The importance of adiponectin in the human body

Adipose tissue produces various types of proteins, including adipocytokines, which is why it should be treated as an endocrine organ. Adiponectin is one of the most important adipokines in the human body. We distinguish three factions of adiponectins: low molecular weight (LMW), middle molecular weight (MMW) and high molecular weight (HMW). The purpose of this article is to attempt to summarize the current state of knowledge regarding adiponectin, in particular its role in the human body. Adiponectin significantly influences the metabolism of carbohydrates by stimulating the activity of AMPK and PPAR-α through the AdiopoR1 receptors, which results in an increase in uptake and oxidation of glucose in cells. The literature has repeatedly demonstrated a negative correlation of serum adiponectin concentrations in relation to the BMI index, insulin and triglyceride levels, HOMA-IR and blood pressure. Decreased adiponectin levels have been demonstrated in such diseases as obesity, type 2 diabetes, hypertension, ischemic heart disease or in patients after a stroke. The significant effect of this adipocytokine on the reduction of inflammation, lipid metabolism and effect on the vascular endothelium is of key importance in the process of atherosclerotic plaque formation. In conclusion, the correct concentration of adiponectin is important for maintaining proper function of the whole organism. It affects numerous metabolic processes, mainly the metabolism of carbohydrates and lipids. It has antiatherogenic and anti-inflammatory properties. Due to the low concentrations of adiponectin found in patients with chronic diseases, including type 2 diabetes, there is a need for further research to determine the exact effect of adiponectin on these morbidities

Vitamin D deficiency in obese patients with Type 2 diabetes

Introduction: Vitamin D deficiency is involved in the pathogenesis of insulin resistance, which is the main factor in the development of type 2 diabetes. In Poland, a high percentage of people with vitamin D deficiency is observed, as well as incidences of type 2 diabetes. In 2013, recommendations regarding vitamin D supplementation for Central Europe inhabitants were published, which recommend the use of vitamin D preparations for obese people with a dose of 600-4000 IU / per Day Purpose of the work: Evaluation of the prevalence of vitamin D deficiency in obese patients with chronically decompensated type 2 diabetes mellitus and appropriate supplementation in accordance with given recommendations. Material and metod: Evaluation of laboratory tests and applied pharmacotherapy in 40 patients with chronically decompensated type 2 diabetes, aged from 38 to 89 years old. Results: In the experimental group the average concentration of 25 (OH) D3 was 20.3 ng / ml ± 11.7. Supplementation of vitamin D preparations was used by 15% of patients. Only 22.5% of patients had correct concentrations of 25 (OH) D3, but only one person used vitamin D supplements in this group. Conclusions: One in five obese patients with type 2 diabetes have normal levels of vitamin D. Among obese diabetics nearly 90% of patients do not apply the recommendations for vitamin D supplementation. Knowledge about the benefits of vitamin D supplementation should be widely propagated among diabetologists and general practitioners

The influence of selenium on thyroid gland

The proper functioning of the thyroid gland depends on many factors, which include adequate supply of various trace elements, including iodine, but also selenium or iron. The purpose of this article was to attempt to summarize the current knowledge on the effects of selenium on the thyroid gland and the clinical implications associated with it. Selenium affects the homeostasis of the entire human body, and its main function in the thyroid gland is to counteract damage of oxidative origin. This microelement is part of selenoproteins, which include glutathione peroxidase and thioredoxin reductase. Both selenium deficiency and excess can negatively affect the thyroid gland. The research results show that selenium supplementation may bring benefits in some morbidities, eg Graves-Basedow disease. Currently, I advise recommending semi-annual selenium supplementation in a mild form of thyroid orbitopathy. However, no clinical benefit has been demonstrated in increasing the supply of selenium in the diet of other patients with thyroid disease, including Hashimoto's disease. In conclusion, despite the numerous studies already conducted, further work is necessary to fully explain the mechanisms of action of this element on the thyroid gland, but also to deepen knowledge about the benefits and risks of selenium supplementation in various types of thyroid structural disorders and, most importantly, to establish safe guidelines for possible treatment

Sun exposure among young people

We are exposed to ultraviolet radiation every day. The amount of absorbed dose depends on the latitude, time of day, season of the year and the content of melanin in the skin. Deficiencies are the cause of many health problems and deterioration of the course of many disease processes. Negative effects on the cardiovascular system, on the formation of tumors or on the development of autoimmune diseases have been confirmed. In daily consumed foods, the dose of vitamin D is about 10% of the daily requirement. Increased physical activity, sunbathing when using radiation protection and oral supplementation allow you to achieve your goals. The level of vitamin D should be monitored regularly. There was a significant deficiency of vitamin D among athletes regardless of the type of sport performed. In addition to the benefits of sun exposure, we also get the risk of developing skin cancer. Risky behavior in the sun, the occurrence of erythema can contribute to the future of serious skin problems associated with cancer. We can prevent them by applying prophylaxis and individually selected sun protection. Education of patients, parents with small children families of patients with diagnosed melanoma and people with skin cancer may have positive effects in the future. Smoking and drinking alcohol have an adverse effect on sunbathing and the risk of sunburn. Planning for a pro-health policy should be based on preventive and public education programs. The increase in skin cancer cases around the world is alarming

The incidence of thyroid diseases in patients with polycystic ovary syndrome

WSTĘP: Zespół policystycznych jajników (PCOS) jest najczęstszą przyczyną hiperandrogenizmu i niepłodności u kobiet w wieku rozrodczym. W przebiegu klinicznym tej endokrynopatii należy uwzględniać wpływ zaburzeń tyreologicznych. CEL BADANIA: Ocena częstości występowania chorób tarczycy u pacjentek z PCOS w po­równaniu ze zdrową populacją. MATERIAŁ I METODY: Badaniem objęto 67 pacjentek, hospitalizowanych w Klinice Endokrynologii w Lublinie w latach 2012–2014, w wieku 18–44 lata (średnia wieku 26,5 ± 5,9 r.), u których rozpoznano PCOS według kryteriów rotterdamskich. Analiza retrospektywna dokumentacji medycznej ze szczególnym uwzględnieniem badania podmiotowego, przedmiotowego oraz badań laboratoryjnych. WYNIKI: Choroby tarczycy zdiagnozowano u 21 pacjentek (31,3%), średnia wieku 27,9 ± 7,8 roku, TSH 2,03 ± 0,9 mj./l. Wśród rozpoznań tyreologicznych w badanej grupie chorych dominowało autoimmunizacyjne zapalenie tarczycy u 14 pacjentek (70%), z tego 5 w stadium eutyreozy. Częstość występowania niedoczynności tarczycy na podłożu hipoplazji gruczołu tarczowego wynosiła 15%, wole guzkowe rozpoznano u 10% chorych. U jednej pacjentki nie ustalono etiologii niedoczynności tarczycy. Leczenie substytucyjne preparatami L-tyroksyny stosowano u 65% pacjentek. WNIOSKI: U pacjentek z PCOS częściej niż w populacji ogólnej występują choroby tarczycy, zwłaszcza przewlekłe zapalenie tarczycy o podłożu autoimmunizacyjnym, co wskazuje na konieczność prowadzenia badań przesiewowych w tej grupie kobiet.BACKGROUND: The polycystic ovary syndrome (PCOS) is the most common cause of hyperandrogenism and infertility among women of childbearing age. The impact of thyroid disorders must be considered in the clinical course of this endocrinopathy. OBJECTIVE: The evaluation of the incidence of thyroid diseases in PCOS patients compared to the healthy population. MATERIAL AND METHODS: The study included 67 patients, aged between 18 to 44 years (the mean age 26.5 ± 5.9 years) hospitalized in the Department of Endocrinology in Lublin in the years 2012–2014. Retrospective analysis of the medical documentation with a particular emphasis on the interview, physical examination and laboratory studies. RESULTS: The thyroid diseases were diagnosed in 21 patients (31.3%) with the mean age 27.9 ± 7.8 years, TSH: 2.03 ± 0.9 mU/L. Among the thyroid d iagnoses in the study group the autoimmune thyroiditis dominated 14 patients (70%), including 5 at the stage of euthyreosis. The incidence of hypothyroidism on the ground of h ypoplasia of the thyroid gland was 15%, nodular goiter was diagnosed in 10% of the patients. In one patient the etiology of hypothyroidism was unknown. The replacement therapy with the L-thyroxine was used in 65% of patients. CONCLUSIONS: The thyroid diseases are more likely to appear in patients with PCOS than in general population, especially the chronic autoimmune thyroiditis, which indicates the necessity of screening tests in this group of women

Farmakoterapia otyłości — obecny stan wiedzy

Obesity, which affects about 13% of the world population, results in significant deterioration of health and serious clinical, mainly meta­bolic and cardiovascular complications. Although the basis of therapeutic treatment is behavioural treatment, often non-pharmacological effects do not produce the desired effect. Currently there are several drugs with a safe action profile that improve the effect of treatment (5–10% weight reduction). The aim of the paper is to present the potential of modern pharmacotherapy in the treatment of obesity, in terms of mechanism of action, efficacy, and side effects, in order to individualise therapy. The drugs already registered include substances with a variety of mechanisms of action, including phentermine, orlistat, lorcaserin, and liraglutide. Compounded preparations (phenter­mine/topiramate, naltrexone SR/bupropion SR) are also available, which, by using low doses of active substances, have beneficial effects while reducing side effects. In addition, several drugs used to treat diabetes, such as metformin, SGLT2 inhibitors, GLP-1 agonists, and pramlintide, promote weight loss, although their use is reserved for diabetics, especially type 2 patients. Regarding the current alarm­ing epidemiological data there is a need for intensive prevention and treatment of obesity as well as the development of a new form of pharmacotherapy (new substances and treatment regimens) to develop effective, safe, and, above all, long-term effective therapy for the treatment of obesity.Otyłość, która dotyczy około 13% populacji światowej, skutkuje istotnym pogorszeniem stanu zdrowia oraz wystąpieniem poważnych powikłań klinicznych, głównie metabolicznych oraz ze strony układu sercowo-naczyniowego. Chociaż podstawą postępowania terapeutycznego jest leczenie behawioralne, niejednokrotnie działania niefarmakologiczne nie przynoszą pożądanego efektu. Obecnie mamy do dyspozycji kilka leków o bezpiecznym profilu działania, które pozwalają na poprawę efektu leczenia (5–10-procentową redukcję masy ciała). Celem pracy jest przedstawienie możliwości współczesnej farmakoterapii w leczeniu otyłości, w zakresie mechanizmu działania, skuteczności i objawów ubocznych, aby ułatwić indywidualizację leczenia. Do leków już zarejestrowanych należą substancje o różnorodnym mechanizmie działania, między innymi fentermina, orlistat, lorkaseryna i liraglutyd. Dostępne są również preparaty łączone (fentermina/topiramat, naltrekson SR/bupropion SR), które przez jednoczesne zastosowanie małych dawek substancji aktywnych, przynoszą korzystne rezultaty przy ograniczeniu działań niepożądanych. Ponadto kilka leków stosowanych w leczeniu cukrzycy, takich jak metformina, inhibitory SGLT2, agoniści GLP-1 i pramlintyd, promują utratę masy ciała, choć ich stosowanie zarezerwowane jest dla pacjentów z cukrzycą, szczególnie typu 2. Wobec aktualnych, niepokojących danych epidemiologicznych istnieje konieczność intensywnego zapobiegania i leczenia otyłości, a także rozwoju nowej formuły farmakoterapii (nowe substancje i schematy leczenia) w celu opracowania efektywnej, bezpiecznej, a przede wszystkim długotrwale skutecznej terapii w leczeniu otyłości

Obesity in perimenopause — current treatment options based on pathogenetic factors

The health of post-menopausal women has become of paramount concern due to the aging of the world’s population. Concurrently, the prevalence of obesity among postmenopausal women is expected to increase, presenting a significant public health challenge. Although weight gain during menopause is a well-observed phenomenon, its underlying causes and mechanisms remain incompletely understood. This manuscript reviews the literature to explore potential hormonal factors and pathomechanisms contributing to obesity during perimenopause, aiming to identify pathogenic factors that can guide treatment selection. Menopause-induced hormonal changes, including hypoestrogenaemia, hypergonadotropinaemia, relative hyperandrogenaemia, growth hormone deficiency, leptin resistance, and chronic stress affecting the hypothalamic-pituitary-adrenal axis, have been implicated in the onset of obesity in perimenopausal women. These hormonal fluctuations, alongside lowered daily energy expenditure, lead to metabolic alterations that elevate the risk of developing metabolic disorders and cardiovascular diseases. Weight gain in perimenopausal women is associated with higher total and abdominal adipose tissue and lower lean body mass. Addressing this issue requires individualized behavioural management, supported by effective pharmacological therapy, and, when warranted, complemented by bariatric surgery. Modern obesity treatment therapies have demonstrated safety and efficacy in clinical trials, offering the potential to reduce excess body fat, improve metabolic profiles, lower cardiovascular risk, and enhance the quality and longevity of women’s lives. In addition to standard obesity therapies, the article examines different treatment strategies based on obesity’s pathogenic factors, which may offer promising options for treating obesity with or without complications in perimenopausal women. One such potential approach is menopausal hormone therapy (MHT), which hypothetically targets visceral obesity by reducing visceral adipose tissue accumulation, preserving metabolically active lean body mass, and improving lipid profiles. However, despite these reported benefits, gynaecological and endocrinological societies currently do not recommend the use of MHT for obesity prevention or treatment, necessitating further research for validation. Emerging evidence suggests that visceral obesity could result from hypoestrogenaemia during perimenopause, potentially justifying the use of MHT as a causal treatment. This highlights the importance of advancing research efforts to unravel the intricate hormonal and metabolic changes that occur during perimenopauseand their role in obesity development

Adverse effects of paracetamol

Konopelko Michał, Szafraniec Aneta, Porada Dominik, Pucułek Małgorzata, Przybylska Daria. Adverse effects of paracetamol. Journal of Education, Health and Sport. 2017;7(7):998-1003. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.998976 http://ojs.ukw.edu.pl/index.php/johs/article/view/4901 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.08.2017. Revised: 10.09.2017. Accepted: 10.09.2017. Adverse effects of paracetamol Niepożądane działania paracetamolu Michał Konopelko1, Aneta Szafraniec2,3, Dominik Porada2, Małgorzata Pucułek4, Daria Przybylska1 1 Katedra i Zakład Higieny, Uniwersytet Medyczny w Lublinie 2 Katedra i Klinika Endokrynologii, Uniwersytet Medyczny w Lublinie 3 Katedra i Zakład Immunologii Klinicznej, Uniwersytet Medyczny w Lublinie 4 Anatomii Prawidłowej Człowieka, Uniwersytet Medyczny w Lublinie Abstract Admission. Paracetamol (acetaminophen) is one of the most popular medicinal substances in the world, characterized by analgesic and antipyretic properties. This pharmacy is issued without a prescription and can be purchased not only in pharmacies. Easy accessibility and lack of full control over its sales lead to the abuse of paracetamol, creating a risk of side effects. Purpose of work. The aim of the study is to present adverse reactions in paracetamol treatment, with particular emphasis on the risk of hepatotoxicity. Paracetamol (up to 4g / day) may cause nausea, diarrhea, skin lesions and haematological disorders during therapy. The most serious side effect of paracetamol is, however, a hepatotoxic effect that can cause acute liver failure leading to total hepatic necrosis. If paracetamol poisoning is observed (at doses above 8 g / day), antidote treatment should be considered: N-acetylcysteine and liver transplantation. Unfortunately, many times patients die. Summary. The social conviction of low harm of paracetamol and the high availability of preparations containing this substance make the side effects an important aspect of therapy with this drug. Acute poisoning with paracetamol, which often results in liver failure, is an important problem for modern toxicology. Key words: paracetamol, side effects, hepatic insufficiency, N-acetylcysteine Streszczenie Wstęp. Paracetamol (acetaminofen) to jedna z najpopularniejszych na świecie substancji leczniczych charakteryzująca się właściwościami przeciwbólowymi i przeciwgorączkowymi. Farmaceutyk ten wydawany jest bez recepty lekarskiej i można go nabyć nie tylko w aptekach. Łatwa dostępność oraz brak pełnej kontroli nad jego sprzedażą, prowadzą do nadużywania paracetamolu, stwarzając przy tym zagrożenie wystąpienia działań niepożądanych. Cel pracy. Celem pracy jest przedstawienie działań niepożądanych w przebiegu leczenia paracetamolem, ze szczególnym uwzględnienia ryzyka jego hepatotoksyczności. W trakcie terapii dawkami terapeutycznymi paracetamolu ( do 4g/dobę) mogą występować nudności, biegunki, zmiany skórne i zaburzenia hematologiczne. Najpoważniejszym działaniem niepożądanym paracetamolu jest jednak efekt hepatotoksyczny, który może wywołać ostrą niewydolność wątroby prowadzącą do całkowitej martwicy wątroby. W przypadku stwierdzenia zatrucia paracetamolem (przy dawkach powyżej 8g/dobę) należy rozważyć poddanie antidotum: N-acetylocysteina, a także przeszczep wątroby. Niestety niejednokrotnie dochodzi do zgonów pacjentów. Podsumowanie. Społeczne przekonanie o małej szkodliwości paracetamolu oraz duża dostępność preparatów zawierających tą substancję sprawia, że działania niepożądane są istotnym aspektem terapii tym farmaceutykiem. Ostre zatrucia paracetamolem, skutkujące niejednokrotnie niewydolnością wątroby, są istotnym problemem współczesnej toksykologii. Słowa kluczowe: paracetamol, działania niepożądane, niewydolność wątroby, N-acetylocystein

A sesamoid fracture as a cause of foot pain

Introduction: A sesamoid bone is an important element of a foot construction. Its function is to properly distribute weigh while walking and to provide correct amortization. The bone is a point which transfers weight in the central part of a foot and that is why it is more prone to damage because of repeated loads. Sesamoid fracture is most often a stress fracture which is common among athletes. Case presentation: 22-year-old patient visited the Orthopedist due to constant pain focused in the plantar range of metatarsophalangeal joint in the left foot with swelling which lasted for 2 months. The pain occurred without any injury and it intensified during physical activity, especially walking. On the basis of performed medical imagining (computerized tomography and magnetic resonance) comminuted lateral sesamoid fracture was diagnosed. Unburdening of foot, cold compresses, physiotherapeutic procedures, kinesiotherapy and intake of non-steroid anti-inflammatory drugs were recommended. Conservative treatment which was used did not provide long-lasting improvement. Surgical interventions were not performed. The patient developed complications due to the abnormal loads of painful foot - locomotion and balance disturbances, pain in the lumbosacral spine. Results: Despite the fact that stress fracture of the sesamoid most often affects athletes who overload forefoot, it can occur also among people with moderate physical activity. During the diagnostic process precise history and magnetic resonance (MR) ought to be taken. The most sensitive and specific imagining exam is MR. At the beginning patient should be treated conservatively. Sesamoidectomy can be considered only when other treatment methods have failed

Sun exposure among young people

Przybylska Daria, Konopelko Michał, Przybylski Piotr, Szafraniec Aneta, Porada Dominik. Sun exposure among young people. Journal of Education, Health and Sport. 2018;8(9):1449-1454. eISNN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.1435381 http://ojs.ukw.edu.pl/index.php/johs/article/view/6106 https://pbn.nauka.gov.pl/sedno-webapp/works/879117 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part b item 1223 (26/01/2017). 1223 Journal of Education, Health and Sport eissn 2391-8306 7 © The Authors 2018; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 12.08.2018. Revised: 18.08.2018. Accepted: 15.09.2018. Sun exposure among young people Daria Przybylska 1, Michał Konopelko 1, Piotr Przybylski 2, Aneta Szafraniec 3, Dominik Porada 3 Chair and Department of Hygiene, Medical University of Lublin I Department of Medical Radiology, Medical University of Lublin Department of Endocrinology, Medical University of Lublin Correspondence: Daria Przybylska, Chair and Department of Hygiene, Medical University of Lublin, ul. Radziwiłłowska 11, 20-080 Lublin Tel. +48 81448 6130. E-mail: [email protected] Abstract We are exposed to ultraviolet radiation every day. The amount of absorbed dose depends on the latitude, time of day, season of the year and the content of melanin in the skin. Deficiencies are the cause of many health problems and deterioration of the course of many disease processes. Negative effects on the cardiovascular system, on the formation of tumors or on the development of autoimmune diseases have been confirmed. In daily consumed foods, the dose of vitamin D is about 10% of the daily requirement. Increased physical activity, sunbathing when using radiation protection and oral supplementation allow you to achieve your goals. The level of vitamin D should be monitored regularly. There was a significant deficiency of vitamin D among athletes regardless of the type of sport performed. In addition to the benefits of sun exposure, we also get the risk of developing skin cancer. Risky behavior in the sun, the occurrence of erythema can contribute to the future of serious skin problems associated with cancer. We can prevent them by applying prophylaxis and individually selected sun protection. Education of patients, parents with small children families of patients with diagnosed melanoma and people with skin cancer may have positive effects in the future. Smoking and drinking alcohol have an adverse effect on sunbathing and the risk of sunburn. Planning for a pro-health policy should be based on preventive and public education programs. The increase in skin cancer cases around the world is alarming. Key words: ultraviolet radiation, vitamin D, exposure to the sun, skin cancer