Specific IgE Antibodies in Young Children with Atopic Dermatitis--Correlation of Multiple Allergen Simultaneous Immunoblot Test and ImmunoCap System.

BACKGROUND: Sensitization to food allergens is a common condition in pediatric atopic dermatitis (AD). Recently, the multiple allergen simultaneous test (MAST) allowing for a comprehensive assessment of atopy has been developed, but the usefulness in young AD children is not known. The aim of this study was to determine IgE specificity in AD children using MAST and to compare the results for selected food allergens with the reference ImmunoCap system. METHODS: The study enrolled 50 children up to 2 years old with a diagnosis of AD. IgE antibodies were measured with the MAST-immunoblots. Children with specific IgE levels ≥ 0.35 kU/L were identified as sensitized to allergens. RESULTS: Most often children were sensitized to food allergens (egg white and yolk, hazelnuts, potato, cow's milk proteins, wheat flour, codfish, and soybean), but a high percentage of them also had IgE antibodies against house dust mites (12%), grass (10%), and birch (10%). Eight percent of children were sensitized to domestic animals (cats and dogs). Almost perfect (kappa index 0.8 - 1.0) and substantial (kappa index 0.6 - 0.8) agreement between MAST and ImmunoCap was found for food allergens except codfish. Pearson's analysis of antibody classes showed a very strong correlation between two methods (r = 0.8 - 1.0) for egg white, hazelnuts, potato, cow's milk proteins, wheat flour, and soybean, and a strong correlation (r = 0.6 - 0.79) was observed for peanut, egg yolk, and codfish. CONCLUSIONS: The study showed the frequent occurrence of IgE antibodies against food and airborne and animal allergens in young AD children and confirmed the usefulness of MAST-immunoblots for screening of sensitization in pediatric patients.

EGFR and Bcl-2 in gastric mucosa of children infected with Helicobacter pylori.

UNLABELLED: The aim of the study was to evaluate the expression of EGFR and Bcl-2 proteins as inhibitory markers of apoptosis in surface epithelial cells and gland cells of antral gastric mucosa in children infected with Helicobacter pylori according to the severity and activity of antral gastritis and to assess the correlation between the number of cells expressing EGFR and the number of cells expressing Bcl-2 in H. pylori infected children. MATERIALS AND METHODS: The study included 44 children: 68.2% with chronic gastritis and positive IgG against H. pylori, and 31.8% with functional disorders of the gastrointestinal tract and with normal IgG against H. pylori. The evaluation of EGFR expression in gastric mucosa was performed immunohistochemically using monoclonal mouse anti-EGFR antibody. The polyclonal antibody was used to determine the expression of anti-Bcl-2. RESULTS: A significant increase in the number of cells expressing EGFR and Bcl-2 protein was found in the epithelial cells in severe as well as mild and moderate gastritis in the group of children infected with H. pylori. An increase in the number of cells expressing EGFR and Bcl-2 protein was also found in the epithelial cells in group I according to the activity of gastritis. There was a statistically significant positive correlation between the numbers of cells expressing EGFR and Bcl-2 in H. pylori infected children. CONCLUSION: Increased expression of EGFR and Bcl-2 proteins in the epithelial cells and a statistically significant positive correlation between the numbers of cells expressing EGFR and Bcl-2 in H. pylori infected children could suggest increased regeneration abilities of gastric mucosa.

The assessment of sIgA, histatin-5, and lactoperoxidase levels in saliva of adolescents with dental caries.

BACKGROUND: Saliva contains a number of protective factors such as mucins, immunoglobulins (e.g., IgA, IgG, and IgM), and enzymes (e.g., lysozyme and lactoperoxidases) that play an important role in the maintenance of oral health. The aim of this study was to compare levels of sIgA, histatin-5, and lactoperoxidase in saliva of adolescents with dental caries. MATERIAL AND METHODS: Thirty-five adolescents (age 18 years) from high school were examined. Eight subjects with DMF=3 (Group I) and 27 adolescents with DMF>11 (Group II) were enrolled for this study. Clinical evaluation procedures comprised oral examination (including tooth, periodontal, and oral mucosal status) and collection of saliva samples. Saliva was collected for enzyme-linked immunosorbent assay (ELISA) and was used for determination of sIgA, histatin-5, and lactoperoxidase levels. RESULTS: Our results showed that adolescents with very high intensity of dental caries (DMF>11) had increased levels of sIgA, histatin-5, and lactoperoxidase compared to adolescents with lower intensity of caries. The increase was statistically significant (p<0.05). CONCLUSIONS: We suggest that high intensity of caries is associated with increased levels of some salivary components - sIgA, histatin-5 and lactoperoxidase - that possess strong bactericidal or bacteriostatic effects, resulting in aggregation of oral bacteria and their clearance from the oral cavity.

Mucin levels in saliva of adolescents with dental caries.

BACKGROUND: Human saliva, a complex secretion that contains a mixture of inorganic and organic molecules, plays an essential role in the maintenance of oral health. Mucins are the major macromolecular component of the secretion and are considered the first line of defense for epithelial tissues. The aim of this study was to compare levels of mucins (MUC5B, MUC7, and MUC1) in saliva of young subjects with dental caries. MATERIAL AND METHODS: All patients had DMF (decay/missing/filled) higher than value 0. Eight subjects with DMF=3 (control group) and 27 adolescents with DMF >11 (research group) were recruited for this study. Clinical evaluation procedures were oral examination, including tooth, periodontal, oral mucosal status, and collection of saliva samples. Saliva was collected for mucin assay. Enzyme-linked immunosorbent assay was used to quantitate MUC5B, MUC7, and MUC1. RESULTS: Our results indicate that adolescents with very high intensity of dental caries disease had increased levels of MUC1 and MUC5B. The membrane mucin MUC1 protein levels in the group with DMF>11 (research group) were higher compared to the group with DMF=3 (control group), and the increase was statistically significant (p=0.011). Similarly, secreted mucin MUC5B protein levels were higher (p=0.06) in the group with DMF>11 (research group). Although MUC7 protein levels were slightly reduced in symptomatic subjects, the decrease was statistically insignificant (p=0.918). CONCLUSIONS: Our data suggest links between the production of mucins, especially MUC1 and MUC5B in saliva, and dental caries disease.

Cytotoxicity and topoisomerase I/II inhibition activity of novel 4-aryl/alkyl-1-(piperidin-4-yl)-carbonylthiosemicarbazides and 4-benzoylthiosemicarbazides.

A series of eight thiosemicarbazide derivatives was examined for cytotoxicity in breast cancer cell cultures. Among them, 4-benzoylthiosemicarbazides proved to be only slightly less potent than chlorambucil in both MDA-MB-231 and MCF-7 lines. In contrast, 4-aryl/alkylthiosemicarbazides revealed significantly lower cytotoxicity effect. Subsequently, all titled compounds were tested as potential human topoisomerase I and II (topo I and topo II) inhibitors. Mechanistic studies revealed that tested thiosemicarbazides act as both topoisomerase I and topoisomerase II inhibitors. Among them, the best inhibitory activity was found for 4-benzoylthiosemicarbazides (1 and 2) with IC50 at 50 µM against topo II.

[Dental caries of the developmental age as a civilization disease]. / Próchnica wieku rozwojowego choroba cywlizacyjna.

According to the definition of the World Health Organization (WHO), dental caries is a local pathological process of the extrasomatic background, leading to enamel decalcification, decomposition of dental hard tissue, and in consequence to formation of a dental cavity. Morbidity of dental caries increases with age, reaching 100% of children, aged from 6 to 7. Poland is one of few European countries where the incidence of dental caries in children did not decrease, despite recommendations of WHO for 2000 year, aimed at the decrease in the incidence of dental caries among 6-year-old children to the level of 50%. The recommendation of WHO for 2015 year is to reduce the incidence of dental caries to 30% among 6-year-olds, i.e., 70% of 6 year-old children should be free of dental caries. Apart from genetic conditioning, inappropriate health behaviors, nutritional habits and gastroesophageal reflux disease influence the development of dental caries. Consumption of 'fast food' and drinking sweetened beverages of low pH contribute markedly to the development of dental caries, decreasing simultaneously consumption of pro healthy foods, including milk and cereals. Taking into consideration perspective clinical examinations of children and adolescents, evaluating the relationship between dental caries and nutritional habits as well as environmental conditioning, the study shows current data about factors, contributing to the incidence of dental caries in children, collected from the literature. The attention was paid to the relationship between dental caries and gastroesophageal reflux disease and the necessity of its early diagnostics and proper treatment.

Pneumocystis Pneumonia: Still a serious disease in children.

Pneumocystis carinii pneumonia is a common opportunistic respiratory infection among children with human immunodeficiency virus and a weakened immune system. The primary infection in immunocompetent patients may be asymptomatic, whereas fever, shortness of breath, night sweats, nonproductive (dry) cough, pneumonia, progressive respiratory distress and apnea are cardinal symptoms of full-blown pneumocystis pneumonia. The diagnosis can be confirmed by histochemical staining of biological specimens or, recently, by polymerase chain reaction. International recommendations indicate that the drug of choice is the intravenously administered trimethoprim-sulfamethoxazole combination. Early diagnosis and appropriate treatment reduce the mortality of the disease. This article briefly highlights the epidemiology of Pneumocystis pneumonia, its diagnosis and therapeutic options in the pediatric population.

The Effectiveness of Probiotic Lactobacillus rhamnosus and Lactobacillus casei Strains in Children with Atopic Dermatitis and Cow's Milk Protein Allergy: A Multicenter, Randomized, Double Blind, Placebo Controlled Study.

Probiotics seem to have promising effects in the prevention and treatment of allergic conditions including atopic dermatitis (AD) and food allergy. The purpose of this multicenter randomized placebo-controlled trial was to evaluate the effectiveness of a probiotic preparation comprising Lactobacillus rhamnosus LOCK 0900, Lactobacillus rhamnosus LOCK 0908, and Lactobacillus casei LOCK 0918 in children under 2 years of age with AD and a cow's milk protein (CMP) allergy. The study enrolled 151 children, who-apart from being treated with a CMP elimination diet-were randomized to receive the probiotic preparation at a daily dose of 109 bacteria or a placebo for three months, with a subsequent nine-month follow-up. The primary outcomes included changes in AD symptom severity assessed with the scoring AD (SCORAD) index and in the proportion of children with symptom improvement (a SCORAD score decreased by at least 30% in comparison with that at baseline). After the three-month intervention, both the probiotic and placebo groups showed a significant (p < 0.0001) decrease in SCORAD scores, which was maintained nine months later. The percentage of children who showed improvement was significantly higher in the probiotic than in the placebo group (odds ratio (OR) 2.56; 95% confidence interval (CI) 1.13-5.8; p = 0.012) after three months. Probiotics induced SCORAD improvement mainly in allergen sensitized patients (OR 6.03; 95% CI 1.85-19.67, p = 0.001), but this positive effect was not observed after nine months. The results showed that the mixture of probiotic LOCK strains offers benefits for children with AD and CMP allergy. Further research is necessary to assess the effect of probiotic supplementation on the development of immune tolerance (NCT04738565).

The Relationship between the Infant Gut Microbiota and Allergy. The Role of Bifidobacterium breve and Prebiotic Oligosaccharides in the Activation of Anti-Allergic Mechanisms in Early Life.

The increase in allergy prevalence observed in recent decades may be a consequence of early intestinal dysbiosis. The intestinal microbiota is formed in the first 1000 days of life, when it is particularly sensitive to various factors, such as the composition of the mother's microbiota, type of delivery, infant's diet, number of siblings, contact with animals, and antibiotic therapy. Breastfeeding and vaginal birth favorably affect the formation of an infant's intestinal microbiota and protect against allergy development. The intestinal microbiota of these infants is characterized by an early dominance of Bifidobacterium, which may have a significant impact on the development of immune tolerance. Bifidobacterium breve is a species commonly isolated from the intestines of healthy breastfed infants and from human milk. This review outlines the most important environmental factors affecting microbiota formation and the importance of Bifidobacterium species (with a particular emphasis on Bifidobacterium breve) in microbiota modulation towards anti-allergic processes. In addition, we present the concept, which assumes that infant formulas containing specific probiotic Bifidobacterium breve strains and prebiotic oligosaccharides may be useful in allergy management in non-breastfed infants.

Dietary Habits and Physical Activity of 18-Year-Old Adolescents in Relation to Overweight and Obesity.

BACKGROUND: The purpose of this study was to evaluate the correlations between the nutritional status, nutritional habits, and physical activity in the representative population of 18-year-old students. METHODS: A total of 1,631 participants aged 18 years, originating from secondary schools/senior high schools in the city of Bialystok, Szpitalna, Bialystok, Poland were enrolled. Participants completed anonymous questionnaires, and their body mass index was assessed. Data were analyzed using standard statistical procedures with Statistical PL 12.0. RESULTS: The analysis showed that consumption of only one to two or three meals was associated with an increased risk of overweight and obesity-in case of one or two meals among girls, OR=1.78 (P<0.05), in case of one or two meals among boys, OR=2.325 (P<0.01), and in case of three meals, OR=1.771 (P<0.05). First breakfast was consumed by 82.1% of boys with normal BMI and 73.1% overweight and obesity (OR=0.593; P<0.05). 24.5% of the eutrophic compared to only 20.3% of adolescents with elevated BMI reported attending all PE classes. Physical activity undertaken after school was associated with a 35.9% decrease risk of overweight and obesity among girls and 57.7% among boys. CONCLUSION: A specific pattern of nutritional habits, that is, decreased meal frequency in adolescents, skipping meals, appear the most frequent nutritional mistakes associated with overweight and obesity. Insufficient physical activity and exposure to sedentary behaviors among adolescents are disturbing. The obesity problem requires monitoring, prevention and the change of nutritional habits and physical activity early in childhood.

Pneumocystis pneumonia: still a serious disease in children.

Pneumocystis carinii pneumonia is a common opportunistic respiratory infection among children with human immunodeficiency virus and a weakened immune system. The primary infection in immunocompetent patients may be asymptomatic, whereas fever, shortness of breath, night sweats, nonproductive (dry) cough, pneumonia, progressive respiratory distress and apnea are cardinal symptoms of full-blown pneumocystis pneumonia. The diagnosis can be confirmed by histochemical staining of biological specimens or, recently, by polymerase chain reaction. International recommendations indicate that the drug of choice is the intravenously administered trimethoprim-sulfamethoxazole combination. Early diagnosis and appropriate treatment reduce the mortality of the disease. This article briefly highlights the epidemiology of Pneumocystis pneumonia, its diagnosis and therapeutic options in the pediatric population.

[Occurrence rate of Helicobacter pylori iceA alleles in infected patient in the Bialystok Province]. / Czestosc wystepowania alleli icea helicobacter pylori u zakazonych w województwie podlaskim.

UNLABELLED: Intensity of gastric mucosa and/or duodenal inflammation and their clinical consequences in response to Helicobacter pylori infection depend on a given strain virulence. A receptor protein IceA, induced by contact with epithelium gene A, is one of important proteins in the process of infection. Examinations of iceA genotype have show that the rate of occurrence of H. pylori strains containing iceA1 or iceA2 is differentiated in various regions of the world. OBJECTIVE: The aim of the study was the evaluation of H. pylori iceA alleles occurrence in infected children and adults, inhabitants of the Bialystok Province regarding the place of living (country, town). METHODS: H. pylori genotyping was carried out on the basis of the analyses bacterial gene iceA, and allelo-specific PCR were used to determine the former gene and two variants of the gene--iceA1 and iceA2. RESULTS: Out of 50 analyzed genotypes of H. pylori , the presence of iceA gene was observed in 47 strains of bacteria. iceA allele was presented in 25 isolates of examined bacteria DNA (53.2%) while iceA2--in 29 (61.7%). No iceA alleles were isolated from 3 DNA isolates (6%) whereas in 7 examined isolates (14.0%), the coexistence of both iceA alleles (iceA1 and iceA2) was observed. After excluding isolates of H. pylori DNA with coexisting iceA1 and iceA2 (7 persons), it was stated that iceA1 allele occurred in 19 examined isolates (45.0%) and iceA2--in 23 (55.0%). CONCLUSIONS: The occurrence of H. pylori strains of iceA2 genotype was more frequent in adults (59.1%). The occurrence of H. pylori strains of iceA2 genotype was more frequent in persons living in the country and town (52.4% and 54.5%, respectively).

The evaluation of vacA gene alleles frequency in Helicobacter pylori strains in children and adults in Podlaskie region.

The frequency of Helicobacter pylori infection in population can depend on the organism resistance, genetic condition, and bacterial strains virulence. A vacA gene, of mosaic structure, which encodes vacuolating cytotoxin is one of the known genes of H. pylori. The existence of several different genotypes of s and m regions enables the formation of numerous combinations of vacA gene genome. The studies on vacA genotype revealed that the frequency of occurrence of H. pylori containing s1 or s2, as well as m1 and m2 alleles varies in different parts of the world. The aim of the studies performed in the group of children and adults was to evaluate the prevalence of particular vacA gene alleles distribution in the population of the Podlasie province. The allele s1, which occurred in 84.3% of the examined group (86.8% in children and 81.3% in adults), turned out to be the most frequently observed of the signal encoding region. Statistically significant differences in s1 and s2 alleles distribution in relation to a dwelling place were not detected. The allele m2 (42.1% in children and 59% in adults) was the allele of midregion, most frequently occurring in our studies. The allele m2 was observed more often in H. pylori strains in the inhabitants from the urban areas (data statistically significant).

Selected nutritional habits of teenagers associated with overweight and obesity.

INTRODUCTION: A balanced diet is at the heart of healthy growth and development of children and youth, whereas inappropriate eating habits considerably influence the incidence of disorders connected with nutrition, including overweight and obesity. This paper aims at studying nutritional factors of 18-year-old secondary school youth in the urban environment and their effect on the incidence of overweight and obesity. MATERIALS AND METHODS: The survey was conducted among 1,999 secondary school students chosen at random. The research tool consisted an original survey questionnaire. The measurements of respondents' height and body mass provided data for calculating the body mass index. RESULTS AND CONCLUSION: The percentage of youth with deficient body mass was estimated at 8.4%. The percentage of normal weight students in the surveyed group was estimated at 77.6%. Overweight and obesity characterized 14.0% of the total number. As many as 21.8% of overweight and obese respondents would eat one or two meals as opposed to 16.8% of normal weight students. Three-fourths of the surveyed students would eat breakfast regardless of their nutritional habits. Lunch is eaten by 52.9% of normal weight 18-year-olds and 46.1% of overweight and obese students. The analysis of mealtimes suggests that overweight and obese students would have their breakfast and dinner at later hours than the rest of the surveyed. More than half of the participating students failed to eat lunch (53.9%), and one in four students within this group resigned from supper. Girls would eat fruit and vegetables more frequently than boys several times a day. The percentage of persons in the surveyed groups who would eat fast foods on a daily basis was similar regardless of their nutritional status. Sweetened carbonated beverages would be drunk more often by overweight and obese boys (81.2%) as compared with boys with proper body mass (75.8%). The same type of beverages would be popular with two-thirds of girls, and this result was similar regardless of their nutritional status. About 44.2% of overweight and obese girls and 20% of girls with proper body mass attempted to lose weight, and 5.7% of boys tried to go on a diet. Eating limitations were declared by 16.5% of overweight and obese boys and ca. 3% of normal weight boys. CONCLUSION: Within the surveyed group of youth, it was possible to indicate eating errors primarily consisting in irregular eating, too low a number of meals during the day, particularly skipping breakfast, which took place more frequently among overweight and obese students rather than normal weight ones. The survey points to the insufficient intake of vegetables and fruit as opposed to salty and sweet meals. It is essential to convey the knowledge on the causes of overweight and obesity as well as rules of a healthy diet as factors preventing civilization diseases.

Expression of beta2-integrin on leukocytes in liver cirrhosis.

AIM: To analyze beta2-integrin expression on blood leukocytes in liver cirrhosis. METHODS: In 40 patients with liver cirrhosis and 20 healthy individuals, the evaluation of expression of CD11a (LFA-1alpha), CD11b (Mac-1alpha), CD11c (alphaX) and CD49d (VLA-4alpha) on peripheral blood leukocytes was performed using flow cytometry. The analysis was carried out in groups of patients divided into B and C according to Child-Pugh's classification. RESULTS: An increased CD11a, CD11b, CD11c and CD49d integrin expression was observed on peripheral blood leukocytes in liver cirrhosis. The integrin levels were elevated as the advancement of liver failure progressed. The highest expression of integrins occurred predominantly on monocytes. A slight expression of VLA-4 was found on lymphocytes and granulocytes and it increased together with liver failure. A positive correlation was noted between median intensity of fluorescence (MIF) expression on polymorphonuclear cells of CD11a and CD11c and CD49d (r = 0.42, P < 0.01; r = 053, P < 0.01, respectively) in liver cirrhosis stage C. However, no correlation was observed between integrin expression on leukocytes. The concentrations of sICAM-1, sVCAM-1, and TNFalpha, were significantly elevated in liver cirrhosis. CONCLUSION: beta2-integrin expression on leukocytes increases in liver cirrhosis decompensated as the stage of liver failure increases, which is a result of permanent activation of leukocytes circulating through the inflamed liver environment. beta2-integrin expression on circulating leukocytes can intensify liver cirrhosis.

[Familial transmission of Helicobacter pylori infection in Podlasie Region]. / Transmisja Helicobacter pylori w rodzinach województwa podlaskiego.

The purpose of the study was to assess the incidence of Helicobacter pylori infection in members of families in the Podlasie Region. The study included members of 205 families in whom IgG antibodies against H. pylori were determined. The mean number of members examined in a family was 3.07. The mean age was 16.6 years; the mean level of specific IgG antibodies was 67.35 U/ml. Of the families examined 47 (22.0%) had all members with a positive titer of antibodies against H. pylori (> 24 U/ml); in 62 (30.2%) families, all members presented a negative result of IgG antibodies against H. pylori (< 24 U/ml). Of 97 mothers examined, a positive titer of IgG was found in 77.1%. Of 33 fathers (81.8%) were seropositive. In the families with a mother seropositive, the infection in at least one child examined was revealed in 48.6% of the families, whereas in the families with a mother seronegative, all her children were healthy in 63.6% of the families. In case of a father, a positive IgG in at least one child was found in 55.5% of the families, whereas no infection in children was estabilished in 44.4%.

[Helicobacter pylori infection in children and socio-economic factors]. / Zakazenie Helicobacter pylori u dzieci a uwarunkowania spoleczno-ekonomiczne.

UNLABELLED: The aim of the study was to find a correlation between the presence of Helicobacter pylori infection in children and their accommodation and socio-economic conditions. The results of questionnaire studies were analyzed and levels of IgG specific antibodies against H. pylori were assessed in children randomly chosen in the north-east of Poland at the level of a district, county and province city. The incidence of H. pylori infection in the studied children was varied and depended on the living place. The highest percentage of the infected was revealed in a district (40.4%) and the lowest in a province city (19.0%). There was a correlation between H. pylori infection and socio-economic conditions. The highest percentage of the infected children (59.7%) was found in families whose income was within the first income tax group. The incidence of the infection was also determined by the type of a flat, the number of members in a family, water intake and personal hygiene. CONCLUSIONS: 1) the highest incidence of H. pylori infection in children was found in a county, the lowest in a province city. 2) environmental and socio-economic conditions influence the presence of H. pylori infection in children.

Volumetric Magnetic Resonance Imaging Study of Brain and Cerebellum in Children with Cerebral Palsy.

Introduction. Quantitative magnetic resonance imaging (MRI) studies are rarely used in the diagnosis of patients with cerebral palsy. The aim of present study was to assess the relationships between the volumetric MRI and clinical findings in children with cerebral palsy compared to control subjects. Materials and Methods. Eighty-two children with cerebral palsy and 90 age- and sex-matched healthy controls were collected. Results. The dominant changes identified on MRI scans in children with cerebral palsy were periventricular leukomalacia (42%) and posthemorrhagic hydrocephalus (21%). The total brain and cerebellum volumes in children with cerebral palsy were significantly reduced in comparison to controls. Significant grey matter volume reduction was found in the total brain in children with cerebral palsy compared with the control subjects. Positive correlations between the age of the children of both groups and the grey matter volumes in the total brain were found. Negative relationship between width of third ventricle and speech development was found in the patients. Positive correlations were noted between the ventricles enlargement and motor dysfunction and mental retardation in children with cerebral palsy. Conclusions. By using the voxel-based morphometry, the total brain, cerebellum, and grey matter volumes were significantly reduced in children with cerebral palsy.

Inequalities in mortality of infants under one year of age according to foetal causes and maternal age in rural and urban areas in Poland, 2004-2013.

INTRODUCTION: European countries are characterized by low mortality during the infancy period compared to other areas of the world. However, there are significant disparities in the state of infant health which are related to socio-economic conditions and place of residence. OBJECTIVE: Analysis of mortality in Poland from foetal and maternal causes (length of gestation, birth weight, maternal age) in the neonatal and post-neonatal period depending on place of residence (rural and urban areas) in 2004-2013. MATERIALS AND METHOD: Data on mortality during the neonatal and infancy period in 2004-2013 was obtained from the Central Statistical Office. Diagnosed cases of deaths in rural and urban areas were analyzed, taking into account the causes of death according to ICD-10, the duration of pregnancy in weeks, birth weight, and maternal age. Trend analysis and comparison of mortality between rural and urban areas were performed using the Poisson regression model. RESULTS: In rural areas, neonatal and post-neonatal death rates due to congenital malformations were siginificantly higher than in urban areas. The mortality rate was also higher in rural areas in children born to women aged 20-34 years, and children born after 37 weeks gestation with low birth weight. In the cities, higher post-neonatal mortality was due to respiratory diseases, and in children born after 37 weeks gestation to mothers under the age of 20 years. A decrease in the mortality of newborns and infants was observed, but in rural areas neonatal mortality decreased significantly more slowly. CONCLUSIONS: The results indicate the need to intensify programmes aimed at improving access to prenatal and maternity care, especially among women in rural areas.

Expressions of Matrix Metalloproteinases (MMP-2, MMP-7, and MMP-9) and Their Inhibitors (TIMP-1, TIMP-2) in Inflammatory Bowel Diseases.

Crohn's disease (CD) and ulcerative colitis (UC) belong to a group of inflammatory bowel diseases (IBD). The aim of our study was to evaluate the expression of MMP-2, MMP-7, MMP-9, TIMP-1, and TIMP-2 in ulcerative colitis and Crohn's disease. The study group comprised 34 patients with UC and 10 patients with CD. Evaluation of MMP-2, MMP-7, MMP-9, TIMP-1, and TIMP-2 expression in tissue samples was performed using immunohistochemistry. The overexpression of MMP-9 and TIMP-1 was dominant in both the glandular epithelium and inflammatory infiltration in UC patients. In contrast, in CD subjects the positive expression of MMP-2 and TIMP-1 was in glandular tubes while mainly MMP-7 and TIMP-2 expression was in inflammatory infiltration. Metalloproteinases' expression was associated with the presence of erosions, architectural tissue changes, and inflammatory infiltration in the lamina propria of UC patients. The expression of metalloproteinase inhibitors correlated with the presence of eosinophils and neutrophils in UC and granulomas in CD patients. Our studies indicate that the overexpression of metalloproteinases and weaker expression of their inhibitors may determine the development of IBD. It appears that MMP-2, MMP-7, and MMP-9 may be a potential therapeutic target and the use of their inhibitors may significantly reduce UC progression.