Prevention, diagnosis and treatment of tumor lysis syndrome

Tumor lysis syndrome (TLS) is an acute, life-threatening condition that occurs either spontaneously or as a complication of cytoreductive antitumor therapy, and occurs in both children and adults. As a result of TLS, intracellular components are released into the extracellular space, leading to dysregulation of the body's homeostasis due to the accumulation of uric acid, phosphate and potassium ions, and hypocalcemia, which may lead to cardiac arrhythmias, convulsions, or kidney failure

Cardiovascular comorbidities in acromegaly

Introduction and purpose: Acromegaly is a rare disease which occurs with the frequency of 0.2-1.1 cases per 100 000 patients per year. The main cause is the excess level of growth hormone (GH) which stimulates the liver to the insulin-like growth factor type 1 (IGF-1) secretion. IGF-1 leads to the tissues overgrowth. In addition, acromegalic patients suffer from many comorbidities, such as: cardiovascular, endocrinological, neoplastic and musculoskeletal complications. The main aim of this review is the update of the latest information concerning cardiovascular comorbidities in patients with acromegaly.State of knowledge: Studies revealed that 80% of acromegalic patients will develop cardiovascular comorbidities. Complications such as: hypertension, cardiomyopathy, arrhythmia, heart valve disease, atherosclerosis and coronary heart disease as well as myocardial infarction were the most widely described. They are responsible for 44% of deaths in the first decade of the acromegaly and 23% in the second one.Conclusions: Because of the delayed diagnosis of acromegaly in most patients, most comorbidities are discovered in advanced stages leading to the decrease in patients’ life span. Adequate knowledge about potential complications is necessary to increase patients’ quality of lives

The gut microbiota and mental health

INTRODUCTION AND PURPOSE Recent studies have shown that changes in the microbiome, probiotic and antibiotic supplementation, can significantly modulate various forms of neuropsychiatric disorders - such as depression, anxiety and stress-related disorders. There is growing body of evidence pointing to a bidirectional correlation along the brain-gut microbiota line. This axis is connected through endocrine, immune and neuronal pathways. The nerves that make up the enteric nervous system transmit modifications occurring in the gastrointestinal tract and through the vagus nerve to the central nervous system (1). The main purpose of this review is to update recent information on the correlation between the gut microbiota and mental health. STATE OF KNOWLEDGE Interactions between the gastrointestinal system and brain function have become an important field of psychiatric research in recent years. Probiotics are thought to be a potentially valuable player in the treatment of many neuropsychiatric disorders. However, the role of specific gut microbiota species in the development of these disorders remains unclear. CONCLUSIONS Increasing knowledge of the correlation between gut microbiota and mental health may improve the quality of treatment for patients with neuropsychiatric conditions. Further research on larger groups is needed to assess whether probiotics can modify altered psychological well-being and be integrated into current, conventional treatments.INTRODUCTION AND PURPOSE Recent studies have shown that changes in the microbiome, probiotic and antibiotic supplementation, can significantly modulate various forms of neuropsychiatric disorders - such as depression, anxiety and stress-related disorders. There is growing body of evidence pointing to a bidirectional correlation along the brain-gut microbiota line. This axis is connected through endocrine, immune and neuronal pathways. The nerves that make up the enteric nervous system transmit modifications occurring in the gastrointestinal tract and through the vagus nerve to the central nervous system (1). The main purpose of this review is to update recent information on the correlation between the gut microbiota and mental health.  STATE OF KNOWLEDGE Interactions between the gastrointestinal system and brain function have become an important field of psychiatric research in recent years. Probiotics are thought to be a potentially valuable player in the treatment of many neuropsychiatric disorders. However, the role of specific gut microbiota species in the development of these disorders remains unclear. CONCLUSIONS Increasing knowledge of the correlation between gut microbiota and mental health may improve the quality of treatment for patients with neuropsychiatric conditions. Further research on larger groups is needed to assess whether probiotics can modify altered psychological well-being and be integrated into current, conventional treatments

Monkeypox in humans – the review

Monkeypox is an emerging zoonotic disease caused by the monkeypox virus with a presentation similar to smallpox. Being previously endemic to Africa, now the disease is spreading across the world, causing fear of a potential next pandemic. Smallpox vaccine, previously providing cross-immunity to monkeypox virus, due to cessation of vaccinations, caused the decline in immunity against these viruses. Defined ways of transmission are animal-to-human through consumption or attack by an affected animal, human-to-human through close contact, or via respiratory droplets. Currently, there are no specific antiviral drugs and vaccine specific to monkeypox, and for symptomatic care, there are no determined guidelines

Prolactin – friendly lactation hormone or hostile cancerogenic factor?

Prolactin is a hormone secreted by lactotrophic cells of the pituitary gland and its main function is stimulating lactation. Binding prolactin by its membrane receptor leads to the activation of signalling pathway that enables cell proliferation and differentiation. Due to this mechanism, the potential oncogenic role of the hormone is of great interest. Prolactin and its receptor have many forms and a complicated signalling pathway, that is why defining prolactin’s specific role in cancerogenesis is difficult and poses a serious challenge. Researches also indicate an important role of extra-pituitary prolactin synthesised in many other tissues in the process of cancerogenesis. This article focuses on connection between prolactin and breast cancer, as it is the most common cancer in women. In several studies, prolactin and its receptor were significantly associated with an increased breast cancer risk. Recent research papers focus also on the treatment of breast cancer, using knowledge about prolactin and its role in the development of the tumour

An impact of selected micronutrients on fertility

Introduction and purpose: The problem with infertility affects between 8 and 12% of reproductive-aged couples. Among the reasons, smoking, adulterated food, hormonal disorder are featured. Our purpose is to check how micronutrients impact fertility.Brief description of the state of knowledge: Micronutrients deficiency, specifically zinc and selenium deficiencies have also unpropitious impact on fertility. In this review, the potential role of these microelements in male and female reproductive health is considered. Zinc had been proved to regulate sperm motility, spermatogenesis and reduce oxidative stress. Lower delivery of selenium decrease testosterone level by causing changes in receptor of the luteinising hormone. It is also compared with lower spermatozoa concentration. In this review the role of iron, manganese, lead, nickel, copper, magnesium and cobalt is described as well. Summary: Deficiencies of some micronutrients may make worse the fertility. That’s the reason why additional supplementation may be important in the treatment of infertility

Bipolar Androgen Therapy in the management of prostate cancer

Introduction and purpose: Prostate cancer (PCa) as one of the most frequent neoplasms in men remains a challenge for oncologists. The main strategy of its treatment is the Androgen Deprivation Therapy (ADT) the principle of which is an inducement of hypogonadism. The lack of testosterone is not only a factor greatly contributing to a decrease of quality of life overall, but additionally it increases the odds of the complications, including low libido and erectile disfunction, metabolic abnormalities, high cardiovascular risk, osteoporosis, anaemia, or depression. ADT also has the potential of inducement of castration resistance (CRPC), which significantly worsen patients prognosis. The main purpose of this review is to explore the Bipolar Androgen Therapy (BAT), which has the potential to solve the aforementioned problems. State of knowledge: The mechanism of BAT action has been described. BAT is effective not only against CRPC, but androgen-dependant PCa as well. BAT reverses the hormone resistance in CRPC, thus allowing the rechallenging of the ADT. It has the direct cytotoxic effect on cancer cells. Additionally BTA increases the exponents of the general quality of life of the patients. There is a number of active clinical trials regarding BAT. Conclusions: BAT is a safe therapeutic strategy with the high efficacy in reversing hormone resistance in CRPC patients, thus significantly increasing their health prognoses and it allows to alleviate or avoid the adverse effects of ADT

Have thyroid hormones an impact on ovarian cancer?

Thyroid hormones show not only genomic, but also nongenomic activity, which is related to specific membrane, cytoplasmic and organelle receptors. The best known receptors are located on the alpha-V-beta-3 integrin of cell membrane. Their stimulation results in an activation of mitogen-activated protein kinases (MAPKs) or phosphoinositide 3-kinase (PI3K), which directly leads to an inhibition of apoptosis and increased proliferation of tumor cells, as well as promotes angiogenesis and metastasis formation. In ovarian cancer cells L-thyroxine is proven to be involved in MAPK activation as well as in the up-regulation of expression and enhanced cellular accumulation of programmed death ligand 1 (PD-L1), which results in an inhibition of neoplastic cells apoptosis

Male hypogonadism with its systemic complications

Introduction and purpose: Total lack of testosterone or its level lower than 9-12 mmol/L (250-350 ng/dL) of serum in men is called hypogonadism. Due to the importance of testosterone in male body, hypogonadism usually causes a variety of symptoms, mostly of sexual nature – lack of libido, erectile dysfunction, infertility and associated psychological problems, it can though be the cause of more dangerous changes in the male body. The purpose of this study is to review possible systemic complications of male hypogonadism (with the emphasis on hypogonadotropic hypogonadism) apart from those sex-related.State of knowledge: The lack of testosterone and gonadotropins was proven to cause a number of negative changes in different systems and various clinical situations. It can negatively impact the condition of skeletal system. Although testosterone is widely thought to increase cardiovascular risk some studies show that the hypogonadism has a negative impact on it as well. Some studies hypothesised the role of hypogonadism in anaemia development, but generally it isn’t taken into account in investigation of this condition. Some studies show the impact of hypogonadism on higher risk of some metabolic and endocrine diseases. The most interesting conclusions were found in literature on oncological implications of testosterone and lack of it. It turns out that there is a number of studies showing the positive impact of relatively higher testosterone concentrations while androgen deprivation therapy is the main therapeutic option in advanced prostate cancer.Conclusions: Due to very unpleasant and possibly dangerous complications of hypogonadism endocrinologists should stay alert to signs of hypogonadism to be able to start testosterone replacement in the right moment

The role of artificial intelligence in cancer diagnostics - a review

Introduction and purposeArtificial intelligence (AI) is more advanced than ever and finds more and more new applications. Attempts are being made to use computer data analysis in medicine. The aim of this study is to summarize the knowledge on the use of AI in the diagnosis of breast, prostate, skin and colorectal cancer with particular emphasis on the applications and effectiveness of AI in making diagnoses. A brief description of the state of knowledgeThe most frequently used form of artificial intelligence in diagnostics are algorithms that analyze databases and recognize patterns. They can capture the features of samples characteristic of tumors, such as abnormal cells in the biopsy material or the alarming size and color of the skin lesion. Additionally, AI is capable of analyzing magnetic resonance images, radiographs, and other standardized test results. In most cases, AI is more effective than clinicians, sometimes as effective as they are, and almost never less effective. As a rule, the most accurate and adequate diagnosis can be obtained by joining the forces of AI and medical specialists. Working with learning algorithms requires the use of very extensive data sets. Every effort should be made to protect sensitive information from patients' medical history. ConclusionsThe results of research on the effectiveness of AI in cancer diagnostics are very promising. Further research and development of information technology systems may positively affect the quality and effectiveness of tumor diagnostics