Prevalence and Factors Associated with Thinness in Rural Polish Children.

A lot of attention has been focused on obesity, however, the other extreme-thinness-may lead to inhibition of physical and intellectual development. The aim was to assess the prevalence of thinness and determine the associated factors in children from rural populations. We used data from the cross-sectional sample of 3048 children, examined in schools from a district in southern Poland. The sample included 89% of the district departments, and included a proportion of rural and small town populations-a representative one for the region. Thinness was determined based on the criteria proposed by Cole and Lobstein. Biological, sociodemographic and lifestyle factors were analysed. The odds ratio (OR) and 95% confidence interval (CI) were calculated using logistic regression analysis. The prevalence of thinness was 11.5% in boys and 13.5% in girls. In the younger group, it was similar in boys and girls at 11.8%; whereas in the older group, it was 11.1% and 14.5%, respectively. The prevalence of thinness Grade 3 in girls was two times higher than in boys. The increased index of leisure time physical activity was connected with thinness in prepubertal boys. The mechanism determining the development of thinness is very complex and further exploration of this trend is recommended.

Risk Factors and Prevalence of Abdominal Obesity among Upper-Secondary Students.

Inadequate eating habits, as well as a low level of physical activity, influence adipose tissue deposition. The aim of the study was to assess the prevalence of central obesity in upper-secondary students and to determine the factors related to its occurrence. The survey included 309 participants, aged 16 to 18 years from Krakow (Poland). Anthropometric measurements were taken during the periodic assessment of students' health status. An anonymous questionnaire was used to assess the nutritional and non-nutritional risk factors of participants. According to different methods of measurement, abdominal obesity (AO) was observed in 15.5% (WC-waist circumference), 10.7% (WHtR-waist to height ratio) or 21.7% (WHR-waist to hip ratio) participants. Abdominal obesity (WC) was significantly associated with family history of excess body weight and higher economic status of the family. The risk of AO (WC) was significantly lower among adolescents who declared higher physical activity. Boys who eat first breakfasts have lower AO risk according to WHtR interpretation. Abdominal obesity in gender group was related to the self-esteem of one's own appearance according to WHtR and WC. Abdominal obesity was associated with the family environment and modifiable lifestyle factors and was dependent on gender.

Applicability of the silver amalgam electrode in voltammetric determination of zinc and copper in gastric juice and gastric mucosa of rats.

The aim of the work was to compare two analytical methods of trace analysis in respect to their applicability in heavy metals determination in biological samples. Atomic absorption spectrometry (AAS) may be considered as the method of choice in such analyses due to its accuracy, precision and low detection limit. On the other hand, voltammetric methods seem to be as useful, but rarely applied. Having in mind that there is no universal analytical method, we have compared two AAS and voltammetric methods as the tools for Zn and Cu determination in the samples collected from rat gastric juice and gastric mucosa. Construction of the renewable silver amalgam film electrode (Hg(Ag)FE) for stripping voltammetry was described. Detailed optimization of measurements procedure and sample preparation for differential pulse anodic stripping voltammetry (DP ASV) and AAS were also performed and presented. The obtained results of quantitative analysis of the chosen parameters by means of both methods are discussed.

Association of the physical activity with leptin blood serum level, body mass indices and obesity in schoolgirls.

Decreased physical activity is undoubtedly significantly associated with obesity. Similarly, the proper hormones secretion, the proper weight and body development. The aim of this study was to investigate the relationship between body mass composition and leptin concentration in relation to the degree of physical activity expressed in MET-h/week (metabolic equivalent per week). The study included 59 girls, aged 9-16 years (12.55±1.67) and divided into two groups: 1) PA: a physically active group of 29 girls and 2) PI: a group of 30 physically inactive girls. In all, physical activity was assessed using modified questionnaire concerning "activity for adolescents" and expressed in MET-h/week. Serum blood leptin concentrations in fasting girls were determined by RIA. Anthropometric parameters were measured and fatness indices calculated (BMI, SF, WHtR). Body composition (%BF, FM, FFM) was assessed using bioelectrical impedance analysis method (BIA). Statistical analysis showed significant differences between groups of PA and PI concerning values of BMI, WHtR, %BF, WC and MET-h/week as well as in leptin concentrations. In both groups of girls negative correlations between physical activity measured in MET and leptin concentrations and in WHtR were observed. The concentration of leptin was directly proportional to the degree of body fat and to the body composition expressed by BMI, WHtR, log SF, WC and %BF, FM and FFM, respectively. Increased physical activity was associated with lower body fat ratios and WHtR, BMI, WC, %BF, but did not affect significantly the changes in the values of log SF, FM and FFM. Higher values of BMI, WHtR and WC can provide not only a greater risk of obesity in general, but also cause excessive accumulation of fat in the central part of the body (abdominal obesity).

Helicobacter pylori and nonsteroidal anti-inflammatory drugs in perforations and bleeding of peptic ulcers.

BACKGROUND: This study was designed to assess the relative contribution of H pylori (Hp) infection and NSAID in the pathogenesis of perforation and bleeding of peptic ulcer (PU). MATERIAL/METHODS: Total of 91 PU perforations and 135 active bleeding were examined during last 5 years. At the same time, 1384 age- and gender-matched PU patients without such complications were examined. Furthermore, the effects of various concentrations of aspirin on the growth of Hp isolated from antral mucosa of these PU were examined in vitro. RESULTS: The average rates of Hp prevalence in PU patients with perforation or bleeding in NSAID intake were, respectively, only 50% and 62% as compared to 70.7 and 74% in PU patients non-using NSAID. The Hp prevalence in perforated and bleeding PU at all ages, particularly those at age of 60 years or higher, were significantly lower compared to that found below this age, while no such difference in Hp infection rate was seen in PU not using NSAID. In vitro studies on CagA and VacA positive Hp subjected to culture medium containing aspirin showed a dose dependent reduction in bacterial growth with complete bacteria killing occurring at 500 microg/ml of aspirin. CONCLUSIONS: The Hp prevalence, especially in older PU patients using NSAID, is significantly lower in perforated and bleeding PU compared to that in non-complicated PU, and this could be explained by direct suppression of Hp by NSAID used by these patients.

Serological differentiation of Helicobacter pylori CagA(+) and CagA(-) infections.

Many Helicobacterpylori strains causing gastroduodenal diseases have a cagA gene encoding CagA protein, a virulence factor of these bacteria. Anti-CagA antibodies produced by the majority of people infected with CagA(+) strains can indicate such an infection. In this study, the efficacy of three immunoenzymatic tests for detecting CagA(+) and CagA(-) infections were compared: immunoblot (Milenia ID Blot H. pylori IgG; MB) and ELISA conducted either with a recombinant immunodominant fragment of CagA (rCagA) or the full-length CagA molecule (flCagA). The 13C-urea breath test (13C-UBT) was used for establishing H. pylori status. The serum samples from 157 individuals were used for serodiagnosis. H. pylori CagA(+) infection was detected in H. pylori-infected individuals with similar frequencies by MB (64%) and flCagA-ELISA (60%) and a little less frequently by rCagA-ELISA (53%). There was a high coincidence between the negative results of these three tests for H. pylori-uninfected individuals with no anti-CagA IgG in the serum (96-100%). The results show that rCagA-ELISA and, especially, flCagA-ELISA are easy, inexpensive and useful noninvasive assays for the discrimination of CagA(+) and CagA(-) H. pylori infections in subjects examined by urea breath test.

The usefulness of capsulated 13C-urea breath test in diagnosis of Helicobacter pylori infection in patients with upper gastrointestinal bleeding.

BACKGROUND: H. pylori infection and peptic ulcerations and their complications such as bleeding are causally related, but the available methods used in bleeding to confirm active H. pylori lack accuracy. AIM To evaluate the usefulness of 13C-urea breath test (UBT) in diagnosing of H. pylori infection in bleeding patients. PATIENTS AND METHODS: Eighty-one patients with upper gastrointestinal bleeding and 258 matched controls without bleeding were enrolled to the study. UBT was performed using low-dose capsulated 13C-urea and IgG antibodies to H. pylori were determined by ELISA. RESULTS: UBT performed in bleeding patients was positive in 77.7%. In this group anti Hp IgG was positive in 79% of cases and among them gastroscopy showed 40.7% of bleeding duodenal ulcer, 38% bleeding gastric ulcer, and 86% hemorrhagic gastritis. UBT was positive in 90.9%, 77.4%, and in 52.97% cases, respectively, and it was not statistically different from that in non-bleeding controls, duodenal and gastric ulcers and gastritis. All patients with blood or "coffee grounds" in the stomach had both UBT and serology positive. CONCLUSION: The UBT is simple and non-invasive method, which can be successively applied also in patients with upper gastrointestinal bleeding to detect active H. pylori infection prior to emergency endoscopy.

Detection of specific Helicobacter pylori DNA and antigens in stool samples in dyspeptic patients and healthy subjects.

In this study stool samples from dyspeptic patients and healthy subjects were used for detection of specific Helicobacter pylori antigens and DNA by immunoenzymatic test (PPHpSA) and semi-nested PCR (ureA-PCR), respectively. The H. pylori status was estimated by invasive endoscopy-based rapid urease test and histology or noninvasive urea breath test (UBT), and by serology (ELISA, Western blot). The coincidence of H. pylori-negative invasive tests or UBT and negative antigen or DNA stool tests was very high (mean 95%). The PPHpSA results were found positive for 56% and ureA-PCR for 26% of individuals with H. pylori infection confirmed by invasive tests or UBT. The detection of specific H. pylori antigens and especially DNA in feces is not sufficient as a one-step diagnosis of H. pylori infection.

Interaction of Helicobacter pylori (Hp) and nonsteroidal anti-inflammatory drugs (NSAID) on gastric mucosa and risk of ulcerations.

Hp and NSAID are the most common pathogens in the stomach, but their interaction on gastro-duodenal mucosa has been little studied. Hp infection in humans does not interfere with NSAID-induced gastric ulcer healing by omeprazole, therefore, there is no rationale to eradicate the germ. Hp infection induces COX-2 expression resulting in excessive biosynthesis of gastroprotective prostaglandin (PG), which should in turn counteract NSAID-induced gastropathy and contribute to healing of existing ulcers. Some investigators claim that Hp infection acts synergistically with NSAID on ulcerogenesis and propose that Hp should be eradicated, particularly at the onset of long-term NSAID therapy. Our studies in about 6500 dyspeptic patients undergoing upper endoscopy and 13C-urea breath test revealed that about 70% of these patients are Hp positive and 31% of these develop gastro-duodenal ulcers. Of these ulcers, 66% were Hp positive and NSAID negative, 3%--NSAID positive and Hp negative, 8% were both Hp positive and NSAID positive, while 23% ulcers were Hp and NSAID negative. An evidence was obtained for negative interaction between Hp infection and NSAID on risk of gastro-duodenal ulcers suggesting that Hp may attenuate the peptic ulcerogenesis. Our results support the concept 1) the interaction between Hp infection and NSAID on gastro-duodenal ulcerations is antagonistic, 2) the Hp and NSAID are independent risk factors for peptic ulcerations in humans, 3) there is no need for the Hp eradication in NSAID-treated patients, and 4) the rate of ulcer complications (hemorrhage and perforation) remains constant despite the decrease in Hp and ulcer prevalence.

Impact of Helicobacter pylori and nonsteroidal anti-inflammatory drugs on gastric ulcerogenesis in experimental animals and in humans.

Helicobacter pylori (H. pylori) and nonsteroidal anti-inflammatory drugs (NSAID) are the most common pathogens in the gastroduodenal mucosa in animals and humans, but their relationship in ulcerogenesis has been little studied. According to some authors, H. pylori infection in humans does not act synergistically with NSAID on ulcer healing, therefore, there is no need to eradicate the germ. This notion is supported by the finding that the eradication of H. pylori does not affect NSAID-induced gastropathy treated with omeprazole and that H. pylori infection induces a strong cyclooxygenase-2 expression resulting in excessive biosynthesis of gastroprotective prostaglandins, which should in turn counteract NSAID-induced gastropathy and heal the existing ulcer. Other investigators claim that H. pylori infection acts synergistically with NSAID on ulcer development, therefore, H. pylori should be eradicated, particularly at the start of long-term NSAID therapy. Maastricht 2-2000 consensus also recommends eradication prior to NSAID treatment, but this eradication does not appear to accelerate ulcer healing or to prevent the recurrent ulcers in NSAID users. Our studies in almost 6,000 dyspeptic patients undergoing upper endoscopy and [(13)C]-urea breath test (UBT) revealed that about 70% of these patients are H. pylori (+) and about 30.6% of these develop gastroduodenal ulcers. Of these ulcers, over 70% were H. pylori (+) positive, 12% NSAID (+), 8% were both H. pylori (+) and NSAID (+), while 22% ulcers were H. pylori (-) and NSAID (-) or "idiopathic" ulcers. Basically, our results support Hawkey's concept and this also agrees with our findings in the rat model showing that: (1) there is no synergistic interaction between H. pylori infection and NSAID on gastric ulcer development, (2) H. pylori and NSAID are independent risk factors for peptic ulceration, and (3) NSAID therapy in H. pylori positive patients attenuates the ulcer development possibly due to direct inhibitory action of these drugs on H. pylori.

Incidence of complications of peptic ulcers in patients with Helicobacter pylori (Hp) infection and/or NSAID use in the era of Hp eradication.

BACKGROUND: Hp and NSAID are considered as major pathogens in peptic ulcerations and their complications but little is known about the incidence of ulcers and their complications following wide-spread use of Hp eradication. The aims of the study were: 1) to analyze incidence of ulcers and their complications, bleeding and perforations at time when the Hp eradication has been used in ulcer therapy, and 2) to assess the impact of Hp infection and NSAID use on the incidence of ulcers and complications. MATERIAL/METHODS: From 1996 to 2001, 381 patients with complications of peptic ulcers were admitted to the emergency surgery, including 273 patients with bleeding ulcers and 108 with perforations out of a sample of 6515 dyspeptic patients examined with upper endoscopy and 13C-urea breath test (UBT). RESULTS: The rate of ulcer bleeding and perforations, remained relatively constant throughout the study period. NSAID use in that group increased form 15.8% in 1999 to 19.4% in 2001. The incidence of Hp in patients with complications assessed by UBT or CLO was 76.7%, while the incidence of Hp in 7920 patients ranged form 72.8% in 1996 to 53.8% in 2001. There were 1940 (29.7%) patients with duodenal and/or gastric ulcer diagnosed by upper gastroscopy. The decline in the prevalence of peptic ulcer from about 44% to 8% occurred over the same time. A slight increase in the number of ulcer resulting from NSAID use was observed so was the number of ulcers without Hp or NSAID (idiopathic). CONCLUSIONS: Despite decreased Hp prevalence, the incidence of ulcers complications remained unchanged probably due to increased use of NSAID and the appearance of idiopathic ulcers.