Diabetic peripheral neuropathy - advances in diagnosis and treatment

Diabetes mellitus is one of the most alarming conditions of the 21st century. The prevalence of both type 1 and 2 diabetes is constantly increasing, which also entails a growing number of patients suffering from its various complications. One of the most common chronic complications is diabetic neuropathy (DN), which is developed by at least 50% of patients with diabetes. Diabetic peripheral neuropathy (DPN) is the most frequent type of DN. Clinically, a non-painful and a painful-DPN can be distinguished. The painful type causes a massive decrease in the quality of life and affects around 30% of individuals with DM. In recent years many instruments have been used to diagnose and treat DPN but none of them seems to be sufficient in early diagnosis and satisfactory symptoms management. To date, there is any gold standard to recognize DNP and usually it is noticed when a patient presents symptoms of neuropathy, which is too late to introduce an effective therapy. The main approaches for patients with DNP focus on improving glycaemic control, lifestyle modifications and pain therapy. Multiple medicaments are used for this purpose, among which SNRIs, TCAs and anticonvulsants are most effective. Non-pharmacologic treatment, such as acupuncture, physical therapy, nerve stimulation, also has been used, however their effectiveness remains uncertain. &nbsp

The impact of childbirth on women's sexuality and methods of treating its disorders

Postpartum sexual disorders can significantly impact individuals and their partner relationships, affecting a considerable percentage of women, with reduced libido being the most common symptom. Factors such as breastfeeding, postpartum depression, and communication issues with partners increase the risk of experiencing these disorders. This review aimed to explore scientific reports on the frequency, contributing factors, and treatment options for postpartum sexual disorders. The analysis was conducted by reviewing literature available in PubMed. The mode of delivery (natural or cesarean) does not significantly differ in its impact on postpartum sexual disorders. Non-pharmacological treatments encompass psychotherapy, from which mindfulness-based cognitive is the most effective and physical exercises. Engaging in regular physical exercises contributes to enhanced sexual experiences, notably in terms of sexual arousal and offers other health benefits. Moreover, Kegel exercises have been demonstrated as a method to increase sexual satisfaction. Medications used to treat libido dysfunction include flibanserin, bremelanotide, and bupropion. For women experiencing depression and sexual dysfunction, antidepressants with a lesser impact on sexual function may be considered. Vaginal dryness can be effectively addressed with moisturizing gels, globules, and lubricants. When considering pharmacotherapy, it is essential to evaluate the severity of symptoms, potential side effects for both the woman and her child being breastfed, and psychological discomfort. Physicians play a vital role, as women with sexual disorders may find it challenging to express their concerns. Partner support is crucial in improving a woman's sexual life

Cochlear implants – An Overview. Are CIs world’s most successful sensory prostheses?

Cochlear implants (CIs) have greatly improved over the last 2 decades and now are the world’s most successful sensory prostheses, that restored hearing to more than 800,000 deaf people. CIs are small electronic devices that consists of an external portion that is located behind the ear and a second portion that is surgically fixed under the skin, they replace the function of the inner hair cells in the cochlea by direct electrical stimulation of the auditory nerve. Although cochlear implantation has been used for almost 50 years, the indications for this procedure are subject to constant modifications but the main indication is the inability to achieve sufficient speech understanding. Properly implanted, fitted, and rehabilitated hearing prostheses allow to achieve open speech understanding in 70-80% of post-lingual deafness patients and very good speech development results in children. These days cochlear implantation has become the treatment of choice for people with significant hearing loss and are constantly being developed intensively

Recent advances in the treatment of functional dyspepsia and irritable bowel syndrome

Introduction and purpose: While irritable bowel syndrome (IBS) and functional dyspepsia (FD) are common problems in everyday clinical practice, their treatment often remains inefficient. The aim of our work is to present the newest discoveries and research conducted in the topic, while putting special accents on methods available in Poland. We decided to refer to British Society of Gastroenterology guidelines of treatment of IBS and FD as commonly accepted treatment standards in Europe. Description of the state of knowledge: Number of patients suffering from IBS and FD remains high. According to current research, there are some new therapeutical options in IBS: fecal microbiota transplant, spinal catepsin S, olorinab and tenapanor. Methods already being in use in other applications such as vitamin D supplementation, losartan and fecal microbiota transplant are also being investigated. Fecal microbiota transplant seems the most promising one. There are no new treatment options in FD, however there are new research on already used rifaximin and prokinetics, which show their efficacy. Intensive research is being conducted on the use of herbal medicines in treatment of FD. Even though some papers prove the effectiveness of acupuncture we have decided to omit this topic due to its controversial nature.   Conclusions: Treatment of IBS and FD remains difficult, there are few advances in that area. Unconventional methods such as herbal medicine and fecal microbiota transplant seem to be gaining in importance

Recent advances in the treatment of functional dyspepsia and irritable bowel syndrome

Introduction and purpose: While irritable bowel syndrome (IBS) and functional dyspepsia (FD) are common problems in everyday clinical practice, their treatment often remains inefficient. The aim of our work is to present the newest discoveries and research conducted in the topic, while putting special accents on methods available in Poland. We decided to refer to British Society of Gastroenterology guidelines of treatment of IBS and FD as commonly accepted treatment standards in Europe. Description of the state of knowledge: Number of patients suffering from IBS and FD remains high. According to current research, there are some new therapeutical options in IBS: fecal microbiota transplant, spinal catepsin S, olorinab and tenapanor. Methods already being in use in other applications such as vitamin D supplementation, losartan and fecal microbiota transplant are also being investigated. Fecal microbiota transplant seems the most promising one. There are no new treatment options in FD, however there are new research on already used rifaximin and prokinetics, which show their efficacy. Intensive research is being conducted on the use of herbal medicines in treatment of FD. Even though some papers prove the effectiveness of acupuncture we have decided to omit this topic due to its controversial nature.   Conclusions: Treatment of IBS and FD remains difficult, there are few advances in that area. Unconventional methods such as herbal medicine and fecal microbiota transplant seem to be gaining in importance

Diabetic peripheral neuropathy - advances in diagnosis and treatment

Diabetes mellitus is one of the most alarming conditions of the 21st century. The prevalence of both type 1 and 2 diabetes is constantly increasing, which also entails a growing number of patients suffering from its various complications. One of the most common chronic complications is diabetic neuropathy (DN), which is developed by at least 50% of patients with diabetes. Diabetic peripheral neuropathy (DPN) is the most frequent type of DN. Clinically, a non-painful and a painful-DPN can be distinguished. The painful type causes a massive decrease in the quality of life and affects around 30% of individuals with DM. In recent years many instruments have been used to diagnose and treat DPN but none of them seems to be sufficient in early diagnosis and satisfactory symptoms management. To date, there is any gold standard to recognize DNP and usually it is noticed when a patient presents symptoms of neuropathy, which is too late to introduce an effective therapy. The main approaches for patients with DNP focus on improving glycaemic control, lifestyle modifications and pain therapy. Multiple medicaments are used for this purpose, among which SNRIs, TCAs and anticonvulsants are most effective. Non-pharmacologic treatment, such as acupuncture, physical therapy, nerve stimulation, also has been used, however their effectiveness remains uncertain. 

Cochlear implants – An Overview. Are CIs world’s most successful sensory prostheses?

Cochlear implants (CIs) have greatly improved over the last 2 decades and now are the world’s most successful sensory prostheses, that restored hearing to more than 800,000 deaf people. CIs are small electronic devices that consists of an external portion that is located behind the ear and a second portion that is surgically fixed under the skin, they replace the function of the inner hair cells in the cochlea by direct electrical stimulation of the auditory nerve. Although cochlear implantation has been used for almost 50 years, the indications for this procedure are subject to constant modifications but the main indication is the inability to achieve sufficient speech understanding. Properly implanted, fitted, and rehabilitated hearing prostheses allow to achieve open speech understanding in 70-80% of post-lingual deafness patients and very good speech development results in children. These days cochlear implantation has become the treatment of choice for people with significant hearing loss and are constantly being developed intensively

Prognostic Role of Prolactin-Induced Protein (PIP) in Breast Cancer

Prolactin-inducible protein (PIP), also referred to as gross cystic disease fluid protein 15 (GCDFP-15), has been a trending topic in recent years due to its potential role as a specific marker in breast cancer. PIP binds to aquaporin-5 (AQP5), CD4, actin, fibrinogen, β-tubulin, serum albumin, hydroxyapatite, zinc α2-glycoprotein, and the Fc fragment of IgGs, and the expression of PIP has been demonstrated to be modulated by various cytokines, including IL4/13, IL1, and IL6. PIP gene expression has been extensively studied due to its captivating nature. It is influenced by various factors, with androgens, progesterone, glucocorticosteroids, prolactin, and growth hormone enhancing its expression while estrogens suppress it. The regulatory mechanisms involve important proteins such as STAT5A, STAT5B, Runx2, and androgen receptor, which collaborate to enhance PIP gene transcription and protein production. The expression level of PIP in breast cancer is dependent on the tumor stage and subtype. Higher expression is observed in early-stage tumors of the luminal A subtype, while lower expression is associated with luminal B, basal-like, and triple-negative subtypes, which have a poorer prognosis. PIP expression is also correlated with apocrine differentiation, hormone receptor positivity, and longer metastasis-free survival. PIP plays a role in supporting the immune system’s antitumor response during the early stages of breast cancer development. However, as cancer progresses, the protective role of PIP may become less effective or diminished. In this work, we summarized the clinical significance of the PIP molecule in breast cancer and its potential role as a new candidate for cell-based therapies

Promising uses of probiotic bacteria and prebiotics in the course of COVID-19 - a review of recent studies

COVID-19 is a disease caused by the coronavirus Sars-CoV-2. The most common symptoms are fever, cough and high temperature, which can lead to complications ranging from the widely documented pneumonia to less obvious ones such as intestinal dysfunction. In recent years, there has been a great deal of research into the impact of the gut microbiota on the course of many diseases, including COVID-19. Microbiota play an important role in maintaining general health and immune function. The connection between the gastrointestinal tract and the respiratory system can be both direct, where the oral microbiome colonises the respiratory tract, and indirect, involving the passage of microbiota from the gut into the bloodstream. Susceptibility to SARS-CoV-2 virus infection varies and depends on sanitation standards, immunity, as well as the presence of other medical conditions. There are also reports indicating a positive role for the microbiota in reducing the body's susceptibility to viral infection. Microbiota supports the regulation of the immune response, influences receptor expression, limits viral entry into host cells, and exerts an inhibitory effect on the development of inflammation, which is a risk factor for Covid-19 complications, which can manifest as so-called post covid with respiratory, circulatory and nervous system symptoms. The composition of the microbiota and its changes due to diseases and therapies used correlate with susceptibility to viral infections. Studies show that disruption of the tightness of the intestinal barrier affects the course of many diseases, including the respiratory system. Intestinal microbiota disorders leading to dysbiosis have a negative impact on the prognosis of patients with acute respiratory failure due to viral infections. The aim of this paper is to review PubMed, Scopus and Google Scholar databases of recent studies on the effects of probiotics in the treatment and support of COVID-19. The review presented here discusses the potential for probiotics as agents used in the prevention and support of therapy of viral infection. The principles of quality assurance and safety of the probiotic product are also included