Antibiotic-Resistant Strains of Helicobacter pylori in 50 Antibiotic Treatment-Naive Children in Northeast Poland Diagnosed by Gastric or Duodenal Biopsy Between February 2019 and May 2022.

BACKGROUND In recent years, an increasing prevalence of Helicobacter pylori resistance to antibiotics has been observed. The aim of this study was to assess antibiotic resistance of Helicobacter pylori in previously untreated children from northeast Poland. MATERIAL AND METHODS Inclusion criteria comprised suspicion of Helicobacter pylori infection based on the presence of Helicobacter pylori antigen in the stool and/or characteristic macroscopic lesions seen on esophagogastroduodenoscopy. Samples of the gastric and/or duodenal mucosa were collected from 82 children with a median age of 13 years (range 3-17) during esophagogastroduodenoscopy between February 2019 and May 2022. The material was cultured, and positive Helicobacter pylori strains were tested for drug resistance to amoxicillin, metronidazole, and clarithromycin using the quantitative antibiotic concentration gradient stripe method E-test. RESULTS Based on biopsy culture, Helicobacter pylori infection was confirmed in 50 (61%) children. Helicobacter pylori resistance was most common to clarithromycin (n=19; 38%), followed by metronidazole (n=15; 30%), and the least frequent to amoxicillin (n=13; 26%). The resistance to 1 antibiotic was found in 14 children (28%). Double-drug resistance was noted in 3 children (6%) and triple drug resistance in 9 children (18%). In the whole group, 24 children (48%) were susceptible to all 3 antibiotics. CONCLUSIONS In this study, conducted for the first time in treatment-naïve children in northeast Poland, we found a high proportion of Helicobacter pylori strains resistant to at least 1 antibiotic. Our results may help in the appropriate choice of antibiotics for treatment of Helicobacter pylori in our region.

Immunohistochemical markers for eosinophilic esophagitis.

BACKGROUND AND AIMS: Eosinophilic esophagitis (EoE) is a chronic, local immune-mediated esophageal disease with eosinophil-dominated inflammation. The incidence of the disease is rapidly increasing in both children and adults. The pathogenesis of the disease is still not well understood. We present a review of the literature devoted to the EoE immunopathology, in particular the markers of inflammation and epithelial integrity, and their usefulness in disease monitoring and therapy. METHODS: We performed a systematic search of the MEDLINE/PubMed databases for studies to examine the use of immunohistochemistry as a diagnostic tool for EoE. RESULTS: The gold standard of EoE diagnosis requires multiple endoscopies with biopsies for histological assessment. The minimum number of eosinophils evaluated in hematoxylin-eosin staining to diagnose EoE is 15 per high-power field in at least one esophageal mucosa biopsy. However, in some cases, the count of eosinophils is not specific and insufficient as the only indicator. Recent works confirm the usefulness of assessment of some biomarkers in establishing the diagnosis and monitoring the treatment effects. CONCLUSIONS: Immunohistochemistry seems to be a promising option not only in clinical recognition, but also in the selection and monitoring of treatment effects. However, these methods have not yet recommended for routine clinical use.

Design of New-Generation Usable Forms of Topical Haemostatic Agents Containing Chitosan.

Designing usable forms of topical haemostatic agents is the most important activity during the design process, resulting in strengthened functional properties of the final medical devices. This study aimed to propose indications for a research programme based on risk management supporting the development of two usable forms of a topical haemostatic agent: chitosan/alginate lyophilized foam and chitosan/alginate impregnated gauze. Both of the usable forms of the topical haemostatic agent, being the main part of the modified combat gauze, were fabricated using the chitosan/alginate complex. Risk analysis is helpful in developing an appropriate research programme, significantly reducing the risk to an acceptable level.

Poly(D,L-Lactide-Co-Glycolide) Tubes With Multifilament Chitosan Yarn or Chitosan Sponge Core in Nerve Regeneration.

PURPOSE: The influence of different kinds of nerve guidance conduits on regeneration of totally transected rat sciatic nerves through a 7-mm gap was examined. MATERIALS AND METHODS: Five different types of conduits made of chitosan and poly(D,L-lactide-co-glycolide) (PLGA) were constructed and tested in vivo. We divided 50 animals into equal groups of 10, with a different type of conduit implanted in each group: chitosan sponge core with an average molecular mass of polymer (Mv) of 287 kDa with 7 channels in a PLGA sleeve, chitosan sponge core with an Mv of 423 kDa with 7 channels in a PLGA sleeve, chitosan sponge core (Mv, 423 kDa) with 13 channels in a PLGA sleeve, chitosan multifilament yarn in a PLGA sleeve, and a PLGA sleeve only. Seven weeks after the operation, we examined the distance covered by regenerating nerve fibers, growing of nerves into the conduit's core, and intensity and type of inflammatory reaction in the conduit, as well as autotomy behavior (reflecting neuropathic pain intensity) in the animals. RESULTS: Two types of conduits were allowing nerve outgrowth through the gap with minor autotomy and minor inflammatory reactions. These were the conduits with chitosan multifilament yarn in a PLGA sleeve and the conduits with 13-channel microcrystalline chitosan sponge in a PLGA sleeve. CONCLUSIONS: The type of chitosan used to build the nerve guidance conduit influences the intensity and character of inflammatory reaction present during nerve regeneration, which in turn affects the distance crossed by regenerating nerve fibers, growing of the nerve fibers into the conduit's core, and the intensity of autotomy in the animals.

Integrative vectors for gene deletion and replacement.

An improved method for gene deletion or replacement in Escherichia coli was developed. It employs a set of integrative vectors and two helper plasmids, as a temporary source of RecA and Flp activities. The integrative vectors combine several useful features including three different selection markers placed between two parallel oriented Flp recombinase target (FRT) sites. Each marker is flanked by two MCSs, for cloning the chosen homologous fragments of DNA to gene targeting. The vectors contain two properly oriented E. coli Chi sites for recombination enhancement. When required, selection markers can be excised from the chromosome resulting in unmarked strains.

Biodegradation study of microcrystalline chitosan and microcrystalline chitosan/ß-TCP complex composites.

Bone repair or regeneration is a common and complicated clinical problem in orthopedic surgery. The importance of natural polymers, such as microcrystalline chitosan, and minerals such as HAp and ß-TCP, has grown significantly over the last two decades due to their renewable and biodegradable source, increasing the knowledge and functionality of composites in technological and biomedical applications. This study compares the biodegradation process, bioactivity, structure, morphology, and mechanical properties of microcrystalline chitosan and microcrystalline chitosan/ß-TCP complex; the latter according to the new method of preparation. The complex showed a homogeneous network structure with regular pores, good bioactivity, even after 60 days of conducting the hydrolytic and enzymatic degradation process, showing a bacteriostatic and bactericidal activity. The complex indicates that it could be used successfully as a base for implants and scaffolds production in orthopedic surgery.

Reduction of post-traumatic neuroma and epineural scar formation in rat sciatic nerve by application of microcrystallic chitosan.

Injury of peripheral nerve is associated with the development of post-traumatic neuroma at the end of the proximal stump, often being the origin of neuropathic pain. This type of pain is therapy-resistant and therefore extremely nagging for patients. We examined the influence of the microcrystallic chitosan gel applied to the proximal stump of totally transected sciatic nerve on the neuroma formation and neuropathic pain development in rats. In 14 rats, right sciatic nerve was transected and the distal stump was removed to avoid spontaneous rejoining. In the chitosan (experimental) group (n = 7), the proximal stump was covered with a thin layer of the microcrystallic chitosan gel. In control animals (n = 7), the cut nerve was left unsecured. Autotomy, an animal model of neuropathic pain, was monitored daily for 20 weeks following surgery. Then, the animals were perfused transcardially and the proximal stumps of sciatic nerves were dissected and subjected to histologic evaluation. The presence, size, and characteristics of neuromas as well as extraneural fibrosis were examined. In chitosan group, the incidence and the size of the neuroma were markedly reduced, as compared with the control group; however, there was no difference in autotomy behavior between groups. In addition, extraneural fibrosis was significantly reduced in chitosan group when compared to the control group. The results demonstrate beneficial influence of microcrystallic chitosan applied to the site of nerve transection on the development of post-traumatic neuroma and reduction of extraneural fibrosis, however without reduction of neuropathic pain.

Biopolymers and Biomaterials for Special Applications within the Context of the Circular Economy.

The main challenge of the economy is counteracting the adverse effects of progressive industrialisation on the environment around the world. Economic development that accompanies this trend correlates to production increase in not only consumer articles but also special application articles that are difficult to remanufacture, such as medical supplies. For many researchers, discovering innovative materials for special applications that could become an essential element of circular economy production is important. Measures to reduce the production of industrial materials whose waste is difficult to recycle are more and more apparent to manufacturers, especially when faced with the new financial situation in European Union, as one of its priorities is to implement the principles of circular economy. The purpose of the article is to analyse the current state of research on special-application biomaterials within the context of the circular economy. Empirical analysis is conducted for Poland compared to the rest of the European Union (EU) within the time-frame of 2014-2020, which is the most recent financial timeframe of the EU. The submitted studies are based on secondary data obtained mainly from European databases, as well as primary data resulting from the research works at Lukasiewicz Research Network-Institute of Biopolymers and Chemical Fibres.

[Chitosan-alginate biocomposites in the form of films used in bedsores treatment]. / Biokompozyty chitozanowo-alginianowe w postaci filmów do leczenia odlezyn.

During recent years here has been a growing interest in developing dressing materials that would provide protection and more effective treatment of bedsores in different phases of healing and at the same time would play a role as a carrier of active substances. Dressings of this type should be made of special biodegradable polymeric materials which are good promoters of absorption of the active substances and characterized by good sorption properties. The paper presents preliminary studies related to the development composite films produced on the basis of biopolymers--chitosan and sodium alginate, with the participation of anti-inflammatory product. Studies concerning the assessment of sorption, physic-mechanical and biological properties suggest a potential opportunity to use this materials for the treatment of bedsores in the first phase of healing.

Eosinophilic Esophagitis in Children in North-Eastern Poland.

BACKGROUND: An increase in the incidence of eosinophilic esophagitis worldwide is being observed in children. The aim of the study was to analyze the incidence, clinical manifestations, biochemical markers and endoscopic features of children with eosinophilic esophagitis in comparison to patients with non-eosinophilic esophagitis. METHODS: This single-center retrospective study included newly diagnosed children with eosinophilic (EoE) and non-eosinophilic (non-EoE) esophagitis based on endoscopic and histopathological results between January 2013 and December 2018. RESULT: Among 433 of enrolled children with esophagitis, 36 (8.31%) were diagnosed with EoE (median age of 10 years). Male predominance and an increased percentage of allergy cases in the EoE group were noticed. Dysphagia was the only symptom that significantly differentiated both groups (p = 0.006). Endoscopic findings with relevant relationships with EoE included linear fissuring, decreased vascular pattern, trachealization and whitish exudates. No significant difference in the prevalence of other reported diseases between groups was observed. CONCLUSION: The results of EoE analysis in children from North-Eastern Poland did not differ from reports from other countries. The reported symptoms were not specific for EoE, and only dysphagia and some endoscopic lesions were helpful to differentiate children with EoE from non-EoE.

Metabolomic profiling in children with inflammatory bowel disease.

Ulcerative colitis (UC) and Crohn's disease (CD) represent inflammatory bowel diseases (IBD) with multifactorial pathogenesis, involving genetic, environmental and microbial factors. Interactions between gut microbiota and immune system result in changes in metabolic pathways. Metabolomics is a comprehensive and quantitative (or semi-quantitative) analysis of metabolites synthetized in human's biological system. It has been shown that metabolic profiling might be used to identify disease biomarkers. Recent findings confirmed alterations in the number of metabolites in patients with IBD. However, most of the studies included adult individuals with ongoing treatment which might have affected the metabolite profiling. Therefore, the aim of our study was to collect the knowledge about metabolomics in paediatric patients with CD or UC based on the currently published literature.

Hepatobiliary manifestations of inflammatory bowel disease in children.

Inflammatory bowel disease (IBD) diagnosis and therapy is challenging for every pediatrician, especially when complicated with extraintestinal manifestations. The article reviews current literature on the hepatobiliary manifestations associated with inflammatory bowel disease in the pediatric population.

The evaluation of resorbable haemostatic wound dressings in contact with blood in vitro.

PURPOSE: For many years research has been conducted on the development of resorbable, polymer, haemostatic materials designed to provide first aid and preliminary protection of injuries. The biological properties in vitro of a dressing in powder form called Hemoguard are expected to provide the ability to instantaneously stem bleeding with safe conditions of use. The aim of the study was to evaluate the haemostatic properties of a model of dressing based on micro- and nanofibrids of the chitosan, sodium/calcium alginate and/or carboxymethylcellulose complex. Dressings were prepared by spray-drying and freeze-drying. METHODS: Human whole blood was subjected to timed contact with the haemostatic dressing model. Haemolytic action was determined by assaying the degree of haemolysis and evaluating blood cell morphology. Haemostatic action was determined on the basis of selected parameters of plasmatic clotting systems. RESULTS: Dressings prepared by freeze-drying activated the coagulation system. The haemolytic index, plasma haemoglobin concentration values and blood cell morphological shapes were normal. Dressings prepared by spray-drying significantly activated coagulation. Activation of the coagulation process was evidenced by shorter clotting time of the plasma coagulation system and a longer process of clot formation. The dressing was associated with an increased haemolytic index and higher plasma haemoglobin concentration. The morphological shape of blood cells changed. CONCLUSIONS: The model of multi-resorbable wound dressings has haemostatic properties. The materials activate the clotting process more quickly than a single-dressing model. Increased activity was found for dressings prepared by spray-drying.

Chitosan-hydroxyapatite composites.

Bone repair or regeneration is a common and complicated clinical problem in orthopedic surgery. The importance of natural polymers such as chitosan and its derivatives, and minerals such as calcium phosphates has grown significantly over the last two decades due to its renewable and biodegradable source, increasing the knowledge and functionality of composites in technological and biomedical applications. The properties of bone in health and disease attract much attention. A great proportion of the population need those medical devices for hard tissue regeneration and/or replacement, the pressure on the health systems in all countries became substantial. The short review focus in biomaterials such as chitosan and calcium phosphates composites with excellent properties such as biocompatibility, biofunctionality, and non-antigenic, showing the feasibility and ideal material to treat musculoskeletal disorders for hard tissue regeneration.

The review of most frequently occurring medical disorders related to aetiology of autism and the methods of treatment.

The medical understanding of autism has changed since it was first defined by Kanner. Nowadays medicine identifies many medical abnormalities and diseases, which may underline or aggravate the cognitive aspect, behavioural issues and general health in autists. This includes chronic inflammation of gastrointestinal tract, dysbiosis, maldigestion, malabsorption, malnutrition, food intolerance, allergies, chronic viral, fungal and bacterial infections, impaired kidney function, impaired detoxification of endo- and exotoxins, disorders of metal ion transportation. Treatment of the above mentioned conditions combined with improving detoxification mechanisms, followed by a special diet and individually customized supplementation of nutritional deficiencies may lead to the improvement of the functioning of these patients, changing their level of functioning and self-dependence. The aim of this paper is to present medical problems of children with autism which may be identified and treated by general practitioners as a review of current medical papers related to Autism Spectrum Disorder, in the context of author's professional experience, based on the medical cases from author's practice.