Serum level of lactadherin (MFGE8) in inflamatory bowel disease.

OBJECTIVE: Evaluation of serum lactadherin level, its correlation with disease activity and certain biochemical parameters in IBD patients. METHODS: The study involved adult IBD patients, comprising 50 with ulcerative colitis (UC), 68 with Crohn's disease (CD), and 29 healthy controls. RESULTS: The MFGE8 median concentration was significantly higher in UC versus controls (1914.54 vs. 1392.21; p = 0.017), but not in CD. The median MFGE8 levels in UC and CD patient groups didn't significantly differ. There was a significant inverse correlation between MFGE8 and CRP (r = -0.283; p = 0.044) and fibrinogen (r = -0.362, p = 0.017) in UC. In active UC, MFGE8 median concentration was higher versus controls (1974.36 vs. 1392.21; p = 0.04) and negatively correlated with CRP (r = -0.482; p = 0.005), WBC (r = -0.391; p = 0.027), and fibrinogen (r = -0.473; p = 0.015). Inactive UC showed negative correlation only with fibrinogen (r = -0.567; p = 0.018). No correlations were found with disease activity measured using appropriate scales, age, BMI, or gender. CONCLUSIONS: Active UC patients show higher MFGE8 levels. These increase inversely with inflammatory markers (CRP, WBC, fibrinogen) in active UC, but not in CD.

Serum inflammatory markers in the diagnosis and assessment of Crohn's disease activity.

INTRODUCTION: The aim of our study was to evaluate the diagnostic characteristics of selected inflammatory markers and the results of multiplication of their concentrations in the diagnosis and assessment of Crohn's disease (CD) activity. METHODS: We studied 49 patients with CD and 31 healthy controls. The CD patients were assigned to subgroups with active and inactive disease based on the Crohn's Disease Activity Index score. Serum interleukins and C-reactive protein (CRP) were measured using immunoassays. RESULTS: Serum CRP and interleukins: IL-6, IL-17A, IL-23 were significantly higher in the CD group than in controls, with the best diagnostic performance for IL-23. Only serum IL-6 and CRP were significantly higher in active than in inactive disease, with the better performance of CRP. Multiplication results did not perform better than individual multipliers. CONCLUSIONS: Serum CRP may be useful in the assessment of CD activity and there is a need for introduction of IL-23 for the CD diagnosis.

Oral non-specific lesions in patient with Crohn's disease - a case report.

Crohn's disease (CD) is a chronic and granulomatous inflammatory disease of the entire gastrointestinal tract. The etiopathogenesis is not fully elucidated. The most common symptoms in the active phase of the disease include abdominal pain, prolonged diarrhea, fever, fatigue, malaise and weight loss. Oral manifestations of CD are classified into specific for CD with granulomatous changes and non-specific ones. This rare extraintestinal manifestation of CD in adults may precede gastrointestinal tract involvement, occur together or appear after years of its duration. Oral lesions can be initiated by malnourishment, poor absorption of nutrients or side-effect of medications. A CASE REPORT: We describe a 28-year-old female with a 9-years CD history, who presented in the active disease with oral lesions. They were classified as non-specific ones, and included oral candidiasis, irregular erythematous patches on the cheek mucosa, exfoliative lip inflammation, and angular cheilitis. The patient was treated with azathioprine, and since the last exacerbation of symptoms, induction therapy with adalimumab, (anti-TNF-alpha), has been prescribed. Nystatin was applied to treat the oral lesions, based on the microbiological assessment of the Candida albicans susceptibility, and symptomatic treatment. After a two-week treatment the oral mucosa was healed and angular cheilitis showed marked improvement compared to the initial presentation. CONCLUSIONS: The young female with active CD presented the nonspecific lesions in the oral cavity. The lesions coexisted with the active inflammatory process in the intestinal tract with characteristic clinical symptoms, and were associated with sideropenic anemia. The implementation of the local therapy, systemic CD treatment and supplementation of micronutrient deficiencies have led to a healing of the oral lesions. We emphasize a personalized approach to treatment and close cooperation between the dentist and the gastroenterologist.

Serum concentration of selected biochemical markers of endothelial dysfunction and inflammation in patients with the varying activity of inflammatory bowel disease.

INTRODUCTION: Endothelial dysfunction leads to an increased expression of cell adhesion molecules, leukocyte diapedesis, vascular smooth­muscle tone, excessive permeability of vascular walls, and increased procoagulant activity. OBJECTIVES: We investigated whether serum levels of several endothelial and platelet activation markers correlated with disease activity in patients with inflammatory bowel disease (IBD). PATIENTS AND METHODS: This study included 56 patients with ulcerative colitis, 66 with Crohn disease, and 40 healthy controls. We measured the complete blood count and levels of fibrinogen, C­reactive protein, albumin, interleukin 6, tumor necrosis factor α, E­selectin, P­selectin, monocyte chemoattractant protein 1 (MCP­1), soluble CD40 ligand (sCD40L), and microparticles. RESULTS: There were no significant differences in the median levels of E­selectin, P­selectin, MCP­1, sCD40L, and microparticles between patients with active IBD, those with inactive IBD, and healthy controls. The clinical disease activity assessed with the Mayo scale in the ulcerative­colitis group was weakly, positively correlated with sCD40L (R = 0.32, P = 0.02), P­selectin (R = 0.32, P = 0.02), and inflammatory marker levels. The clinical disease activity index in the Crohn disease group was positively correlated with the markers of inflammation yet not with the markers of endothelial activity. CONCLUSIONS: E­selectin, P­selectin, sCD40L, MCP­1, and microparticle levels do not significantly differ between patients with the varying activity of IBD. However, due to the observed correlations, further studies of a larger patient group should be conducted to confirm our observations.

Relative homogeneity of oral bacterial oral in Crohn's disease compared to ulcerative colitis and its connections with antioxidant defense - preliminary report.

INTRODUCTION: Interactions between oral microbiota and systemic diseases have been suggested. We aimed to examine the composition of oral microbiota with reference to antioxidative defense and its correlation with clinical state in Crohn's disease (CD) in comparison to ulcerative colitis (UC). MATERIALS AND METHODS: Smears were taken from the buccal and tongue mucosa of patients with CD, UC and controls, and cultured with classical microbiology methods. Bacterial colonies were identified using matrix-assisted laser desorption/ionization (MALDI) with a time-of-flight analyzer (TOF). Blood morphology and C-reactive protein (CRP) were analyzed in the hospital laboratory. Antioxidative defense potential (FRAP) was determined using spectrophotometry in saliva and serum. RESULTS: Oral microbiota in CD patients were characterized by lower diversity in terms of the isolated bacteria species compared to UC and this correlated with reduced FRAP in the oral cavity and intensified systemic inflammation. Oral microbiota composition in CD did not depend on the applied treatment. In CD patients, a negative correlation was observed between the FRAP value in saliva and serum and the CRP value in serum. Individual differences in the composition of oral microbiota suggest that different bacteria species may be involved in the induction of oxidative stress associated with a weakening of antioxidative defense in the oral cavity, manifested by ongoing systemic inflammation. CONCLUSIONS: Analysis of both the state of the microbiota and antioxidative defense of the oral cavity, as well as their referencing to systemic inflammation may potentially prove helpful in routine diagnostic applications and in aiding a better understanding of CD and UC pathogenesis associated with oral microbiota.

Levels of tissue factor pathway inhibitor in patients with inflammatory bowel disease.

INTRODUCTION Endothelial dysfunction has been reported to be involved in the pathogenesis of inflammatory bowel disease (IBD) and concomitant thromboembolic complications. Inflammation stimulates the expression of tissue factor and tissue factor pathway inhibitor (TFPI) by endothelial cells. OBJECTIVES This study assessed the relationship between TFPI levels and disease activity in patients with IBD. PATIENTS AND METHODS A total of 50 consecutive adult patients with ulcerative colitis (UC), 50 patients with Crohn disease (CD), and 50 healthy controls were enrolled to the study. Plasma levels of total TFPI, free TFPI, and von Willebrand factor were measured. Associations among these levels, disease activity, and inflammatory marker levels were assessed. RESULTS Total TFPI levels were higher in patients with IBD (median, 68.5 [IQR, 60.2-80.1] ng/ml) than in controls (median, 61.1 ng/ml [IQR, 54.3-74.2]; P = 0.01). Free TFPI levels were higher in patients with active UC (median, 12.8 ng/ml [IQR, 11.1-15.4]), inactive UC (median, 9.9 ng/ml [IQR, 7.3-11.5]), active CD (median, 11.7 [IQR, 9.7-14.4] ng/ml), and inactive CD (median, 9.7 ng/ml [IQR, 8.6-11.6]) than in controls (median, 5.5 ng/ml [IQR, 4.3-7.2]; P <0.001). In the CD and UC groups, free TFPI levels correlated with the levels of inflammatory markers and disease activity. The von Willebrand factor level was higher in patients with UC (median, 143.4 IU/dl [IQR, 115.5-170.4]) and those with CD (median, 151.8 IU/dl [IQR, 112.8-189.4]) than in controls (85.1 IU/dl [IQR, 77.1-101.5]; P <0.001 for both comparisons). CONCLUSIONS The anticoagulant TFPI pathway is activated during remissions and flares in patients with IBD. The free TFPI level correlates with biochemical markers of inflammation and disease activity.

Doping in sport - attitude and professional experience among physicians in Poland.

INTRODUCTION: The history of using performance-enhancing substances (PES) is long and it goes back to ancient times. At present, PES are employed at all levels of sport competition, starting from Olympic level contestants to individuals recreationally involved in various sports disciplines. PURPOSE: e objective of the study was examining the views on doping in sports in a group of physicians, together with evaluating the frequency of their contacts with this phenomenon, in their professional activities. METHODS: e investigation was carried out using a validated questionnaire developed by the authors. Questionnaire included 34 questions divided into 6 sections. In total, 257 individuals participated in the study. e percentage of answers was 75.81%. RESULTS: Among the responders, 96.50% believed that using PES by sports competitors represented unethical behavior. 42% participants declared that they met doping problem during their professional career. Almost one-third of the physicians (28.79%) declared that during their work, they consulted patient suffering from adverse side effects resulting from using PES. CONCLUSIONS: In Poland, physicians regard using PES as unethical behavior. They believe that a health care system professional should participate in counteracting doping in sports. Physicians - regardless of their specialty - are also exposed to PES-related problems in their professional work. In view of the above facts and the consistently increasing popularity of PES, extending the knowledge in this field among physicians seems to be of importance to allow for their offering better medical services to their patients.

Evaluation of plasma concentrations of selected antioxidant parameters in patients with active Crohn's disease.

Oxidative stress (OxS) has been implicated in the pathogenesis of Crohn's disease (CD). The aim of this study was to examine whether nonenzymatic antioxidants are associated with active CD, by using the FRAP and GSH assay in plasma. Additionally, we measured bilirubin and albumin levels as two individual components of the plasma antioxidant system. A total of 55 patients with established CD, 30 with active CD and 25 with inactive disease, and 25 healthy individuals were prospectively enrolled in this study. We evaluated CD activity index, BMI and blood morphology, platelet count, serum CRP level, and bochemical parameters of OxS: ferric reducing ability of plasma (FRAP), reduced glutathione (GSH) in plasma and bilirubin and albumin levels in serum. Plasma FRAP and GSH concentrations were decreased in both CD groups compared to controls and negatively correlated with CDAI values (FRAP: r = -0.572, p = 0.003; GSH: r = -0.761, p = 0.001), CRP and platelet count. Bilirubin and albumin levels were lower in the serum of active CD patients than inactive CD patients and controls and negatively correlated with the CD activity index (r = -0328, p = 0.036, r = -0.518, p = 0.002) and CRP (r = -0.433, p = 0.002). e decreased FRAP and GSH levels in plasma and bilirubin and albumin levels in serum of patients with active CD compared to inactive CD and controls underlines the importance of OxS in the pathophysiology and activity of CD.

Correlation of Paraoxonase-1 with the Severity of Crohn's Disease.

Diagnostics of Crohn's disease (CD) requires noninvasive biomarkers facilitating early detection and differentiation of the disease. Therefore, in this study, we aimed to determine the relationship between paraoxonase-1 (PON-1), the severity of CD, oxidative stress, and inflammation in CD. The CD activity index was based on the current classification. Plasma PON-1 was measured in 47 patients with CD, and in 23 control volunteers. Using quantitative variables such as receiver operating characteristics (ROC) (area under the curve (AUC)), the diagnostic utility of PON-1 in differentiating the severity of CD was assessed. Circulating PON-1 was found to be decreased in the CD group compared to the control group (269.89 vs. 402.56 U/L, respectively), and it correlated well with the disease activity. PON-1 correlated positively with hemoglobin (Hb) (r = 0.539, p < 0.001), hematocrit (Ht) (r = 0.48, p < 0.001), total cholesterol (TC) (r = 0.343, p < 0.001), high density lipoprotein (HDL) (r = 0.536, p < 0.001), low density lipoprotein (LDL) (r = 0.54, p < 0.001), and triglyceride (TG) (r = 0.561, p < 0.001) and correlated negatively with white blood cell count (WBC) (r = -0.262, p = 0.029), platelet count (PLT) (r = -0.326, p = 0.006), C-reactive protein (CRP) (r = -0.61, p < 0.001), and malondialdehyde (MDA) (r = -0.924, p < 0.001). PON-1 as a marker for CD differentiation possessed a sensitivity and specificity of 93.62% and 91.30%, respectively. CD was found to be associated with the decrease in the levels of PON-1, which correlates well with activity of the disease and reflects the intensification of inflammation, as well as intensified lipid peroxidation. High sensitivity and specificity of PON-1 determines its selection as a good screening test for CD severity.

Markers of lipid peroxidation and antioxidant status in the serum and saliva of patients with active Crohn disease.

Introduction Increased oxidative stress has been implicated in the pathogenesis of Crohn disease (CD). Except for C­reactive protein (CRP), good biological markers of CD activity are lacking. Objectives We aimed to investigate the diagnostic usefulness of selected markers of oxidative stress in the serum and saliva of patients with active and inactive CD. Patients and methods A total of 58 patients with confirmed CD (32 with active CD, 26 with inactive CD, and 26 healthy controls) were prospectively enrolled to the study. The markers examined were malondialdehyde (MDA), ferric reducing ability of plasma (FRAP), reduced glutathione (GSH), and catalase (CAT). Results MDA levels were higher in the serum and saliva of patients with active CD than in those with inactive CD and controls and were positively correlated with the Crohn's Disease Activity Index (r = 0.8, P <0.001) and CRP (P <0.001). Serum and saliva antioxidant indicators (FRAP and GSH) were decreased in both CD groups compared with controls and were negatively correlated with clinical activity and inflammation (FRAP, r = -0.5, P <0.001; GSH, r = -0.5, P <0.001; and CAT, r = -0.5, P <0.001). Conclusions The increased lipid peroxidation and decreased antioxidant activity in serum and saliva confirm that CD patients are under oxidative stress. The positive correlations of MDA with the clinical activity and inflammation, as well as the comparison of the receiver operating characteristic curves for MDA and CRP, suggest that MDA could be a good diagnostic marker of CD.

Insulin­like growth factor system in remission and flare of inflammatory bowel diseases.

INTRODUCTION    Insulin­like growth factor 1 (IGF­1) is involved in the modulation of immunity and inflammation. It also plays a role in regulating the migration of endothelial cells and production of vasoactive agents. OBJECTIVES    This study assessed the concentrations of IGF­1 and insulin­like growth factor-binding protein 3 (IGFBP­3) and their relationships to disease activity in patients with inflammatory bowel disease (IBD). PATIENTS AND METHODS    A total of 129 adult patients with IBD (69 with Crohn disease [CD] and 60 with ulcerative colitis [UC]) were involved in the study. The control group consisted of 31 healthy volunteers. Biochemical serum analyses were performed and the associations of IGF­1 and IGFBP­3 with inflammatory markers and disease activity were assessed. RESULTS    IGF­1 levels were decreased in patients with active UC compared with those with nonactive UC (mean [SD], 78.3 [22.7] ng/ml and 96.2 [24.5] ng/ml, respectively; P = 0.02) and controls (94.5 [26.5] ng/ml; P = 0.03). The IGF­1 level was lower in patients with active CD compared with those with nonactive CD (mean [SD], 79.2 [24.9] ng/ml and 110.1 [43.4] ng/ml, respectively; P <0.001). The IGFBP­3 level was lower in patients with active UC compared with those with nonactive UC (P = 0.04) and controls (P = 0.04). IGF­1 correlated negatively with C­reactive protein (CRP) levels (P <0.01), disease activity (P <0.05), and disease duration (P <0.05). IGFBP­3 levels correlated negatively with CRP levels (P <0.05). CONCLUSIONS    The IGF system is disrupted in patients with IBD. Systemic levels of the IGF axis components are related to disease activity and duration.

Levels and activities of von Willebrand factor and metalloproteinase with thrombospondin type-1 motif, number 13 in inflammatory bowel diseases.

AIM: To evaluate the levels of von Willebrand factor (VWF) and metalloproteinase with thrombospondin type-1 motif, number 13 (ADAMTS13) in inflammatory bowel disease (IBD) and correlate them with the disease activity. METHODS: Consecutive patients with IBD aged 18 years or older were enrolled in the study. Forty-seven patients with ulcerative colitis (UC), 38 with Crohn's disease (CD), and 50 healthy controls were included. The white blood cell count, haematocrit, platelet count, fibrinogen, partial activated thromboplastin time, C-reactive protein, albumin, VWF antigen level (VWF:Ag), VWF ristocetin cofactor activity (VWF:RCo), VWF collagen-binding activity (VWF:CB), and ADAMTS13 antigen level (ADAMTS13:Ag) and activity (ADAMTS13act) were measured. The following ratios were assessed: VWF:RCo/VWF:Ag, VWF:CB/VWF:Ag, VWF:Ag/ADAMTS13act, and ADAMTS13act/ADAMTS13:Ag. RESULTS: Compared to controls, the odds ratio (OR) of an elevated VWF: Ag > 150% was 8.7 (95%CI: 2.7-28.1) in the UC group and 16.2 (95%CI: 4.8-54.0) in the CD group. VWF:CB was lower in UC patients, and active CD was associated with a higher VWF: RCo (+38%). The ORs of VWF:CB/VWF:Ag < 0.7 (a marker of acquired von Willebrand syndrome) in the UC and CD groups were 11.9 (95%CI: 4.4-32.4) and 13.3 (95%CI: 4.6-38.1), respectively. Active UC was associated with lower ADAMTS13:Ag (-23%) and ADAMTS13act (-20%) compared to UC in remission. Patients with active CD had a 15% lower ADAMTS13act than controls. The activity of UC, but not that of CD, was inversely correlated with ADAMTS13:Ag (r = -0.76) and ADAMTS13act (r = -0.81). CONCLUSION: Complex VWF-ADAMTS13-mediated mechanisms disturb haemostasis in IBD. A reduced WVF:CB is a risk factor for bleeding, while a lower ADAMTS13 level combined with an elevated VWF:Ag could predispose one to thrombosis.

Second generation H1 - antihistamines interaction with food and alcohol-A systematic review.

Histamine is a mediator of many physiological processes. It plays an important role in modulating allergy reactions and immune system responses. H1 receptor is a therapeutic target for drugs applied in allergic diseases such as allergic rhinoconjunctivitis, urticarial, or atopic dermatitis. H1-antihistamines display different chemical structures, pharmacokinetics and a potential for drug-drug and drug-food interactions. Drug-food interactions are known to reduce therapeutic effects of the medicine, as well as to induce a potent adverse drug reactions. Considering it all, a systematic review was conducted to investigate the importance of drug-food interaction for H1-antihistamine drugs. As non-sedating second generation H1-antihistamines remain to be drugs of choice in treating allergic conditions, the review has been focused on this particular class of medicines. The aim of this paper is to examine the evidence of food-drug and food-alcohol interactions for second generation H1-antihistamine drugs. A systematic literature queries were performed in the following databases: Medline (via PubMed), Cochrane Library, Embase and Web of Science (all from their inception date till October 2016). The queries covered nine specific names of second generation anthistamine drugs, namely bilastine, cetirizine, desloratadine, ebastine, fexofenadine, levocetirizine, loratadine, mizolastine, and rupatadine, in combinations with such terms as "food", "juice", "grapefruit", "fruits", "alcohol", "pharmacokinetics", and "meal". Additional publications were found by checking all the reference lists. Where none data on drug-food interaction could be found within the investigated databases, a specific drug prescribing information was used. 2326 publications were identified with the database queries. Articles were subjected to analysis by reviewing their title, abstract and full text; duplicated papers were removed. Having collected a complete set of data, a critical review was undertaken. For selected H1-antihistamines food, fruit juices or alcohol consumption may significantly impact the efficacy and safety of the therapy. This issue shall be well understood to educate patients properly, as it provides the major therapeutic element in allergic diseases.

The use of selected neutrophil protein plasma concentrations in the diagnosis of Crohn's disease and ulcerative colitis - a preliminary report.

BACKGROUND: Difficulties in diagnosis of inflammatory bowel disease (IBD) motivate the search for new diagnostic tools, including laboratory tests. The aim of this study was to evaluate concentrations of the neutrophil (NEU) proteins leukocyte elastase (HLE-α1AT), lactoferrin and calprotectin as potential biomarkers used in the diagnosis and assessment of clinical activity of Crohn's disease (CD) and ulcerative colitis (UC). MATERIAL/METHODS: The study included 27 patients with CD, 33 patients with UC and 20 healthy controls. Plasma concentrations of calprotectin, lactoferrin and HLE-α1AT were measured using ELISA. RESULTS: In patients with CD higher concentrations of HLE-α1AT (64.3±43.1 vs. 30.1±7.7 ng/l, P<0.001), calprotectin (151.6±97.8 vs. 69.9±22.1 ng/l, P<0.001) and lactoferrin (243.2±102.0 vs. 129.7±32.7 ng/l, P<0.001) than in the control group were found. In patients with UC higher plasma concentrations of HLE-α1AT (62.0±30.9 vs. 30.1±7.7 ng/l, P<0.001), calprotectin (149.6±72.3 vs. 69.9±22.1 ng/l, P<0.001) and lactoferrin (242.6±107.5 vs 129.7±32.7 ng/l, P<0.001) than in the control group were found. HLE-α1AT/NEU and lactoferrin/NEU ratios in patients with UC were significantly higher compared with patients with CD. Calprotectin (P=0.010) and lactoferrin (P=0.023) levels were higher in patients with the active compared with inactive phase of CD. CONCLUSIONS: The diagnostic characteristics of plasma granulocyte protein concentrations indicate the usefulness of these tests in the diagnosis of IBD. Higher HLE-α1AT and lactoferrin/NEU ratios in patients with UC than with CD may suggest the usefulness of these ratios in differential diagnostics. Plasma calprotectin and lactoferrin levels may be useful in CD activity assessment.

Oral mucosa lesions in patients with active Crohn's disease - a prospective study.

Introduction: Crohn's disease (CD) is a chronic inflammatory disease, which may involve any part of the gastrointestinal tract, including the oral cavity. Mucosal lesions in the oral cavity are described in various populations, but observations in active disease with severe clinical symptoms are quite rare. Objectives: To evaluate the prevalence and nature of oral mucosa lesions in adult patients with active CD and their correlation with clinical and laboratory indicators of disease activity. Material and Methods: Prospective study was performed in 62 patients (29 women, 33 men, age 18-49 years) admitted between December 2010 and February 2013 to the gastroenterology department with a confirmed diagnosis of CD and exacerbations of symptoms, and 40 sex- and gender-matched healthy volunteers. CD activity was classified according to clinical and blood parameters, and the CD activity index (CDAI). We examined: blood morphology, hemoglobin and CRP levels, BMI. Examination of the oral cavity included a detailed interview and physical examination, based on the WHO recommendations. Results: In patients with active CD we found: increased CDAI score (258.4±21.5), higher CRP levels (24.6±1.3 mg/l) and platelet count, anemia with significantly reduced RBC and hemoglobin level, and reduced BMI, in comparison to controls. The specific for CD symptoms were found in the mouth: indurated tag polypoid lesions on vestibular retromolar region in 12.9% of patients, cobblestoning of the mucosa in 9.7%, diffuse asymptomatic buccal swelling in 16.2%, mucogingivitis in 19.4% of patients. Oral nonspecific lesions were more frequent: angular cheilitis in 29.1%, atrophic glossitis in 14.5% of patients. Oral lesions correlated with hemoglobin and CRP concentrations (r=-0.431 and r=0.437; respectively; p<0.001), platelet count (r=0.45; p<0.003), CDAI (r=0.421; p<0.001) and BMI (r=0.307; p<0.006). No correlation has been found between specific or non-specific lesions and location of inflammatory changes in the gastrointestinal tract. Conclusions: Changes in the oral mucosa in adult patients with active CD are frequent. They should be correlated with other clinical symptoms of gastrointestinal tract and biochemical parameters in patients with CD. The nature of these changes may have an impact on the further therapeutic approach.

A short review of drug-food interactions of medicines treating overactive bladder syndrome.

Background Overactive bladder syndrome is a condition where one or more of the symptoms such as pollakiuria, urgent need to urinate, nocturia and urinary incontinence is observed. Its prevalence ranges between 7 and 27 % in men and 9-43 % in women. The role of a pharmacist is to educate the patient on medications administration scheme, and drug interactions with particular food or food components. Aim of the review To assess a potential impact of food and fruit juice on the pharmacokinetic and therapeutic effects of medications used in treating overactive bladder syndrome. This information will enhance pharmaceutical care and is vital and helpful for pharmacists counseling their patients. Method In order to gather information on interactions of medications employed in bladder dysfunctions, the English language reports published in the PubMed, Embase, Cochrane and CINAHL database over the years 1996-2015 were studied. Additionally, other resources, namely drugs.com, Medscape, UpToDate, Micromedex, Medical Letter, as well as Stockley Drugs Interaction electronic publication were included in the study. The analysis also covered product data sheets for particular medicinal products. Results Meals and the consumption of grapefruit juice were found to exert a diversified effect on the pharmacokinetics of drugs employed in overactive bladder syndrome therapy. Neither tolterodine, nor mirabegron interact with food and citrus fruit juice, whereas darifenacin, fesoterodine, oxybutynin and solifenacin do interact with grapefruit and others citrus fruit juice. The effects of such interactions may potentially be negative to patients. Trospium absorption is significantly decreased by food. Conclusion For selected medicines used in treating bladder dysfunctions food and grapefruit juice consumption may significantly affect efficacy and safety of the therapy. All information on the topic is likely to enhance the quality of pharmaceutical care.

Interactions between medications employed in treating benign prostatic hyperplasia and food - A short review.

Benign prostatic hyperplasia (BPH) is the most common disease in elderly men. BPH symptoms include frequent urination, urgent tenesmus and urination at night, a weak and interrupted urine flow and a sense of incomplete emptying of the bladder. Alpha- 1 adrenergic receptor antagonists and 5 α-reductase inhibitors form the most important groups of medications employed in BPH. Appropriately managed BPH patients shall be subject to counselling on interactions between agents belonging to these groups, and on particular components of the food they have. The present review has been aimed at assessing potential effects of consumed food, alcohol and fruit juices on the pharmacokinetics and pharmacodynamics of medications for benign prostatic hyperplasia. The authors reviewed the English PubMed database covering the years 1991-2015. Additionally, a digital version of Stockley Drugs Interaction and other electronic databases such as drugs.com and Medscape were also researched; characterisation charts for particular medical products were also analyzed. Pharmacokinetics of extended-release forms of alfuzosin, doxazosin, tamsulosin and silodosin is well known to be food-sensitive. Alfuzosin, tamsulosin and silodosin due to their likely interaction with grapefruit juice and citrus fruits, may intensify adverse effects of the drugs. Alpha-1 adrenergic receptor antagonists are known to interact with alcohol, leading to orthostatic hypotension. For 5 alpha-reductase inhibitors, such as finasteride, or dutasteride, the pharmacokinetic effect due to consumed food is of no clinical importance and thus they may be taken regardless of meals. As in general grapefruit juice and alcohol tend to significantly affect the efficacy and safety of the applied drug therapy, it is highly advisable to be knowledgeable on the subject in order to educate patients.

Diet and nutritional factors in inflammatory bowel diseases.

Inflammatory bowel disease (IBD) development is affected by complex interactions between environmental factors, changes in intestinal flora, various predisposing genetic properties and changes in the immune system. Dietary factors seem to play an underestimated role in the etiopathogenesis and course of the disease. However, research about food and IBD is conflicting. An excessive consumption of sugar, animal fat and linoleic acid is considered a risk factor for IBD development, whereas a high fiber diet and citrus fruit consumption may play a protective role. Also, appropriate nutrition in particular periods of the disease may facilitate achieving or prolonging remissions and most of all, improve the quality of life for patients. During disease exacerbation, a low fiber diet is recommended for most patients. In the remission time, an excessive consumption of alcohol and sulfur products may have a negative effect on the disease course. Attempts are also made at employing diets composed in detail in order to supplement IBD therapy. A diet with a modified carbohydrate composition, a semi-vegetarian diet and a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols are under investigation. Due to chronic inflammation as well as side effects of chronically used medications, patients with IBD are also at increased risk of nutritional factor deficiencies, including iron, calcium, vitamin D, vitamin B12, folic acid, zinc, magnesium and vitamin A. It should also be remembered that there is no single common diet suitable for all IBD patients; each of them is unique and dietary recommendations must be individually developed for each patient, depending on the course of the disease, past surgical procedures and type of pharmacotherapy.