Etiological factors and treatment of chylothorax in paediatric patients - a systematic review

Chylothorax is an accumulation of chyle in the pleural cavity. It is a relatively rare cause of pleural effusion in children and its annual incidence is 14 cases per 100 000 children in Europe.  The pleural fluid triglyceride level greater than 110 mg/dl with a cholesterol level lower than 200 mg/dl confirms the diagnosis of chylothorax. Medical imaging are also necessary such as a non-invasive and easily accessible lung ultrasound. Symptoms of this disease are tachypnea, dyspnea, and in some cases dry cough. This review aims to summarize the current literature regarding chylothorax in children, analyze its possible etiologies and treatments. The causes of chylothorax are varied. It may appear after surgical interventions, traumas, infections and also be congenital. Iatrogenic factors are the most common cause of chylothorax in children with cardiothoracic surgeries. Management of chylothorax can be quite complex and highly variable, depending on patient’s condition and their response to the introduced treatment. Conservative treatment consisting of nutrition therapy, chest drain, and pharmacotherapy is typically a first-line of treatment. Diet modification consist in dietary supplements enriched with medium chain triglycerides (MCT) or starting the patient on a total parenteral nutrition (TPN). In most of the analyzed cases the conservative treatment alone proved sufficient in the management of chylothorax. In case of its failure, surgical treatment was a secondary therapy choice. One of the most common surgical procedures for pleural effusion is a thoracic duct ligation (TDL) or pleurodesis and both of these methods are highly effective therapy for chylothorax. This review of the literature reveals a wide variety of causes and methods of treatment of chylothorax. There are no clear standards of management and the therapy is adjusted to the clinical condition of the patient

Do lifestyle habits have an impact on infertility in couples? A systematic review of the topic

Background: Infertility is a widespread concern that significantly impacts numerous couples in contemporary times. While the underlying causes of infertility often remain unknown, there is a growing interest in understanding the significant impact that modifiable lifestyle factors can have on its development. Lifestyle factors encompass various habits and ways of life that can be modified to improve overall health, including fertility. It is worth highlighting that these factors are under an individual's control.They play a significant role in determining reproductive health and can positively or negatively influence the ability to conceive. Aim of study: The main purpose of this article is to review the recent research of this topic. It emphasizes the crucial importance for healthcare professionals to gain a thorough understanding of which lifestyle behaviors and habits can either adversely or positively impact fertility and use this knowledge to educate the patients. Material and methods: The work was based on the scientific literature  and databases available on PubMed. The main used terms were „infertility” and „infertility and lifestyle”. Results and conclusions: Lifestyle factors, including smoking, alcohol consumption, drug use, stress or obesity have been implicated in the issue of male and female infertility. However, establishing a precise cause-effect relationship remains challenging due to the limited number of conducted studies and available literature on this topic. Nevertheless, there is a growing interest in this field, as infertility continues to be one of the most significant healthcare challenges worldwide, with rates of infertile couples on the rise. &nbsp

Akkermansia muciniphila – multifunctional bacteria

Introduction: The complex symbiotic connection between the host and the gut microbiome, which has many important functions in the organism, provides an opportunity for dysbiosis to potentially serve as a catalyst for various health disorders. Akkermancia muciniphila, a bacterium that degadates mucin, is a noteworthy element of the human gut microbiome and has captured the attention of researchers due to its correlation with numerous diseases. Aim of the study: The purpose of this research was to review literature and determine the impact of Akkermansia muciniphila in selected diseases. A systematic review was conducted using PubMed database. State of knowledge: Studies have shown that reduced numbers of Akkermansia muciniphila have been associated with many diseases, including obesity, type 2 diabetes, atherosclerosis, fatty liver, some neurological conditions, inflammation, and response to cancer immunotherapies. Furthermore, the administration of this bacterium has been shown to have a positive impact on reducing obesity-related parameters, improving insulin sensitivity and glucose homeostasis, mitigating inflammation, and enhancing the prognosis of immune checkpoint inhibitor treatment.  Conclusions: The condition and composition of the intestinal microbiome play a significant role in the development and progression of numerous diseases. Akkermansia muciniphila, as demonstrated in various studies, is an example of a bacterium associated with beneficial effects in multiple diseases. It is regarded as a promising candidate for probiotic use

Medicinal plants in burns treatment – a systematic review

Introduction and aim. The World Health Organization (WHO) reports that around 11 million people experience burn injuries each year.1,2 Burn injuries occur when tissue damage is caused by various factors such as UV radiation, heat, chemicals, or electric current.3,4 While burns primarily affect the skin, they can also extend to deeper tissues like bones or muscles. When the skin is burned, its vital functions, including protection against the external environment, pathogens, and evaporation, are compromised.1 The appropriate treatment method must be chosen based on the burn stage, the patient's condition, and the cause. The aim of this paper is to provide a comprehensive review based on literature, concerning superficial burns and sunburns treatment, with a focus on nature-derived topical treatment methods. Material and methods. PubMed database was searched for the following terms: “burns”, “burn treatment”, “aloe vera”, “sunburn”, “centella asiatica”, “climate change”, “wound healing” for the articles published between 2005-2023 and written in the English language. Conclusion. Herbal-derived compounds, with their diverse mechanisms of action, antibacterial activity, and safety profiles present a competitive alternative to conventional treatment of burns and sunburns, however, there are still not enough clinical trials to assess the effectiveness and safety profiles of nature-derived compounds

The potential of using exosomes in modern medicine

Introduction and purpose of the work: The purpose of this article is to determine the potential for the application of exosomes in modern medicine, inferring from research directions in world  literature. Among other things, this paper considers some of the most recent work in the fields of aesthetic medicine, dermatology and transplantation.  Methodology and materials: The search was conducted using PubMed, Google Scholarship, Scopus and Web of Science databases. The search strategy was based on the following terms: exosomes, regenerative medicine, dermatology. The variety of available scientific works on exosomes raises the question in which of the fields of medicine they will be used the fastest and/or most commonly. Given that a significant part of research focuses on their use in skin treatments, it can be expected that it will be dermatology and/or aesthetic medicine, given its exceptional openness to the implementation of new techniques and the constant search for new solutions that allow physiologically or optically to oppose aging. In addition, the use of exosomes is characterized by a relatively low risk of life-threatening complications or permanent damage to health. However, the potential applications of exosomes in other fields of medicine should not be underestimated. Therefore, it can be expected that procedures and therapies using exosomes will also be developed and implemented independently in transplantology, cardiology, or other fields that can use exosomes as drug carriers or markers for early detection of complications or diseases.

Exploring the Impact of Intermittent Fasting on Metabolic Syndrome, Prediabetes and Type 2 Diabetes: a systematic review

Introduction: Metabolic syndrome, prediabetes and type 2 diabetes mellitus represent a growing and interconnected health challenge, gaining significant attention due to their high prevalence and impact they have on individuals' well-being. Intermittent Fasting (IF), involving cycling between periods of fasting and eating, has emerged as a promising dietary approach garnering substantial attention for its potential therapeutic effects on metabolic health. Purpose: This review aims to explore the impact of intermittent fasting on metabolic disease by examining recent studies. Methods: A review of the recent literature was conducted to explore potential positive effects of IF on relevant metabolic parameters. Results: The findings from the reviewed studies demonstrated favorable effects of IF associated with improvements in glycemic control as improved insulin sensitivity and decreased HbA1c levels. Additionally, it led to significant reductions in body weight and waist circumference. Beneficial effects on lipid profiles, such as reduced triglyceride levels, were also observed in some studies. Conclusions: The reviewed studies provide strong evidence supporting the effectiveness of IF regimens in improving metabolic factors, including weight, insulin sensitivity and lipid profiles in individuals with abnormal glucose metabolism. IF offers a promising dietary strategy potentially providing additional benefits beyond conventional dietary interventions. However, further research is needed to elucidate the long-term effects, optimal fasting protocols and potential mechanisms underlying the benefits of intermittent fasting in these conditions.&nbsp

Consequences and management of sleep-wake rhythm disorders resulting from social jetlag and nightshifts

Our day to night cycle is ruled by a social, biological and sun clock. The social clock being a local time is aligned with others’ lives. The biological clock (circadian time) that controls our physiology and the sun clock that defines natural light and darkness. Social jetlag refers to the misalignment between local and circadian time. This term is usually used in reference to travels to places in different time zones. Nevertheless, it is worth noticing that “jetlag” also applies to people working in a medical industry such as doctors, nurses, paramedics, and others involved in an on-call work. Thus, I would like to look closer to the physiology of social jetlag and to analyze its implications

Three successful pregnancies after kidney transplantation with long-term graft survival: case report

Pregnancies after kidney transplantation are considered high risk. Preconceive care is crucial for favorable mother-fetal outcome but also for good renal graft function. Herein, we report a case of kidney transplant recipient secondary to lupus nephritis with three consecutive successful pregnancies and excellent graft function after 16 post-transplant years. Preconception care included two protocolar biopsies performed prior to immunosuppressive treatment modifications. No signs of rejections were found in either biopsy, no additional treatment was necessary, and the patient was safely converted from mycophenolate mofetil to azathioprine. First pregnancy was naturally conceived, its course was uncomplicated and a healthy female newborn wasdelivered via vaginal birth. Within one year after delivery the patient presented proteinuria, borderline changes were found in the biopsy of allograft and were treated with immunosuppression augmentation and ACEI.  At 7th post implantation year, after surveillance biopsy showing no signs of rejection and appropriate pharmacotherapy adjustments, second pregnancy occurred from in vitro fertilization (IVF). It was complicated with deep vein thrombosis, intrauterine growth restriction and premature birth in 32nd week of gestation. Three months after delivery, the patient conceived spontaneously, third pregnancy course was uncomplicated. Close follow up, including protocol and indication biopsies, allowed to preserve excellent graft function in the context of multiple immunosuppressive treatment adjustments. Here we present a case where natural conception and in vitro fertilization intertwine without harming the transplanted organ

Selected aesthetic medicine treatment in patients with autoimmune diseases - a literature review

Introduction Interest in cosmetic procedures has been increasing. Data on practices for correcting aesthetic deficits, including those caused by autoimmune diseases are limited. There are fears of disease reactivation and exacerbation of inflammation after surgery. Aim of the study The aim of the study was to investigate the potential influence and safety of aesthetic medicine treatment - hyaluronic acid, botulinum toxin and breast augmentation with implants in patients with autoimmune diseases. Materials and methods A search was conducted using PubMed and Google Scholar databases. Articles were searched in English using the following key words: autoimmune disease, immunogenicity, inflammation, connective tissue, aesthetic medicine. Results Hyaluronic acid is considered the best filler for cosmetic procedures, mainly due to its lack of immunogenicity. No clinical studies have identified contraindications to the administration of hyaluronic acid-based dermal fillers in patients with inflammatory diseases. Botulinum toxin is essential in alleviating involuntary functions currently associated with dystonia, spasticity, and autonomic disorders. The long-term safety of implants should be assessed concerning genetic and environmental factors and whether the autoimmune disease is in remission.Conclusion With the increasing number of aesthetic procedures using hyaluronic acid, there are more reports of potential adverse events. Most side effects are associated with hypersensitivity reactions. The use of hyaluronic acid products in patients with autoimmune diseases is controversial. However, no clinical studies have identified contraindications to the administration of hyaluronic acid-based fillers. Botulinum toxin is used for healing and pain control in patients with systemic sclerosis who have suffered phalangeal ulcers. Despite epidemiological studies conducted to assess the association between breast implants and autoimmune diseases the results remain inconclusiv

Exploring the Impact of Intermittent Fasting on Metabolic Syndrome, Prediabetes and Type 2 Diabetes: a systematic review

Introduction: Metabolic syndrome, prediabetes and type 2 diabetes mellitus represent a growing and interconnected health challenge, gaining significant attention due to their high prevalence and impact they have on individuals' well-being. Intermittent Fasting (IF), involving cycling between periods of fasting and eating, has emerged as a promising dietary approach garnering substantial attention for its potential therapeutic effects on metabolic health. Purpose: This review aims to explore the impact of intermittent fasting on metabolic disease by examining recent studies. Methods: A review of the recent literature was conducted to explore potential positive effects of IF on relevant metabolic parameters. Results: The findings from the reviewed studies demonstrated favorable effects of IF associated with improvements in glycemic control as improved insulin sensitivity and decreased HbA1c levels. Additionally, it led to significant reductions in body weight and waist circumference. Beneficial effects on lipid profiles, such as reduced triglyceride levels, were also observed in some studies. Conclusions: The reviewed studies provide strong evidence supporting the effectiveness of IF regimens in improving metabolic factors, including weight, insulin sensitivity and lipid profiles in individuals with abnormal glucose metabolism. IF offers a promising dietary strategy potentially providing additional benefits beyond conventional dietary interventions. However, further research is needed to elucidate the long-term effects, optimal fasting protocols and potential mechanisms underlying the benefits of intermittent fasting in these conditions.