Zawał serca współistniejący z udarem mózgu po wszczepieniu protezy aorty wstępującej z powodu ostrego rozwarstwienia typu A — jakie jest źródło materiału zatorowego?

Myocardial infarction as a reflection of advanced coronary artery disease is often associated with atherosclerosis of other arteries, especially renal, peripheral and carotid, resulting in chronic renal disease, peripheral artery disease, or stroke. Nevertheless, atherosclerosis is not always the only cause of those diseases. In this article, was presented the case of a patient with myocardial infarction and concomitant stroke probably caused by percutaneous coronary intervention.Zawał serca jako odzwierciedlenie zaawansowanej miażdżycy tętnic wieńcowych często współistnieje z miażdżycą innych tętnic, zwłaszcza nerkowych, obwodowych i szyjnych, które objawia się odpowiednio przewlekłą chorobą nerek, chorobą tętnic obwodowych oraz udarem mózgu. Niemniej nie zawsze miażdżyca jest przyczyną powyższych stanów chorobowych. W niniejszej pracy zaprezentowano przypadek pacjenta z ostrym zespołem wieńcowym — zawałem serca i współistniejących udarem mózgu najprawdopodobniej wtórnie do interwencji w obrębie tętnic wieńcowych

Just do it? When to do what you judge you ought to do

While it is generally believed that justification is a fallible guide to the truth, there might be interesting exceptions to this general rule. In recent work on bridge-principles, an increasing number of authors have argued that truths about what a subject ought to do are truths we stand in some privileged epistemic relation to and that our justified normative beliefs are beliefs that will not lead us astray. If these bridge-principles hold, it suggests that justification might play an interesting role in our normative theories. In turn, this might help us understand the value of justification, a value that's notoriously difficult to understand if we think of justification as but a fallible means to a desired end. We will argue that these bridge-principles will be incredibly difficult to defend. While we do not think that normative facts necessarily stand in any interesting relationship to our justified beliefs about them, there might well be a way of defending the idea that our justified beliefs about what to do won't lead us astray. In turn, this might help us understand the value of justification, but this way of thinking about justification and its value comes with costs few would be willing to pay

The use of the GLP-1 analog - dulaglutide in the treatment of morbid obesity - case report

Obesity is a disease that is diagnosed in an increasing number of people around the world. Its development is influenced by many factors, both environmental and genetic. It leads to the development of further diseases, thus contributing to a reduction in life expectancy. There are many methods used to treat overweight and obesity. The most important element of the therapeutic process is a reduced diet and physical activity. However, it is often not sufficient, therefore it is becoming more and more common to introduce pharmacotherapy into treatment. One drug is dulaglutide (Trulicity), a GLP-1 analog with promising results. It was included in the treatment of a 49-year-old patient who was diagnosed with morbid obesity. The patient had been struggling with obesity since childhood, and the previously used methods of weight reduction did not bring satisfactory results. After switching to Trulicity (1.5 mg / 0.5 mL s.c.) taken once a week, it was possible to achieve a significant decrease in body weight and the well-being of the patient. If it is officially registered in the treatment of this disease in the future, there is a chance that the results of therapy will improve in many patients

Clinical development success rates and social value of pediatric Phase 1 trials in oncology

ObjectivesDrug development trials must fulfill social value requirement but no estimates of value provided by pediatric Phase 1 trials in oncology exist. These trials involve a particularly vulnerable population. Our objective was to assess of surrogates of social value of Phase 1 trials performed in pediatric oncology: rates of approval of tested interventions, transition to further phases of testing and citation in subsequent primary research reports.MethodsWe performed an analysis on a subset of eligible trials included in a previous meta-analysis. That study systematically searched EMBASE and PubMed for small sample size, non-randomized, dose escalation pediatric cancer Phase 1 studies of any malignancy, assessing chemotherapy and/or targeted therapy and looked at risk and benefit. The current analysis assessed all studies in that review published between January 1st 2004 and December 31st 2013 for predictors of social value. This time range allowed for at least five years of subsequent development activity. Sources of data included FDA and EMA medicine databases (for approval), ClinicalTrials.gov and EU Clinical Trials Register (for transition) and Google Scholar (for citation).ResultsOne hundred thirty-nine trials enrolling 3814 patients met the eligibility criteria. Seven trials (5%) led to drugs being registered for pediatric use in therapy of cancer. Fifty-two (37%) transitioned to later phases of pediatric oncology trials according to ClinicalTrials.gov and/or EU Register. Over 90% of trials were cited by at least one subsequent primary research report or systematic review. Most of the citations were preclinical studies.ConclusionsOur analysis shows that treatments tested in pediatric Phase 1 trials in oncology have low rates of regulatory approval. However, a large proportion of Phase 1 trials inform further testing and development of tested interventions

Depresja i myśli samobójcze u pacjentów z rakiem płuc oczekujących na zabieg chirurgiczny

Aims of the study: An assessment of the incidence and severity of suicidal thoughts and depression in a group of patients with lung cancer. Furthermore, we have investigated whether the increase in suicidal thoughts and depression depends on pain intensity and the overall physical function of patients. Material and methods: The study included 62 patients diagnosed with lung cancer, hospitalised in the Department of Thoracic Surgery at the Thoracic Surgery Clinic in Lublin, at the Independent Public Clinical Hospital No. 4 in Lublin. The patient population included 21 females (34%) and 41 males (66%). A total of 35 (56%) respondents came from rural regions, and the remaining 27 (44%) from the city. The average age was 59 years (standard deviation was 12.6). The severity of depression and suicidal thoughts was evaluated using the Beck Depression Inventory. In addition, Numeric Pain Intensity Scale and the Karnofsky Scale were used to assess the general functioning of the study population. Sociodemographic variables were analysed using a self-designed survey. Results: Suicidal thoughts occurred in 6.45% of respondents, exclusively in males. Statistical analysis showed that the group with depression received significantly less points in a scale measuring general functioning. There was a negative correlation between depression severity and the general functioning of patients. Depression was diagnosed in 32.25% of respondents, including mild in 25.8%, moderate in 6.45%, and severe in 4.83%. Depression affected 36.58% of men and 23.8% of women. No correlation between the severity of depression and the severity of pain was observed. Conclusions: The severity of depression increases with the decrease in overall physical functioning and is not related to pain severity

The role of iron metabolism and oxidative stress in the pathogenesis of endometriosis

Despite many years of extensive investigations and increasing number of studies, the pathogenesis of endometriosis remains unclear. Accumulated data suggests that disrupted iron metabolism may induce oxidative stress in the peritoneal cavity of endometriosis patients