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© Borgis - Postępy Nauk Medycznych 2/2009, s. 158
Comment
Research on digestive system disorders traditionally included gastroenterology, hepatology and pancreatology. From the beginning histopathology was associated with these sciences. In the course of time also gastroenterological endoscopy and ultrasonography joined these branches. There has been dramatic progress in molecular biology relating, among other things, to diseases of the gastrointestinal tract, liver and pancreas during recent years.
All these branches and trends are presented in this issue of „Progress in Medical Sciences”. The article by Prof. Habior, dedicated to risk of liver diseases in Europe, merits attention. The paper´s author describes the current epidemiological situation of viral and metabolic liver diseases and reflects on expected liver cancer incidence.
The endoscopy section presents an article devoted to analgosedation. A questionnaire study carried out in 138 endoscopic laboratories in Poland showed that the percentage of gastroscopy and colonoscopy performed under intravenous sedation was respectively about 7 and 64%. The type of drug used for sedation differed depending on medical specialization: endoscopist´s most often applied midazolam while anaesthetists applied propofol. This analysis shows that it is necessary to work out uniform guidelines of analgosedation in endoscopic examination in our country.
Two facts provide the basis for the next publication about Helicobacter pylori infection: 1) its variable sensitivity to antibiotics, and 2) high morbidity and poor results of gastric cancer treatment. Indications and new principles of Helicobacter pylori infection treatment are presented in the article and the prophylactic eradication of these bacteria with reference to gastric cancer is discussed.
Rarer intestinal diseases, such as intestinal pseudo-obstruction and microscopic colitis, are the next problems raised in this issue. These diseases are neither correctly diagnosed nor properly treated. The respective articles present the diagnostic criteria for each of these diseases and describe treatment methods having proven value.
The articles of Prof. J. Orłowska and Dr M. Kiedrowski move us into the word of less known colon polyps, namely the serrated adenomas and the hyperplastic polyposis syndrome. The importance of these changes, recently introduced into the classification of epithelial polyps, rests on the fact that they increase the risk of colon cancer through methylation and the „silencing” of DNA repair genes.
The remaining articles concern pancreatic adenocarcinoma and new techniques in ultrasonography and molecular biology. Among them, it is worth paying particular attention to the articles written by Prof. J. Ostrowski and Collaborators, which touch on different problems of molecular and mitochondrial medicine as well as proteomics. Molecular biological techniques should help in identification of biomarkers of various diseases (not only neoplastic), the prediction of their development, treatment sensitivity and their prevention. There is no doubt that today these research directions, together with the new discipline of integrative genomics, will be decisive for the future development of medicine.
Prof. Witold Bartnik
Postępy Nauk Medycznych 2/2009
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