The impact of left circumflex coronary artery ostium stenosis on outcomes of patients after percutaneous coronary intervention for unprotected left main disease

Background: The impact of left circumflex coronary artery (LCX) ostium atherosclerosis in left main coronary artery (LM) bifurcation disease is not well-known. Aim: The aim of the study was to assess whether the involvement of LCX ostium carries prognostic implications in patients undergoing unprotected LM percutaneous coronary intervention (PCI). Methods: Consecutive 564 patients with unprotected LM (ULMCA) disease who underwent LM PCI between January 2015 and February 2021, with at least 1-year available follow-up were included in the study. First group composed of 145 patients with ULMCA disease with LCX ostium stenosis and the second group consisted of 419 patients with ULMCA disease without LCX ostium stenosis. Results: Patients in group with ULMCA disease with LCX ostium stenosis were significantly older and comorbidities were found more often in this group. Two stents technique was used more often in group with LCX ostium stenosis (62.8% vs 14.6%; P<0.001). During 7 years follow-up, all-cause mortality between groups with and without LCX ostium stenosis did not differ significantly (P=0.50). The use of one-stent or two-stent technique also did not impact the mortality in patients with LCX ostial lesions group (P=0.75). Long-term mortality subanalysis for three groups of patients (1) patients with LM + LCX ostium stenosis, (2) LM + left anterior descending artery (LAD) ostium stenosis, (3) LM + LCX ostium + LAD ostium stenosis also did not differ significantly (P=0.63). Conclusions: LCX ostium involvement in LM disease PCI is not associated with adverse long-term outcomes, which is highly beneficial for the Heart Team decision making process

When does a healthy lifestyle turn into a disorder? Orthorexia – diagnostic problems, methods of treatment

Introduction: Orthorexia nervosa (ON) is a common phenomenon. Its prevalence in society ranges from 1% to 60%. Yet, there are no specific diagnostic criteria or effective screening tests. Moreover, orthorexia does not appear in any of the available international psychiatric classifications such as the ICD (International Statistical Classification of Diseases and Related Health Problems) and DSM (Diagnostic and Statistical Manual of Mental Disorders). Due to this fact many people remain undiagnosed, which significantly affects their standard of living, and later puts a strain on the health care system. Material and method: The article is based on a study and analysis of available publications in the last few years, published in the PubMed database. Conclusions: It is crucial to create specific diagnostic criteria for orthorexia. This will enable efficient detection of patients at an early stage of the disorder, which will significantly shorten the diagnostic path. Moreover, specifying potential risk factors will help to reduce new cases

Modern methods of treating marijuana addiction (cannabis use disorders) and its influence on health

Introduction: Worldwide, cannabis is the most widely used illegal psychoactive substance and the third most common drug, after alcohol and tobacco. Cannabis use disorder (CUD) affects approximately 10% of the 193 million cannabis users worldwide. In recent years, cannabinoids have become more and more popular. The CUD is becoming a growing social and health problem. The search for effective forms of pharmacotherapy is still ongoing, and an effective combination of psychotherapy and pharmacotherapy may be crucial for the future of CUD treatment.   Material and method: The article was based on a review and analysis of publications and discoveries in recent years, which were available in the PubMed and Google Scholar database.   Results: 82 study participants attempted abstinence from cannabis use. In the final primary endpoint analysis, both 400 mg of CBD and 800 mg of CBD were more effective than placebo in reducing cannabis use.  50 people who were addicted to cannabis treated with gabapentin showed a significant reduction in cannabis use and cannabis withdrawal compared to placebo. Moreover, 70 men addicted to cannabis were randomized and those, who used FAAH inhibitors reported fewer cannabis withdrawal symptoms, less cannabis use and lower THC urine levels than placebo users. Conclusions: Gabapentin has been proven to show a reduction in CUD. The use of CBD, FAAH inhibitors and psychotherapy MET/CBT/CM also appear to be effective. In addition, the use of the principles of People-First Language, avoiding slang and idioms, using medical and curing vocabulary, respects the addicted person, and also positively influences the chances of abstinence

Giardia intestinalis - atypical symptoms of infection in the daily practice of various specialists

Giardia intestinalis infection is the most common parasitic infection in the world. The parasite's reservoir is mainly humans and many species of mammals. Giardiasis is a parasitic disease of the duodenum and small intestine. Infection spreads easily through the oral-fecal route. Its most frequent symptom is chronic diarrhea, but it can also be asymptomatic. This article analyzes atypical symptoms of Giardia Intestinalis infection based on available studies in the PubMed database. Observations have shown that giardiasis can manifest in various types of dermatoses such as urticaria, angioedema, atopic dermatitis, erythema nodosum, or Wells syndrome. A relationship between Giardia Intestinalis infection and various allergic syndromes, manifesting as chronic urticaria or angioedema, has also been observed, as well as an increased occurrence of food allergies due to increased exposure to antigens. Studies have also shown that giardiasis can cause polyneuropathy, avitaminosis, and malabsorption syndrome. Even years after infection, chronic fatigue syndrome can still be observe

The impact of right coronary artery support on outcomes of patients with unprotected left main disease undergoing percutaneous coronary intervention

Background: Many operators are discouraged from performing left main (LM) percutaneous coronary interventions (PCI) in the absence of right coronary artery (RCA) support due to the increased procedure risk. Aims: We aimed at assessing the impact of absent functional RCA on prognostic implications in patients undergoing unprotected LM PCI. Methods: 613 patients underwent LM PCI in our department between 2015 and 2019. Consecutive 385 patients with unprotected LM and at least 1-year follow-up were included in the study. The study population comprised 272 patients with unprotected left main coronary artery disease (ULMCAD) with dominant RCA, without any significant lesions (Group 1), and 113 ULMCAD patients and without RCA support (Group 2). Results: In Group 2, 32.7% patients had a significant RCA stenosis, 48.7% had chronic total occlusion (CTO) of RCA, and 18.6% had recessive RCA. Patients in Group 2 were older and had higher prevalence of chronic obstructive pulmonary disease (COPD). SYNTAX Score (median [IQR] 26.0 [20.0–33.0] vs 19.0 [13.0–25.5]; P < 0.001) was higher and left ventricular ejection fraction was lower (median [IQR] 50.0 [40.0–60.0]% vs 55.0 [45.0–60.0]%; P = 0.01) in this group. All periprocedural complications did not differ among the groups. Long-term all-cause mortality at a median follow-up of 1149 days did not differ significantly (23% vs 20%; P = 0.37). The long-term mortality in CTO-RCA group was also not significantly different. Conclusions: Patients with ULMCAD who have undergone LM PCI in the absence of RCA support, compared with those with ULMCAD and RCA support, differed neither in the prevalence of periprocedural complications nor in long-term all-cause mortality

When does a healthy lifestyle turn into a disorder? Orthorexia – diagnostic problems, methods of treatment

Introduction: Orthorexia nervosa (ON) is a common phenomenon. Its prevalence in society ranges from 1% to 60%. Yet, there are no specific diagnostic criteria or effective screening tests. Moreover, orthorexia does not appear in any of the available international psychiatric classifications such as the ICD (International Statistical Classification of Diseases and Related Health Problems) and DSM (Diagnostic and Statistical Manual of Mental Disorders). Due to this fact many people remain undiagnosed, which significantly affects their standard of living, and later puts a strain on the health care system. Material and method: The article is based on a study and analysis of available publications in the last few years, published in the PubMed database. Conclusions: It is crucial to create specific diagnostic criteria for orthorexia. This will enable efficient detection of patients at an early stage of the disorder, which will significantly shorten the diagnostic path. Moreover, specifying potential risk factors will help to reduce new cases

Hyperosmolar hyperglycemic syndrome: A comprehensive review of clinical presentation, diagnosis, and treatment strategies in hyperglycemic crises

Introduction and Purpose Hyperosmolar Hyperglycemic State (HHS), a severe type 2 diabetes complication, presents with profound hyperglycemia, hyperosmolality, and dehydration sans ketosis, posing distinct challenges in diagnosis and treatment compared to diabetic ketoacidosis (DKA). This article aims to enhance medical community awareness by examining HHS features, prevalence, and associated risk factors, contributing to improved clinical management. Emphasizing tailored treatment strategies for dehydration, coexisting illnesses, and metabolic decompensation, it ultimately seeks to enhance outcomes for type 2 diabetes individuals. Material and methods Conducting a systematic review of medical articles from 1972 to 2023 using PubMed, this study analyzed keywords such as hyperglycemic hyperosmolar state, HHS, diabetes mellitus, hyperglycemia, and dehydration. Inclusion of pertinent articles ensured a comprehensive exploration of Hyperosmolar Hyperglycemic State (HHS) literature during the specified timeframe. Brief description of the state of knowledge. Hyperosmolar Hyperglycemic Syndrome (HHS) predominantly affects elderly type 2 diabetes individuals, often triggered by infections like pneumonia or urinary tract infections. Clinical presentation includes fatigue, weakness, polydipsia, polyuria, nausea, and altered consciousness. Diagnosis relies on criteria such as elevated blood glucose levels and increased osmolality. HHS management involves a multidisciplinary approach, addressing fluid depletion, compromised cerebral perfusion, and achieving gradual normalization of osmolality and blood glucose levels to prevent complications. Summary Hyperosmolar Hyperglycemic Syndrome (HHS), a severe metabolic disorder linked to diabetes, extends beyond hyperglycemia, necessitating a comprehensive understanding. This review sheds light on HHS etiology, clinical manifestations, diagnostic criteria, and treatment modalities, emphasizing its critical nature in diabetes care

Mediation in resolving the conflicts of adolescence

Praca recenzowana / peer-reviewed paperMediacja, choć jest instytucją stosunkowo młodą w polskim systemie prawa (ma niespełna trzynaście lat), z powodzeniem może być wykorzystywana w bardzo szerokim zakresie. Podstawowym jej założeniem jest koncepcja sprawiedliwości naprawczej, opierająca się w głównej mierze na zadośćuczynieniu, która może być rozumiana jako alternatywa bądź uzupełnienie obowiązującej wciąż jeszcze sprawiedliwości odwetowej. Wyrasta bowiem z przeświadczenia, że to interes pokrzywdzonego przestępstwem (lub innym szkodliwym działaniem), a nie państwo i społeczeństwo są centralnym punktem postępowania