IntroductionGastric cancer remains one of the leading causes of cancer-related death. Many frequently used drugs (proton pump inhibitors (PPI), statins, metformin, and non-steroidal anti-inflammatory drugs (NSAID)) can play a role in the development of gastric cancer or attenuate Helicobacter pylori’s adhesion (cysteine derivatives).AimTo analyse the patterns and dynamics of consumption of PPIs, statins, metformin, NSAIDs and cysteine derivatives in Ukraine in comparison with global trends, and to explore their potential impact on the gastric cancer morbidity in Ukraine.Material and methodsThe consumption of PPIs, statins, metformin, NSAIDs, and cysteine derivatives (by mean of daily defined doses (DDDs)/100 000 habitants per year, 2014–2020) and gastric cancer epidemiological indices, such as the incidence rate (per 100 000 habitants per year, 2014–2021), main forms, and age prevalence, were estimated in Ukraine.ResultsLevels of PPI, statins, metformin, NSAID, and cysteine derivative consumption increased by 98.61% (p < 0.0001), 199.15% (p < 0.0001), 141.29% (p < 0.0001), 23.51% (p < 0.0001), and 42.06% (p < 0.0001), respectively, in 2020 compared to 2014 whereas the gastric cancer incidence rate decreased by 26.56% (p < 0.0001) in 2021 compared to 2014 in Ukraine.DiscussionThe gastric cancer incidence rate decreased, and its epidemiological structure was stable, in Ukraine between 2014 and 2021. The consumption of PPIs, statins, metformin, NSAIDs, and cysteine derivatives might play a complex role in the development of gastric cancer.ConclusionsThe trends of the gastric cancer incidence rate, its epidemiological structure, and the increased consumption of PPIs, statins, metformin, NSAIDs, and cysteine derivatives in Ukraine between 2014 and 2021 correspond to global trends. Statins, metformin, NSAIDs, and cysteine derivatives might lead to a decline in gastric cancer in the population despite the increased consumption of PPIs.

IntroductionThe lack of effective pharmacological methods, at a time of great advances in medicine and pharmacotherapy, to alleviate patients’ symptoms drives the search for alternative methods of treatment. Patients often experience mental disorders and symptoms of depression. The difficulty in fully alleviating these symptoms has prompted interest in unconventional interventions that involve close collaboration between doctors, psychologists and coaches.AimThe purpose of this study was to evaluate the effect of physical exercise and selected relaxation techniques on the quality of life (QOL) of patients with irritable bowel syndrome (IBS).Material and methodsForty-one women diagnosed with IBS were included in the study. To assess the effectiveness of the method used, the validated IBS-QOL questionnaire was used. The study used an original training program. Twenty-nine women completed the entire 2-month training cycle, in line with the assumptions of the study. The analysis of the results was performed using the program Statistica.ResultsThe questionnaire contained questions grouped into 9 dimensions. The results demonstrated a 12.5% relationship between physical activity and QOL of IBS patients. Of the QOL dimensions analysed, the largest differences were found in the areas of sexuality, health preoccupation, body image, and dysphoria, and the smallest in the activity interference dimension. There was a statistically significant difference between physical activity and QOL in patients diagnosed with IBS.ConclusionsAppropriate physical activity with selected relaxation techniques improved the QOL of the study subjects.

IntroductionEndoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) and endoscopic ultrasound-guided ethanol ablation (EUS-EA) are emerging novel methods for managing non-functioning and functioning pNET and adenocarcinoma in the pancreas.AimTo assess the safety profile, feasibility, and outcomes of EUS-RFA and EUS-EA of focal pancreatic masses.Material and methodsThis prospective study included 27 patients, 15 males and 12 females, with a mean age of 36.38 years. EUS-RFA was carried out in 13 patients; 11 had pancreatic insulinoma, and 2 had advanced pancreatic adenocarcinoma. The mean size of the masses was 20.6 mm, while that of the insulinomas was 17.4 mm. The median number of needle passes was 3, with a range of 1 to 6. RFA was conducted using 19G EUSRA needles from Taewoong Co., Ltd., South Korea. No minor or major complications were observed. EUS-EA was carried out in 14 patients, all of whom had pancreatic insulinoma. The mean size of the masses was 15.3 mm. The median number of needle passes was 2, with a range of 1 to 3. We used 19G and 22G echo tip FNA needles from Cook Company, USA. The mean duration of follow-up was 12.4 months. There was mild to moderate acute pancreatitis in 4 patients in the EUS-EA group; all were relieved by conservative therapy, and no hospital admission was required. No early or late significant complications were reported in the EUS-RFA group.ResultsThere was a complete clinical cure of 10 out of 11 (91%) patients with pancreatic insulinoma who underwent EUS-RFA. However, 1 patient required three sessions, and 2 patients required two sessions of EUS-RFA. The 11th patient with insulinoma showed a poor response after the first session, then a partial response after the second session of EUS-RFA. The size of the two masses with advanced adenocarcinoma was decreased, but no downstaging of the masses was achieved. There was a complete clinical cure of 8 out of 14 (57%) patients with pancreatic insulinoma who underwent EUS-EA. No clinical cure was observed in 4 patients; 3 underwent major surgery, and the 4th one underwent EUS-RFA. The last 2 patients showed a partial clinical response with decreased frequency, duration, and severity of hypoglycemic attacks. They were managed by diet regulation; no major surgery was needed.ConclusionsEUS-RFA and EUS-EA can potentially treat lesions and control symptoms. EUS-RFA is a more promising and safer technique for managing functioning insulinomas. However, it cannot downstage pancreatic ductal adenocarcinoma patients. EUS-EA seems less efficient, with more adverse events than EUS-RFA.

IntroductionRelationships between redox homeostasis, nutritional status, and postoperative complications in patients with colorectal cancer are still unexplained.AimThis study aimed to evaluate selected parameters of oxidative stress and nutritional status in colorectal cancer patients and their impact on postoperative complications.Material and methodsThe study included 50 patients with colorectal cancer. In all patients, body mass index (BMI), body weight loss, and the Nutritional Risk Screening tool (NRS 2002) were assessed. The levels of total protein and albumin, complete blood count (CBC), total antioxidant capacity (TAC), total oxidant status (TOS), and malondialdehyde (MDA) level were measured. Oxidative stress index (OSI) and the TAC/MDA ratio were calculated.ResultsWe detected a significantly higher TAC level (p = 0.0017) and lower TOS level in patients with normal BMI compared to those with increased BMI. We observed a higher TAC level in patients without weight loss (p = 0.0407), whereas the MDA concentration was higher in patients with weight loss than in those without weight loss (p = 0.0025). TAC was significantly higher whereas TOS, OSI, and TAC/MDA ratio were significantly lower in patients without symptoms of malnutrition (p < 0.05). Patients without postoperative complications had higher levels of TOS and MDA, and a lower level of TAC (p < 0.05).ConclusionsThe occurrence of postoperative complications may be associated with increased oxidative stress in patients with colorectal cancer.

IntroductionInflammatory bowel diseases (IBD) significantly influence sexual function due to their symptoms. The impact of the disease on sexuality and intimacy is a predominant concern for IBD patients, though data on sexual (SD) and erectile dysfunction (ED) and their determinants remain scarce.AimThe aim of this study was to evaluate sexual function and identify predictors of SD among patients with IBD during biological treatment.Material and methodsThis prospective study included 135 adult patients with Crohn’s disease (n = 106) and ulcerative colitis (n = 29) who were selected for biological treatment based on established criteria (CD: CDAI > 300; UC: Total Mayo score > 6). Participants completed validated questionnaires on their sexual function: the Female Sexual Function Index (FSFI) and the International Index of Erectile Function-5 (IIEF-5), with a question from the Inflammatory Bowel Disease Questionnaire (IBDQ).Results43.7% of patients reported SD, with similar proportions in men and women (p = 0.536). There was no significant correlation between the duration of IBD, type of medication or calprotectin levels and the results of the FSFI and IIEF-5 questionnaires. Self-reported limitations were greater for women compared to men (p < 0.001), with a significant correlation between them and both IIEF-5 and FSFI scores across both disease types (p < 0.001).ConclusionsSD and ED among patients treated with biologics were associated with psychological factors but not disease severity. The type of medication used to treat the underlying disease did not influence the development of SD. These findings underscore the need for a comprehensive understanding of sexual health and psychological support for IBD patients.

IntroductionRecently there has been significant progress in research on the pathogenesis of inflammatory bowel diseases (IBD).AimOur study aimed to assess selected markers of bacterial translocation in children with IBD in relationship to disease activity.Material and methodsLipopolysaccharides (LPS) – markers of bacterial translocation – and proinflammatory cytokines – interleukin (IL)-8, IL-12 and tumor necrosis factor (TNF) α – were assessed in the serum of 27 pediatric IBD patients at the outbreak of the illness and then 1 and 3 months after the introduction of the treatment. The analyzed markers were taken once in 6 healthy children in the control group.ResultsSerum TNF-α and LPS concentrations were significantly higher in IBD patients than in the control group (1.74 vs. 0.83 ng/ml and 21.83 vs. 10.26 pg/ml, p < 0.05). In the study group, clinical and laboratory activity mediators significantly decreased during 3 months of the treatment. All proinflammatory cytokines decreased, but significant down-regulation was observed only in relation to IL-12 (129.21 vs. 82.98 pg/ml, p < 0.05) in CD and IL-8 (32.72 vs. 20.97 pg/ml, p < 0.05) in UC patients. TNF-α levels decreased but did not reach values as in healthy children, while LPS levels increased in both groups.ConclusionsIL-12 in CD and IL-8 in UC could be non-invasive markers of reduced inflammation during IBD in children. Improvements in clinical status and reductions in systemic inflammatory markers do not necessarily mean complete cessation of the inflammatory cascade. The elevated TNF-α and LPS levels found in patients in early remission may be a marker of subclinical inflammation.

IntroductionMalignant polyps are primarily adenocarcinomas arising from adenomatous polyps, with the potential to metastasize to regional lymph nodes and distant sites. In our institute, significant gaps in knowledge about the histopathological characteristics of malignant colorectal polyps continue to exist despite their recent increase in prominence.AimThis study aims to describe the demographic and pathological features of malignant polyps and investigate the correlation between the Haggitt level and various parameters.Material and methodsThis retrospective study included patients who underwent colonoscopy and polypectomy with the diagnosis of adenocarcinoma arising from an adenomatous polyp between January 2018 and December 2022.ResultsThe correlation between the Haggitt level and variables was assessed using the χ2 test. The study included 53 patients with a 2 : 1 male-to-female ratio and a mean age of 66 years. Malignant polyps were primarily located in the sigmoid colon and rectum. The presence of lymphatic and perineural invasion was correlated with a deeper level of invasion.ConclusionsThe rectosigmoid colon is the predilection site for malignant polyps, and a deeper level increases the risk of lymphatic and perineural invasion.

IntroductionMajor depressive disorder (MD) is a significant mental health issue projected to become the leading contributor to the global burden of disease by 2030. MD substantially increases between teenage years and early adulthood. In addition, 25% of mood disorders manifest by 18 years old and 50% by age 30. Prior research investigated the relationship between the administration of corticosteroids and the onset of depression, revealing notable depressive symptoms and occurrences of depression in individuals undergoing corticosteroid treatment.AimWe aimed to determine the prevalence of depression following corticosteroid therapy among a cohort of patients who received corticosteroids.Material and methodsThis cross-sectional study was carried out at various centers, including Al-Azhar University Hospitals, involving a cohort of 500 cases.ResultsThe results of the Beck Depression Inventory showed a significant increase across all questionnaire items following corticosteroid therapy. The mean total score was 6.02 ±2.05 before corticosteroid therapy and 11.28 ±7.94 after therapy, showing a significant increase (p < 0.001). None of the participants exhibited depression before corticosteroid therapy, according to the Beck Depression Inventory. Following corticosteroid therapy, 26% of cases experienced depression, with 10% being mild, 6% moderate, 8% severe, and 2% very severe. Significant changes were observed in body mass index, C-reactive protein, glycated hemoglobin, serum total calcium, and systolic blood pressure (p < 0.001).ConclusionsThe presence of depression and severity of depression were significantly higher after corticosteroid therapy compared to before therapy.

The diagnosis, treatment, and follow-up of pancreatic cystic tumors require a careful expert consensus approach due to their diverse nature and variable potential for malignancy. In view of these challenges, a panel of experts from the Polish Pancreatic Club has developed comprehensive recommendations. These guidelines are based on the most recent literature data and reflect current advances in diagnostic imaging and therapeutic interventions. The panel conducted an extensive review of available publications, meticulously formulating each recommendation and subsequently voting on them using the GRADE system (providing the quality of evidence and recommendation strength for each statement). The guidelines emphasize the importance of advanced imaging modalities (such as computed tomography, magnetic resonance, and endoscopic ultrasound), fine needle aspiration biopsy in selected situations and applicable laboratory tests to improve diagnostic accuracy. Furthermore, treatment strategies are carefully tailored to match individual risk profiles and specific lesion characteristics. Management options range from conservative treatment with routine follow-up examinations to surgical interventions when clinical indications require such an approach. Overall, these expert recommendations provide clinicians with a valuable and reliable framework, firmly anchored in current scientific data and consensus among specialists, for effectively managing pancreatic cystic tumors in clinical practice. Ultimately, these guidelines will lead to improved patient outcomes.

IntroductionToll-like receptors (TLRs) play a key role in activating the immune system response after liver injury.AimThis experimental study aimed to investigate the expression of TLRs and their connecting signaling molecules in liver regeneration.Material and methodsEighty C57BL/6J mice were divided into eight equal groups: four groups underwent partial hepatectomy (liver resection, LR), and four groups underwent an abdominal incision without hepatectomy (sham, Sh). One group of each type was sacrificed at 12 h (LR12 and Sh12), 24 h (LR24 and Sh24), 36 h (LR36 and Sh36), and 168 h (LR168 and Sh168). Histological and immunohistochemical analyses, blood tests, and quantitative real-time polymerase chain reaction (qRT-PCR) were performed.ResultsThe qRT-PCR tests indicated significant differences in all immune response proteins (TLR1, TLR2, TLR6, IRAK4, TIRAP, NF-kB, MYD88) between all LR and Sh groups. A progressive increase in the expression of TLRs was observed in the first three pairs, with stabilization of their expression in the last group. Histological examination of liver specimens revealed regeneration of liver tissue in the LR groups. Immunohistochemical analysis revealed increased expression of signaling proteins (TLR1, TLR2, MYD88, IRAK4, TIRAP, NF-kB) in the LR groups as compared to the control groups. White blood, red blood cell count and liver function tests were significantly different between LR and Sh groups.ConclusionsTLR expression was significantly higher in mice that underwent partial hepatectomy than the controls. Further research is required to investigate their potential as therapeutic targets in the management of acute or chronic liver failure after partial hepatectomy.