Can vitamin D deficiency affect the development of cancer? - review of the literature

Introduction and purpose: Over recent years, there has been a noticeable increase in cases of cancer around the world. At the same time, there is the problem of vitamin D deficiency, which may affect up to one-quarter of the population. The aim of this article is to link these two epidemics and organize knowledge about vitamin D and its multidirectional effects related to many diseases, especially cancer. State of knowledge: Many scientific works have proven that vitamin D has a beneficial effect not only on the known calcium-phosphate metabolism. Researchers emphasize its pleiotropic effect on many organs and systems in the human body, and thus on many diseases, including cancer. Studies show that vitamin D modulates the expression of many different miRNAs specific to various types of cancer. The results of in vitro and in vivo studies showed the effect of calcitriol on cell growth and development. It influences processes such as differentiation, proliferation, apoptosis, strengthens the immune system, and reduces oxidative stress. Summary: Based on accumulated research, we can conclude that vitamin D presumably regulates the entire process of tumorigenesis, from initiation to metastasis and cell-microenvironment interactions. However, some studies do not confirm these data or provide contradictory results. For this reason, it is necessary to deepen research on this topic in order to establish specific recommendations, therapeutic and preventive plans. However, vitamin D and its role in the pathogenesis of many diseases should not be underestimated. In cases of low vitamin D concentration in the body, its supplementation will be reasonable, considering the functional identity of this source compared to sun exposure or diet

How does the consumption of processed food affect the pathogenesis of various diseases? - literature review

Introduction and purpose: With the development of civilization, the amount of technology enabling food processing increases. Due to the implementation of these procedures, food can gain new properties that will make it more attractive in the eyes of the consumer. The aim of our work is to collect information on the relationship between the consumption of processed and ultra-processed food and the development of various diseases, with particular emphasis on civilization diseases. State of knowledge: Processed food often contains non-nutritive ingredients, for example, artificial food additives, which have a negative impact on health. Numerous studies demonstrate the correlation between the consumption of ultra-processed food and the development of various diseases. Scientific research suggests that ultra-processed foods may lead to addictive behavioral and biological responses through their reinforcing effects. It also influences the development of various conditions, including obesity, type II diabetes, cardiovascular diseases, depression, and anxiety. Furthermore, its components pass through the placenta. Summary: In light of the research discussed, we are convinced that we cannot remain indifferent to the role of ultra-processed food in the pathogenesis of many diseases. Its multidirectional negative effects show that it is worth conducting further research to discover more consequences of its mechanisms. At the same time, consumers should become more aware of food composition data to be able to make conscious choices and countries should strive to change the food policies

Methadone Maintenance Therapy (MMT) and Alternatives in Opioid Use Disorder: Reviewing the latest advancements, outcomes, and challenges in substitutional therapy for opioid addiction - literature review

Introduction and Purpose: Opioid addiction is a serious challenge for public health worldwide, and methadone maintenance therapy (MMT) is a key therapeutic approach. This review intends to provide an up-to-date summary of the pathophysiology, clinical manifestation, diagnostic techniques, and treatment options for Opioid Use Disorder.   Materials and methods: The literature available in PubMed, Scopus, and Google Scholar databases was reviewed using the following keywords: "MMT," "methadone maintenance therapy", “maintenance therapy”, "opioid use disorder",  "opioid addiction," "methadone”, ”naloxone” “naltrexone”, and “buprenorphine”.   State of Knowledge: This review examines current approaches in maintenance therapy for Opioid Use Disorder (OUD). In the study, we focus on treatments using methadone, buprenorphine, naloxone, and naltrexone. It focuses on recent advancements, comparing the effectiveness, safety, and patient outcomes of these therapies. Key challenges in treatment accessibility and implementation are also discussed, providing an updated overview of the field and identifying areas for future research in opioid addiction therapy. Conclusion: There is a series of studies researching the psychological and behavioral problems associated with opioid addiction. This research has given medical practitioners valuable guidance on effective management techniques. According to the authors, compared to other alternative treatment methods, methadone maintenance therapy (MMT) is still considered the most effective pharmacotherapeutic method in the treatment of opioid addiction. Nevertheless, ongoing research is essential to improve diagnostic processes, develop innovative therapies, and enhance the overall quality of care for those affected by these challenges

Late diagnosed necrotizing fasciitis as a cause of multiorgan dysfunction syndrome: A case report

Necrotizing fasciitis is a rapidly progressive, life-threatening soft tissue bacterial infection. We present a serious case of a 43-year-old male who suffered from necrotizing fasciitis of the left leg in whom a delayed diagnosis caused multiorgan dysfunction

Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project

Purpose: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). Methods: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. Results: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. Conclusion: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection

Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units: a comparison of two large cohorts

Background: Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients. Methods: This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1–15, 2002 (SOAP study, n = 3147), and May 8–18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO2 corresponding to the most abnormal value of arterial PO2 were recorded prospectively every 24 h. In both studies, patients were followed for outcome until death, hospital discharge or for 60 days. Results: The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1–7) days after admission in SOAP and 2 (1–6) days in ICON. Within 24 h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (> 29 cmH2O) and driving pressure (> 14 cmH2O) on the first day of mechanical ventilation but not tidal volume (> 8 ml/kg predicted body weight [PBW]) were independently associated with a higher risk of in-hospital death. Conclusion: The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure > 29 cmH2O and driving pressure > 14 cmH2O on the first day of mechanical ventilation but not tidal volume > 8 ml/kg PBW were independently associated with a higher risk of death. These data highlight the continued burden of ARDS and provide hypothesis-generating data for the design of future studies

The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

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