The influence of nutrition on the development of the child's intestinal microflora

Mikrobiota jelitowa, zwana również mikroflorą jelitową lub inaczej florą jelitową, to grupa mikroorganizmów (mikrobiomu), głównie bakterii, które tworzą złożony ekosystem w układzie pokarmowym. U człowieka jest jednym z elementów jego bioty fizjologicznej [1]. Poród jest ważnym etapem kolonizacji układu pokarmowego człowieka przez mikrobiotę. Forma karmienia odgrywa również ważną rolę w kolonizacji jelit noworodka i niemowlęcia [2]. Mleko matki ma wiele zalet. Karmienie piersią odgrywa ważną rolę w kształtowaniu mikroflory jelitowej dziecka. Mleko matki zawiera prozdrowotne bakterie, które wspomagają pierwotną kolonizację jelit noworodka. Dieta ma istotny wpływ na kształtowanie się mikroflory jelitowej. Dlatego ważne jest, aby kobieta nie tylko podczas całej ciąży, ale także przed ciążą dbała o zróżnicowaną, zbilansowaną i bogatą w prebiotyki dietę [3]

The application of TORS – into the larynx

Laryngeal squamous cell carcinoma is one of the most common head and neck cancer, and it occurs more commonly in men than in women. The thought of losing phonatory and swallowing function has become the driving force of advancements in laryngeal cancer treatment.Transoral robotic surgery (TORS) is one of the fastest growing areas of head and neck surgery. This technology is assisted by remote-controlled miniaturized surgical instruments and magnified visualization with a high-definition three-dimensional camera. TORS is increasingly being used and was described in the context of laryngeal cancer surgery. It has been explored as minimally invasive surgery for supraglottic and glottic lesions, as well as for total laryngectomy. Transoral organ-preserving approaches have shown favorable oncologic and functional outcomes with good quality of life. Rapidly advancing TORS technique affords surgeons exceptional views of the larynx and hypopharynx with facile maneuverability in difficult to access areas. Thus, achieving negative margins and preserving normal laryngeal structures has become increasingly possible. The use of the robot for laryngeal cancer falls into three main categories:  supraglottic laryngectomy,  total laryngectomy and glottic cordectomy.            Transoral robotic surgery for laryngeal cancer has been shown to be feasible for minimally invasive partial laryngectomy for either supraglottic or glottic cancer, as well as for total laryngectomy, in selected patients. TORS supraglottic laryngectomy and TORS total laryngectomy have demonstrated good functional and oncologic outcomes

The relationship between the occurrence of psoriasis and depression

Psoriasis (skin psoriasis, PsO) is a chronic auto‐immune skin inflammatory condition. In about one-third of cases, the joints are affected (psoriatic arthritis, PsA). Both conditions, especially PsA, profoundly impact patients' health-related quality of life.  This disease affects between 2% and 3% of the population. The onset occurs before the age of 40 as a sharply demarcated scaly, red skin lesions, most often on the elbows, knees, scalp, hands, feet and joints considering osteoarticular involvement. Patients are suffering from itching, irritations, stinging and pain. Etiology of this disease is multifactorial, with genetic and environmental involvement, psychological stress and depression being the key factors considering the onset, flare or therapeutic resistance of psoriatic disease. The purpose of this article is to review and analyze how depression and stress affect the life of patients with psoriasis and in which way prevention could play a role regarding the evolution of this disease.Proinflammatory cytokines such as interleukin (IL)‐1 and IL‐6 are elevated in both psoriasis and depression, indicating that the inflammatory process may be involved in the progression of both diseases. Psoriasis has long been recognized to be associated with potentially adverse effects on mental health. However, there have been relatively few studies evaluating psychological outcomes in patients with psoriasis.Depression and stress decrease the quality of life, psoriasis being the last drop in the glass, with bimodal intensification of these pathologies. Quality of life in patients with psoriasis is directly associated with the severity of the disease, family status, work status and stigmatization

The correlation between second-hand tobacco smoke exposure and biofilm formation in chronic rhinosinusitis

Introduction and purpose Tobacco smoke is a major health concern globally. Due to tobacco epidemic, approximately 8 million people died as a result of cigarette smoking in 2020 alone, where 1.2 million were caused by non-smokers inhaling second-hand smoke. Chronic rhinosinusitis (CRS) is an inflammatory condition that has a significant health and  economic impact worldwide. Despite its great burden on the health-care system and patients' quality of life, the variety of therapy options for CRS is currently limited. Tobacco-induced biofilm formation may contribute to the refractory nature of many respiratory diseases reported in smokers and second-hand smokers, due to increased resistance to antibiotics. The aim of this study is to present that exposure to household passive smoking may induce the formation of nasal biofilms. Brief description of the state of knowledge             Chronic bacterial infections involving biofilms have recently been recognised as a factor in CRS pathogenesis. The presence of biofilms on the mucosa of CRS patients is associated with more severe pre-operative disease, persistent postoperative symptoms, ongoing mucosal inflammation, and infections following endoscopic sinus surgery. Tobacco smoke and CRS have been associated because of the immunosuppressive and irritating effects of tobacco smoke on sinonasal epithelial cells. Smoking uptake and cessation have been shown to affect microbial communities, with smokers having not just distinct microbial communities, but also a higher frequency of possible pathogens in those communities. Summary             Biofilms may play a significant role in the development of chronic rhinosinusitis. The impact of tobacco smoke on biofilm development could have major implications not only for CRS but also for other respiratory infections. &nbsp

Neoadjuvant chemotherapy for IIIC stage ovarian cancer - case report

Introduction: Ovarian cancer accounts only for 4.7% of female malignancies in Poland but has the worst prognosis among gynaecological neoplasms. Due to non-specific and scant symptoms the disease is diagnosed in nearly 70% of cases in stages III and IV (FIGO). The primary goal of surgical treatment is complete cytoreduction with no residual disease left after surgery involving hysterectomy, bilateral adnexectomy, omentectomy and removal of all metastatic foci from the peritoneum and abdominal organs. If it is not possible to achieve the complete cytoreduction, patients may be qualified for neoadjuvant chemotherapy (NACT) and surgery after achieving complete or partial remission.Purpose: Description of NACT protocol used for the treatment of stage IIIC ovarian cancer. Comparison of treatment results of advanced ovarian cancer using NACT and primary debulking surgery (PDS).Case report: A 58-year-old female patient was hospitalized with the diagnosis of the pelvic mass. Her predominant signs were abdominal pain on the right flank and flatulence. Laboratory tests and imaging studies indicated a high risk of metastatic ovarian cancer. Initial diagnosis was confirmed on the laparoscopy. Ovarian cancer matched stage IIIC with Fagotti score of 8 points. The inspection of the abdominal organs revealed tumors in both adnexa, miliary spread on the parietal peritoneum, the surface of the small intestine and the diaphragm and the thick infiltration of greater omentum. Multiple specimens for the pathology were collected and left adnexectomy was done. Due to the inability to achieve complete cytoreduction, the patient was qualified to NACT. Following 6 cycles of standard protocol paclitaxel and carboplatin chemotherapy, laparotomy with hysterectomy, bilateral adnexectomy and omentecomy was done. Residual disease was found only within greater omentum but complete cytoreduction was achieved. The patient was discharged in good condition.Summary: Clinical data indicates that patients with advanced ovarian cancer treated with NACT and surgery have similar prognosis  to those treated by primary cytoreductive surgery. The advantages of NACT are reduced perioperative morbidity and mortality, lower  complication rate and shorter hospital stay. In the described patient, the implementation of the NACT protocol has resulted in complete surgical cytoreduction which is the main factor permitting prolongation of life expectancy in woman with advanced ovarian cancer

Polycystic ovary syndrome (PCOS) - risk factor, diagnostic and current treatment

Introduction:  Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders in women in reproductive age, defined as a combination of signs and symptoms resulting from androgen excess and ovarian dysfunction in the absence of other specific diagnoses. PCOS is often associated with an increased risk of obesity, insulin resistance, metabolic disorders and cardiovascular events. The aim of the study: The purpose of this systemic review was to collect and analyze materials about risk factors, diagnostics, and the current treatment of polycystic ovary syndrome.Material and method: Review of the literature published in 2004-2018.Description of the state of knowledge: PCOS is characterized by an excessive secretion of androgens from the ovaries and / or adrenal glands. Intrinsic ovarian factors, such as altered steroidogenesis, and factors external to the ovary, such as hyperinsulinemia, contribute to the ovarian overproduction of androgens. PCOS requires careful selection of an appropriate diagnostic method and therapeutic approach to combat hyperandrogenism, a consequence of ovarian dysfunction and related metabolic disorders. Treatment of both women at risk of PCOS and those with a confirmed diagnosis of PCOS includes education, healthy lifestyle interventions and symptomatic therapeutic interventions.Summary:  PCOS is a complex disorder involving many organs and affecting many body functions. It is important to diagnose this disease as soon as possible in order to implement appropriately selected therapeutic treatment aimed at eliminating disease symptoms and reducing the systemic consequences of hyperandrogenism in patients

Iron deficiency anemia in pregnancy: evaluation and management

Anemia is a condition in which the number of red blood cells (RBC) is insufficient to meet the body's physiological needs for oxygen transport. A limiting factor for the erythrocyte mass increase is iron deficiency, which can also have a negative impact on the pregnancy's prognosis. The most frequent pathogenic cause of anemia in pregnancy is iron deficiency anemia (IDA). Biochemical tests such as serum iron concentration, total iron binding capacity (TIBC), transferrin concentration, and ferritin concentration are decreased in iron deficiency anemia. In clinical practice, iron deficiency is defined as low serum ferritin or a decreased percentage of transferrin saturation by iron. Usually, the diagnosis begins with the determination of serum ferritin. Although iron supplementation for iron deficiency is advised as soon as the condition has been diagnosed, prophylactic iron delivery is still under discussion. In patients for whom oral iron is ineffective or contraindicated, intravenous iron can be used to restore lost iron

Pregnancy-induced rhinitis: nose problems at the obstetrician's office

Introduction and purpose Pregnancy-induced rhinitis (PIR) manifests as nasal congestion, with resolution of symptoms after delivery. Pregnancy-induced rhinitis is a distinct condition from allergic rhinitis, it may not respond to treatment for allergic rhinitis. The first stage in providing adequate and effective management of PIR is to have a clear and appropriate diagnosis. Therefore, each patient-specific management of PIR must take careful consideration of a variety of circumstances. The aim of this study was to conduct a literature review on pregnancy-induced rhinitis. A literature review was carried out in the PubMed, MEDLINE, and Scopus databases using the terms ‘rhinitis and pregnancy’. Brief description of the state of knowledge Physiological factors underlying PIR are not well understood at the moment. There is no single explanation for the pathophysiological mechanism that would account for the changes in PIR. Nasal congestion is the primary nasal symptom in pregnancy-induced rhinitis. It can result in night-time mouth breathing and poor sleep quality. The mother's sleep may be negatively impacted by nasal congestion resulting in maternal hypertension, pre-eclampsia, and intrauterine growth retardation. Increasing awareness not only benefits pregnant patients' quality of life but also has a favourable impact on how a pregnancy turns out. Summary PIR has gained relevance in recent years due to its major effects on maternal quality of life as well as the identification of a relationship with OSAS in the mother and potential harmful consequences on the foetus. The mother's quality of life is significantly impacted by PIR, as shown, thus both the otorhinolaryngologist and the obstetrician must use caution in the early identification and treatment of pregnancy-induced rhinitis

Laparoscopic myomectomy in the treatment of large myomas – unnecessary risk or effective method?

Introduction:Mięśniaki macicy są najczęstszymi łagodnymi guzami macicy. Większość mięśniaków przebiega bezobjawowo i nie wymaga interwencji lekarskiej, jednak jeśli tak się dzieje, podstawą terapii pozostaje dostęp chirurgiczny. Miomektomia to jedna z chirurgicznych metod usuwania mięśniaków dla osób chcących zachować płodność. W dzisiejszych czasach udoskonalono techniki operacyjne i opracowano metody mniej inwazyjne, takie jak laparoskopowa miomektomia (LM). Jednak bezpieczeństwo i skuteczność LM jest dobrze udokumentowana w przypadku mięśniaków średniej wielkości. Dostęp laparoskopowy w przypadku większych guzów macicy (średnica> 10 cm) może budzić kontrowersje i może stanowić wyzwanie ze względu na możliwe trudności. Cel, powód: Ocena skuteczności, wyzwań technicznych i powikłań LM w leczeniu dużych mięśniaków. Materiały i metody: Przeszukaliśmy bazy danych Pubmed, Springer Link i ResearchGate.  Wyniki: Systematyczne analizy zakwalifikowane do tego przeglądu sugerowały, że pomimo wielu możliwych komplikacji i trudności, metoda może być z powodzeniem stosowana przez doświadczonego specjalistę. Jednak leczenie LM w dużych mięśniakach jest nadal rzadkie, a dane na ten temat są nadal ograniczone. Wnioski: Miomektomia laparoskopowa może być alternatywną metodą leczenia dużych mięśniaków. Chirurgia laparoskopowa dużych mięśniaków LM może stanowić wyzwanie, a skuteczność takiego leczenia zależy od umiejętności chirurga. Metoda jest również przydatna u kobiet rozważających ciążę.

Folic acid supplementation among students

Introduction: Pregnancy is a period in which the supply of vitamins, micro- and macroelements is essential for the proper growth of the fetus. One of the most important substances, which is believed to have a considerable influence on the proper fetus growth is folic acid. Folic acid (i.e. vitamin B9) plays a significant role in rapidly dividing cells and lack of this vitamin causes serious fetal defects - for example neural tube anomalies. Supplementation is important not only during pregnancy but also during the period of pregnancy planning. Methods: Students' knowledge regarding the importance of folic acid supplementation was verified using anonymous Internet questionnaire. The obtained results were analyzed using statistical methods and checked on the basis of scientific literature. Results: The percentage of students who supply folic acid is 18,1% and only 9,5% do this regularly. The most common cause of supply is due to the fact that that folate can be found in vitamin kits students usually take. Part of respondents claim that they plan the pregnancy and want the fetus to develop correctly. Other causes of vitamin B9 intake is prevention of arteriosclerosis, vascular system diseases, anemia, lung, esophagus and uterus cancer. Conclusion: Outcomes showed that students are not fully aware of the importance of vitamin B9 during pregnancy and there is a great need to share knowledge about folic acid supplementation among people in procreative age