Neuropsychiatric dimensions of COVID-19 - literature review

SARS-CoV-2 infection leads to severe multiple organ failure. The immune system is stimulated by activating the inflammatory mechanism and by releasing inflammatory cytokines. COVID-19 is able to penetrate the central nervous system, inducing neuritis and neurodegeneration. In our study, we analyzed the latest available articles. We focused on the subject of COVID-19 infection and consequences of neuroinflammation. For this study, we searched the literature available in Pubmed and Google Scholar databases using keywords. There is evidence of a common background of COVID-19 complications and neurological diseases such as Parkinson's or Alzheimer's disease. This type of complication is more frequently observed in serious cases of COVID-19, with a more intense immune response, with higher levels of CRP, ferritin and D-dimers. Organic changes in conjunction with environmental stress caused by the experience of severe illness, fear of becoming ill and social limitations, lead to neuropsychiatric pathologies, including major depressive disorders and post-traumatic stress. The neuropsychiatric implications of COVID-19 represent a severe clinical problem that deserves special attention in the treatment of COVID-19 infection. There is a need to monitor the neuropsychiatric consequences of COVID-19, in order to completely understand the impact of SARS-CoV-2 infection. This knowledge is necessary to be able to confront the public health crisis created by the COVID-19 pandemic.&nbsp

Topical treatment of psoriasis

Psoriasis is an autoimmune systemic disease that affects approximately 2-3% of the population. Its symptoms, although focused mainly on the skin, can also have a negative impact on other spheres of the patient's life, including their mental state, because this illness still works with some misunderstanding on the part of society. This chronic, severe inflammatory disease affects mainly skin, but other manifestations, such as joint manifestations, may occur in about 30% of patients. One of the aims of this work is to present the topic of psoriasis, and in particular its topical treatment. It discusses the most commonly used topical preparations for the treatment of psoriasis. Currently thanks to the dynamic development in the fields of medicine, pharmacology and chemistry, schemes and specimens for the effective treatment of psoriasis have been developed. They allow to treat the main, persistent and most affecting the patient’s health symptoms, at the same time improving their quality of life. These specimens are divided into local and systemic ones. They can be used in monotherapy or in combination, depending on the severity of the disease. Topical agents have a symptomatic effect, limited to the maximum remission of skin lesions. These agents not only support the healing process, but also improve the condition of the patient’s skin, which undoubtly has a positive impact on the patient’s daily life

Depression in regard to postcovid syndrome - literature review

Coronavirus disease-2019 (COVID-19) is a global pandemic health problem that causes a wide spectrum of clinical manifestations. Recovered patients who survive COVID-19 may continue to report a wide variety of clinical manifestations such as depression, which is named post covid syndrome. In our article, we sought to determine the frequency and possible causes of depressive symptoms and clinically-significant depression in the post COVID syndrome. We conducted a review of postcovid manifestations by searching PubMed, Scopus, World health organization (WHO) databases. The symptoms of postcovid syndrome have been shown as a weakness, cognitive impairment, sleep disturbance, and depression, among others. Persistent mental disorders among people who suffer from long-term COVID-19 may be related to psychological factors, as well as from infection and the associated neurobiological trauma. According to available studies, a significant percentage of depression symptoms is observed among people with postcovid syndrome, especially in older age groups. Also symptoms of mental, neurological and physical illness as well as inflammatory brain injury in people with post-COVID syndrome are likely to increase suicidal ideation and behavior in this patient population

Semaglutide for the treatment of obesity

Introduction and purpose Due to the growing tendency to diagnose obesity in patients, scientists are trying to find drugs that facilitate weight reduction.  An example of such a formulation is the GLP-1 analogue semaglutide. The following article is an analysis of the current knowledge on the effectiveness and safety of obesity treatment with semaglutide based on available publications in Pubmed and Google Scholar databases. State of knowledge The main mechanism of semaglutide is based on a stimulation of insulin secretion from pancreatic beta cells, and inhibition of glucagon from alpha cells, inhibition of hepatic gluconeogenesis, and reduction of energy consumption with minimal impact on energy expenditure. In clinical trials, it showed the best results compared to placebo and other drugs used in weight reduction. Participants treated with semaglutide achieved a reduction in waist circumference, improvements in blood pressure parameters, HbA1c levels, total cholesterol, LDL cholesterol, triglycerides, and CRP protein, and increased HDL cholesterol levels. Semaglutide is well tolerated by patients, and its main side effects come from the gastrointestinal tract, including nausea, emesis, diarrhea. Summary The analysis of the latest publications and meta-analyzes of the literature shows that the use of semaglutide is safe and effective in the treatment of obesity. The positive effect of semaglutide on weight reduction also contributes to the reduction of the risk of cardiovascular events and other obesity-related complications. It is also well tolerated by patients, which translates into possible longer use, and weekly subcutaneous injections are not burdensome for patients. Key words: semaglutide; obesity; GLP-1 analogue; overweigh

The problem of pregnancy complicated by chronic kidney disease

Chronic kidney disease (CKD) in high-risk pregnancies is a challenge for multidisciplinary teams of doctors. Due to the fact that the disease affects both the mother and the fetus, and the course of the pregnancy. The following article reviews the literature about the interaction between pregnancy and CKD and dialysis therapy. Even pregnancy itself can lead to a worsening of kidney dysfunction. The risk of this consequence increases with the degree of renal failure, therefore renal parameters and other pregnancy test results should be monitored. On the other hand, the most common complications of chronic kidney disease in pregnancy described in the literature include pre-eclampsia, preterm labor, intrauterine growth restriction (IUGR) or low birth weight, surgical delivery by caesarean section and miscarriage. Dialysis therapy also leads to abnormalities in the course of pregnancy, and patients require constant monitoring during its course. Attention is also drawn to the high percentage of newborns requiring intensive postpartum care. Due to the risk for the fetus and mother mentioned in the article, nephrologists and gynecologists should cooperate closely from the pre-contraceptive period in order to reduce the risk of sequelae and better control of the underlying disease

Aristolochic acid nephropathy - still real danger

Arystolocholic acid nephropathy is chronic kidney disease caused by the use of substances of natural origin that contain arystolocholic acid. The effects of their use are arystolochic acid nephropathies, which include "Chinese Herbs" nephropathy. The course of the disease is very fast, resulting in progression to end-stage renal disease, and in the future it results in the development of urinary tract cancer. That is why it is so important to recognize it early and start treatment. However, due to disease progression, some patients require dialysis and even kidney transplantation. Although the World Health Organization is trying to stop the spread of the use of harmful substances, there are still reports of this nephropathy appearing in some populations. Despite warnings from the Food and Drug Administration regarding the safety of botanicals containing arystolochic acid and its classification as a human carcinogen, products containing it are still available for purchase online. The purpose of the literature review below is to analyze the latest knowledge on aristolochic acid nephropathy and its associated complication

What does the future look like - home hemodialysis

Home hemodialysis (HHD) is a discovery from 1961 that is now experiencing a revival. It is a convenient and modern method of renal replacement therapy that allows the patient to undergo hemodialysis sessions at home. Due to the growing interest in home hemodialysis, we decided to present the potential of this renal replacement method, show both its benefits and complications resulting from its use. Undoubtedly, HHD has many benefits resulting mainly from the possibility of regulating the duration of the sessions and increasing their frequency. However, this method is also burdened with numerous complications. There are training courses in the use of HHD for patients who have just been diagnosed with end-stage renal disease as well as for patients undergoing dialysis using other methods. Appropriate patient selection is an important factor for the success of home therapy. There is a fierce battle in the home hemodialysis machine market. Manufacturers are outdoing each other in innovative technologies to ensure ease of use, trouble-free operation and minimize complications. The costs of home hemodialysis include more components than the dialysis treatment itself. Home hemodialysis gives patients comfort and independence above all. This is part of nephrology that undoubtedly requires a lot of work and development, but is certainly an invention of the 21st century

The significance of spoligotyping method in epidemiological investigations of tuberculosis

Introduction: The control of tuberculosis (TB) requires methods for rapid detection and tracing sources of infection, so that further transmission can be arrested. Recent developments in molecular biology have resulted in techniques that allow prompt identification and tracking specific strains of M. tuberculosis as they spread through the population. Most of these techniques take advantage of M. tuberculosis DNA polymorphism and are based on various repetitive DNA elements as genetic markers. Each method yields strain-specific genetic profiles (fingerprints). Strains showing identical fingerprints are referred to as clustered and are usually associated with recent transmission, whereas strains whose fingerprints are unique are presumed to represent remote transmission, a reactivation of infection acquired in the distant past. Material and methods: In recent years, spoligotyping has become one of the most widely used genotyping method for epidemiological studies of TB. Spoligotyping is a PCR-based method allowing to analyze strain-dependent polymorphisms observed in spacer sequences present within the direct repeat (DR) genomic region of M. tuberculosis complex strains. Spoligotyping provides some important advantages over other genotyping techniques. These are simplicity, rapidity, high reproducibility and stability of the results, with the latter being expressed in a simple digital pattern, readily named and databased, and the ability to perform spoligotyping directly on clinical samples, without the need for prior culture. However, spoligotyping has relatively low discriminatory capacity, which makes it necessary to use secondary fingerprinting methods to prove clonality between isolates. Results: The aim of this study was to evaluate the usefulness of spoligotyping in epidemiological investigations of TB by analyzing 16 isoniazid-resistant M. tuberculosis strains isolated from patients with pulmonary TB in the central region of Poland. A total of 11 distinct spoligopatterns were obtained. 9 isolates were represented by a unique pattern, whereas 7 were clustered in 2 groups of 5 and 2 isolates, respectively. When compared with an international spoligodatabase SpolDB4, 13 isolates shared already described spoligotypes, whereas 3 did not match any existing spoligopattern in database and were defined as orphans. Spoligotyping overestimated the number of clustered isolates in one of its two clusters when compared to IS6110 Mtb1/ /Mtb2 PCR. Strains clustered using the latter method were assumed to be closely epidemiologically related. Conclusion: This report demonstrates the utility of spoligotyping as an initial screening technique, to be supplemented by another typing method of greater discriminatory power, such as the IS6110 Mtb1/Mtb2 PCR in order to better recognize the epidemiological links between TB patients.Wstęp: Obserwowany w ostatnich latach intensywny rozwój nowoczesnych metod biologii molekularnej umożliwił ich zastosowanie do badań w epidemiologicznych dochodzeniach gruźlicy. Techniki te polegają na wykrywaniu w genomie prątków sekwencji insercyjnych lub powtórzonych sekwencji DNA, których liczba i zmienność genetyczna stanowią marker identyfikacyjny. Każda z metod wykorzystujących właściwości jednego lub kilku markerów genetycznych prowadzi do uzyskania charakterystycznego dla danego szczepu wzoru genetycznego - fingerprint. Szczepy prątków gruźlicy, których wzory typowania genetycznego są identyczne lub bardzo do siebie podobne, są grupowane (clustering) i mogą mieć wspólne źródło pochodzenia. Szczepy takie uznaje się jako transmitowane między ludźmi, podczas gdy szczepy o różnych wzorach wykazują odmienne źródło transmisji, mogą również pochodzić z reaktywacji dużo wcześniejszego zakażenia. Materiał i metody: W ostatnich latach metoda spoligotyping stała się jedną z powszechnie stosowanych metod genetycznych w gruźlicy. Metoda ta oparta na PCR wykorzystuje polimorfizm chromosomalnego regionu DR występującego u prątków należących do M. tuberculosis complex. Jest to metoda szybka, łatwa w wykonaniu i wydajna. Cechuje ją wysoka powtarzalność wyników. Może być stosowana do wykrywania i identyfikacji M. tuberculosis complex bezpośrednio w materiale klinicznym z pominięciem hodowli. Ponieważ jednak metoda ma pewne ograniczenia, szczepy posiadające te same spoligotypy muszą być dalej różnicowane inną metodą molekularną. Wyniki: Badania przeprowadzone przez autorów pracy dotyczyły szczepów prątków gruźlicy opornych na izoniazyd, które wyizolowano od 16 chorych z centralnego regionu Polski. Otrzymano 11 różnych wzorów spoligo, w tym 9 szczepów posiadało unikalne (niepodobne do siebie) wzory, natomiast 7 należało do dwóch rodzin molekularnych. Otrzymane wzory sprawdzano w międzynarodowej bazie opisanych wzorów molekularnych SpolDB4. Szczepy od 13 chorych posiadały swoje wzorce w bazie, natomiast 3 szczepy zdefiniowano jako sieroce (orphans), to znaczy niezgłoszone jeszcze do bazy. Zastosowanie metody IS6110 Mtb1/Mtb2 PCR pozwoliło na zróżnicowanie szczepów posiadających takie same wzory spoligo. Wnioski: Praca potwierdza przydatność metody spoligotyping jako metody przesiewowej w dochodzeniach epidemiologicznych w gruźlicy. Ze względu na ograniczoną zdolność różnicowania, szczepy o tym samym spoligotypie muszą być poddane dodatkowej analizie metodą IS6110 Mtb1/Mtb2 PCR