Neuroendocrine tumour metastasis to the orbit

Neuroendocrine neoplasms are tumours that usually arise in the gastrointestinal tract and the bronchopulmonary system. The orbit is a rare anatomical site for their metastases. In the following article we present a case report of a 73-year-old man who was admitted to the Ophthalmology Department because of eye pain and high intraocular pressure in the right eye. There was also eye motility restriction, diplopia, oedema of the eyelid, and subconjunctival haemorrhage. Magnetic resonance imaging revealed a tumour in the right orbit, probably arising from the inferior rectus muscle. The patient was qualified for surgery, during which orbit decompression was conducted and a sample of the tumour tissue was collected. Based on the biopsy of the lesion, diagnosis of a metastatic neuroendocrine neoplasm, probably of gastrointestinal origin, was made. Further diagnostic procedures revealed metastases to other organs, and the patient was qualified for oncological treatment. In this case, orbital metastasis was the first diagnosed location of the neoplasm.

Rosacea – a modern view of diagnostics and treatment

Introduction: Rosacea is a chronic inflammatory skin disease affecting central region of the face. Main symptoms consist of erythema, flushing, telangiectasia, phymatous changes and inflammatory papules and pustules. It can also affect eyes, causing blepharitis, conjunctivitis, keratitis or lid margin telangiectasia. Rosacea can negatively affect the quality of life, causing low self-esteem, avoidance of social interactions and mental health issues such as anxiety and depression. There are two classifications of rosacea, one from 2002 focusing on subtypes, and new phenotype-based classification. Phenotype-based approach allows individual management of each patient instead of categorizing by predefined subtype. Due to increased frequency of Demodex infestation in patients with rosacea, diagnosis and treatment of demodicosis can be helpful in management of rosacea. General treatment of rosacea consists of combination of oral and topical therapies, choosing adequate skincare cosmetics, laser therapies and avoidance of identified trigger factors specific for the patient. The aim of the study: This study aims to gather current knowledge about classification, diagnostics, skincare and treatment of rosacea. Materials and methods: This review was based on available data collected in the PubMed database, using the keywords: ‘rosacea’, ‘ocular rosacea’, ‘rosacea treatment’. Conclusions: The treatment of rosacea requires selection of appropriate treatment depending on symptoms specific for the patient. Because of increased Demodex infestation present in some of the patients with rosacea, eradication can mitigate rosacea symptoms. Identification and avoidance of trigger factors and assortment of adequate skincare products are also substantial parts of management of rosacea and can alleviate rosacea symptoms. &nbsp

How to diagnose, treat and prevent from hospital-acquired and ventilator-associated pneumonia?

Introduction and purpose: hospital-acquired pneumonia and ventilator-associated pneumonia are common risk factors for morbidity and mortality. They are difficult to diagnose and treat due to the large number of factors that may contribute to the deterioration of the clinical condition of critically ill patients. In this article, the authors summarize the diagnosis, treatment and prevention of these diseases based on current guidelines, the latest research and other scientific works. Material and metod: sources available in the PubMed database were analyzed using the following keywords: "pneumonia", "hospital-acquired pneumonia", "ventilator-associated pneumonia", "HAP", "VAP", publications related to the subject of the work were selected and used. Conclusion: A patient with HAP or VAP should undergo non-invasive testing such as blood and sputum cultures and nasal swabs to isolate the pathogen responsible for the infection and to adjust antibiotic therapy. The procalcitonin level can be used in conjunction with the clinical assessment to assess the adjustment of the duration of treatment. Patients with HAP or VAP who are immunocompromised, haemodynamically unstable, or cannot be sampled from the lower respiratory tract for microbiological testing should be treated with empiric antibiotics based on individual risk factors and antibiotic resistance

Major depression disorder - etiology and treatment

Introduction and purpose: The problem of major depression disorder (MDD) affects more and more people. In a few years, it may become the most common disease after cardiovascular diseases and cancer. MDD are manifested by a depressed mood, decreased energy, loss of interest and the ability to enjoy life, as well as a number of other additional symptoms. Untreated MDD can lead to disability. This entails not only consequences for the sick person but also increased social costs. That is why it is so important to know the causes of its formation and to look for new therapeutic methods. State of knowledge: The development of MDD is influenced by genetic factors, inflammatory factors and hormonal disorders, changes in the structure of the brain, disorders in neurotransmission. The microbiome-gut-brain axis affects mood regulation and neurotransmission in the brain. Bacteria such as Escherichia, Shigella, Enterococcus, Streptococccus, Alistipes, Parabacterioides, Veillonella have been identified as having a potential negative effect on the development of MDD and response to treatment. The use of probiotics containing Lactobacillus helveticus R0052, Bifidobacterium longum and Clostridium butyricum MIYAIRI 588 may help reduce the symptoms of MDD. In recent years, the US Food and Drug Administration (FDA) has approved the intranasal preparation of esketamine for the treatment of treatment-resistant depression and major depressive disorder with severe suicidal thoughts. Unlike other antidepressants, it has a quick effect on reducing symptoms. Summary: Due to the global problem of MDD, further research is needed to better understand the mechanisms of its formation. Particular attention should be paid to the influence of microbiota

Pain - ways to determine the intensity and the choice of the appropriate form of treatment

Introduction and purpose of the study: The problem of pain occurs in many patients, and its perception is a subjective aspect. This is a big problem because it negatively affects not only the patient's health but also many aspects of his life: physical activity, social relations, mental and emotional state. Physicians of many specialties face the problem of treatment both in doctor's offices and in hospital rooms. The choice of the appropriate form of therapy can be facilitated by scales and pain assessment questionnaires. This paper presents ways to determine the severity of pain that can be used in contact with both children and the elderly. Proper determination of the degree of pain intensity enables the selection of the appropriate threshold of the analgesic ladder. Materials and methods: The review was based on the analysis of materials collected in the "PubMed" database and WHO guidelines. The work uses the latest scientific works, review articles. The search was carried out using the keywords: "pain management", "analgesic ladder", "pain management scales", "pain management questionnaires", "neuropathic pain", "opioids". Summary: Treatment is a big challenge because each patient feels pain differently, which means that each patient must be approached individually. In order to facilitate and systematize the treatment to some extent and, above all, to choose the best therapeutic method for the patient, pain scales and questionnaires should be used to assess pain intensity and observe the results of the treatment. The variety of methods of imaging the pain intensity scale allows us to choose the most appropriate one for a given patient, depending on his cognitive abilities and age. The choice of treatment method should be based on the analgesic ladder. It is necessary to take into account both the patient's condition, his diseases, treatment and side effects of the introduced treatment

GERD - still current problem of society, diagnosis, practical methods of management and treatment

Introduction and purpose: Gastroesophageal reflux disease (GERD) is a very common digestive disease worldwide. About half of all adults will report symptoms of reflux at some point in their lives. The symptoms of the disease are non-specific, which is why doctors of many specializations face the problem both in doctor's offices and hospital rooms. GERD is a disorder with troublesome symptoms and complications resulting from the regurgitation of gastric contents into the esophagus, causing subjective symptoms and related complications, negatively affecting the quality of life. Symptoms negatively affect the quality of life of patients, lowering well-being, physical activity, and social functioning. Diagnosis is based in most cases on the observation of symptoms, which is why this paper presents the symptoms that should be taken into account when diagnosing patients. Therapeutic procedures, selection of the appropriate form of treatment: conservative, pharmacological and surgical, were discussed.Materials and methods: The review was based on the analysis of materials collected in the "Pubmed" database, books and other scientific articles.Summary: Gastroesophageal reflux disease is an important health problem because it is associated with impaired daily functioning and morbidity. Proper management of GERD symptoms can result in significant improvements in patients' well-being, including reduction in physical pain, increase in vitality, physical and social functioning, and improvement in emotional well-being. In some patients, only lifestyle modification and a change in habits are enough to reduce the occurrence of symptoms. First-line drugs are proton pump inhibitors. Endoscopic examination should be performed when pharmacological therapy is ineffective or in the event of alarm symptoms, i.e. dysphagia, weight loss, anemia, bleeding and recurrent vomiting. Surgical treatment is used as a last resort when pharmacological treatment fails

Cystic Fibrosis - a very common genetic disease among the population - a general review

Cystic fibrosis is the most common genetic disease inherited in an autosomal recessive manner occurring among populations of Caucasian descent. It is an incurable, multi-composition monogenic disease caused by mutations in the gene encoding the CFTR protein, which is a membrane conduction regulator. Mutations of the CFTR gene can cause symptoms from many organs and systems as a result of extracellular secretion disorders, but the main symptoms of this disease are related to the respiratory system and digestive system. Although a lot of changes have occurred in regards to treating the disease and making the lives of sick patients easier and longer, there is still a long way to go. New therapy methods bring a lot hope and get us closer to reaching the ultimate goal of successfully treating all patients with CF. In this review, we summarize the information available about CF for the present moment, diagnostic methods, current methods of treatment and discuss possible future outcomes of therapy

Risk factors of colorectal cancer – literature review

Introduction and purpose: Colorectal cancer is one of the most common cancers in the world. It is very important to expand knowledge about this disease because it affects millions of people. Better understanding of the disease will help develop better prevention and treatment strategies. The aim of our work is to classify, analyze and describe colorectal cancer risk factors. This article was written based on articles found in the PubMed database. State of knowledge: Colorectal cancer risk factors can be divided into two groups: modifiable and unmodifiable. Modifiable factors include: diet, low physical activity, smoking, alcohol, overweight and obesity. Unmodifiable factors include: age, sex, inflammatory bowel diseases, genetic factors, family history of colorectal cancer. Each of them increases the risk of developing the disease, the risk is the greater the more factors are present simultaneously. Modifiable factors seem to play a greater role in the development of the disease than unmodifable factors. Summary: Studies of colorectal cancer risk factors may help in the development of prevention. It can also facilitate the personalization of preventive examinations and treatment. By influencing modifiable factors, we can reduce the risk of developing the disease, because following the principles of a healthy lifestyle can minimize the risk associated with genetic factors for the development of colorectal cancer

Methods of treating gestational diabetes through an adapted diet and physical activity

Gestational diabetes mellitus (GDM) is a carbohydrate tolerance disorder that results in elevated blood glucose levels and was first recognized during pregnancy. Diabetes is the most common metabolic complication that complicates pregnancy. Therefore, it is important to quickly diagnose and prevent the effects of diabetes, which may arise in the mother and fetus. The occurrence of diabetes during pregnancy is a risk factor for diabetes and cardiovascular diseases later in life. Studies have shown a reduction in complications in patients with gestational diabetes after personalized health education in the field of nutrition. All pregnant women should be screened for impaired glucose tolerance as soon as possible after pregnancy is diagnosed. In the risk group, additionally, a 75g OGTT test should be performed on the first visit. Gestational diabetes affects one in ten pregnant women worldwide, and this percentage is increasing day by day. The main goal is to strive, during therapy, to equalize the glycemic value. The aim of this publication is to present the diagnostic process and, most importantly, the treatment of diabetes diagnosed in pregnancy. The publication focuses on gestational diabetes treated with an adapted diet, exercise and lifestyle changes. This publication describes how to create a balanced diet with a low glycemic index and how to choose physical exercise for a patient with gestational diabetes

Major depression disorder - etiology and treatment

Introduction and purpose: The problem of major depression disorder (MDD) affects more and more people. In a few years, it may become the most common disease after cardiovascular diseases and cancer. MDD are manifested by a depressed mood, decreased energy, loss of interest and the ability to enjoy life, as well as a number of other additional symptoms. Untreated MDD can lead to disability. This entails not only consequences for the sick person but also increased social costs. That is why it is so important to know the causes of its formation and to look for new therapeutic methods. State of knowledge: The development of MDD is influenced by genetic factors, inflammatory factors and hormonal disorders, changes in the structure of the brain, disorders in neurotransmission. The microbiome-gut-brain axis affects mood regulation and neurotransmission in the brain. Bacteria such as Escherichia, Shigella, Enterococcus, Streptococccus, Alistipes, Parabacterioides, Veillonella have been identified as having a potential negative effect on the development of MDD and response to treatment. The use of probiotics containing Lactobacillus helveticus R0052, Bifidobacterium longum and Clostridium butyricum MIYAIRI 588 may help reduce the symptoms of MDD. In recent years, the US Food and Drug Administration (FDA) has approved the intranasal preparation of esketamine for the treatment of treatment-resistant depression and major depressive disorder with severe suicidal thoughts. Unlike other antidepressants, it has a quick effect on reducing symptoms. Summary: Due to the global problem of MDD, further research is needed to better understand the mechanisms of its formation. Particular attention should be paid to the influence of microbiota