The influence of nutrition on the development of the child's intestinal microflora

Mikrobiota jelitowa, zwana również mikroflorą jelitową lub inaczej florą jelitową, to grupa mikroorganizmów (mikrobiomu), głównie bakterii, które tworzą złożony ekosystem w układzie pokarmowym. U człowieka jest jednym z elementów jego bioty fizjologicznej [1]. Poród jest ważnym etapem kolonizacji układu pokarmowego człowieka przez mikrobiotę. Forma karmienia odgrywa również ważną rolę w kolonizacji jelit noworodka i niemowlęcia [2]. Mleko matki ma wiele zalet. Karmienie piersią odgrywa ważną rolę w kształtowaniu mikroflory jelitowej dziecka. Mleko matki zawiera prozdrowotne bakterie, które wspomagają pierwotną kolonizację jelit noworodka. Dieta ma istotny wpływ na kształtowanie się mikroflory jelitowej. Dlatego ważne jest, aby kobieta nie tylko podczas całej ciąży, ale także przed ciążą dbała o zróżnicowaną, zbilansowaną i bogatą w prebiotyki dietę [3]

The solution to drug resistance of Gram-negative bacteria – Cefiderocol

Introduction: A major public health problem is the emergence of anti-gram-negative antimicrobial resistance worldwide. Cefiderocol is a new agent targeting Gram-negative bacteria, including strains with resistance to carbapenems. Aim of the study: Analysis of the efficiency of cefiderocol in the treatment of infections caused by gram-negative bacteria, the drug's mechanism of action and pharmacokinetics and pharmacodynamics of the drug. Material and Methods: Search of the PubMed database using the following keywords: cefiderocol, resistance, gram negative bacteria. Only full-length articles were taken into consideration. Results: The studies show that cefiderocol is active against Enterobacteriaceae, P. aeruginosa, B. cepacia and A. baumannii and effective in the treatment of pneumonia in both non-ventilated and ventilated patients. Moreover, it has been used in the treatment of sepsis as a rescue therapy. Conclusion: Cefiderocol is an effective treatment for infections caused by gram-negative bacteria. However, more research is needed to learn more about the use of this drug, side effects and resistance mechanisms

Iron deficiency anemia in pregnancy: evaluation and management

Anemia is a condition in which the number of red blood cells (RBC) is insufficient to meet the body's physiological needs for oxygen transport. A limiting factor for the erythrocyte mass increase is iron deficiency, which can also have a negative impact on the pregnancy's prognosis. The most frequent pathogenic cause of anemia in pregnancy is iron deficiency anemia (IDA). Biochemical tests such as serum iron concentration, total iron binding capacity (TIBC), transferrin concentration, and ferritin concentration are decreased in iron deficiency anemia. In clinical practice, iron deficiency is defined as low serum ferritin or a decreased percentage of transferrin saturation by iron. Usually, the diagnosis begins with the determination of serum ferritin. Although iron supplementation for iron deficiency is advised as soon as the condition has been diagnosed, prophylactic iron delivery is still under discussion. In patients for whom oral iron is ineffective or contraindicated, intravenous iron can be used to restore lost iron

Pregnancy-induced rhinitis: nose problems at the obstetrician's office

Introduction and purpose Pregnancy-induced rhinitis (PIR) manifests as nasal congestion, with resolution of symptoms after delivery. Pregnancy-induced rhinitis is a distinct condition from allergic rhinitis, it may not respond to treatment for allergic rhinitis. The first stage in providing adequate and effective management of PIR is to have a clear and appropriate diagnosis. Therefore, each patient-specific management of PIR must take careful consideration of a variety of circumstances. The aim of this study was to conduct a literature review on pregnancy-induced rhinitis. A literature review was carried out in the PubMed, MEDLINE, and Scopus databases using the terms ‘rhinitis and pregnancy’. Brief description of the state of knowledge Physiological factors underlying PIR are not well understood at the moment. There is no single explanation for the pathophysiological mechanism that would account for the changes in PIR. Nasal congestion is the primary nasal symptom in pregnancy-induced rhinitis. It can result in night-time mouth breathing and poor sleep quality. The mother's sleep may be negatively impacted by nasal congestion resulting in maternal hypertension, pre-eclampsia, and intrauterine growth retardation. Increasing awareness not only benefits pregnant patients' quality of life but also has a favourable impact on how a pregnancy turns out. Summary PIR has gained relevance in recent years due to its major effects on maternal quality of life as well as the identification of a relationship with OSAS in the mother and potential harmful consequences on the foetus. The mother's quality of life is significantly impacted by PIR, as shown, thus both the otorhinolaryngologist and the obstetrician must use caution in the early identification and treatment of pregnancy-induced rhinitis

The solution to drug resistance of Gram-negative bacteria – Cefiderocol

Introduction: A major public health problem is the emergence of anti-gram-negative antimicrobial resistance worldwide. Cefiderocol is a new agent targeting Gram-negative bacteria, including strains with resistance to carbapenems. Aim of the study: Analysis of the efficiency of cefiderocol in the treatment of infections caused by gram-negative bacteria, the drug's mechanism of action and pharmacokinetics and pharmacodynamics of the drug. Material and Methods: Search of the PubMed database using the following keywords: cefiderocol, resistance, gram negative bacteria. Only full-length articles were taken into consideration. Results: The studies show that cefiderocol is active against Enterobacteriaceae, P. aeruginosa, B. cepacia and A. baumannii and effective in the treatment of pneumonia in both non-ventilated and ventilated patients. Moreover, it has been used in the treatment of sepsis as a rescue therapy. Conclusion: Cefiderocol is an effective treatment for infections caused by gram-negative bacteria. However, more research is needed to learn more about the use of this drug, side effects and resistance mechanisms

Potential anti-cancer features of metformin

INTRODUCTION AND PURPOSE: Metformin is one of the most frequently prescribed medications in the whole world. This lipophilic biguanide is widely used as a first-line medicine for patients suffering from type 2 diabetes mellitus because of its high effectiveness in monotherapy, and in connection with other antidiabetic drugs. Glucose-lowering properties of metformin were initially used only in the therapy of type 2 diabetes mellitus, but some data indicate that these properties might state an alternative in the prevention or treatment of some cancers both among diabetic and non-diabetic patients. STATE OF KNOWLEDGE: Metformin molecular mechanisms of action were thoroughly investigated, differentiated, and described, but in the context of the glucose-lowering effect. As a multiway drug, used mainly in diseases characterized by an increased level of glucose in the blood, numerous medical trials were conducted to find other treating properties of metformin. Recently, a few reports presented the potential connection between using metformin in the prevention and treatment of neoplasms in the same mechanisms. The scientists analyzed the influence of metformin’s action on various cancers and drew conclusions. The research on potential anti-cancer features of metformin was conducted for a relatively short period and still presents a challenge to scientists. CONCLUSIONS: The aim of this review is to gather current knowledge and present the latest discoveries about potential anti-cancer features of metformin. We discuss the potential underlying molecular mechanisms of metformin’s action in the human body and indicate the connection between the prevention and treatment of neoplasms. Additionally, we point out the exact cancers in which metformin might play a significant role

Hypothermia as a treatment option for hypoxic-ischemic encephalopathy in newborns – A literature review

Introduction and purpose: Neonatal asphyxia is a medical condition in which the neonate is not able to maintain sufficient respiratory function. The hypoxia may be caused by either an impaired respiratory activity of the neonate or an interruption of blood flow to the placenta in the period immediately before or during delivery, which resulted in inadequate oxygen perfusion to vital organs. Description of the state of knowledge: Hypoxic-ischaemic encephalopathy (HIE) is a form of perinatal hypoxia, occurring in newborns after the 35th week of gestation and presenting along with neurological disorders. In fact, it is a major cause of death and infant disability. The incidence of HIE is approximately 2-5 per 1000 live births. The standard recommended treatment for perinatal hypoxic-ischaemic encephalopathy is therapeutic hypothermia. There are two methods used: selective head cooling with moderate whole-body hypothermia (SHC) and whole-body hypothermia (WBC). In both cases, metabolism and neural tissue destruction are slowed down. Conclusions: Therapeutic hypothermia is a promising treatment option for neonatal encephalopathy. Thus, it decreases the risk of death and neurological deficits in the form of cerebral palsy, epilepsy and psychomotor retardation. Whole-body hypothermia appears to be a more successful method than selective head cooling, however more research is still needed. &nbsp

Celiac disease - a review on recent advances in characteristics, diagnostic and treatments

Introduction and purpose: Celiac disease occurs in 1% of the general population. However, many cases remain unrecognized. The disease is a chronic immune-mediated disorder triggered by the ingestion of gluten that appears in individuals with genetic susceptibility. Celiac disease can develop in paediatric patients as well as adults. The purpose of this review is to analyze the newest information on the characteristics, diagnosis and treatment of patients with celiac disease.  Material and methods: This review was based on available data collected in the PubMed database and published between 2015 and 2022. The research was done by looking through keywords such as: “celiac disease”, “Gluten-Free Diet”, “diagnosis” and “treatment”. Results: The diagnosis of celiac disease is most often delayed due to the broad spectrum of presentations. Screening of at-risk individuals is important to progress the diagnosis. It is additionally crucial to raise clinicians' attention to non-specific parenteral symptoms that may indicate celiac disease. The majority of the symptoms arise from nutritional deficiencies caused by intestinal malabsorption. According to scientific reports, the most common deficiencies of people with celiac disease are iron, folic acid, vitamin B12, fat-soluble vitamins and a calcium. Conclusions: Recent years have seen the emergence of research into new therapeutic options, but their efficacy and safety still need to be evaluated more thoroughly. Strict adherence to a gluten-free diet by patients is still the only treatment option at present. Celiac disease, due to the constant increase in knowledge about its pathogenesis, diagnosis and treatment is an important material for further research

Cardiometabolic consequences of PCOS

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder in terms of clinical symptoms and laboratory findings. It is one of the most common endocrinopathies in women of childbearing age. The development of symptoms and the degree of severity in the course of the disease are the results of changes in the ovaries which may be caused by many genetic, metabolic, neuroendocrine, and environmental factors. The main clinical manifestations are menstrual disorders, difficulties with becoming pregnant, and changes related to hyperandrogenism, e.g., acne, hirsutism. Recognition is above mainly based on Rotterdam criteria.A comprehensive explanation of pathophysiology is still lacking. Nevertheless, it probably is a multifactorial condition with a genetic component. Women suffering from PCOS experience lipid and carbohydrate metabolism disorders, which lead to insulin resistance, obesity, hypertension, and cardiac complications. Insulin resistance affects 65-70% of women and not only plays a significant role in the development of the disease but also contributes to the development of hypertension and dyslipidemia. Potential mechanisms of hypertension in PCOS include endothelial dysfunction, increased aldosterone, and excess testosterone secretion, whereas lipid abnormalities consist of reduced high-density lipoprotein-cholesterol (HDL-C), increased triglycerides, and low-density lipoprotein-cholesterol (LDL-C). All of these factors cause high cardiovascular risk. Currently, therapy considers both lifestyle improvements and medications and must be tailored on a case-by-case basis.  It is very important not to consider PCOS only in the context of gynecological and endocrine diseases, but also metabolic changes and cardiovascular diseases. Treatment of PCOS should be individualized and dependent on the predominant disorders, as well as the short- and long-term goals chosen. It also should take the prevention of cardiovascular diseases into account

Futile therapy in the conditions of the Covid-19 pandemic

Futile therapy is the prolonged maintenance of organ function. This process in this case does not bring therapeutic benefits, and its task is to maintain the failed organs. The article aims to present the differences between influenza and Covid-19 and to draw attention to the problem of the futility of therapy in the context of a pandemic