A developmental anomaly of the mammary glands - gigantomastia. A case report

Developmental anomalies of the breast are frequently observed in women. The most serious pathology is gigantomastia. This type of breast hypertrophy may be caused by hypersensitivity of the breast oestrogen and progesterone receptors, by disturbances of the normal balance of oestrogen and androgen hormones, by hyperthyroidism or by hormonal activity of the neoplasm. In most cases gigantomastia produces pathological changes in the vertebral column which become manifest as discopathia, scoliosis or scoliokyphosis. A case of gigantomastia treated with surgery is presented and the effect of plastic operation is demonstrated. Surgery may be recommended as an excellent therapeutic treatment of gigantomastia

Mammary gland anatomy and the role of mammography and ultrasonography in the early diagnostics of breast cancer. A case report

Progress in imaging techniques has brought a solution to the problem of the early diagnosis of breast cancer. An interesting case of breast cancer is presented here, pictures of the malignant tumour are demonstrated and the usefulness of new diagnostic methods analysed. The presentation of this case may contribute to greater effectiveness in early breast cancer detection

Axillary lymph node and early breast cancer diagnostics. A case report

Understanding of the anatomy of the axillary lymph nodes is important in diagnostic and treatment procedures for breast cancer. An interesting case is presented here of breast cancer without a breast tumour. The first symptom of the disease was lymphadenopathy of the axillary region. This kind of case is extremely rare in clinical practise (one case per 1-5 years) and constitutes a great problem for specialists, since in many cases the primary neoplasm source is unknown. The anatomical and clinical implications of such a situation are discussed

Lipid and exocrine pancreatic ultrastructural changes due to experimental diabetes

The aim of this study was to establish if the changes in the ultrastructure of the exocrine part of the pancreas are correlated with changes in serum glucose, cholesterol and lipoprotein fractions during the progression of diabetes in rabbits. Diabetes mellitus was induced in male New Zealand rabbits by a single injection of alloxan into the auricular vein. On the day 7th the glucose level in the whole blood was measured and this day was designated as the first day of diabetes. Rabbits were divided into 5 groups: untreated control, 21-day diabetes, 42-day diabetes, 90-day diabetes and 180-day diabetes. The cholesterol, HDL (high-density lipoprotein) and LDL (low-density lipoprotein) levels were examined in the serum. The total pancreatic lipase activity was measured spectrophotometrically in the pancreatic homogenate. Histological specimens were examined under an electron microscopy. The glucose level increased significantly in all of the alloxan exposed animals. The significant elevation of cholesterol level was observed on day 21 and 180. The HDL level was increased (P<0.05) only on the day 21st. The LDL level and the total activity of pancreatic lysosomal lipase increased significantly on day 21, 42 and 90. Further dilation of granular endoplasmic reticular ducts and decrease in the number of zymogen granules were observed amongst exocrine cells. Fragmented mitochondrial and translucent matrix were also seen. Intensification of the pancreatic fibrosis was found on day 90. Microvascular changes were reported in exocrine cells after 180 days. Their nuclei were smaller with large bulges on the nuclear membrane, and the number of heterogeneous electron granules of zymogen further declined. We concluded that the intensification of ultrastructural changes of the exocrine part of the pancreas correlated with the changes of the pancreatic lipase activity, and glucose and lipoprotein levels

Cardiac rehabilitation in the Comprehensive Cardiac Care program in the time of a COVID – 19 pandemic

Introduction and purpose: Cardiac rehabilitation in patients after myocardial infarction is an established form of therapy. Its main tasks in the context of the implementation of the KOS program are to improve quality of life, consolidate the effects of hospital treatment and ensure better functioning after a cardiovascular incident. The purpose of this paper is to analyze the current level of knowledge regarding cardiac rehabilitation of patients during the COVID-19 pandemic. Description of the state of knowledge: COVID-19 poses a significant threat to patients with cardiovascular disease. Physiotherapy in the Cardiac Rehabilitation Unit involves a step-by-step, individualized rehabilitation plan in accordance with the patient's condition. An important tool for clinical evaluation is capacity tests, the results of which provide key information for the rehabilitation team in selecting exercise intensity. These tests are performed on the first and last days of rehabilitation. In Polish conditions, the most common tests examining capacity are an exercise test on a treadmill or bicycle cycler or a 6-minute walk test. Due to the diversion of a significant number of specialists and health care teams to treat COVID - 19 patients, access to the possibility of implementing the various stages of the Coordinated Specialized Care program after myocardial infarction has been limited. Summary: Post-infection patients are often forced to live a sparing lifestyle. They show reduced exercise tolerance and easier fatigability. With these aspects in mind, improving the quality of life of patients after cardiovascular incidents in the era of the pandemic requires even greater involvement of the entire rehabilitation team

Tirzepatide - a novel dual GLP-1 and GIP receptor agonist used in pharmacotherapy of obesity: A literature review

Background: Obesity is a chronic disease, which along with its complications, poses a huge threat to both our health as individuals and our healthcare as a community. Objective: The aim of this work is to review efficacy and safety of Tirzepatide, a novel dual GIP/GLP-1 receptor agonist in the treatment of obesity Method: A literature review was conducted on databases such as PubMed and Google Scholar using terms “obesity”, “obesity treatment”, “glucagon-like peptide 1”, “Glucose-dependent insulinotropic polypeptide”, “Tirzepatide” as keywords. The review was performed in accordance with the PRISMA guidelines. Results:&nbsp; Administration of tirzepatide once weekly provides a substantial and sustained reduction in bodyweight with little side effects. Conclusions: Clinical trials showed both high efficacy and safety of Tirzepatide in management of obesity. Due to its novel, broadened mechanism of action it seems to be the most effective drug for reducing bodyweight available on the market. Tirzepatide could be our answer to tackling the problem of world-wide obesity epidemic. &nbsp

Multifaceted therapeutic options for stress urinary incontinence in women

 Stress urinary incontinence (SUI) affects many women worldwide in every age group. Involuntary leakage of urine during abdominal pressure increase significantly reduces the quality of life. The choice of treatment depends on the patient's expectations, the doctor's experience and the severity of symptoms. Aim of the study: The aim of this study is to discuss the therapeutic methods of stress urinary incontinence (SUI). Material and method: The work was based on a review of the available literature in the PubMed, Google and Google Scholar databases using the following keywords: stress urinary incontinence; SUI; urinary incontinence in women; Surgical treatment; TOT; TVT. Results and conclusions: We use conservative and surgical methods in the treatment of stress urinary incontinence. Conservative treatments such as physiotherapy, pharmacotherapy, and behavioral therapy are first-line treatments. In the case of severe symptoms of stress urinary incontinence, surgical treatment is used. The most common method is the Burch operation and TVT and TOT sling operations. Treatment of stress urinary incontinence (SUI) in women requires an approach that takes into account the patient's goals, severity of symptoms, desired effect, physician experience and complications, therefore there is no single effective management

Peripartum cardiomyopathy: current theories about etiopathogenesis, potential biomarkers and treatment - a literature review

Background: Peripartum cardiomyopathy (PPCM) is a form of an idiopathic systolic heart failure, which occurs the most often in the last weeks of pregnancy or in the early postpartum period. Symptoms of this disease include exertional dyspnea, orthopnoea, paroxysmal nocturnal dyspnoea and edema. They are typical for a heart failure, but also can be attributed to late pregnancy or the effects of labor, which is a cause of common misdiagnosis or its delay and significantly affects the worsening of the prognosis and the high mortality rate. In more severe cases, cardiogenic shock, arrhythmias, thromboembolic complications may occur, leading to death. Aim of the study: The study aim is to summarize the current state of knowledge and the recent scientific reports on the potential etiopathogenesis, diagnostics including new biomarkers, and treatment of the peripartum cardiomyopathy. Material and methods: The study is based on the scientific literature available in the PubMed and Google Scholar databases, using the following keywords: „peripartum cardiomyopathy”, „pregnancy-associated cardiomyopathy” and “16-kDa prolactin”. Results and conclusions: The diagnosis of peripartum cardiomyopathy should be considered in every pregnant or postnatal woman with symptoms of heart failure. Despite great advances made in understanding and diagnosing PPCM over the last few years, the pathogenesis and complex interactions of genetics and the vascular and hormonal balance of late pregnancy are still unclear. Further research is needed to determine the benefits and risks of bromocriptine treatment and the use of new markers in the diagnostics of PPCM

Do the benefits outweigh the risks? Potential dangers associated with long-term therapy of proton pump inhibitors

Introduction:Proton pump inhibitors (PPIs) are one of the most popular and also one of the most commonly prescribed medications worldwide. In many conditions associated with excessive secretion of hydrochloric acid in the stomach, they are the first-line treatment. When they are used in a balanced manner in strict indications, they have a high level of efficacy and a favorable safety profile. The low rate of side effects refers mainly to their short-term use.&nbsp; With the over-the-counter availability of PPIs, increasing dangerous trend of their abuse has provided new evidence suggesting the presence of numerous, more serious side effects of long-term PPI therapy. Purpose:The purpose of this review is to summarize current reports regarding the potential risks and causal relationship of adverse effects occurring as a consequence of long-term use of proton pump inhibitors. Material and methods:This literature review based on the available scientific literature, published between 2015 and 2023 in the Pubmed database, searched using the terms, listed under "keywords”. Conclusion:PPIs are relatively safe drugs. However, they are not completely free of side effects. There are a lot of reports suggesting a potential connection between their long-term use and the development of complications, such as: various infections, decreased absorption of nutrients, kidney disease, liver disease, pancreatic disease, musculoskeletal disease, nervous system disease, cardiovascular disease, dementia, hypergastrinemia and even cancer. However, some of them are fraught with errors, and another often provide contradictory results. More precisely designed studies are needed to draw clear conclusions, especially in view of the ever-increasing abuse of PPIs worldwide. It is worth noting that patients with strictly defined indications for long-term PPI therapy, may benefit significantly outweighing the potential dangers

Transcranial magnetic stimulation as a promising method of treatment in depression and various neuropsychiatric conditions. A literature review

Background: Transcranial magnetic stimulation (TMS) is a method of non-invasive and painless brain stimulation with an electromagnetic field, which induces changes in the electric field in the brain leading to the cortical activity modulation and stimulation of neurons. Currently, transcranial magnetic stimulation is increasingly used in the diagnosis and treatment of various neuropsychiatric conditions, such as depression, schizophrenia, neurodegenerative diseases, and more. TMS can be used as a method of enhancing the effect of pharmacotherapy as well as a regular treatment. Aim of the study: The study's aim is to summarize the current state of knowledge on transcranial magnetic stimulation as a method of treatment in depression and various neuropsychiatric conditions. Material and methods: The study is based on the literature available in scientific databases such as PubMed, using the following keywords: „transcranial magnetic stimulation”, „tms”, “depression” and “treatment-resistant depression”. Results and conclusions: Transcranial magnetic stimulation is a non-invasive, painless and generally safe method of diagnosis and treatment of many neuropsychiatric diseases, such as depression, schizophrenia, obsessive-compulsive disorders, neurodegenerative diseases, tinnitus, addiction to psychoactive substances and many more. TMS is a well-documented, approved, and recommended treatment primarily for treatment-resistant depression due to its effectiveness, mild side effect profile and good tolerability. Recently there are more and more reports on the effectiveness of TMS in the diagnosis and treatment of other neuropsychiatric conditions, but further research and setting guidelines are needed, so is increasing the availability of the method for patients