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Background: Due to multiple morbidities, patients experience various symptoms that may be of psychogenic or somatic origin. Anxiety and depression can induce somatization and the feeling that ailments require urgent medical intervention. Aim of the study: This study aimed to: (1) identify which symptoms self-referral patients most commonly report at the emergency department (ED) and which medical diagnoses they are discharged with; and (2) determine whether the type and severity of symptoms, as well as, sociodemographic variables are related to anxiety and depression levels. Material and methods: The study included 110 patients who self-referred to the ED at the University Clinical Hospital in Opole. Diagnostic surveys and questionnaires were used, including the Hospital Anxiety and Depression Scale and an original questionnaire developed by the authors. Results: Among those suffering from chronic diseases (n = 53; 48.62%), 12 patients (22.64%) did not complete a single visit to the PHCF (Primary Health Care Facility), and 30 patients (56.60%) did not complete a visit to OSC (Outpatient Specialist Care) during the previous 12 months. The most common cause of reporting to the ED were pain and a burning sensation in the chest (n = 29; 27.10%). During discharge, the most common diagnosis was “other chest pains” (n = 22; 20.00%). 82.73% (n = 91) of patients had clear anxiety disorders, and 68.18% (n = 75) had clear depressive disorders. Conclusions: In case of somatic symptoms without a discernible cause in patients, it is necessary to implement comprehensive measures within PHCF, such as periodic measurements of anxiety and depression severity, psychological consultation, and an in-depth medical interview. These data also suggest that proper clinical monitoring should be implemented, including clinical parameters relevant for chronic diseases and the number of visits to the PHCF and OSC.
 Introduction: Hydrogen breath test (BT) is commonly used as a diagnostic tool for the detection of small intestine bacterial overgrowth (SIBO). It was reported that colonic methane production is far more frequent in cystic fibrosis (CF) patients than in other subjects. Therefore, measuring exclusively hydrogen in the diagnostic breath test for diagnosing SIBO might be of limited value. We aimed to assess the usefulness of combined measurement of hydrogen and methane expiration for the diagnosis of SIBO in CF. Material and Methods: The study comprised 62 CF patients aged 5 to 18 years. Three-hundred-ninety subjects assessed due to gastrointestinal symptoms for the presence of SIBO served as a comparative group. In all subjects hydrogen/methane BT using glucose was performed. A positive BT was defined as fasting hydrogen ≥ 20 ppm or fasting methane ≥ 10 ppm or a rise of ≥ 12 ppm hydrogen or ≥ 6 ppm methane over baseline during the test. Results: In 23 (37.1%) CF patients and in 52 (13.3%) subjects from the comparative group abnormal BT results were found. In seven (11.3%) CF patients and 29 (7.4%) of the other subjects studied methane measurement allowed diagnosis of SIBO. Conclusions: Small intestine bacterial overgrowth is frequent in cystic fibrosis. For its detection in cystic fibrosis and other gastrointestinal patients, combined hydrogen and methane measurement instead of hydrogen breath test should be applied. Without the additional measurement of methane a significant percentage of SIBO will be missed.
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