The Influence of Epstein-Barr virus infection on developing multiple sclerosis

Multiple sclerosis (MS) is the most common inflammatory-demyelinating disease. MS leads to the multifocal damage of the central nervous system, which causes the gradual deterioration of sensory, motor and cognitive functions. The etiology of this disease is not fully understood, but genetic and environmental factors (including the EBV infection) are suspected. In this review, we would like to summarize the state of knowledge over the effect of Epstein-Barr virus infection on developing multiple sclerosis. Infectious mononucleosis (IM) which is caused by EBV and MS have similar epidemiology: both diseases mainly affect people at a young age, geographical prevalence is also identical. There are many theories that explain the mechanism of the EBV involvement in the development of MS including: the migration of EBV-infected B cells into the Central Nervous System, the theory of molecular mimicry, the induction of αB-crystallin by EBV in lymphoid cells or cooperation of the EBV and other viruses in the development of MS. Observations by physicians from around the world suggest that EBV infection is a strong factor in the development of multiple sclerosis. Epstein-Barr virus is prevalent in the population. There are a lot of evidences that suggest its involvement in the development of multiple sclerosis. Prevention of EBV infection could potentially reduce the amount of cases of MS. However, more researches are needed to clearly confirm the involvement of EBV in the etiopathogenesis of developing MS

Use of deep brain stimulation for treatment-resistant depression – review of main stimulation targets

Deep brain stimulation (DBS) is an innovative method using neuromodulation in treatment of various diseases, most commonly used in Parkinson’s disease, tremor and dystonia. Due to method’s minimally invasive nature and very low incidence of severe adverse effects, the research upon its use in other indications is conducted. Treatment-resistant depression (TRD) is one of these emerging indications. Currently available data regarding the matter concentrate mainly of electrode placement within seven particular structures of the brain: the subgenual anterior cingulate cortex, the ventral capsule/ventral striatum, the lateral habenula, the nucleus accumbens, the inferior thalamic peduncle, the bed nucleus of the stria terminalis and the medial forebrain bundle. It is yet to be determined which stimulation targets bring the most optimal effect. Published clinical trials give basis to theorize that stimulation of each DBS target results in different neurotransmitter modulation. Antidepressant effects vary also depending on stimulation parameters and overall duration. The aim of this review is to compare various targets for stimulation and underlying physiological mechanisms in therapy of TRD. It is needed to keep in mind that there is still high demand on well-designed, randomized, double-blind trials on bigger groups of patients in order to exclude potential inconsistency between results of clinical research

Diagnosis and treatment of cardiac angiosarcoma

Primary cardiac tumors are very rare in the population. About 20% of it are malignant. The most common type of cardiac malignant tumor is angiosarcoma. This tumor has the ability to infiltrate surrounding tissues and form distant metastases. Angiosarcoma is most often located in the right atrium and it mostly attacks men. This neoplasm is difficult to diagnose, because it has no specific symptoms. Patients with this tumor may complain of a chest pain, cardiac arrhythmias, suffocation and distal oedema. The rarity of occurrence and the lack of specyfic symptoms contribute to late diagnosis of the disease and worse prognosis of patients. Angiosarcoma can also be misdiagnosed as pneumonia or more common cardiovascular disease for example coronary artery disease. In advanced stage, this tumor can even lead to myocardial rupture. Various imaging methods are used in the diagnostics of this neoplasm for example: CT, MRI, PET-CT or Echocardiography. Histopathological examinations are less frequently used due to the risk of serious complications like hemothorax. Due to the very uncommon occurrence of the angiosarcoma, guidelines describing treatment of patients with this neoplasm, have not been developed yet. Currently, surgical removal of the tumor (if it is possible), chemiotherapy and radiotherapy are used. Reaserches on the genetic mutations which cause angiosarcoma and the development of appropriate drugs may give patients a chance for more effective treatment in the futur

A nonspecific clinical picture and the course of Conn syndrome — current findings in the screening program for hypertensive patients

Conn syndrome (CS), next to bilateral adrenal hyperplasia, is one of the most common causes of primary hyperaldosteronism. It leads to potentially curable secondary hypertension. The 54-year-old woman underwent an abdominal computed tomography (CT) examination for symptomatic nephrolithiasis. A focal lesion of the left adrenal gland was found with a diameter of 16 mm and a density of 34 Hounsfield units (HU). The lesion was under observation, and the next magnetic resonance imaging (MRI) scans showed a slight enlargement of the lesion to a size of 18 x 12 mm. The lesion was interpreted as an atypical adenoma of the adrenal gland. According to the course, the patient was referred to the endocrinology clinic. The patient's symptoms included hypertension and paresthesia. During two separate hospitalizations, Conn syndrome was diagnosed using a specific laboratory test. The patient was successfully treated by surgical intervention, resulting in remission of all symptoms. This case illustrates the difficulties in diagnosing primary hyperaldosteronism. The symptoms of Conn syndrome may vary in severity or may be absent. Early diagnosis and appropriate treatment can save many ill individuals from cardiovascular, metabolic, or renal complications. The case underscores the need for screening hypertensive patients using the aldosterone-renin ratio (ARR)

Relationship between Postural Stability, Lead Content, and Selected Parameters of Oxidative Stress

This study attempts to determine whether the increased blood lead concentration affects the posturographic test and to determine the relationship between the parameters of posture stability and selected parameters of oxidative stress. The study population consisted of 268 male employees and was divided into two equal subgroups, depending on the lead content in the blood. A posturographic examination was performed. Concentrations of lead, cadmium, zinc protoporphyrin, selected essential elements, and selected markers of oxidative stress in the blood were tested. Higher blood lead concentrations positively affected the values of the sway results: the field and the mean velocity of the center of the feet pressure in posturography. The absolute value of the proprioception ratio was similar in both subgroups. The content of malondialdehyde shows a statistically significantly higher value in a subgroup with high blood lead concentration and exhibits significant correlations only with some of the posturography parameters. The lipofuscin content in erythrocytes correlates with the results of the posturography test. Zinc protoporphyrin, total oxidant status, total antioxidant capacity, selected minerals, and metals did not correlate with the results of the posturography test. In conclusion, posturographic results correlate only with selected markers of oxidative stress, so it can be assumed that the effect on the body balance is only partial

Is immunohistochemical evaluation of p16 in oropharyngeal cancer enough to predict the HPV positivity?

AimOur goal was to determine the expression levels of p16 in the cohort of the OPSCC patients and evaluation of the pathological and clinical differences between these two groups including patients’ survival.BackgroundHPV infection is the main causative factor of oropharyngeal cancer (OPSCC). Identification of HPV status in OPSCC requires positive evaluation of viral DNA integration into host cell however, p16 accumulation in the proliferating cell layers has been accepted as an alternative marker for HPV infection.Material and MethodsThe IHC staining for p16 has been performed in tumor tissue from 382 OPSCC patients. The sample was considered positive based on more than 70% of carcinoma tissue showing strong and diffused nuclear and cytoplasmic immunostaining. The clinicopathological characteristics of the patients including site, age, gender, tumor grade, tumor stage, the nodal status, smoking and survival have been analyzed when comparing p16 positive and p16 negative tumors.ResultsOut of our cohort in 38.2% cases positive staining for p16 has been recorded. Our analysis did not indicate significant differences in the distribution of the p16 positive patients and age of the patients, stage of the disease. Among the patients who have presented with the N+ neck, there were significantly more p16 positive tumors than in the group with N0 neck (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.0062). There was highly significant correlation between the expression of p16 and smoking (p[[ce:hsp sp="0.25"/]

Antidotes in Clinical Toxicology—Critical Review

Poisoning and overdose are very important aspects in medicine and toxicology. Chemical weapons pose a threat to civilians, and emergency medicine principles must be followed when dealing with patients who have been poisoned or overdosed. Antidotes have been used for centuries and modern research has led to the development of new antidotes that can accelerate the elimination of toxins from the body. Although some antidotes have become less relevant due to modern intensive care techniques, they can still save lives or reduce the severity of toxicity. The availability of antidotes is crucial, especially in developing countries where intensive care facilities may be limited. This article aims to provide information on specific antidotes, their recommended uses, and potential risks and new uses. In the case of poisoning, supportive therapies are most often used; however, in many cases, the administration of an appropriate antidote saves the patient’s life. In this review, we reviewed the literature on selected antidotes used in the treatment of poisonings. We also characterised the antidotes (bio)chemically. We described the cases in which they are used together with the dosage recommendations. We also analysed the mechanisms of action. In addition, we described alternative methods of using a given substance as a drug, an example of which is N-acetylcysteine, which can be used in the treatment of COVID-19. This article was written as part of the implementation of the project of the Polish Ministry of Education and Science, “Toxicovigilance, poisoning prevention, and first aid in poisoning with xenobiotics of current clinical importance in Poland”, grant number SKN/SP/570184/2023