imperative to identify risk factors in patients who use NASIDs and to undertake the appropriate preventive measures. Nowadays it is possible to implement prophylaxis and to avoid complications and to improve the safety profile. In this paper authors presented conditions under which the complications of use of NSAIDs could appear and the possible prophylactic measures that could be undertaken. The most common is the use of proton pump inhibitor.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed2004

[Clinical analysis of unsuccessful Helicobacter pylori eradication].

Numerous medical reports claim that the effectiveness of H. pylori therapy decreases. The aim of the study was the analysis of the reasons of this phenomenon on own material. The study included 437 subjects, aged 19-64 years with chronic gastritis with H. pylori infection. All patients were subjected to: endoscopy, fast urease test, breath test (UBT-13C) and antibody titer in IgG class was determined. In the case of ineffective therapy bacteriological examination was performed. In the first stage of the therapy pantoprazol (2 x 40 mg) and amoxicillin (2 x 1000 mg) with metronidazol (2 x 500 mg) were applied in 282 subjects for 7 days (group I), amoxicillin with clarithromycin (2 x 500 mg) in 182 subjects (group II) and clarithromycin with metronidazol in 43 subjects (group III). After 6 weeks negative breath test was observed on average in 65.68% without significant differences between the groups. Ineffective therapy was more frequent in subjects over 45 years of age with high intensity of H. pylori colonization and earlier treated with antibiotics due to other reasons; such differences were not observed dependently on the antibody titer. In the second stage of the therapy pantoprazol was still administered but antibacterial drugs were changed among the groups. From among 150 subjects eradication was obtained in 117 (78.0%). In 33 subjects with ineffective therapy bacteriological examination of gastric bioptates confirmed antibiotic resistance in 75.76%. It results from the study that the applied therapy, consistent with current recommendations of the experts, does not ensure H. pylori eradication in part of the patients, what points to the necessity of searching for other effective antibiotics.

Adult↗

PubMed2004

[Estimation of gastric mucosa morphological changes in subjects with asymptomatic Helicobacter pylori infection and family history of gastric cancer].

Helicobacter pylori is a known carcinogen but the natural history of gastric carcinoma development has not been recognized thoroughly and early diagnostics is difficult particularly in asymptomatic infection. The aim of own study was gastric mucosa morphological estimation in subjects with asymptomatic H. pylori infection. Investigations were performed in 60 subjects, aged 24-55 years with family history of gastric cancer and with asymptomatic (group I; n=30) and symptomatic infection (group II; n=30). The infection and its severity were confirmed with breath test with the use of 75 mg of 13C labelled urea and Olympus FANci-2 analyzer. Gastric mucosa macro- and microscopic state was evaluated according to 4-degree Sydney scale. In group II macroscopic changes were more pronounced than in group I (p=0.032); no such differences were seen in microscopic picture (p=0.625). The extent of macro- and microscopic changes demonstrated positive correlation with the results of breath test (group I: r=0.8169; group II: r=0.8393). In subjects with family history of gastric cancer H. pylori infection both, symptomatic and asymptomatic causes similar gastric mucosa histopathological changes including intestinal metaplasia. The degree of morphological changes demonstrates positive dependence with the severity of infection.

Adult↗