Żaneta Malczyk

Bio: Żaneta Malczyk is an academic researcher from University of Silesia in Katowice. The author has contributed to research in topics: Anorexia nervosa (differential diagnoses) & Thyroid hormone receptor. The author has an hindex of 2, co-authored 11 publications receiving 17 citations.

Gastrointestinal complications and refeeding guidelines in patients with anorexia nervosa

Abstract: Anorexia nervosa (AN) is the third most common disorder, after obesity and asthma, in the population of adolescents between 13-18 years of age. Food intake reduction is associated with whole body dysfunction, affecting its physical, psychological and social spheres. As a result of starvation, dysfunction develops in virtually all systems and organs. However, most frequently patients with AN complain of digestive symptoms, such as a feeling of fullness after meals, pain in the upper abdomen, dysphagia, nausea, bloating and constipation. They can have mild functional character, but may also reflect serious complications, including diseases requiring urgent surgical intervention. In addition, gastric complaints may hinder nutritional management of AN. Care of AN patients requires cooperation of many specialists in the field of psychiatry, psychology, paediatrics, internal medicine and nutrition. However, it is often difficult to organize such a team. Therefore, we decided to approach the issues of gastrointestinal symptoms and complications in the course of AN, and the rules of nutritional therapy.

Praktyczne aspekty leczenia zaparć stolca u dzieci

Abstract: 1 Samodzielny Publiczny Szpital Kliniczny nr 1 im. prof. Stanisława Szyszko w Zabrzu, Katedra i Klinika Pediatrii Śląskiego Uniwersytetu Medycznego w Katowicach. Kierownik Katedry i Kliniki: dr hab. n. med. Katarzyna Ziora 2 Oddział Endokrynologii Dzieci, Samodzielny Publiczny Szpital Kliniczny nr 1 im. prof. Stanisława Szyszko w Zabrzu. Kierownik Oddziału: dr hab. n. med. Katarzyna Ziora 3 Oddział Gastroenterologii i Hepatologii Dzieci, Samodzielny Publiczny Szpital Kliniczny nr 1 im. prof. Stanisława Szyszko w Zabrzu. Kierownik Oddziału: dr n. med. Jolanta Porębska Adres do korespondencji: Lek. med. Żaneta Malczyk, Klinika Pediatrii ŚUM, Oddział Endokrynologii Dzieci, ul. 3 Maja 13–15, 41‐800 Zabrze, e‐mail: zaneta.malczyk@gmail.com Praca finansowana ze środków własnych

Changes in Platelet Count and Size Indices in Adolescent Patients With Anorexia Nervosa.

Abstract: The significance of platelet size indices has not been widely analyzed in anorexia nervosa (AN). It seems important to get more knowledge on the easily available indices of platelet function obtained by routine complete blood count analysis in patients with AN. We analyzed platelet count (PLT), platelet distribution width (PDW), and mean platelet volume using an automated blood cell counter in 25 females with AN and healthy age- and gender-matched nonatopic controls. Mean PLT was significantly lower in patients with AN than in the control group. Platelet distribution width values in patients with AN were significantly higher than those in the controls. Platelet distribution width values significantly correlated with the disease duration and rate of body weight loss in the anorectic patients. Anorexia nervosa in adolescents is associated with a decrease in PLT along with an increased PDW, which may be an indicator of dysregulated thrombopoiesis.

Zespół całkowitej niewrażliwości na androgeny – opis przypadku

Abstract: Disorders of sex development (DSD) are rare, but represent one of the most difficult diagnostic and therapeutic problems. Until now it has not been established when surgical interventions in patients with DSD should be undertaken. Androgen insensitivity syndrome (AIS, Morris syndrome) is a congenital, inherited in a recessive, X-linked manner disorder of sex development. The prevalence of the disease is estimated for 1: 20,000 to 1:64,200. According to the severity of androgen resistance AIS can be classified into three categories: complete androgen insensitivity syndrome (CAIS), partial androgen insensitivity syndrome (PAIS) and mild androgen insensitivity syndrome (MAIS). Diagnosis of AIS requires clinical, hormonal and molecular investigation. We present a case of 17-year-old girl referred due to primary amenorrhea. Her cytogenetic analysis revealed the kariotype of 46, XY. Hormonal and imaging investigations confirmed the diagnosis of complete androgen insensitivity syndrome.

Exocrine Pancreatic Function in Girls with Anorexia Nervosa

Abstract: Objectives: To assess pancreatic exocrine function in patients with anorexia nervosa using a breath test with 13C-labeled mixed triglycerides (MTG-BT) and to determine the relationship between the test results and selected biochemical and hormonal parameters. Material and methods: Anthropometric measurements, biochemical and hormonal parameters (serum leptin, soluble leptin receptor (sLR), acylated and desacylated ghrelin, free leptin index (FLI)), and MTG-BT were performed in a group of 31 girls with the restrictive type of AN, as well as 38 healthy girls (C). Results: The average cumulative dose of 13C-triglycerides recovered with exhaled air (%CD) was similar in both study groups, while the average time from 13C-triglycerides administration to peak 13CO2 excretion in expired air (time to peak (TTP)) was significantly longer in patients with AN compared to C. In both groups, %CD correlated negatively with FLI. TTP correlated negatively with sLR and FLI in the AN and with serum insulin and HOMA-IR values in the C. Conclusions: In girls with AN, the pancreatic efficiency of lipase secretion was found to be normal, while the kinetics of this enzyme secretion were disturbed. These changes may result from disorders in the functioning of the adipose–insular and islet–acinar axes.

Medication in AN: A Multidisciplinary Overview of Meta-Analyses and Systematic Reviews.

Abstract: Drugs are widely prescribed for anorexia nervosa in the nutritional, somatic, and psychiatric fields. There is no systematic overview in the literature, which simultaneously covers all these types of medication. The main aims of this paper are (1) to offer clinicians an overview of the evidence-based data in the literature concerning the medication (psychotropic drugs and medication for somatic and nutritional complications) in the field of anorexia nervosa since the 1960s, (2) to draw practical conclusions for everyday practise and future research. Searches were performed on three online databases, namely MEDLINE, Epistemonikos and Web of Science. Papers published between September 2011 and January 2019 were considered. Evidence-based data were identified from meta-analyses, if there were none, from systematic reviews, and otherwise from trials (randomized or if not open-label studies). Evidence-based results are scarce. No psychotropic medication has proved efficacious in terms of weight gain, and there is only weak data suggesting it can alleviate certain psychiatric symptoms. Concerning nutritional and somatic conditions, while there is no specific, approved medication, it seems essential not to neglect the interest of innovative therapeutic strategies to treat multi-organic comorbidities. In the final section we discuss how to use these medications in the overall approach to the treatment of anorexia nervosa.

Gastrointestinal Interoception in Eating Disorders: Charting a New Path

Abstract: Abnormal interoception has been consistently observed across eating disorders despite limited inclusion in diagnostic conceptualization. Using the alimentary tract as well as recent developments in interoceptive neuroscience and predictive processing as a guide, the current review summarizes evidence of gastrointestinal interoceptive dysfunction in eating disorders.Eating is a complex process that begins well before and ends well after food consumption. Abnormal prediction and prediction-error signals may occur at any stage, resulting in aberrant gastrointestinal interoception and dysregulated gut sensations in eating disorders. Several interoceptive technologies have recently become available that can be paired with computational modeling and clinical interventions to yield new insights into eating disorder pathophysiology. Illuminating the neurobiology of gastrointestinal interoception in eating disorders requires a new generation of studies combining experimental probes of gut physiology with computational modeling. The application of such techniques within clinical trials frameworks may yield new tools and treatments with transdiagnostic relevance.

Backstage of Eating Disorder-About the Biological Mechanisms behind the Symptoms of Anorexia Nervosa.

Abstract: Anorexia nervosa (AN) represents a disorder with the highest mortality rate among all psychiatric diseases, yet our understanding of its pathophysiological components continues to be fragmentary. This article reviews the current concepts regarding AN pathomechanisms that focus on the main biological aspects involving central and peripheral neurohormonal pathways, endocrine function, as well as the microbiome–gut–brain axis. It emerged from the unique complexity of constantly accumulating new discoveries, which hamper the ability to look at the disease in a more comprehensive way. The emphasis is placed on the mechanisms underlying the main symptoms and potential new directions that require further investigation in clinical settings.

Incontinence and constipation in adolescent patients with anorexia nervosa—Results of a multicenter study from a German web‐based registry for children and adolescents with anorexia nervosa

Abstract: OBJECTIVE: Nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI) are common disorders in childhood and are frequently accompanied by comorbid psychiatric disorders. Despite a high association between urinary and fecal incontinence with psychiatric and neurodevelopmental disorders, research on comorbidity between incontinence and anorexia nervosa (AN) remains scarce. Yet, it is well known that somatic consequences of AN include metabolic and gastrointestinal disorders. The study sought to assess the prevalence of incontinence and constipation in children and adolescents with AN and to examine associations of these two symptoms with body weight at admission and with BMI changes during inpatient treatment. METHODS: Data collected between 2015 and 2017 by a multicenter German web-based registry for AN were analyzed. Three hundred and forty-eight patients with AN (96.3% female, mean age = 15.1 ± 1.8 years) were assessed regarding AN subtype, psychiatric comorbidity, body weight, incontinence, and constipation. RESULTS: Overall, 27.6% of patients had constipation, 1.8% had NE and 1.8% DUI. Prevalence of constipation did not significantly differ between AN subtypes. Constipation did not lead to any significant differences in weight/BMI changes during inpatient treatment. DISCUSSION: This is the largest study of incontinence and constipation in patients with AN, so far. Our results indicate that constipation is highly prevalent in adolescent patients with AN and reflects a clinically relevant condition. Despite, patients with AN do not have an increased prevalence of incontinence compared with the general population. Future studies should include medical examinations like ultrasound and physical examination of the lower abdomen to evaluate the severity of constipation.