Review of the literature on the dangers of zolpidem use, its potential for abuse and addiction

Introduction and purpose of the work : Commonly Z-drugs, especially zolpidem , are considered safer than short-acting drugs benzodiazepines . Recently, more and more is said about the abuse of these relatively harmless drugs. The aim of this study is to collect scientific reports on the increasing abuse of these drugs. State of knowledge: There are many reports of zolpidem abusers and addicts in the available literature . These people belong to three groups of patients: the first is people with insomnia who develop tolerance, the second is recreational use, and the third is people with mental disorders. Taking increased doses of zolpidem causes a psychostimulant effect, increased activity during sleep, up to delusions and psychotic symptoms. Rapid discontinuation of high doses of the drug should be performed in a hospital setting. Summary : Physicians should be advised to remain vigilant during therapy with group Z drugs and to check that the patient is not receiving the drug from multiple sources and is not taking zolpidem in supra-therapeutic doses

Men’s eating disorders – A literature review

Introduction and purpose: Eating disorders belong to the group of mental diseases characterized by significant somatic complications and high mortality. There is a common opinion that these disorders mainly affect women. Such assumptions may result in limited knowledge of the diagnosis and treatment of an eating disorder in the male population. The aim of this study is to summarize the current knowledge about eating disorders among men, including binge eating disorder (BED), anorexia nervosa (AN) and bulimia nervosa (BN). Description of the state of knowledge: It turns out that the problem of eating disorders among the male sex is not so rare- it is estimated that approximately 10 million US men will experience an eating disorder at some point in their lives. The most common eating disorder among men appears to be binge eating disorder (BED). Men are also more likely to report binge eating than women. AN and BN occur much less frequently than BED in the male population. The symptoms of anorexia nervosa and bulimia nervosa may differ between men and women. More and more often we observe a development of a certain type of muscle dysmorphia among men, the so-called “reverse anorexia". Eating disorders carry a number of medical complications such as cardiac disorders, electrolyte disturbances, digestive problems and skeletal disturbances. Therapeutic interventions in the treatment of male eating disorders should take into account gender-specific problems. Conclusions: The real number of men suffering from eating disorders may be underestimated due to the neglect of the problem in the context of the male gender. It also results in poorly developed diagnostic and support schemes for men struggling with this problem. More research is needed on the topic of eating disorders in this group of patients as it will help to develop better diagnostic and therapeutic regimens adapted to the male gender

Stężenie rezystyny w surowicy u dzieci z cukrzycą typu 1 — negatywna relacja z masą tłuszczową ciała

Introduction: Insulin is one of the major factors regulating adipose tissue function. On the other hand, adipocytes secrete adipocytokines that may influence insulin synthesis and action, and are involved in blood glucose regulation. In type 1 diabetes mellitus (t1DM), beta cells function is replaced with exogenous insulin therapy. This raises a question concerning the impact of t1DM on adipose tissue secretory function. The aim of this study was to evaluate one of the adipocytokines, resistin, serum concentrations in relation to body fat mass in children with t1DM.Material and methods: The study comprised 75 children with t1DM and a control group of 20 healthy coevals. All children had estimated serum resistin concentrations, glycated haemoglobin levels, growth and body weight measurements, and bioelectrical impedance analysis in order to establish body composition.Results: Resistin serum concentrations were significantly lower in children with t1DM vs. controls (median values: 343 vs. 590 pg/mL; mean values ± SD: 577 ± 561 vs. 861 ± 628 pg/mL; p < 0.001), and they negatively correlated with body fat mass (p = 0.022) and age (p = 0.022) in the t1DM group, but not in the control group. Disease duration, glycated haemoglobin levels and insulin dosage revealed no direct statistical relation to resistin levels.Conclusions: Diminished serum resistin concentrations and a negative correlation between resistin levels and body fat mass in children with type 1 diabetes seem to result from broken physiological adipo-insular regulations, independent of disease duration, its metabolic control and insulin supply. (Endokrynol Pol 2014; 65 (5): 342–347)Wstęp: Insulina jest jednym z głównych czynników regulujących funkcje tkanki tłuszczowej. Z drugiej strony, adipocyty wydzielają adipocytokiny, które mogą wpływać na sekrecję i działanie insuliny oraz brać udział w regulacji stężenia glukozy we krwi. W cukrzycy typu 1 sekrecja insuliny przez komórki beta zostaje zastąpiona przez egzogenną insulinoterapię. Powstaje pytanie o wpływ tej choroby na czynność sekrecyjną tkanki tłuszczowej. Celem pracy była ocena stężenia jednej z adipocytokin, rezystyny, w surowicy dzieci z cukrzycą typu 1, oraz związku oznaczonej rezystynemii z masą tkanki tłuszczowej.Materiał i metody: Badaniami objęto 75 dzieci z cukrzycą typu 1, oraz grupę kontrolną 20 zdrowych dzieci. U wszystkich wykonano oznaczenia stężenia rezystyny w surowicy, poziomu hemoglobiny glikowanej, pomiary wzrostu i masy ciała, oraz badanie impedancji bioelektrycznej celem oceny składu ciała.Wyniki: Stężenia rezystyny w surowicy były niższe u dzieci z cukrzycą typu 1 niż w grupie kontrolnej (mediana: 343 vs. 590 pg/ml, średnia ± SD: 577 ± 561 vs. 861 ± 628 pg/ml, p < 0,001) oraz korelowały ujemnie z masą tkanki tłuszczowej (p = 0,022) oraz wiekiem (p = 0,022) w grupie dzieci z cukrzycą, ale nie w grupie kontrolnej. Czas trwania choroby, poziom hemoglobiny glikowanej i dawkowanie insuliny nie wykazały bezpośredniego związku statystycznego ze stężeniami rezystyny.Wnioski: Obniżone stężenie rezystyny w surowicy oraz ujemna korelacja między stężeniami rezystyny i masą tłuszczową ciała u dzieci z cukrzycą typu 1 wydają się wynikać z przerwania fizjologicznych regulacji adipo-insularnych, niezależnie od czasu trwania choroby, jej kontroli metabolicznej i podaży insuliny. (Endokrynol Pol 2014; 65 (5): 342–347

Comparison of the impact of e-cigarettes and new tobacco heating devices on the human body and their potential in the fight against smoking

Nicotine is one of the most common stimulants used by humans in the world. Its addictive potential is almost the same as that of cocaine. [1] The most popular way of delivering nicotine to the body, which is cigarette smoking, has many negative effects, including considerable carcinogenic potential. Cigarette smoke contains approx. 6,500 chemical compounds, of which around 150 are considered toxic. [2] With the advancement of technology, alternative ways of delivering nicotine to the body have been found. These include e-cigarettes and tobacco heaters. In the following study, we will compare the method and mechanism of operation of these devices and their possible effects on human health compared to smoking

Analiza wyników i powikłań pooperacyjnej radioterapii u dzieci z rozpoznaniem wyściółczaka mózgu

Purpose. This study was conducted to analyze the efficacy of radiotherapy within the combined treatment of children with intracranial ependymoma and also to determine prognostic factors, patterns of failure and late effects after therapy.Methods and materials. Between 1984 and 2005, 115 children with intracranial ependymoma received radiotherapy after surgery in the Department of Radiation Oncology of the Cancer Center and Institute of Oncology. During this time the radiotherapy protocol was changed. Most patients were treated with craniospinal radiotherapy followed by a boost to the primary site. The remaining patients were treated with conformal local radiotherapy. A new chemotherapy regime was used after 1997. The Kaplan-Meier method was used to estimate survival. Multivariate analysis was performed with the Cox proportional hazards model to study prognostic factors. The risk of occurrence of complications including impairment of intellectual functions, growth, endocrine deficits and hearing loss were analyzed.Results. The 5-year overall survival and survival without progression were 69% and 62% respectively. A better overall outcome: survival and progression-free survival rates were observed, for patients who were treated with 3D radiotherapy 1997–2005, but this was not a statistically significant difference. As calculated by multivariate analysis an age of less than 4 years had was associated with a significantly worse outcome. There were no significant influences of other factors such as extent of resection, leptomeningeal spread, sex and neurological condition patients, tumour grade, location and size. In the analysis of patterns of failure no statistical significant differences between incidence dissemianation after craniospinal radiation versus local irradiation were observed. The probability of late effects such as cognitive and growth dysfunction in the patients treated with 2D irradiation were observed twice as much than with those after 3D irradiation. More frequently impairment of intellectual function in children younger than 4 years and more growth dysfunction in children under the age of 9 years were observed.Conclusion. The results of combined treatment of the children with intracranial ependymoma, obtained in our Radiotherapy Department are comparable to those published in other centers. The use of 3D conformal radiotherapy causes a trend towards improvement in outcome. The improvement of treatment results after 1997 is due to advances in diagnosis and treatment. The use of conformal local irradiation does not increase the risk of spreading disease and reduces incidence late complications.Cel. Celem pracy jest analiza skuteczności radioterapii zastosowanej w ramach skojarzonego leczenia dzieci z rozpoznaniemwyściółczaków mózgu, jak również ocena czynników rokowniczych, niepowodzeń leczenia i późnychpowikłań po leczeniu.Materiał i metody. Przeprowadzono retrospektywną analizę wyników leczenia 115 dzieci z rozpoznaniem wyściółczakamózgu, napromienianych pooperacyjnie w Zakładzie Radioterapii CO-I przy ul. Wawelskiej w Warszawie w latach1984–2005. W tym okresie zmieniły się zasady wyznaczania obszaru napromieniania (od elektywnego napromienianiacałej osi mózgowo-rdzeniowej do napromieniania ograniczonego do loży po guzie) oraz wprowadzono techniki planowaniatrójwymiarowego — 3D. Po 1997 roku wprowadzono również nowy protokół intensywnej chemioterapii. Doanalizy czasu przeżycia zastosowano krzywe przeżycia obliczone metodą Kaplana-Meiera. Do identyfikacji czynnikówprognostycznych zastosowano analizę wielowariantową z wykorzystaniem modelu Coxa. Analizę powikłań późnych,takich jak zaburzenia intelektualne, zaburzenia wzrostu i endokrynologiczne oraz niedosłuch, przeprowadzono napodstawie częstości ich wystąpienia.Wyniki. Prawdopodobieństwo 5-letniego przeżycia całkowitego i przeżycia bez progresji choroby wyniosło odpowiednio69% i 62%. Zaobserwowano różnicę w krzywych przeżycia całkowitego i bez progresji choroby na korzyśćleczenia w latach 1997–2005 z wykorzystaniem technik planowania 3D, nie była to jednak różnica istotna statystycznie(p > 0,05). W analizie wielowariantowej wykazano niekorzystny wpływ wieku dziecka < 4 roku życia na przeżycie całkowitei bez progresji choroby. Nie wykazano znaczenia innych czynników takich jak zakres operacji, zróżnicowaniehistopatologiczne, lokalizacja i wielkość guza, obecność rozsiewu, płeć oraz stan neurologiczny pacjenta. W analizieniepowodzeń leczenia nie stwierdzono różnicy znamiennej statystycznie w częstości występowania rozsiewu chorobyw zależności od rozległości obszaru napromieniania (OUN vs guz pierwotny).Ryzyko wystąpienia późnych powikłań, takich jak upośledzenie rozwoju umysłowego i zaburzenie wzrostu w grupieleczonej z zastosowaniem planowania 3D, było dwukrotnie niższe w porównaniu do grupy napromienianej z wykorzystaniemtechnik 2D. Stwierdzono częstsze występowanie upośledzenia rozwoju umysłowego u dzieci w wiekuponiżej 4 lat w chwili zastosowania radioterapii oraz większy odsetek zaburzeń wzrostu u dzieci w wieku poniżej 9 lat.Wnioski. Wyniki leczenia kompleksowego u dzieci z wyściółczakami mózgu, napromienianych w naszym Zakładzie,są porównywalne do publikowanych w innych ośrodkach europejskich. Wprowadzenie do radioterapii bardziej precyzyjnychmetod planowania 3D przekłada się na poprawę wyników leczenia w postaci zarysowującego się trendudo zwiększenia odsetka przeżyć 5-letnich w tej grupie chorych. Widoczna poprawa wyników w okresie po 1997 rokujest zależna od postępu dokonującego się w diagnostyce obrazowej oraz wszystkich metodach kompleksowegoleczenia. Zastosowanie radioterapii konformalnej na obszar ograniczony do loży po guzie pierwotnym nie powodujeistotnego statystycznie wzrostu ryzyka wystąpienia rozsiewu choroby oraz wpływa na zmniejszenie wystąpieniapóźnych powikłań

The relationship between magnesium deficiency and depression, and the effects of magnesium supplementation on depression symptoms – literature review

Magnesium is a very important macronutrient in the human body. Its main storage is bones. The correct concentration of this macronutrient within the normal range is necessary for the proper functioning of the body. Deficiency of this element negatively affects the entire body. One of the symptoms of magnesium deficiency is depression and other psychiatric disorders. The factors explaining the mechanism of magnesium's antidepressant effect are not fully understood, however, a relationship between magnesium deficiency and the pathogenesis of depression has been demonstrated. Supplementation with preparations of this element improves the condition in ill people with depression. [3][6

Influence of selenium deficiency on the development of thyroid disorders - a literature review

Introduction and purpose: Selenium is essential for the proper course of many physiological and biochemical processes in the human body. It plays a large role in ensuring proper immunoendocrine function. The organ with the greatest amount of selenium per gram of tissue is the thyroid gland. This element builds enzymes involved in antioxidant processes - peroxidase, as well as deiodinases involved in the metabolism of thyroid hormones. There are scientific reports showing a beneficial effect of selenium supplementation in autoimmune diseases of the thyroid gland. The aim of this study is to summarize the current knowledge on the relationship between selenium deficiency and the development of thyroid dysfunction. Description of the state of knowledge: There is a correlation between selenium deficiency and the functioning of the thyroid gland. It has been shown that selenium levels are often lowered in patients with autoimmune thyroiditis. Research shows that selenium supplementation may lower TPOAb and TgAb antibody levels in patients with Hashimoto's disease. In patients with Graves' orbitopathy, administration of selenium resulted in delayed progression of orbitopathy and less disease severity. There are reports that supplementation with this element may also increase the effectiveness of antithyroid drugs in patients with Graves-Basedow disease. There was also an association between selenium deficiency and the development of goiter and thyroid nodules. Conclusions: Selenium plays an important role in the proper functioning of the thyroid gland. Although the specific role of selenium in the pathogenesis of thyroid disease is still under investigation, there are numerous reports saying that its deficiency may affect it. More research is needed on the relationship between selenium concentration and the regulation of thyroid function, because introducing it into the treatment regimen of thyroid disorders may give hope for better therapeutic effects

The role of magnesium deficiency in the pathogenesis of hypertension and the influence of magnesium supplementation on blood pressure – literature review

Magnesium is a macronutrient that is very important for the proper functioning of the human body. Deficiency of this element is crucial in the development of many disorders in the proper functioning of many organ systems. The optimal level of magnesium has a significant influence on the functioning of the cardiovascular system, among others. Although the factors showing the mechanism of lowering blood pressure by magnesium ions are not fully understood, the influence of the correct concentration of magnesium in the human body on cardiovascular protection is beyond doubt. Magnesium supplementation produces positive effects in the functioning of blood vessels and in maintaining blood pressure within the normal range. In our article, we focused on the role of magnesium in maintaining normal blood pressure at the molecular, cellular and tissue levels, as well as on the impact of magnesium supplementation on reducing blood pressure

Alcohol use and depression - literature review

Alcohol consumption has serious health and social consequences. A coexistence of alcohol use disorders and depressive disorders is common. Alcohol abuse is more common in men, but women are at greater risk of its harmful effects. Alcohol consumption in adolescence and early adulthood is associated with a higher risk of developing depressive disorders in the future. The order in which these disorders appear may vary, but it is important to make a diagnosis of depression during the period of abstinence. Drinking alcohol can be seen as a form of coping with stress and anxiety disorders. The aim of this article is to review the literature on the relationship between depression and alcohol. Alcohol changes your neural pathways. Long and intense exposure may cause irreversible changes. The stress response pathways responsible for emotions and the reward system are the most sensitive. They deregulate the hypothalamic-pituitary-adrenal axis. Coexistence of alcohol use disorders and depressive disorders is treated primarily with antidepressants. Cognitive behavioral therapy has been shown to have a modest positive effect in relieving symptoms of depression and reducing the amount of alcohol consumed