Causes of hoarseness - systematic review

Introduction and purpose of the work: Hoarseness is a symptom of a disease characterized by a hoarse, tense or hoarse voice resulting from disturbance of the vibration of the vocal folds. It is a common symptom of the disease in patients during medical consultations in primary health care, and the causes of its occurrence can be varied. State of knowledge (brief description): Treating hoarseness depends on what causes it. For this reason, during the diagnosis, various causes that may be the cause of hoarseness should be taken into account, such as infections, structural changes caused by the use of the voice organ, psychogenic causes, autoimmune diseases, systemic diseases or neoplastic diseases. Summary: In-depth diagnosis and an interdisciplinary approach are necessary to identify the cause of chronic hoarseness and initiate effective treatment

New treatment strategies for bipolar disorder in the elderly

Introduction and objective: The purpose of this paper is to systematically review articles and new research in the context of bipolar geriatric patients. Materials and methods: PubMed searches were completed using the key terms bipolar disorder, bipolar elderly, bipolar depression, bipolar elderly treatment and review articles. In addition, references in these resources were searched. Search dates: 2010 to 2022. Description of the state of knowledge: Mental disorders in the context of the elderly concern all depressive disorders. A problem with other disorders such as bipolar disorder is also increasingly recognized. In the elderly, it is quite rare in the general cross-section of society, but it may have a higher percentage, e.g. in nursing homes and care institutions. This review article shows both the difference and the similarities in the course of this disease in older and younger patients. The most important and common aspect for both age groups is psychotherapy with parallel pharmacological treatment. The greatest difficulty in pharmacotherapy in the elderly is polypharmacy and numerous drug interactions, as well as different pharmacodynamics and pharmacokinetics of the drugs used compared to younger patients. Attention should also be paid to the differentiation of bipolar disorder from different types of dementia and other cognitive disorders. Therefore, one should strive to carefully assess the patient's need for a given treatment, establish appropriate periodic monitoring of treatment, and assess the risk of taking or not intervening. This article also aims to review new research and drugs that seem promising, while the individualized and interdisciplinary approach to a geriatric patient with BD is the most important finding of this review. Summary: Bipolar disorder in older people, compared to the younger population, should be treated pharmacologically in combination with psychotherapy. The elderly patient population requires a multidisciplinary approach due to the number of drugs used in a large number of diseases

Tyrosol and Hydroxytyrosol: Their Role in Cardioprotection

Introduction: Recent research are focused on natural compounds for preventing cardiovascular diseases, with emphasis on tyrosol and hydroxytyrosol in olive oil. Cardiovascular diseases are linked to risk factors, and adopting a Mediterranean diet rich in these compounds is recognized for reducing risks.  Understanding these compounds' actions may inform new strategies for preventing and treating cardiovascular diseases.  Aim: The aim of this paper is a systematic review of articles and research regarding the Role of tyrosol and hydroxytyrosol in Cardioprotection  Review methods: An systematic review of scientific literature was conducted using the following keywords: Tyrosol, hydroxytyrosol, cardioprotection, cardiovascular diseases, olive oil cardioprotective role. Thirty-four articles published until 2023 were searched and analyzed.  Abbreviated description of the state of knowledge: Tyrosol and hydroxytyrosol, prominent in olive oil, are studied for their potential cardioprotective properties. Linked to a Mediterranean diet, these compounds show promise in reducing cardiovascular disease risk. They counter oxidative stress, improve lipid profiles, and modulate inflammatory processes. Clinical studies suggest their positive impact, with tyrosol also explored as a potential anticoagulant. Ongoing research aims to uncover optimal doses and mechanisms, highlighting their significance in cardiovascular health.  Conclusions: Tyrosol and hydroxytyrosol, found in olive oil, show promise in cardioprotection by combating oxidative stress, improving lipid profiles, and modulating inflammation. Clinical studies suggest their positive impact on cardiovascular health. Tyrosol has potential as a anticoagulant and exhibits antioxidant effects. These compounds present a compelling avenue for future therapeutic interventions, with emphasis on understanding mechanisms and optimizing supplementation.

Sub-Perception and Supra-Perception Spinal Cord Stimulation in Chronic Pain Syndrome: A Randomized, Semi-Double-Blind, Crossover, Placebo-Controlled Trial

Background: The introduction of modern sub-perception modalities has improved the efficacy of spinal cord stimulation (SCS) in refractory pain syndromes of the trunk and lower limbs. The objective of this study was to evaluate the effectiveness of low and high frequency SCS among patients with chronic pain. Material and methods: A randomised, semi-double-blind, placebo controlled, four period (4 × 2 weeks) crossover trial was conducted from August 2018 to January 2020. Eighteen patients with SCS due to failed back surgery syndrome and/or complex regional pain syndrome were randomised to four treatment arms without washout periods: (1) low frequency (40-60 Hz), (2) 1 kHz, (3) clustered tonic, and (4) sham SCS (i.e., placebo). The primary outcome was pain scores measured by visual analogue scale (VAS) preoperatively and during subsequent treatment arms. Results: Pain scores (VAS) reported during the preoperative period was M (SD) = 8.13 (0.99). There was a 50% reduction in pain reported in the low frequency tonic treatment group (M (SD) = 4.18 (1.76)), a 37% reduction in the 1 kHz treatment group (M (SD) = 5.17 (1.4)), a 34% reduction in the clustered tonic settings group (M (SD) = 5.27 (1.33)), and a 34% reduction in the sham stimulation group (M (SD) = 5.42 (1.22)). The reduction in pain from the preoperative period to the treatment period was significant in each treatment group (p < 0.001). Overall, these reductions were of comparable magnitude between treatments. However, the modality most preferred by patients was low frequency (55% or 10 patients). Conclusions: The pain-relieving effects of SCS reached significance and were comparable across all modes of stimulation including sham. Sub-perception stimulation was not superior to supra-perception. SCS was characterised by a high degree of placebo effect. No evidence of carryover effect was observed between subsequent treatments. Contemporary neuromodulation procedures should be tailored to the individual preferences of patients