Zalecenia w zakresie profilaktyki półpaśca u biorców przeszczepów narządów litych w Polsce

Herpes zoster (i.e. shingles) is a widespread infectious disease caused by reactivation of the varicellazoster virus. Although the cutaneous manifestation of the disease is the most common, shingles is also associated with numerous complications, e.g. neurological, including postherpetic neuralgia. It is estimated that one-third of the general population will develop herpes zoster during their lifetime, and the incidence in solid organ recipients is even higher. What is more transplant recipients are more likely to suffer from severe complications of the disease. The most effective method of preventing herpes zoster is vaccination. The only vaccine recommended and available in Poland is recombinant adjuvanted zoster vaccine. Its safety and effectiveness were demonstrated in both the general adult population and solid organ recipients. In this article, we present the position of experts in transplantation and infectious diseases on herpes zoster prevention in the solid organ transplant recipient population. The group includes kidney, liver, lung, and heart recipients

Angiotensin-converting enzyme inhibitors and angiotensin-II-receptor antagonists modulate sodium handling based on endogenous lithium clearance

Background: Numerous studies based on assessment of lithium clearance demonstrated higher sodium reabsorption in renal proximal tubules in individuals with hypertension, overweight, obesity, metabolic syndrome, or diabetes.Aims: We aimed to assess the influence of angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin-II-receptor antagonists (ARB) treatment on sodium handling.Methods: In a sample of 351Caucasian subjects without diuretic treatment with prevailing sodium consumption, we studied associations between renal sodium reabsorption in proximal (FPRNa) and distal (FDRNa) tubules assessed by endogenous lithium clearance and daily sodium intake measured by 24-hour excretion of sodium (UNaV), in the context of obesity and long-term treatment with ACE-I or ARB.Results: In the entire study population, we found a strong negative association between FPRNa and ACE-I/ARB treatment (b = –19.5; SE = 4.9; P <0.001). Subjects with FPRNa above the median value showed a significant adverse association between FPRNa and age (b = –0.06; SE = 0.02; P = 0.003), with no association with ACE-I/ARB treatment (P = 0.68). In contrast, in subjects with FPRNa below the median value, we found a strongly significant adverse relationship between FPRNa and ACE-I/ARB treatment (b = –30.4; SE = 8.60; P <0.001), with no association with age (P = 0.32).Conclusions: ACE-I/ARB long-term treatment modulates FPRNa in the group with lower reabsorption, but not in that with higher than median value for the entire study population

[Retracted] Metformin for the Prevention of Prediabetes Progression to Type 2 Diabetes: A Systematic Review and Meta-Analysis

Objective: The aim of this meta-analysis was to explore the effectiveness of metformin in retarding the progression of pre-diabetes to type 2 diabetes (T2D). Materials and methods: A web-based search was conducted using the Cochrane Library identifying ten citations for analysis. In the pre-analysis stage, outlier detection was carried out using funnel plots, culprit citations identified using Byjat plot and influence analysis. The meta-analysis was conducted using a random-effects model using relative-risk (RR) as the effect-size and prediction interval (PI) as the indicator of heterogeneity. The RR was calculated by comparing the metformin and the control arm [lifestyle modification (LSM)/placebo]. R studio (2022.07.1, Build 554) software was used for analysis. Results: A total of 8869 patients with pre-diabetes were included in the meta-analysis, with 4328 patients in the metformin arm and 4541 in the control arm (LSM/placebo). There was a 22% RR reduction with metformin compared to LSM/placebo with a 95% CI of 0.71–0.86. No heterogeneity was detected in the summary effect size (PI: 0.69–0.88). Subgroup analysis using the dose of metformin (low versus high) did not influence the outcome (p = 0.39) Conclusions: The addition of metformin to intensive LSM is an effective value addition in patients with pre-diabetes at high-risk of progression to T2D

Relationship between autism spectrum disorder and suicide: a narrative review

Introduction: Suicide is a complex issue that must be considered within an interdisciplinary context, regarding the role of sociocultural factors such as support, values, beliefs, economic status, upbringing, and stigma. The objective of this article is to review and raise awareness of current evidence-based data regarding suicidality among people with ASD, by analysing the latest academic papers. It is noted that people with ASD are at elevated risk of suicidal behaviour. Materials and methods: The search for relevant materials was conducted using the PubMed, Medline, and Embase databases. Articles were chosen according to their significance, with a focus on the risk factors and management of suicidality among people with autism spectrum disorder. Results: The article identified risk factors of suicide behaviours among people with ASD such as co-occurring mental health conditions, difficulty in expressing emotions, social isolation, bullying and victimisation, lack of access to mental health care, and difficulty in adapting to change. To prevent suicide in individuals with ASD, it is essential to identify and address these risk factors and provide appropriate support and interventions. Conclusions: The review of published literature provides insights into manifestations of ASD and the common features associated with the disorder. Evidence-based treatments and interventions for ASD are evolving over time, and there is a great demand for randomised controlled trials to investigate their effectiveness. Clinicians’ knowledge and attitudes play a crucial role in suicide prevention for individuals with ASD, and there is a need for reliable, adapted risk-assessment tools

Therapeutic effect of the temperature-controlled radio frequency technology in female sexual dysfunction

Objectives: To explore the therapeutic effect of the temperature-controlled radiofrequency technology in female sexual dysfunction (FSD). Material and methods: From July 2020 to June 2021, patients with FSD who visited the Gynecology Clinic of Peking University Shenzhen Hospital were treated with the temperature-controlled radiofrequency technology once every two weeks, for a total of five times. The therapeutic effect was objectively evaluated with pelvic floor dysfunction (PFD) indicators (FSFI score, pelvic floor muscles surface electromyography, sexual function test). The pre- and post-treatment (2 weeks)/follow-up (3 months) results were compared to evaluate the feasibility of this technology for treating FSD, as well as using PFD-related indicators in objective evaluation of FSD patients. Results: Fifty patients completed treatment; 31 patients completed follow-up. The mean FSFI score for post-treatment/follow-up was significantly higher than pre-treatment (p < 0.05). There were no significant changes in the mean pelvic floor resting surface myoelectric potential and its variability and mean myoelectric potential of sexual function test between pre- and post-treatment/follow-up. The mean surface myoelectric potential of the patients’ type I and II muscle fibers of the pelvic floor for post-treatment/follow-up was significantly higher than pre-treatment (p < 0.05). The mean peak myoelectric potential for post-treatment was significantly higher than pre-treatment (p < 0.05). Conclusions: Temperature-controlled radiofrequency technology has a certain therapeutic effect on FSD. Pelvic floor surface electromyography and sexual function test can be used as an objective indicator for PFD in FSD patients. Subsequent studies may involve a larger size sample and evaluate the effect over a consecutive time-point, to develop a better therapeutic approach

Female sexual functioning during pregnancy

Sexuality is a fundamental, biological function of every human body, regardless of age, gender or race. However, the need for intimacy, closeness and sexual activity changes over time; it is influenced by the age, experience, physical and health condition. Sex is also one of the most important domains of the quality of life (QoL). However, this topic is still uneasy and rarely discussed, even though female sexual dysfunction (FSD) is a common problem, which affects 20% to 50% of women. Moreover, women experience processes that do not affect men, such as menstruation, pregnancy and menopause. In this review we focused on pregnancy, since sexual life of pregnant women alters during pregnancy due to the physiological, anatomical and hormonal changes in her body. Nonetheless, woman can keep having sex during a physiological pregnancy, but this issue is rarely addressed by physicians-gynecologists. Therefore, the aim of this manuscript was to discuss female sexuality during pregnancy

Therapeutic effect of autophagy induced by rapamycin versus intermittent fasting in animal model of fatty liver

Introduction. High-fructose, high-fat diet consumption (HFHF) is one of the primary causes of non-alcoholic fatty liver disease (NAFLD), which is due to impaired beta-oxidation or apolipoprotein secretion by hepatocytes. Activation of autophagy in hepatocytes could be a therapeutic method against hepatic complications. This study was designed to compare effects of rapamycin and intermittent fasting-inducing autophagy in rats with experimentally induced nonalcoholic fatty liver. Material and methods. Male rats were divided into five groups: C (control, n = 6), the experimental group (EX) subdivided, EXIa (HFHF, n = 6), EXIb (recovery, n = 6), EXII (rapamycin, n = 6) and EXIII (intermittent fasting, n = 6). All rats in the experimental group received HFHF diet for 8 weeks to induce nonalcoholic-fatty liver and obesity. Then, for the next 8 weeks the animals received either a daily oral dose of rapamycin (EXII group) or to intermittent fasting (IF) for 16 hours daily (EXIII group). Blood samples were drawn, and serum TG concentration as well as ALT and AST activities were determined. Hepatic sections were examined by light and electron microscopy. LC3B immunohistochemical staining, morphometric and statistical studies were performed. Results. Subgroups EXIa (HFHF subgroup) and EXIb (Recovery subgroup) showed marked increase in TG, ALT, and AST levels associated with loss of normal hepatic architecture, cytoplasmic vacuolations and faint LC3B immunoreactivity. Ultrathin sections exhibited many autophagosomes in hepatocytes. On the other hand, rapamycin (EXII) and IF (EXIII) groups showed significant improvement to a variable extent in comparison to EXI groups. Conclusions. It could be concluded that rapamycin and intermittent fasting significantly improved NAFLD-induced changes of liver structure and function by inducing autophagy in hepatocytes