COVID-19 - postinfectious hypercoagulable state as a probable cause of basilar artery occlusion - Case Report

Covid-19 can manifest with serious neurological complications and hypercoagulability. Latest data from China showed neurological complications in 36% of 214 COVID-19 patients- mainly ischemic stroke. Coagulopathy associated with Covid-19 was reported to increase the risk of stroke also in young adults without comorbidities. A 29-year-old patient with hypertension admitted to the hospital with dysarthric speech and balance disorders and dizziness with vomiting was referred for thrombectomy of an occluded basilar artery after ineffective RTPA therapy. After the thrombectomy, a gradual reduction in the neurological deficit was observed-the permeability of the basilar artery was restored. However, during the intervention, the posterior right cerebral artery was damaged and a short-term extravasation of the contrast blood to the subarachnoid space occurred. MRI showed minor multifocal ischemic changes in the area of the cerebellum, pons and cerebral peduncle. In the pre-hospital interview a week earlier, transient changes in smell and taste were noted. On the day of admission, the patient had a negative antigen and PCR tests for SARS-CoV-2- virus. Laboratory tests showed high D-Dimers (5696 H ng /ml) and reduced fibrinogen. After mechanical thrombectomy, the patient reported double vision when looking straight and left. He was correctly oriented with slight ataxia and a deficit of strength in the left limbs, meningeal symptoms were negative. It is important to understand the association between Covid 19 and the possibility of an ischemic stroke and coagulation changes in order to choose appropriate stroke treatment methods

Case report - sulfonylurea poisoning mimicking vertebrobasilar acute ischemic stroke

Background: We report the case of sulfonylurea induced hypoglycemia manifesting as acute encephalopathy with focal neurological signs misdiagnosed as posterior circulation acute ischemic stroke (AIS) and discuss the potential effects of hypoglycemia on central nervous system, as well as its differentiation from AIS. Case presentation: A 64-year-old patient with type II diabetes treated with glimepiride was transferred to the Department of Neurology after the procedure of radical prostatectomy. On admission, the patient was unconscious with four limb paresis and bilateral Babinski sign. Non-contrast head CT and CT angiography vessels did not reveal any abnormalities. Due to exceeded therapeutic window the patient was disqualified from intravenous thrombolysis. At the admission hypoglycemia was observed and promptly corrected with the 5% dextrose infusion. For the next 72 hours repeated intravenous glucose infusions were needed to maintain its levels above 70 mg/dl. Based on the absence of ischemic changes on MRI and repeated decreases in glucose level for the next 3 days, glimepiride induced hypoglycemic encephalopathy was diagnosed. Within 24 hours of admission the patient regained consciousness and eventually presented four-limb paresis as a result of prolonged neuroglycopenia. Conclusions: Prolonged insufficient brain nutrition can result in permanent or long-lasting brain damage, manifesting as impaired consciousness and focal neurological signs. Perioperative sulfonylureas intake may result in prolonged hypoglycemia

Physicians' Perspectives on Vaccinations

Protective vaccinations are crucial for preventing infectious diseases and their complications, offering a high safety profile and minimal adverse effects. However, vaccine hesitancy has emerged as a public health concern, leading to outbreaks of communicable diseases. This study aims to investigate the attitudes towards vaccinations among doctors and nurses, as well as their knowledge level and vaccination frequency. The research employed a cross-sectional design and collected data using an anonymous questionnaire. The study was conducted in southern Poland, involving Primary Healthcare Centers and hospitals. A total of 878 paper surveys were collected among 542 doctors and 336 nurses

Impact of COVID-19 outbreak on the mental health in sport and among society

The COVID-19 pandemic has had a significant impact on global mental health, affecting individuals of all age groups and various demographic backgrounds including athletes. Anxiety disorders have become more prevalent during the pandemic, attributed to factors such as quarantine, social isolation, fear of the virus, job insecurity, and the psychological impact of a pandemic. This narrative review aims to summarize the existing literature addressing mental health issues related to the COVID-19 pandemic, as well as the associated risk factors and potential interventions. Additionally, the review explores the impact of COVID-19 on specific populations, including athletes, frontline healthcare workers, children and adolescents, and individuals with pre-existing mental health conditions. In addition, the review explores the long-term consequences of the pandemic on mental health, including the potential for a surge in post-traumatic stress disorder (PTSD) and other trauma-related disorders. Overall, this review underscores the urgent need for comprehensive mental health support and resources in response to the COVID-19 pandemic

Physical Activity in Patients with IBD - Challenge, Opportunity, or Both?

Introduction: Inflammatory bowel diseases (IBD) are a global public health problem, and their incidence is continuously increasing. IBD is characterized by a relapsing nature and is associated with symptoms such as abdominal pain, diarrhoea, malabsorption, and nutritional deficiencies. Patients affected by this disease are typically young individuals, and physical activity plays a significant role in this age group. Understanding the role of exercise and sports activities in individuals with IBD can help consider potential therapeutic interventions for these patients. Objective: The aim of this study is to summarize the knowledge regarding the role of physical activity in patients with IBD. Materials and methods: A literature review was conducted using the PubMed and Google Scholar databases, using the following keywords: IBD, physical activity, stress and fatigue in individuals with IBD, anxiety in patients with IBD. State of knowledge: The role of physical activity in promoting health and preventing various diseases is well-established. However, there is limited research on the association between exercise and IBD. Conclusions: Physical activity, by reducing fatigue and stress, has a positive impact on the functioning of patients with IBD. There are reports suggesting a reduction in gastroenterological symptoms in patients after engaging in exercise. With appropriate control of the underlying disease using pharmacological and other recommended methods, participating in sports activities does not pose a barrier for patients. Physicians should encourage patients to engage in exercise with tailored intensity due to its beneficial effects on various aspects of life for individuals with IBD. Further research is necessary to explore this topic more extensively

Inositol and herbal substances as elements of complementary therapy in patients with PCOS

Introduction: Polycystic ovary syndrome is a common hormonal disorder in women and the leading cause of female infertility. Traditional therapeutic methods often do not yield the expected results, hence the need to explore new treatment strategies. Promising results have been observed in studies on inositol. Objective: The aim of this study is to summarize the current knowledge regarding the effectiveness and safety of inositol and herbal preparations in the treatment of PCOS based on available scientific literature. Materials and Methods: A literature review was conducted using PubMed and Google Scholar databases, using search terms: inositol, PCOS treatment, herbal medicine in PCOS. Current knowledge: Inositol is an oral supplement used in the therapy of PCOS. It is characterised by high safety and minimal risk of side effects. Herbal extracts alleviate symptoms in patients with PCOS. Conclusions: Analysis of scientific research has provided evidence of the effectiveness of inositol, particularly myo-inositol, in complementary therapy for PCOS. Herbal medicine also appears to be an effective supportive treatment. However, these substances should not be considered as primary therapy but rather as an adjunct. Only both - primary medications and complementary treatment methods, can yield a therapeutic effect

Analysis of the relationship between serum sodium concentration and laboratory parameters in diabetic patients

Introduction: Diabetes is a chronic civilization disease that is associated with numerous complications and disturbances in laboratory parameters. One of the observed changes in laboratory studies of individuals suffering from diabetes is a significantly low level of sodium. Aim of study: The aim of study was to compare natremia with selected blood parameters determined on admission to hospital, and then to find correlation, if any, between those parameters. Materials and methods: We retrospectively reviewed the medical records of 169 patients with diagnosed type 2 diabetes and the average age of 72.43±11.62 years. We tested the correlation between natremia and: total, LDL and HDL cholesterol; creatinine; potassium; calcium; eGFRCKD-EPI and alanine aminotransferase levels in the patients. Statistical analysis was run on STATISTICA 13. The nonparametric Mann-Whitney, Spearmans’ rank correlation and the Shapiro-Wilk tests were used to analyse factors affecting laboratory test results for the patients, perform correlation analyses and check the conformity with normal distribution, respectively. Research results: A positive correlation was revealed between LDL level and natremia (p = 0.023), as well as between natremia and chloride ion concentration (p < 0.001) in the patients’ blood. No correlation was found between natremia and sex, age, eGFRCKD-EPI, alanine aminotransferase, HDL cholesterol, triglycerides, creatinine, as well as calcium and potassium concentrations. Conclusions: Statistically significant correlations were found exclusively between LDL level and natremia, and between chloride and sodium concentrations. High LDL level was correlated with high natremia, which requires further research due to the scant literature. The sodium, potassium and chloride concentrations are known to be interconnected by the need to ensure the electrolyte balance, as seen in the Gamble diagram. The remaining parameters were not statistically significant

Coexistence of Slipped Capital Femoral Epiphysis and multiple endocrine neoplasia type 2B (MEN2B) - a case report

Introduction: MEN 2B syndrome is distinguished by the occurrence of medullary thyroid cancer, pheochromocytoma, mucosal neuromas, marfanoid features, and skeletal anomalies, including kyphoscoliosis, joint laxity, pes cavus, and, in a smaller number of cases, slipped capital femoral epiphysis (SCFE). Case report: We describe a case report of a 15-years-old patient with the diagnosis of the MEN2B syndrome with a rare manifestation of Slipped Capital Femoral Epiphysis (SCFE). A 15-year-old female presented to the orthopedics out-patient department (OPD) with complaints of pain around the right hip and knee and walking with a limp for approximately four months. Additionally, the feeling of enlarged thyroid gland was reported. X-ray confirmed the presence of the SCFE, while thyroid biopsy revealed the presence of  medullary thyroid cancer (MTC). Thus, the diagnosis of MEN2B was made. Conclusion: Slipped capital femoral epiphysis (SCFE) can occasionally be a manifestation of MEN 2B syndrome. It is important for physicians to be aware of this association, as it can contribute to the early detection of a potentially life-threatening condition

Case report - sulfonylurea poisoning mimicking vertebrobasilar acute ischemic stroke

Background: We report the case of sulfonylurea induced hypoglycemia manifesting as acute encephalopathy with focal neurological signs misdiagnosed as posterior circulation acute ischemic stroke (AIS) and discuss the potential effects of hypoglycemia on central nervous system, as well as its differentiation from AIS. Case presentation: A 64-year-old patient with type II diabetes treated with glimepiride was transferred to the Department of Neurology after the procedure of radical prostatectomy. On admission, the patient was unconscious with four limb paresis and bilateral Babinski sign. Non-contrast head CT and CT angiography vessels did not reveal any abnormalities. Due to exceeded therapeutic window the patient was disqualified from intravenous thrombolysis. At the admission hypoglycemia was observed and promptly corrected with the 5% dextrose infusion. For the next 72 hours repeated intravenous glucose infusions were needed to maintain its levels above 70 mg/dl. Based on the absence of ischemic changes on MRI and repeated decreases in glucose level for the next 3 days, glimepiride induced hypoglycemic encephalopathy was diagnosed. Within 24 hours of admission the patient regained consciousness and eventually presented four-limb paresis as a result of prolonged neuroglycopenia. Conclusions: Prolonged insufficient brain nutrition can result in permanent or long-lasting brain damage, manifesting as impaired consciousness and focal neurological signs. Perioperative sulfonylureas intake may result in prolonged hypoglycemia

Congenital Pseudarthrosis of the Clavicle Joint and its impact on sports participation – Description of 2 Cases: diagnosis and treatment

Congenital Pseudarthrosis of the Clavicle (CPC) is a rare condition stemming fromincomplete clavicular ossification nuclei fusion. Our work discusses CPC’s history, etiology,clinical features, and methods of therapy. We especially emphasize athletes affected by this condition. Here we presents two clinical cases, treatmentapproaches and outcomes. CPC’s distinct presentation, often painless, with central claviculardiscontinuity and swelling, allows to differentiate it from other conditions. However, in sport athletes, due to the significant physical exertion involved, symptoms can manifest. Accuratediagnosis is crucial for effective management