[Psychometric validation of the Polish translation of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) Questionnaire in patients with reflux disease]. / Psychometryczna walidacja polskiego tlumaczenia Skali Ilosciowej Oceny Objawów Zolkdkowo-Jelitowych (GSRS, Gastrointestinal Symptom Rating Scale) oraz Kwestionariusza Oceny Jakosci Zycia w Chorobie Refluksowej i Dyspepsji (QOLRAD, Quality of Life in Reflux and Dyspepsia Questionnaire) u pacjentów z choroba refluksowa.

UNLABELLED: Symptoms of heartburn and their impact on health-related quality of life (HRQL) are often evaluated in clinical trials. When a questionnaire is translated into a new language, a linguistic validation is necessary but not sufficient unless the psychometric characteristics have been verified. The aim of the study is to document the psychometric characteristics of the Polish translation of the Gastrointestinal Symptom Rating Scale (GSRS) and quality of life in reflux and dyspepsia (QOLRAD) questionnaire. One hundred and thirty-five patients with symptoms of heartburn (mean age: 44, SD = 14.6; females % = 60.7) completed the Polish translation of GSRS, the heartburn version of QOLRAD, the Short-Form-36 (SF-36) and the Hospital Anxiety and Depression (HAD) scale. Seventy patients were scheduled for a second visit a week later to complete the GSRS and QOLRAD again. The internal consistency reliability of GSRS ranged from 0.58 to 0.88 and of QOLRAD from 0.84 to 0.95, and the test-retest reliability of GSRS ranged from 0.34 to 0.63 and of QOLRAD from 0.51 to 0.74. The relevant domains of the GSRS, "reflux", "abdominal pain" and "indigestion", and all QOLRAD domain scores significantly correlated. GSRS domains "abdominal pain" and "indigestion" were related to all SF-36 domains. All QOLRAD domains significantly correlated with all SF-36 domains. CONCLUSIONS: the psychometric characteristics of the Polish translations of GSRS and QOLRAD were found to be good, with satisfactory reliability and validity. The test-retest reliability of the GSRS "reflux" domain was however not optimal.

[Burden of illness in Polish patients with reflux disease]. / Obciazenie polskich pacjentów zwiazane z choroba refluksowa przelyku.

The clinical and socioeconomic burden of gastro-esophageal reflux disease (GERD) is considerable. The primary symptom of GERD is heartburn, but it may also be associated with extraesophageal manifestations, such as asthma, chest pain and otolaryngologic disorders. The objective of the study was to describe the impact of heartburn on patients' Health-Related Quality of Life (HRQL) in Poland, using validated generic and disease-specific instruments to measure patient-reported outcomes. Patients with symptoms of heartburn completed the Polish versions of the Gastrointestinal Symptom Rating Scale (GSRS), the Quality of Life in Reflux and Dyspepsia questionnaire (QOLRAD), the Short Form-36 (SF-36) and the Hospital Anxiety and Depression (HAD) scale. Frequency and severity of heartburn during the previous 7 days were also recorded. 135 patients completed the assessments (mean age of 44 years, SD = 15; 61% female). 55% of patients had moderate symptoms and nearly two thirds (64%) had symptoms on 5 or more days in the previous week. Patients were most bothered by symptoms of reflux (mean GSRS score of 4.1, on a scale of 1 [not bothered] to 7 [very bothered]), indigestion (3.5) and abdominal pain (3.2). As a result of their symptoms, patients experienced impaired vitality (mean QOLRAD score of 3.8, on a scale of 1 to 7, where 1 represents the most severe impact on daily functioning), problems with food and drink (3.9), emotional distress (4.1) and sleep disturbance (4.7). Using HAD, 32% of heartburn patients were anxious and 10% were depressed. In conclusion it should be stated that there is consistent evidence that GERD substantially impairs all aspects of health-related quality of life.

Effect of antibacterial therapy and salivary secretion on the efficacy of Helicobacter pylori eradication in duodenal ulcer patients.

OBJECTIVE: Oral health status may play a role in Helicobacter pylori eradication. Because adequate secretion of saliva promotes oral health, the aim of the study was to assess the effect of salivary secretion on the efficacy of H pylori eradication from the stomach. STUDY DESIGN: The study involved 90 H pylori-positive subjects with duodenal ulcer (68 men, 22 women, aged 20-70 years) in whom saliva was collected under basal conditions for 45 min before antibacterial treatment began. They received no drugs for at least 3 days prior to saliva collection. A 7-day course of either of 2 eradication regimens--omeprazole, amoxicillin, and tinidazole (OAT); or omeprazole, amoxicillin, and clarithromycin (OAC)--was used. The efficacy of eradication therapy was evaluated 30 days after its completion. RESULTS: The efficacy of H pylori eradication from the stomach (per protocol analysis) was 77.5% in the group of subjects treated with OAT and 81.6% with OAC. Combined analysis of both groups (OAT+OAC) showed reduced salivary secretion in subjects with eradication failure (0.395 +/- 0.266 vs 0.25 +/- 0.176 mL/min, P=.042). A similar outcome was obtained when the OAT group was analyzed separately (0.436 +/- 0.316 vs 0.211 +/- 0.216 mL/min, P=.022), but in the OAC group the difference was not significant. In the combined analysis, the efficacy of eradication therapy was lower in women than in men (52.9% vs 86.9%, P=.005). In women, it corresponded to salivary secretion (successful eradication 0.337 +/- 0.133 mL/min, unsuccessful eradication 0.180 +/- 0.144 mL/min, P=.043); whereas in men, the difference was not significant (successful eradication 0.405 +/- 0.282 mL/min, unsuccessful eradication 0.321 +/- 0.186 mL/min). CONCLUSION: Low salivary secretion may contribute to the decrease in efficacy of H pylori eradication from the stomach, at least in subjects treated with certain drug regimens.

Mucosal adenosine deaminase activity and gastritis histology: a comparative study of partially resected and intact stomachs.

BACKGROUND: Adenosine deaminase is an enzyme which is postulated to have a role in the generation of gastric mucosal inflammation. The aim of our study was to determine and compare adenosine deaminase activity in the gastric mucosa of patients with chronic gastritis developed in partially resected and intact stomachs. MATERIAL/METHODS: 182 patients were studied, 102 non-operated and 80 after distal gastric resection. Biopsy specimens were taken endoscopically from the gastric mucosa 2 cm proximal to the stoma or corresponding upper third of the intact stomach. Gastritis was classified according to the Sydney system. The activity of adenosine deaminase in the mucosal homogenates was measured by determination of ammonia liberated from the substrate and expressed in nmol NH3/mg protein/min. RESULTS: Adenosine deaminase activity was lower in partially resected than in intact stomachs, regardless of Helicobacter pylori infection. While no difference was found in adenosine deaminase activity between Billroth I and Billroth II procedures in subjects without H. pylori infection, the activity was lower in those with Billroth II procedure in the presence of H. pylori infection. As the severity of gastritis increased, enzyme activity decreased in the mucosa of the intact stomach, but was not significantly altered in the mucosa of the gastric remnant. CONCLUSIONS: Adenosine deaminase activity differs in intact and partially resected stomachs, but it does not appear to be a factor promoting chronic gastritis.

[The influence of the development of diabetes mellitus in patients with chronic pancreatitis on exocrine pancreatic function measured by secretin-caerulein test]. / Wplyw wystapienia cukrzycy u chorych z przewleklym zapaleniem trzustki na zewnatrzwydzielnicza czynnosc tego narzadu oceniana za pomoca próby sekretynowo-ceruleinowej.

UNLABELLED: Diabetes occurs in 20-30% of patients above forty years old with chronic pancreatitis (CP). The aim of the present study was to determine the relationship between development of diabetes mellitus in CP patients and insufficiency of pancreatic exocrine secretion as well as changes in composition of pancreatic juice. Ninety CP patients with diagnosis confirmed by endoscopic retrograde pancreatography (ERP) were studied. They were divided into 3 groups in dependency on ERP changes (according to Cambridge classification) and oral glucose tolerance test (OGTT): group A--equivocal or mild changes in ERP and normal OGTT (control group); group B--moderate or marked changes in ERP and normal OGTT: group C--moderate or marked changes in ERP and diabetes mellitus. The exocrine pancreatic function was determined by the secretin-caerulein test; volume of duodenal content and bicarbonate, protein, alpha-amylase activity outputs were measured. RESULTS: All exocrine pancreatic function parameters were diminished in B and C groups compared with A group--differences were statistically significant. However in group C values of volume and bicarbonate, protein and amylase activity were especially low. CONCLUSION: Exocrine pancreatic insufficiency is strongly associated with anatomical changes of the pancreas but also depends on endocrine function.