Opioid-induced bowel dysfunction: a literature review

Opioid therapy plays a crucial role in the management of acute and chronic pain, with opioids being widely prescribed worldwide. However, alongside the analgesic benefits, the use of opioids is associated with a range of adverse effects, including opioid-induced bowel dysfunction. Opioid-induced bowel dysfunction refers to a constellation of gastrointestinal symptoms caused by the effects of opioids on the gastrointestinal tract. These symptoms primarily manifest as constipation, but can also include abdominal pain, bloating, nausea, and vomiting. Opioid-induced bowel dysfunction poses a significant clinical challenge, as it can severely affect patients' quality of life. Non-pharmacological approaches alone are rarely sufficient to counteract the adverse effects of opioid therapy. The primary pharmacological agents used in opioid-induced bowel dysfunction management are laxatives, which should be chosen according to individual patient needs. Patients with poorly controlled symptoms can benefit from new pharmacological approaches, particularly peripheral mu-opioid receptor antagonists. By better understanding the underlying mechanisms, clinical manifestations, diagnostic criteria, and management strategies, healthcare professionals can optimize patient care, minimize complications, and improve patients' overall well-being

Opioid-induced bowel dysfunction: a literature review

Opioid therapy plays a crucial role in the management of acute and chronic pain, with opioids being widely prescribed worldwide. However, alongside the analgesic benefits, the use of opioids is associated with a range of adverse effects, including opioid-induced bowel dysfunction. Opioid-induced bowel dysfunction refers to a constellation of gastrointestinal symptoms caused by the effects of opioids on the gastrointestinal tract. These symptoms primarily manifest as constipation, but can also include abdominal pain, bloating, nausea, and vomiting. Opioid-induced bowel dysfunction poses a significant clinical challenge, as it can severely affect patients' quality of life. Non-pharmacological approaches alone are rarely sufficient to counteract the adverse effects of opioid therapy. The primary pharmacological agents used in opioid-induced bowel dysfunction management are laxatives, which should be chosen according to individual patient needs. Patients with poorly controlled symptoms can benefit from new pharmacological approaches, particularly peripheral mu-opioid receptor antagonists. By better understanding the underlying mechanisms, clinical manifestations, diagnostic criteria, and management strategies, healthcare professionals can optimize patient care, minimize complications, and improve patients' overall well-being

PRZESZCZEP MIKROBIOMU JELITOWEGO JAKO METODA LECZENIA NAWROTOWYCH ZAKAŻEŃ CLOSTRIDIUM DIFFICILE

StreszczenieWstępClostridium difficile jest wiodącym czynnikiem etiologicznym szpitalnych biegunek zakaźnych zwłaszcza w krajachrozwiniętych.CelGłównym celem pracy jest przedstawienie swoistej immunoterapii i zasad leczenia bakteriami kałowymi jako skutecznąalternatywę w leczeniu i zapobieganiu nawrotowym biegunkom.PrzeglądWystępowanie zakażeń Clostridium difficile nasila się w wielu krajach, towarzyszy temu również zwiększenie liczbyciężkich przypadków tych zakażeń przebiegających pod postacią rzekomo błoniastego zapalenia jelit, zapalenia okrężnicy,perforacji jelit i posocznicy, z tego powodu rośnie również liczba zgonów. Dominującym czynnikiem ryzyka występowaniatych zakażeń jest narastające stosowanie zwłaszcza empiryczne antybiotyków o szerokim spektrum działania. Zapaleniejelit w przebiegu zakażenia beztlenowej laseczki Clostridium difficile w ostatnim dziesięcioleciu stało się ogólnoświatowymproblemem medycznym. W związku z gwałtownym wzrostem liczby zachorowań w Ameryce Północnej oraz Europie, wzrastaznaczenie przeszczepu flory jelitowej jako bezpiecznej i skutecznej opcji terapeutycznej w przypadku nawracających lubopornych na leczenie antybiotykami zakażeń Clostridium difficile. Zabieg ten jest od 2012 roku wykonywany w niektórychpolskich podmiotach leczniczych z 92% skutecznością. Niektórzy eksperci postulują zasadność stosowania transferumikrobiomu jelitowego jako pierwszej linii terapii w przypadku nawracających lub opornych na leczenie antybiotykamizakażeń Clostridium difficile.WnioskiArgumentem przemawiającym za stosowaniem transferu mikrobiomu jelitowego w pierwszej kolejności jest wykazanaw toku badań wyższa skuteczność leczenia, niż wykazana dla wankomycyny, a także nieporównywalnie mniejsza skalai zakres objawów ubocznych terapii, niż w przypadku wankomycyny.Słowa kluczowe: clostridium difficile, zakażenie, przeszczep, transfer mikrobiomu jelitowego, biegunk

Congenital muscular torticollis – an over view of treatment methods

Kręcz szyi jest zaburzeniem wrodzonym lub nabytym, które może wpływać na postawę i globalną motorykę dziecka, prowadząc do opóźnienia rozwoju ruchowego. Wczesne wdrożenie leczenia zachowawczego gwarantuje wycofanie objawów u większości pacjentów. W przypadkach ciężkich postaci klinicznych, z obecnością guza w masie mięśnia mostkowo-obojczykowo- sutkowego, rokowanie jest mniej pomyślne, a leczenie poza leczeniem zachowawczym, może obejmować metody inwazyjne. Celem pracy jest przedstawienie metod stosowanych w leczeniu niemowląt z wrodzonym kręczem szyi.Torticollis is a congenital or acquired disorder that can affect a child’s posture and global motor skills leading to delayed motor development. Early implementation of conservative treatment guarantees withdrawal of symptoms in most patients. In cases of severe clinical forms, with the presence of tumor in the sterno-cleido-mastoid muscle mass, the prognosis is less favorable and treatment outside the conservative treatment may involve invasive procedures. The aim of the study is to present the methods used in the treatment of infants with congenital torticollis

Polska wieś wobec wyzwań rozwoju społeczno-gospodarczego w XXI wieku w świetle badań IRWiR PAN w roku 2014 i 2015

Niniejszy artykuł przedstawia najważniejsze wnioski z badań statutowych pracowników IRWiR PAN realizowanych w latach 2014–2015. Prowadzone analizy dotyczą kluczowych procesów gospodarczych i społecznych zachodzących na obszarach wiejskich w ostatnich dekadach. Artykuł obejmuje wybrane wnioski na temat: struktury obszarowej sektora gospodarstw indywidualnych, p rzemiany struktur demograficznych, wiejskiego rynku pracy, rozwoju przestrzennego obszarów wiejskich, przeobrażeń społecznych oraz rozwoju instytucjonalnego i organizacyjnego na wsi. Ważnym obszarem badawczym po- dejmowanym w IRWiR PAN jest także ocena ws pólnej polityki rolnej oraz porównanie jej z politykami innych krajów w tym Farm Bill w USA. ----- This article presents the main conclusions from the research conducted by scientists employed in IRWiR PAN in 2014–2015. The analyses conducted address key economic and social processes taking place in rural areas in recent decades. The article contains selected findings on: territorial structure of the individual farms’ sector, changes in demographic structures, the rural labour mark et, spatial development of rural areas, social changes and institutional and organizational development of the countryside. An important area of research undertaken in IRWiR PAN relates to the evaluation of the Common Agricultural Policy and its comparison with policies implemented in other countries, including Farm Bill in the United States

Towards an optimization of stimulus parameters for brain-computer interfaces based on steady state visual evoked potentials.

Efforts to construct an effective brain-computer interface (BCI) system based on Steady State Visual Evoked Potentials (SSVEP) commonly focus on sophisticated mathematical methods for data analysis. The role of different stimulus features in evoking strong SSVEP is less often considered and the knowledge on the optimal stimulus properties is still fragmentary. The goal of this study was to provide insight into the influence of stimulus characteristics on the magnitude of SSVEP response. Five stimuli parameters were tested: size, distance, colour, shape, and presence of a fixation point in the middle of each flickering field. The stimuli were presented on four squares on LCD screen, with each square highlighted by LEDs flickering with different frequencies. Brighter colours and larger dimensions of flickering fields resulted in a significantly stronger SSVEP response. The distance between stimulation fields and the presence or absence of the fixation point had no significant effect on the response. Contrary to a popular belief, these results suggest that absence of the fixation point does not reduce the magnitude of SSVEP response. However, some parameters of the stimuli such as colour and the size of the flickering field play an important role in evoking SSVEP response, which indicates that stimuli rendering is an important factor in building effective SSVEP based BCI systems

On the quantification of SSVEP frequency responses in human EEG in realistic BCI conditions.

This article concerns one of the most important problems of brain-computer interfaces (BCI) based on Steady State Visual Evoked Potentials (SSVEP), that is the selection of the a-priori most suitable frequencies for stimulation. Previous works related to this problem were done either with measuring systems that have little in common with actual BCI systems (e.g., single flashing LED) or were presented on a small number of subjects, or the tested frequency range did not cover a broad spectrum. Their results indicate a strong SSVEP response around 10 Hz, in the range 13-25 Hz, and at high frequencies in the band of 40-60 Hz. In the case of BCI interfaces, stimulation with frequencies from various ranges are used. The frequencies are often adapted for each user separately. The selection of these frequencies, however, was not yet justified in quantitative group-level study with proper statistical account for inter-subject variability. The aim of this study is to determine the SSVEP response curve, that is, the magnitude of the evoked signal as a function of frequency. The SSVEP response was induced in conditions as close as possible to the actual BCI system, using a wide range of frequencies (5-30 Hz, in step of 1 Hz). The data were obtained for 10 subjects. SSVEP curves for individual subjects and the population curve was determined. Statistical analysis were conducted both on the level of individual subjects and for the group. The main result of the study is the identification of the optimal range of frequencies, which is 12-18 Hz, for the registration of SSVEP phenomena. The applied criterion of optimality was: to find the largest contiguous range of frequencies yielding the strong and constant-level SSVEP response

SSVEP responses to stimuli with and without fixation point; organization of the plot as in <b>Figure 2</b>.

<p>SSVEP responses to stimuli with and without fixation point; organization of the plot as in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0112099#pone-0112099-g002" target="_blank"><b>Figure 2</b></a>.</p