Selected genetic factors increasing risk of neoplasia

Introduction: Neoplasia is defined as abnormal and excessive growth of selected tissue. Several factors, such as mutations in selected genes, can increase the risk of cancer expansion in human body. The aim of the article is to review the selected genetic factors which increase the risk of neoplasia and results of their presence in the human body. Material and methods: Articles in the Google Scholar, Pub Med database have been analysed using keywords: cancer, neoplasia, genetic factors, driver genes, cancer transformation, older people. Results: The aim of several genes is repairing damaged or dysfunctional DNA and preventing cells from abnormal or excessive. Mutations in selected genes cause inhibited production of the gene protein product or a change in its function, which increase the risk of neoplasia. The presence of mutated genes results in the initiation of the process leading to expansion of cancer cells in selected tissue. Moreover, a genetic mutation can lead to syndrome of tumors occurring in several organs. However, the increasement of cancer risk is related to numerous mutations, whereas the minority of carcinomas occur because of congenital gene defect and the majority is caused by environmental factors which contribute to creating various mutations. Conclusions: Thanks to the development of genetics in the field of medicine and introduction of genetic tests, the process of diagnosis of several tumors and syndromes is more efficient than in the past. The occurrence of mutation in genes, such as BRCA1, BRCA2, VHL, MSH2 and MLH1 and many more, relates to presence of selected tumors. By the introduction of pharmacogenetics, dozens of molecular-targeted drugs are used in the treatment of several types of cancers leading the achievement of therapeutic success. Nevertheless, the genetic background of many types of cancers is unknown and needs further study, as well as drugs targeting at selected genes mutations requires more development and guidelines in the treatment process. Keywords: cancer; neoplasia; genetic factors; driver genes; cancer transformation; older people

Effects of Sitting Callisthenic Balance and Resistance Exercise Programs on Cognitive Function in Older Participants

Background: Exercise training programs have the potential to improve cognitive function in older subjects. However, the majority of training programs are based on aerobic modality. In the current study, the influence of 3 months programs of sitting callisthenic balance (SCB) and resistance training (RT) on cognitive functioning and the mediating role that a change in the level of neurotrophic factors and strength in older, healthy participants plays were examined. Material and methods: Global cognitive function was examined using MoCA, short-term memory using Digit Span and Delayed Matching to Sample, set shifting using Trial Making Test Part B, speed of processing simple visual stimuli using Simple Reaction Time, decision making using Choice Reaction Time, visual attention with Visual Attention Test (VAT), tests. Strength of lower and upper limbs, neurotrophin level (irisin, brain-derived neurotrophic factor (BDNF), neurotrophin 3 (NT-3), neurotrophin 4/5 (NT 4/5) were examined. Results: Improved scores in RT vs. SCB were noted in MoCA (p = 0.02), reaction time in SRT (p = 0.02), TMT B (p = 0.03), errors committed in CRT (p = 0.04) and VAT (p = 0.02) were observed. No significant changes in the level of neurotrophic factors were observed. Changes in upper limb strength were related to changes in the number of errors committed in the SRT (p = 0.03). Lower limb strength changes explained the dynamics of the number of correct answers (p = 0.002) and errors committed (p = 0.006) in VAT. Conclusions: Both SCB and RT influenced multiple cognitive domains. The RT program improved global cognitive functioning, while no improvement was noticed in the SCB group. Decision making, visual attention and global cognitive function were improved after the RT program. Set-shifting, short-term visual memory processing speed of simple visual stimuli were improved after the SCB program, while a decrease in the processing speed of simple visual stimuli was noted in the RT group. Changes in irisin were related to set-shifting and short-term memory, while in BDNF to an improvement in the processing speed of simple visual stimuli. Resistance exercise training programs could be applied to prevent age related declines of cognitive function in healthy older subjects

Case report of a patient with acute renal failure and cardiovascular disease after 65 years of age

Introduction. Acute kidney injury (AKI) is a clinical syndrome with high mortality. It is a clinical syndrome consisting in rapid impairment of kidney function. The result is retention of metabolic products in the body and the inability to maintain normal water-electrolyte and acid-base homeostasis. Chronic heart failure is a significant clinical, economic and social problem, and despite the continuous development of medicine, the incidence of this disease is still increasing. A weakened inefficient heart is not able to supply the organs with the right amount of blood, oxygen and nutrients. The effect is fast fatigue, weakness of muscle strength and dizziness. Kidney and cardiovascular diseases affect each other and increase their course, which worsens the patient's condition. Periodic monitoring of renal function in patients with cardiovascular disease is very important because it has been proven that the occurrence of kidney disease in these patients increases the risk of death. Case report. Patient, 78 years old, hospitalized many times in the Geriatrics Clinic, Cardiology Clinic, Nephrology Clinic due to shortness of breath, chronic myocardial insufficiency, edema of the lower limbs. The degree of independence is limited, the patient walks with assistance, lives with a family / significant other. Main ailments of the patient: increasing swelling of the lower limbs, left foot pain, nausea, vomiting, palpitations, effortlessness and rest dyspnea without stenocardial complaints. Comorbidities: Type 2 insulin-dependent diabetes mellitus (with unspecified complications), obesity, generalized atherosclerosis, hypertension, chronic NYHA type II heart failure. Cardiac defect in the form of mitral and tricuspid regurgitation, pulmonary hypertension, paroxysmal atrial fibrillation, myocardial infarction. The patient was qualified for hemodialysis treatment, then returned to conservative treatment, followed a strict diet. The applied treatment improved the general condition of the patient and was discharged from the hospital in a stable general condition. Results. Frequent and regular examination of a patient's condition with cardiac-renal syndrome, disease progression and ability to tolerate treatment can be helpful in treating and prolonging the patient's life. It is important to monitor kidney function in people with cardiovascular disease

Results of Fullerton Test in older people. Group comparison due to the Nordic Walking and long walks undertaking

Introduction: Standardly, high level of physical activity is prescribed to the older patients. However, it is worth to examine if every kind of physical activity give the same amount of health benefits, or is it dependent on its modality.Aim: The purpose of above studies is to measure the differences in Fullerton subtests results in group who does vs in group who does not undertake regular long walks (LW) and Nordic Walking (NW).Material and methods: Subtests of Fullerton tests were used to examine the physical performance of patients. Physical activity questionnaire was used to distinguish groups of patients who do vs do not engage in long walks and Nordic Walking regularly.Results: There were no statistically significant differences in Fullerton scores due to NW-engagement. In contrary, group engaged in LW walked 42.41 meters more in 6-minute walk tests than group who do not undertake such activity. Moreover, Upper Right and Left Limbs Strength tests and its mean scores were better in LW-group by 4.23, 4.6 and 4.09 repetitions, respectively.Conclusions: There was no statistically significant differences in results of Fullerton subtests between group of NW-engaged older people comparing to group who do not undertake NW. Group of participants engaged in long walks had better scores aerobic capacity and upper limbs strength tests

The impact of influenza on elderly patients

Background: Influenza is a disease affecting the human respiratory system. A common problem is to confuse colds with influenza, which results in problems with vaccination and complications related to influenza. Particular attention should be paid to the treatment of influenza, as it is a serious health risk if not treated in the elderly. Research conducted by scientists from Taiwan shows that currently the best way to protect against influenza is preventive vaccination. In addition to vaccination, antiviral drugs (Oseltamivir, Zanamivir, Amantadine, Rimantadine), antipyretics (aspirin, paracetamol) are used. Attention is paid to natural methods (ginseng extract, root lichen extract) and supplements (vitamin C, zinc). Material and Methods: This article is based on a review of the current state of knowledge on influenza in the elderly. The most up-to-date literature with EBSCO, Google Scholar and PubMed has been reviewed. Key words such as influenza, influenza complications, vaccinations, influenza treatment. Results: In the context of the above topics, particular attention is paid to the elderly, in whom a low level of immunity predisposes to getting sick. An increase in the incidence of disease causes an increase in the mortality of older people. Complications following the occurrence of influenza are closely related to the type of virus, where the influenza A virus classified as the heaviest in the course. It has been proven that the bird influenza virus is also a threat to humans. The classic symptoms of influenza are cough, fever, while complications associated with untreated influenza are primarily myocarditis or pneumonia. Conclusion: Due to the decline in immunity, older people are particularly at risk of influenza virus. Scientists have demonstrated the high effectiveness of protective vaccination, but one should remember to repeat them every year. Vaccinations in the elderly have reduced effectiveness, which is why antiviral therapies, natural methods and supplements are used. In the rational treatment of influenza, it is noted that natural methods and supplements are an addition to classic antiviral therapy

Insomnia in elderly patients – various ways to manage

Introduction: Impaired duration, rhythm and depth of sleep and wakefulness called insomnia is a common problem in the group of geriatric patients. About 50% of elderly people report insomnia. Material and Methods: The paper reviews literature using the EBSCO and Google Scholar databases. Articles have been analyzed using the keywords insomnia, elderly patients, prevalence and etiology, primary care, treatment, diet, physiotherapy. The article presents various methods to manage insomnia among the elderly. Results: The main treatment for insomnia includes pharmacological and non-pharmacological interventions or a combination of both. A very important aspect is proper dietary, physiotherapy treatment and physical activity. Conclusions: Effective management of sleep disorders improves the quality of life of patients struggling with this disorder and prevents the occurrence of depression and anxiety, which often coexist with insomnia

The impact of artificial sweeteners on the risk and course of large intestinal adenocarcinoma in the elderly

There are many confirmed risk factors for development of the colorectal cancer, which is one of the most common malignant tumor among both females and males. Moreover, it is a cause of significant percentage of all cancer-related deaths. Even with treatment, the 5-year survival rate is very low. We concentrate on impact of artificial sweeteners on risk and course of adenocarcinoma of colon

Pharmacotherapy of depression in palliative patients

Introduction: Depression often affects people suffering from serious illnesses, including oncological and palliative patients. It reduces their quality of life and worsens their prognosis. This is why it is so important to properly treat depression in palliative patients. Material and Methods: The information provided was collected as a result of analysis of various articles and textbooks on development, diagnosis and treatment, as well as prevention of depression in terminally ill patients using Google Scholar and PubMed databases. Results: The results show that the most common drug in therapy for palliative patients with depression are the sluggish serotonin reuptake inhibitors (SSRIs). SSRIs inhibit serotonin transporter reducing serotonin reuptake. This raises the level of neurotransmitter - serotonin - in the synaptic cleft. They are well tolerated and have fewer side effects than older antidepressants (tricyclic antidepressants and monoamine oxidase inhibitors). Tricyclic antidepressants may relieve neuropathic pain and they are also beneficial for patients with insomnia. Mirtazapine in addition to antidepressant effects also causes increasing appetite, reducing nausea and sedative effect. In cancer-diagnosed patients particular attention should be paid to side effects such as nausea and vomiting that may occur in patients undergoing radiotherapy and chemotherapy using SSRIs or TCAs. SSRI therapy have a good safety profile and also interacts less frequently, while atypical antipsychotics may reduce the discomforts of taking chemotherapy. An alternative method of treating depression is the use of psychostimulants such as methylphenidate. Another way to treat depression is psychotherapy. Conclusions: There are several options for treating depression in palliative patients. It is important to pay attention to the side effects of prescribed medicines. Nevertheless, the best results are obtained by combining pharmacotherapy with psychotherapy

Doświadczenie tworzenia i wprowadzania zajęć z zakresu propedeutyki psychiatrii dla studentów medycyny — szanse i trudności

The paper describes concepts and realization of the didactic process on introduction to psychiatry in newly createdmedical faculty of Andrzej Frycz-Modrzewski Cracow Academy. Description of this reality considers students, patientsand professionals perspective. Shows importance of the topic, chances and difficulties, also these touching mentalhealth of the students.Artykuł jest opisem założeń i przebiegu procesu dydaktycznego z zakresu propedeutyki psychiatrii na nowo utworzonym wydziale lekarskim Krakowskiej Akademii im. Andrzeja Frycza – Modrzewskiego (KAAFM). Opisuje tą rzeczywistość uwzględniając perspektywę studentów, pacjentów i osób prowadzących zajęcia. Wskazuje na wagę zagadnienia, związane z nim szansy i trudności, także te dotyczące zdrowia psychicznego studentów

Atherosclerosis as a problem in postmenopausal women

Introduction: Atherosclerosis is defined as a disease in which plaque, consisting of fat, cholesterol and other substances found in blood, builds up in arteries. This leads to stiffness and narrowing of the blood vessels resulting in limiting the flow of the blood rich in oxygen to tissues. The negative effect of atherosclerosis among women can be opposed by the female hormones. The aim of the article is to review clinical approach to atherosclerosis in post-menopausal women. Material and methods: Articles in the Google Scholar, Pub Med database have been analysed using keywords: atherosclerosis, plaque, cardiovascular diseases, menopause, postmenopausal women, female hormones, estrogens, older people. Results: Atherosclerosis process in the arterial walls is based on accumulation of lipids accompanied by inflammatory factors. One of the most important risk factors of this disease are quantitative and qualitative changes of the plasma lipoprotein, especially increasement of LDL cholesterol after menopause, which can be evaluated during lab tests. The diagnosis of atherosclerosis and its progress can be performed by using different methods, including physical examination and medical imaging. Development of atherosclerosis leads to peripheral artery disease connected with cardiovascular diseases, such as stroke or heart attack, which be life-threatening and should be immediately treated. Conclusions: This risk of the negative effects of atherosclerosis can be decreased by both lifestyle change and pharmacological treatment. The usage of estrogen-based hormone replacement therapy combined with statins in postmenopausal women presents benefits by the decreasement of LDL cholesterol and the increasement of HDL cholesterol and reduction of calcification of coronary vessels, which reduces the risk of cardiovascular diseases. However, the time of the start of hormone replacement therapy is crucial – performed too late can result in additional development of atherosclerotic plaque and increasement of the inflammatory processes in the arteries with advanced atherosclerotic changes