The role of immunomodulatory preparations in asthma treatment

Asthma remains one of the most prevalent respiratory tract disorders. The disease affects both adults and children and remains the most common cause of respiratory morbidity. Considering its significant impact on patients’ quality of life and the treatment burdened with side effects, a new therapy approaches affecting the clinical course of asthma are needed. Here we describe the current results that have been obtained on using immunomodulatory preparations in asthma. The analysis of previously published studies was conducted by using the PubMed and Scopus databases.             Probiotics, bacterial lysates (BLs) and pidotimod are immunomodulatory compounds affecting both adaptive and innate immunity. The therapy based on probiotics might modulate the intestinal microbiota and regulate the inflammatory response. Bacterial lysates promote immune response by reversing Th1/Th2 unstable balance, which leads to reduction of allergen-induced airway hyperresponsiveness during asthma exacerbations. Pidotimod stimulates PRRs and increases the release of antimicrobial peptides which also leads to the improvement in the rate of respiratory tract infections. Some studies showed the beneficial effect of described preparations in asthma course. Regrettably, findings do not correspond with each other and the data referring to immunomodulatory compounds is still limited, thus there is an urgent need to conduct more, large sample studies.The conclusion we can only draw is that immunomodulatory compounds may offer an alternative approach for symptom reduction and prophylaxis against both infections and exacerbations of asthma

Apple Cider Vinegar in the Combat Against Type 2 Diabetes and Obesity – An Overview of Recent Research

ABSTRACT Introduction Apple Cider Vinegar, primarily composed of acetic acid, is gaining more recognition for its possible health advantages, especially its anti-diabetic effects and its beneficial impact on weight loss. Aim of this study   The aim of this review is to discuss the current state of knowledge regarding the influence of ACV on glycemic indices and weight management in diabetic and obese patients, explore the possibilities of preventing comorbidities, and assess the safety of ACV consumption. Materials and Methods Research was performed based on Pubmed and Google Scholar databases. The literature was reviewed using the keywords : Apple Cider Vinegar, Diabetes, Glucose, Obesity. Results Studies have confirmed that apple cider vinegar exhibits significant anti-obesity and anti-diabetic properties. It demonstrates dose- and time-dependent effects on reducing fasting glucose, postprandial glucose, glycated hemoglobin, and lipid parameters. It positively impacts weight loss, reducing waist and hip circumference, and enhances tissue sensitivity to insulin. Additionally, apple cider vinegar has been shown to potentiate the effects of metformin, with liquid consumption yielding better results than pill form. Conclusions Although initial findings are encouraging, additional research with a larger participant pool and an extended duration of vinegar consumption is necessary. The brevity of the study period restricts the observation of long-term effects, and a larger sample size would improve the applicability of the findings. Key words: apple cider vinegar; diabetes; glucose; obesit

The Influence of diet on the course and activity of Crohn's disease and ulcerative colitis - a review of available literature

Introduction: Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the digestive tract. It is a clinical entity that includes: Crohn's disease (CD) and ulcerative colitis (UC). Food intake is an important environmental factor that influences the development of IBD. This article reviews studies on different dietary options and their effects on the course and activity of Crohn's disease and ulcerative colitis.  Materials and methods: A review of the literature available in the PubMed database was carried out, using the key words: ”inflammatory bowel disease”; ”Crohn disease”; ”diet”; “nutrition”; „colitis ulcerosa”. Results: Appropriate diet selection is important in the course of inflammation in the intestines. It influences disease activity. It turns out that the diet improves inflammation parameters, clinical symptoms, and quality of life. In patients with inflammatory bowel disease, one should also remember about deficiencies such as iron, vitamin D or protein deficiency, the demand of which is increased in sick patients compared to the general population. Conclusions: An individualized approach to nutritional therapy may be one of the main branches of treatment for patients with inflammatory bowel diseases. However, there is a need for further research on larger groups of patients in order to effectively implement it into treatment standards.

Skuteczne leczenie ciężkich postaci zakażeń RSV i Pneumocystis jirovecii u dziecka z zespołem Downa i ostrą białaczką limfoblastyczną leczonego chemioterapią

There has been significant progress in acute lymphoblastic leukemia (ALL) treatment throughout the previous decades. However, infectious complications are still the main problem during cancer treatment. Literature reports show that treatment-related mortality is 2–4% and is mainly related to infection. Here, the authors report a 3-year-old patient with Down syndrome and ALL who was hospitalized in the Department of Pediatric Hematology, Oncology and Transplantology of the Medical University of Lublin. The patient was treated according to the AIEOP-BFM 2017 protocol and developed a severe co-infection of Pneumocystis jiroveci and respiratory syncytial virus during the induction phase of chemotherapy and P. jiroveci re-infection while receiving Protocol II. As a result, chemotherapy was interrupted for 51 and 31 days, respectively. The patient required the administration of broad-spectrum antibiotics, antiviral and antifungal therapy and passive oxygen therapy. Due to a severe clinical condition, the patient was also temporarily hospitalized in the Intensive Care Unit. Research revealed several risk factors for infectious complications in patients with ALL including intensive chemotherapy or Down syndrome. Therefore, despite anti-infective prophylaxis, increased medical vigilance is necessary. In the case of infectious symptoms, early diagnosis and prompt treatment should be implemented to enable the continuation of the ALL therapeutic protocol.U pacjentów z ostrą białaczką limfoblastyczną śmiertelność związana z leczeniem wynosi 2-4%, przy czym najczęstszą jej przyczyną są zakażenia. Zapalenie płuc wywołane przez Pneumocystis jirovecii było najczęstszą przyczyną zgonów związanych z infekcją u dzieci z białaczką przed włączeniem profilaktyki do standardowej terapii. Natomiast infekcje wirusowe dróg oddechowych są odpowiedzialne za aż 44% epizodów gorączki u dzieci z białaczką. Analizowano dane laboratoryjne i kliniczne 3-letniego chłopca z zespołem Downa i ostrą białaczką limfoblastyczną. W ramach profilaktyki zakażeń otrzymywał on kotrimoksazol i flukonazol. Pacjent rozwinął: ciężką postać koinfekcji Pneumocystis jirovecii i RSV podczas fazy indukcji chemioterapii oraz reinfekcję Pneumocystis jirovecii podczas Protokołu II, co znacznie pogorszyło jego stan kliniczny. Konieczne było odstawienie chemioterapii na kolejno 51 i 31 dni, zmniejszenie dawek sterydów, zastosowanie antybiotyków o szerokim spektrum działania, terapii przeciwwirusowej i przeciwgrzybiczej, tlenoterapii biernej oraz rehabilitacji oddechowej. Podczas pierwszej infekcji, ze względu na krytyczny stan kliniczny, pacjent przez 6 dni przebywał na Oddziale Intensywnej Terapii. Badania pokazują, że infekcje występują częściej i mają cięższy przebieg podczas stosowania intensywnej chemioterapii, zwłaszcza w fazie indukcji remisji i reindukcji. Może być to rezultat zwiększonej częstości i czasu trwania neutropenii. Ponadto zwiększona podatność na infekcje koreluje z młodszym wiekiem pacjenta, płcią żeńską, niedowagą, chorobami genetycznymi. Dlatego, mimo profilaktyki, niezwykle ważna jest wzmożona czujność medyczna, szczególnie w przypadku obecności czynników ryzyka infekcji oraz w okresach intensywnej chemioterapii

Does diet influence the development and treatment of endometriosis? - A literature review

Introduction and objective: Endometriosis is a chronic disease that can cause symptoms that significantly worsen the quality of life of patients. Treatment methods often fail to produce satisfactory results. Therefore, there is growing interest in the potential role of diet in prevention and management of endometriosis. The aim of the review is to analyze available scientific literature on the impact of diet on the development and alleviation of endometriosis symptoms and the possibility of its use in clinical practice. Brief description of the state of knowledge: Both nutrient deficiencies and excesses can affect health, with gene-nutrient interactions playing a key role in disease prevention and progression. Nutrition can alter gene expression and disease susceptibility, making the study of diet's influence on gynecological diseases like endometriosis important. Research suggests dietary changes can improve symptoms and quality of life for patients with endometriosis. Conclusions: This study confirms that consuming or limiting some of the nutrients can reduce the risk of developing endometriosis and alleviate its symptoms. However, there are many contradictions in the research. The role of diet and nutrition in endometriosis still remains an unexplored area that requires further investigation

The impact of overweight and obesity on the results of laparoscopic ventral hernia repair, including robot-assisted repair - a literature review

Obesity is the fifth leading cause of death worldwide. In turn, ventral hernias (including an inguinal hernias) are one of the most common cases in general surgery. Minimally invasive techniques (laparoscopic or robot-assisted procedures) are becoming more and more popular in ventral hernia treatment compared to open procedures. The aim of this study is to analyze the impact of body mass index (BMI) value on the efficacy and safety of laparoscopic ventral hernia repairs, including inguinal hernia repairs. Numerous studies evaluating this relationship are available. In most studies, There were also no statistically significant differences in the rate of intraoperative complications, the median operative time, the median length of hospital stay, the rate of postoperative pain, the surgical site infection, the rate of postoperative complications, the median time to recurrence, and the rate of early and late recurrences between groups with different BMI values. Moreover, studies proved that laparoscopic ventral hernia repair in obese patients is more effective compared to the open repair. The analysis revealed that high BMI values do not have a statistically significant impact on the outcomes of laparoscopic repair, including robot-assisted laparoscopic repair, in patients with ventral hernias. However, it should be noted that the analyzed studies often have limitations. For this reason, it is essential to conduct multicenter studies and perform long-term evaluations of patients