Lidocaine, old drug - new possibilities. Treatment of postoperative pain and reduction of postoperative complications with intravenous administration

Introduction: The number of surgeries requiring sedation continues to increase worldwide. Analgesia is one of the main components of anesthesia used during surgical procedures. Despite improvements in surgical techniques, the invention of new analgesics and a significant expansion of knowledge about the pathophysiology of pain, more than 75% of patients experience postoperative pain. Adequate analgesia reduces postoperative complications and shortens the length of hospitalization. Lidocaine is a local anesthetic also used as an antiarrhythmic drug. Studies report that intravenous administration may find application in perioperative analgesia. Aim of the study: The purpose of our study was to determine in which types of surgery the benefits of IVL (Intravenous lidocaine) are greatest.Methods and Evidence: We reviewed the literature available on PubMed using the words "Intravenous lidocaine"; "Perioperative Lidocaine "; "Postoperative pain".Results: IVL has been shown to have a positive effect on reducing opioid doses, postoperative pain intensity, shortening the duration of postoperative bowel obstruction, faster patient rehabilitation and shortening hospitalization. In non-abdominal surgeries, the greatest benefits have been seen in breast surgery, urology and spinal surgery. Lidocaine has low toxicity; only doses several times higher cause adverse effects.Conclusions: IVL should be used during intraabdominal surgery due to its high efficacy. Further studies on a larger group of patients are needed to better determine the effects of IVL in other surgeries. Keywords: "Intravenous lidocaine"; "Perioperative Lidocaine "; "Postoperative pain"

Angiotensin Receptor Antagonist-Neprilysin Inhibitor (ARNI) therapy as a new hope in the population of people with heart failure with reduced ejection fraction (HFrEF)

Introduction: Heart failure affects an estimated 23 million people, as many as 50% of whom suffer from a heart failure with reduced ejection fraction (HFrEF), in which the left ventricle ejection fraction is <40% and is accompanied by clinical symptoms. Given the high mortality rate in this group of patients and the continuous suboptimal control of the condition, novel pharmacotherapy regimens are needed to slow the progression of the disease. Preliminary studies report a positive effect of including an angiotensin receptor antagonist and neprilysin inhibitors (ARNIs) in this group of patients. Aim of the study: The aim of the study was to summarize the benefits of ARNI in a group of patients with HFrEF. Methods and materials: This article is based on the literature found in PubMed Database with use of keywords such as “ARNI”, “neprilysin inhibition”, HFrEF”, “heart failure” Results: The benefits of ARNI therapy in patients with HFrEF originate from reversing myocardial remodeling and increasing left ventricular ejection fraction. ARNI therapy is associated with reduced number of hospitalizations and a lower need for intensive treatment. In addition, ARNI use reduces the risk of cardiovascular death and is responsible for lower overall mortality rate compared to pharmacotherapy with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor antagonists (ARBs). Conclusion: ARNIs in patients with HFrEF have a positive effect on the rate of cardiovascular hospitalization, as well as reducing cardiovascular-related mortality and total mortality. Future research studies should evaluate the predictive factors of response to treatment with this group of drugs using larger groups of patients

Inositol supplementation - known and possible applications

Introduction: Myo-inositol (MYO) and D-chiro-inositol are chemical compounds known to exert an impact on multiple signaling pathways of a human body. Due to its effects on insulin metabolism and ovaries’ hormone activity their use in polycystic ovary syndrome (PCOS) therapies has been highly recommended in the recent literature. In this article we aim to review the known and possible applications of inositol and its derivatives for treatment of various gynecological and endocrine disorders and to indicate possible directions of further investigations. Methods and materials: This article is based on the literature found in PubMed Database from the period of 2016-2022 with use of keywords such as “inositol”; “myoinositol”; “d-chiro-inositol”; “PCOS”; “insulin”. Results: The applications of myoinositol in the treatment of polycystic ovary syndrome (PCOS) are very well known in recent publications. It is reported that MYO supplementation improves the quality of oocytes, regulates the menstrual cycle and ovulation rates. Prevention of gestational diabetes (GDM) amongst the patients with risk factors is likely another use of inositols. Inositol takes part in phospholipase C pathway, thus its depletion may be the cause for hypothyroidism. Inositol inhibits the expression of aromatase, the enzyme which is responsible for the growth of endometrial tissue - it may constitute a targeting point in the treatment of endometriosis. So far, no adverse effects of inositol isomers have been reported. Conclusion: The use of inositol, its isomers and derivatives represents an interesting direction in the development of the treatment of many conditions associated with endocrine disorders. There is a need for further investigations and studies on larger groups of patients to exploit its potential.

How to restore your voice? - rehabilitation methods after laryngectomy

Introduction: The voice is an unique communication tool, characteristic of each person alone. Lacking the ability to communicate through it, can negatively affect mental health. It turns out that voice and speech rehabilitation after surgery is widely used and allows patients to improve their functioning, giving them a chance to live a normal life.Aim of the study: The purpose of the study was to review the knowledge of voice and speech rehabilitation options for patients after laryngectomy and the results of the methods used. The text is intended to educate professionals and patients who are undergoing surgical treatment and experience concerns about their future functioning.Materials and Methods: Scientific articles were reviewed using the PubMed database using the keywords: voice rehabilitation; total laryngectomy; speech disorders.State of the art: Prevalent methods of voice and speech rehabilitation in patients after total laryngectomy include the teaching of esophageal speech, tracheoesophageal speech and the use of an artificial larynx. Of these, esophageal speech appears to be the least effective method. Under certain circumstances, an artificial larynx may be the optimal choice among certain groups of patients. Numerous studies cited prove tracheoesophageal speech to achieve the best results measurable by commonly used indicators. Summary: Total laryngectomy is not a sentence for patients. Effective rehabilitation significantly improves the quality of life and communication. It is difficult to unequivocally indicate which method of voice and speech rehabilitation is most beneficial for patients - the choice should be tailored to the individual and its preferences and chances. In his work, the specialist should seek a compromise between obtaining the best acoustic results and acceptance of the method by the patient

Bupropion - an antidepressant drug with broad therapeutic potential

Introduction: Bupropion is currently mainly used as an atypical antidepressant due to its psychotropic effects. In addition, it shows high potential in reducing withdrawal cravings in addicts, which is also used in the treatment of nicotinism. However, studies in recent years have shown that it may also be useful in other conditions.Aim of the study: Our aim was to review the known usage of bupropion in the fields of psychiatry, neurology and internal medicine, and to identify potential directions for further research. Methods and materials: We reviewed the literature available in the PubMed database, using the key words: "bupropion"; "depression"; "smoking cessation"; "obesity"; "ADHD".Results: Bupropion- an antidepressant drug belonging to the group of selective norepinephrine and dopamine reuptake inhibitors. Bupropion is approved by the FDA(Food and Drug Administration) for the treatment of depression, seasonal affective disorder and nicotinism. The literature shows that it is also effective in off-label indications - treatment of antidepressant-induced sexual dysfunction, attention deficit hyperactivity disorder (ADHD), depression in bipolar disorder, obesity, neuropathic pain and cancer-related fatigue syndrome.Conclusion: Due to the specific effects of bupropion, there are many more usage for the drug than the primary indications for which it is usually used. The usage of the drug described in the literature require additional studies on a larger group of patients

Von Meyenburg complexes in a patient with chronic gastritis - a case report

Introduction: Bile ducts hamartoma (von Meyenburg complexes) is a common but unknown pathology of the liver. It can lead to the widening of the bile ducts. It is usually detected incidentally in asymptomatic patients. There are indications of transformation into bile duct cancer or hepatocellular carcinoma.Aim of the study: The aim of the study is to draw attention to a little known, but common pathology - von Meyenburg complexes and to sensitize medical professionals to the implications it may cause during the diagnostic process.Material and methods: We conducted a case study. The research material was the patient's medical history.Case report: A 60-year-old man came to the Gastrology Clinic due to chronic epigastric pain and tenderness in the navel area. Colonoscopy ruled out pathology in the large intestine. After six months, the pain worsened. The result of the gastroscopy allowed the diagnosis of chronic gastritis, which was probably the cause of the problem. The abdominal ultrasound showed a suspicion of renal cell carcinoma of the right kidney, but the neoplastic process was excluded on the basis of the abdominal computed tomography. In the same study, for the first time, numerous minor hypodense lesions in the liver were detected. The final diagnosis was made on the basis of magnetic resonance cholangiography, where the disseminated, T2 hyperintense cystic areas were described. This suggested a biliary scythe.Conclusions: Despite the asymptomatic occurrence of biliary hamartoma, it is important to remember about the possible transformation into a malignant neoplasm. It should be considered in the differential diagnosis of disseminated liver lesions. Patients should be treated symptomatically

Diagnosis and treatment of mental disorders – a review of the scientific literature

Introduction: Unambiguous definition of mental disorders is difficult, mainly because of          the heterogeneity of this group of diseases and the clarity of the line between pathology and normal. The definition proposed by the World Health Organization (WHO) is widely accepted.                   In practice, definitions from the legislation of a country are also important. Aim of the work: The purpose of this study is to discuss the basic issues of diagnosis                    and treatment of mental disorders. Material and method: A method of non-systematic literature review from databases such           as scientific Google Scholar, PubMed, CinalHl, Scopus, Arianta, Web of Science was used. Results and conclusions: In the treatment of mental disorders, I use pharmacological and        non-pharmacological methods. Psychopharmaceuticals are divided into several groups depending on their mechanism of action. Their selection depends mainly on the diagnosed disease entity and tolerance to treatment. The most widely used group of drugs is the group of non-selective serotonin reuptake inhibitors (SSRIs). Non-pharmacological methods include psychotherapy, electroconvulsive therapy, deep brain stimulation, and psychosurgery

Ormond's disease - the current state of knowledge about diagnosis and treatment

Introduction: Retroperitoneal fibrosis (Ormond's disease; RPF) is a rare condition characterized by chronic inflammation and resulting progressive fibrosis of the retroperitoneal space. Due to its low prevalence and uncharacteristic symptoms, it is often overlooked in the diagnostic process, resulting in a late-stage diagnosis when complications are already present and treatment options are limited. The aim of the study: The purpose of our study was to present, based on the available literature, the latest reports on the diagnosis and treatment of Ormond disease. State of knowledge: The diagnosis of RPF is based on an anamnesis and imaging. Sometimes a surgical biopsy of the fibrous tissue is necessary. The pathogenesis remains partly unclear. There is no characteristic laboratory marker for early diagnosis of the disease. It is important to distinguish the primary form from the secondary form, in which the trigger factors are known. In therapy, steroid therapy is still the standard. Attempts are being made to treat with other immunosuppressants and biologic drugs with good results, which speaks to the autoimmune basis of the disease. In some cases, surgical treatment and removal of fibrous tissue compressing abdominal structures is essential. Summary: Although the state of knowledge about retroperitoneal fibrosis has been greatly expanded in recent years, many questions remain to be clarified, especially about its pathogenesis and possible early clinical clues to facilitate diagnosis

Health effects of UV nail lamps - is there a risk of cancer?

Introduction:  Every year, more and more people are using manicure and pedicure services performed with UV lamps. As public awareness of the harmfulness of prolonged exposure to UV light increases, there are doubts about the safety of frequent treatments using it. Aim of the study:  The aim of the study was to find out whether regular use of UV nail lamps is safe and to educate patients about the prevention of potential cancer.  Methods and materials:  A literature review was performed in the PubMed database using the keywords: UV; nail lamp; skin cancer; risk. Resulsts:  Certain clinical cases indicate that long-term, regular exposure to UVA radiation from nail lamps can increase the risk of squamous cell carcinoma of the skin and actinic keratosis, but other risk factors may overlap. According to a statement by the U.S. Food and Drug Administration (FDA), the use of these devices is safe. Thus, the results of the studies appear to be inconclusive. Both the researchers who prove the safety of lamp use and those who question it unanimously recommend the use of prophylaxis and educating patients about it. Conclusions:  The use of UV nail lamps is not associated with significant risks. Single clinical cases describing the development of squamous cell carcinoma of the skin and actinic keratosis appear to be anecdotal. As the low probability of cancer formation is still taken into account, it is worth taking the recommended precautions: using creams with a broad-spectrum UV filter 20 minutes before exposure or manicure gloves. Using LED nail lamps instead of classic UV lamps will also be beneficial. The topic is a developing one and will require more research attention

Osteoarthritis of the knee - a condemnation of a prosthesis for a young person? ATLAS Knee System as an effective method of relieving the medial compartment of the knee

Introduction: Osteoarthritis of the knee is one of the more common causes of disability in the elderly. In the United States, one in four adults suffers from the condition, half of whom are under the age of 65. The most commonly affected joint is the knee. A significant proportion of people in the 35-65 age range have degeneration in one compartment of the knee joint. Among the younger population, when non-operative methods are already failing and it is too early for surgery, there is a place for the ATLAS Knee System. Aim of the study:  The purpose of our work is to present a new and innovative form of treatment for single-compartment osteoarthritis of the knee. Based on the available literature, to show the advantages, disadvantages and results of treatment with the ATLAS Knee System. Methods and materials: A literature review was conducted in the PubMed database, using the keywords: "Atlas Knee System"; "osteoarthritis"; "knee osteoarthritis". Results: The ATLAS system is built with an absorber that, as the knee is stretched, absorbs the forces acting on the medial compartment, while not putting stress on the rest of the knee joint. After patients use the implant, a significant reduction in pain and improvement in knee function is observed. Conclusion: Osteoarthritis is a significant health problem increasingly prevalent even among the younger population. The ATLAS system provides an alternative for younger people in whom conservative treatment has failed, while more invasive methods such as osteotomies and total or single-unit prosthetics are impossible or rejected by the patient. More studies are needed, on a larger number of people to accurately evaluate this system