Rafał Filip

Alpha-ketoglutarate decreases serum levels of C-terminal cross-linking telopeptide of type I collagen (CTX) in postmenopausal women with osteopenia: Six-month study

Several studies have shown that alpha-ketoglutaric acid (AKG) increases serum levels of proline and has beneficial effects on skeletal development. We studied the effect of alpha-ketoglutaric (AKG) acid calcium salt (6 g AKG and 1.68 Ca/day) or calcium alone (1.68 Ca/day) on serum C-terminal cross-linked telopeptide of type I collagen (CTX) and osteocalcin (OC), as well as on lumbar spine bone mineral density (BMD) in a randomized, parallel group, double-blind, 6-month study conducted on 76 postmenopausal women with osteopenia. The maximum decrease of the mean CTX level in the AKG-Ca group was observed after 24 weeks (37.0%, p = 0.006). The differences in CTX between study groups were statistically significant after 12 and 24 weeks. The OC serum level was not affected by treatments. The BMD of the AKG-Ca group increased by 1.6% from baseline; however, the difference between treatment groups was estimated as 0.9% (non-significant). This study suggests the potential usefulness of AKG-Ca in osteopenic postmenopausal women. AKG-Ca induced beneficial changes in serum CTX, which was consistent with preserving the bone mass in the lumbar spine; however, the long-term effect needs to be further investigated.

Ten-year secular trend of overweight and obesity in school children in south-eastern Poland

OBJECTIVE To examine the trend in prevalence of overweight and obesity in schoolchildren from south-eastern Poland over a 10-year period. MATERIALS AND METHOD A cross-sectional study was conducted in randomly selected primary schools. In total, 4,248 children (2,182 boys and 2,066 girls), mean age 10.5±2.4 years, were examined in 1998, and 2,412 children (1,184 boys and 1,228 girls), mean age 10.5±2.3 years in 2008. In each school the entire population was studied. RESULTS In 2008, the prevalence of overweight in girls was 13.3% and obesity 7.7%, compared to 12.0% and 10.1% in 1998. The decrease in obesity prevalence was statistically significant. In boys, the prevalence of overweight in 2008 was 14.2% and obesity 6.4%, compared to 10.5% and 6.8% in 1998. The increase in overweight prevalence among boys was statistically significant. CONCLUSIONS A trend toward stabilization of the prevalence of overweight and obesity was noted in school children from south-eastern Poland between 1998-2008. The declining prevalence of obesity in girls and increased prevalence of overweight in boys demonstrates that in this age group of children the secular trend is gender dependent.

Pro-health behaviours – a sense of coherence as the key to a healthy lifestyle in rural areas?

BACKGROUND Health-related behaviours and lifestyle are related to the salutogenic concept of health, whereas the major public health problems faced in rural areas include difficulties in encouraging people to a healthy lifestyle. OBJECTIVE The aim of the study is to explore mutual relationships between psychosocial-demographic factors and a sense of coherence. MATERIAL AND METHOD Two-stage sampling was applied. Data were collected with the use of the Juczynski Health Behaviours Inventory and Antonovskys SOC-29 (Sense of Coherence Questionnaire). The study was conducted among 668 adults. Data were statistically prepared using one-way ANOVA test, linear correlation analysis, and linear regression model. RESULTS A higher level of pro-health behaviours is associated with gender, self-rated health, sense of coherence and age. Almost half of the farmers were characterized by a low level of pro-health attitudes. A higher level of pro-health behaviours was demonstrated by less than one-fifth of the farmers. CONCLUSIONS There is a strong association between sense of coherence and pro-health behaviours. Farmers have bad habits and pro-health attitudes to health and poorer self-assessment of their health. There is a great need to monitor health-related behaviour, increase the effectiveness of health promotion and health education in shaping a pro-health lifestyle among residents of rural areas, particularly among farmers.

Glucose homeostasis dependency on acini–islet–acinar (AIA) axis communication: a new possible pathophysiological hypothesis regarding diabetes mellitus

Studies have highlighted the existence of two intra-pancreatic axes of communication: one involved in the regulation of enzyme production by insulin—the insular–acinar axis; and another involved in the regulation of insulin release by pancreatic enzymes—the acini–insular axis. Previous studies by our laboratory show that pancreatic enzymes can affect blood glucose homeostasis and insulin secretion independently of their digestive functions, both from the gut lumen and probably from the blood. As a result we would like to introduce here the concept of acini–islet–acinar (AIA) axis communication (feedback), which could play an important role in the development of obesity and diabetes type 2. The AIA feedback links the endocrine and exocrine parts of the pancreas and emphasizes the essential role that the pancreas plays, as a single organ, in the regulation of glucose homeostasis by amylase most probably in gut epithelium and by insulin and glucagon in peripheral blood.

Determinants of long-term home nursing care among people over 65 years of age

Introduction: With age comes increasing loss of efficiency, and thereby increasing dependence on others and increasing demand for nursing and care services Aim of the research: To determine the factors of demand for long-term home nursing care among people over 65 years old. Material and methods: The research was conducted on 504 subjects aged between 66 and 94 years. The qualified respondents for the long-term home-based nursing care scored no more than 40 points in Barthel’s Index. The following research tools were used: Barhel’s Index, IADL, GDS, AMTS, and an authorial interview questionnaire. Results: For long-term home-based nursing care 15.67% (n = 79) of subjects were qualified; there were more women (n = 61) than men (n = 18) (p < 0.05). The age of respondents qualified for long-term nursing care was higher than the age of other test subjects (p < 0.001). Among subjects qualified for long-term home-based nursing care there were more people with incomplete primary education (p < 0.01) and a higher number of multi-diseases than with the rest (p < 0.01). Moreover, people qualified for long-term nursing care had worsened agility to perform complex life activities and worsened cognitive and emotional performance (p < 0.001) than people who did not qualify for such services. Conclusions: The need for long-term nursing care was determined by progressing ageing, functional, emotional, and cognitive disorders, more frequent with women, people with low education, and multi-diseases.

Is hyperoxaluria in a porcine model of Roux-en-Y gastric bypass (RYGB) associated with exocrine pancreatic insufficiency?

1Department of Epizootiology and Clinic of Infectious Diseases, University of Life Sciences, Lublin, Poland Head of the Department: prof. Stanislaw Winiarczyk, PhD 2Department of Preclinical Veterinary Sciences, University of Life Sciences, Lublin, Poland Head of the Department: prof. Jose L. Valverde Piedra, PhD 3Department of Animal Physiology, University of Life Sciences, Lublin, Poland Head of the Department: prof. Iwona Puzio, PhD 4Department of Biology, Lund University, Lund, Sweden Head of the Department: prof. Christer Lofstedt, PhD 5R&D, SGPlus, Malmo, Sweden Chief Executive Officer: prof. Stefan G Pierzynowski, PhD 6General Surgery Department of the District Specialist Hospital, Lublin, Poland Head of the Department: Jerzy Mackiewicz, MD, PhD 7Department of Vitreoretinal Surgery, Medical University of Lublin, Poland Head of the Department: Andrzej Chrościcki, MD, PhD 8Department and Clinic of Animal Internal Diseases, University of Life Sciences, Lublin, Poland Head of the Department: Jacek Madany, MD, PhD 9Department of Human Anatomy, Laboratory of Biostructure, Medical University of Lublin, Poland Head of the Department: prof. Ryszard Maciejewski, MD, PhD 10Institute of Rural Health, Lublin, Poland Head of the Institute: prof. Iwona Bojar, MD, PhD 11Department of Cytology, Bogomoletz Institute of Physiology, Kiev, Ukraine Head of Department: prof. Galyna Skibo, MD, PhD

Novel potential of pancreatic-like enzymes of microbial origin in exocrine pancreatic insufficiency – study on a pig model

Introduction. The standard porcine-derived pancreatic enzyme replacement therapy (PERT) is a lifesaving treatment for patients with diseases causing exocrine pancreatic insufficiency (EPI). An attempt to replace PERT with microbial enzymes were undertaken. The aim was to highlight whether the mode of application, mixed with food or applied directly to the stomach, of pancreatic-like enzymes of microbial origin (PLEM) can affect their activity along the gastrointestinal tract. Materials and method. The activity of amylase, lipase and proteinase in the stomach, duodenum and ileum were tested in EPI pigs (n=6) after supplementation of PLEM, either orally – before and during feed consumption – or via the stomach – before and during feed consumption. Healthy pigs not treated with PLEM (n=3) served as controls. Activity of the enzymes measured in the chyme were obtained together with the digesta pH. Activity of the enzymatic residues in the stool samples was also checked. Results. The highest pancreatic enzyme activities were found in the duodenum of the healthy pigs (amylase 162,68 kU/ mL, lipase 507,34 kU/mL and protolitic (trypsin) activity 357,60 kU/mL). Nevertheless, the microbial enzymes remained also active along the entire length of the GIT – including stomach in EPI pigs, regardless of their route of administration. However, activity level was significantly lower. Discussion. Results indicate that the activity pattern of PLEM in the small intestine mimics the activity of the natural endogenous pancreatic enzymes in healthy pigs. The most physiological features of PLEM were observed when enzymes were offered orally. The magnitude of PLEM activity in the stomach of EPI pigs was essential and significantly higher than that measured in healthy pigs, thus being somewhat not physiological, and for health reasons of the patients should be further explored. Interestingly, specific trypsin-like activity was measured in all parts of the GIT after PLEM application. However, proteolytic activity of the experimental proteaze in in vitro studies did not exhibit trypsin-like activity.

Rapid Progression of Primary Sclerosing Cholangitis Complicated with Ulcerative Colitis

Primary sclerosing cholangitis is a cholestatic condition with unknown etiology and long-standing, progressive course, leading to cirrhosis and requiring orthotropic liver transplant. In approximately 80%, primary sclerosing cholangitis is accompanied by inflammatory bowel disease, and in most cases the recognition of bowel disease precedes the diagnosis of primary sclerosing cholangitis. We describe a case of 22-year-old male diagnosed simultaneously with primary sclerosing cholangitis and ulcerative colitis, with a medical history suggesting uncommon prior development of the liver disease. Five months after the initial diagnosis, we observed advanced lesions of bile tree due to progression of primary sclerosing cholangitis, which led to the unusually fast necessity for the orthotopic liver transplant.