Premenstrual Syndrome and Premenstrual Dysphoric Disorder From the theory to the clinical approach

Mental state of women during their reproductive age fluctuates with the changes in menstrual cycle phases. However, only some of them develop psychiatric disorders. The aim of the study is to present the importance of Premenstrual Syndrome and Premenstrual Dysphoric Disorder as important diseases at the edge of gynecology and psychiatry. Many symptoms classified as premenstrual have been described in the literature. Mood swings turn out to be the most important psychological symptom of the disorders whereas bloating is a common somatic manifestation. Despite some difficulties in the establishment of the exact cause, diagnostic criteria for both have been developed and are the basis on which the clinician makes a final diagnosis. The paper also describes the current state of knowledge about the treatment of Premenstrual Syndrome and Premenstrual Dysphoric Disorder. The continuous increase in the importance of non-pharmacological methods such as lifestyle changes and cognitive-behavioral therapy was emphasized. Manners of pharmacological treatment were also described, including SSRIs and hormonal drugs, which should be selected individually, depending on the characteristics of the clinical picture

Zgoda pacjenta warunkiem sine qua non interwencji medycznej

The purpose of the article is to conduct a comprehensive legal analysis of the patient’s consent to carry out a medical procedure in the light of national case-law and doctrinal views, including the issue of the act of will of minors. The concept of informed consent of the beneficiary has become a determinant of the scope of medical or nursing intervention, constituting both its legality and the overall relationship of the patient with the medical staff. The synthetic interpretation of the issue also draws attention to the dilemma of the collision of values between the doctor’s action in the defense of the patient’s life and health without obtaining consent to the confluence, and the issue of violation of the test’s right to preservation of inviolability. In light of this, the authors clarify the premises of legal liability of medical staff under Article 192 of the Criminal Code.Artykuł ma na celu przeprowadzenie kompleksowej analizy prawnej pojęcia zgody badanego na przeprowadzenie zabiegu medycznego w świetle orzecznictwa krajowego i poglądów doktryny, włączając w to problematykę wyrażenia aktu woli osób małoletnich. Koncepcja świadomej zgody świadczeniobiorcy funkcjonuje obecnie jako wyznacznik zakresu lekarskiej bądź pielęgniarskiej ingerencji, decydującej tak o jej legalności, jak i całokształcie relacji pacjenta z personelem medycznym. Syntetyczna wykładnia zagadnienia zwraca uwagę także na dylemat kolizji wartości pomiędzy działaniem lekarza w obronie życia i zdrowia pacjenta bez uzyskania przezeń zgody na zabieg a kwestią pogwałcenia prawa badanego do zachowania nietykalności. W świetle tego autorzy klarują przesłanki odpowiedzialności prawnej personelu medycznego na mocy art. 192 k.k

Infekcyjne zapalenie mięśnia sercowego a szerokość geograficzna

Myocarditis is a worldwide spread disease. Some of the most common causes of myocarditis are cardiotropic viruses such as enteroviruses, adenoviruses, parvoviruse B19, human herpes virus 6, and rarely cytomegalovirus, Ebstein-Bar virus, mumps virus, or hepatitis C virus. In some world regions, parasitic or protozoal infection (Toxoplasma gondii, Trypanosoma cruzi) have also been reported as a frequent aetiology of myocarditis. However, there are some important differences between reported prevalence of each one of those pathogenes, depending on study population. In this work we compared epidemiological data about the frequency of the most common myocardial viruses between the countries of different latitude (Germany, Poland, Italy, Finland,United States, Mexico, Brazil, and countries of Sub-Saharian Africa).Zapalenie mięśnia sercowego jest jednostką chorobową szeroko rozpowszechnioną na całym świecie. Jedną z najczęstszych przyczyn jej występowania są wirusy kardiotropowe, takie jak: enterowirusy, adenowirusy, parwowirus B19 czy wirus opryszczki ludzkiej typu 6, a także rzadziej obecne wirusy cytomegalii, Epsteina-Barr, wirus świnki czy wirus zapalenia wątroby typu C. Procentowy udział wirusów w patogenezie infekcyjnego zapalenia mięśnia sercowego jest jednak różny w zależności od badanej populacji. W niektórych regionach świata jako przyczynę zapalenia odnotowuje się też częste występowanie etiologii pasożytniczej lub pierwotniakowej (Toxoplasma gondii, Trypanosoma cruzi). W niniejszej pracy została podjęta próba zestawienia danych epidemiologicznych na temat najczęściej odnotowywanych czynników infekcyjnych zapalenia mięśnia sercowego, w krajach o różnej szerokości geograficznej (Niemcy, Polska, Włochy, Finlandia, Stany Zjednoczone, Meksyk, Brazylia, kraje Afryki Subsaharyjskiej)

Nadciśnienie płucne w przebiegu niewydolności lewej komory

Pulmonary hypertension (PH) is clinical condition often associated with left ventricular heart failure. Based on the pulmonary arterial pressure and pulmonary arterial wedge pressure we can distinguish 3 subtypes: precapillary, postcapillary and mixed PH. Pathomechanism is derived mainly by passive backward transmission of left ventricular filling pressures to left atrium and pulmonary circulation. In more advanced stage of the disease we can observe vascular remodeling and alterations in right heart function, which usually is associated with worse clinical outcome, increased hospitalization rate and higher mortality among patients. Correct diagnosis is essential and should be based on medical history, clinical evaluation and non-invasive testing. Sometimes invasive tools may be indicated to confirm the diagnosis. Despite some clinical trials there is no targeted therapy for PH-LHD approved and surgical interventions, fluid intake monitoring and concomitant disorders treatment remains the only therapeutic option. Here, we review current guidelines and novel strategies for classification, mechanism, diagnostic procedure and treatment options in PH-LHDNadciśnienie płucne jest stanem klinicznym często towarzyszącym niewydolności lewokomorowej serca. W zależności od uzyskanych pomiarów ciśnień w tętnicy płucnej oraz ciśnienia kąta zaklinowania należy wyróżnić trzy podtypy tej jednostki chorobowej — przedwłośniczkowy, pozawłośniczkowy oraz mieszany. Zjawiskiem napędzającym patomechanizm jest bierne cofanie się podniesionych ciśnień napełniania lewej komory do lewego przedsionka oraz naczyń płucnych. W zależności od stopnia zaawansowania zaburzenia u pacjentów można obserwować przebudowę naczyń płucnych oraz zaburzenia w funkcji prawej komory. Pojawienie się tych powikłań znacznie pogarsza rokowanie chorych i wiąże się z częstszą hospitalizacją oraz wyższą śmiertelnością. Prawidłowe rozpoznanie choroby jest kluczowe i powinno opierać się głównie na zebranym wywiadzie, obrazie klinicznym oraz badaniach nieinwazyjnych, jednak w niektórych przypadkach może być wskazane wykonanie zabiegów inwazyjnych w celu potwierdzenia diagnozy. Pomimo kilku badań klinicznych, do tej pory nie pojawiły się żadne zalecenia dotyczące specyficznej farmakoterapii, a jedynymi metodami leczenia pozostają interwencje chirurgiczne, kontrola stanu nawodnienia i leczenie chorób towarzyszących.W tej pracy dokonano przeglądu aktualnych wytycznych oraz proponowanych strategii w zakresie klasyfikacji, mechanizmu, procesu diagnostycznego i możliwości terapeutycznych nadciśnienia płucnego w przebiegu niewydolności lewego serca

Antiphospholipid Syndrome and Pregnancy

Antiphospholipid syndrome is an autoimmune disease with a wide spectrum of manifestations from different organs, therefore it is challenging to diagnose. The disease presents antiphospholipid antibodies such as anticardiolipin antibodies (aCL), lupus anticoagulant (LA) and antiβ2-glycoprotein 1 antibodies (β2GPI). The most common symptoms include thrombosis in veins and arteries and obstretical complications such as early miscarriage, intrauterine fetal death, intrauterine growth restriction (IUGR), placental insufficiency, premature labor and eclampsia. To diagnose a patient with APS certain criteria have been chosen, where at least one clinical and one laboratory criterion must be present. In many cases it takes a lot of time before a proper diagnosis has been made, when a female patient presents obstretical complications. Adequate pharmacological treatment increases the odds of live birth rate from 20-30% to 70-80%. Scientific research shows correlation between antiphospholipid syndrome, infertility and premature ovarian insufficiency. Treatment mostly consists of heparin and low-dose aspirin, in certain cases hydrochloroquine is prescribed. Aside from pharamcological therapy, it is very important to minimize the effects of modifiable risk factors. The following article focuses on complications, diagnosing and therapy in pregnant women suffering from Antiphospholipid syndrome. All sources can be found in Pubmed’s website database

The impact of shift work and sleep deficiency on health

Shift work refers to work that takes place at different hours, including at night. It is estimated that 15% to 20% of the working population works in shift work, particularly in the healthcare, energy, communication systems, public safety, and hospitality industries. Research indicates that shift work, particularly night work, can lead to health problems such as fatigue, exposure to harmful work environments, increased risk of workplace accidents, and sleep disorders. Night work is also associated with increased risk of hypertension, nervous system dysfunction, cardiovascular dysfunction. Those working at night are also more prone to hormonal disorders, digestive disorders, lowered immunity, and cancer. Sleep-wake cycle disorders, such as excessive sleepiness during waking hours and insomnia at night, are symptoms of shift work intolerance syndrome, which can occur after several months or years of shift work. It is estimated that over 20% of shift workers suffer from sleep-wake cycle disorders, and various factors such as chronotype, age, gender, family and social obligations, medications, medical and psychiatric conditions, and shift work experience can impact tolerance of shift work. The treatment of sleep and wake disorders related to shift work includes planning for main sleep and supplementary naps, appropriate exposure to light, treatment with melatonin, taking sleeping and psychostimulant medications.&nbsp

Dietary Therapies in Pediatric Crohn’s Disease

Introduction and Purpose: Crons’ disease is a chronic illness of the digestive system. Its etiology is multifactorial and one of the factors is nutrition. That is why the researchers are trying to labour the valuable types of dietary therapy, which could be used in treatment of pediatric CD. The purpose of our review is to point out the impact of dietary therapy on achieving remission in pediatric Crohn’s disease. Materials and methods: We have reviewed the literature from the PubMed database searching for clinical trials, meta analysis and randomized controlled trials from the past years. The keywords we agreed on offered us the most informative articles and made us hope for the further development of our article. Brief Description Of The State Of Knowledge: Steroid therapy is the principle of CD treatment, but it has a number of side effects that influence the quality of pediatric patients’ life. It has been shown that the use of dietary therapies (EEN, CDED+PEN, SCD) enables the achievement of clinical and biochemical remission, mucosal healing and regulation of dysbiosis. There are many hypotheses explaining this effect, probably the reason of this is the exclusion from the diet of food products that provoke inflammatory processes. Summary: Despite its effectiveness, dietary therapies require motivation and full commitment from patients in order to achieve results. That is why it is so important to conduct further research in this area so that the selected therapy is as acceptable and tolerated by the patient as possible. In addition, education of children and parents, psychological and dietary support are also crucial in the treatment process

Polycystic Ovary Syndrome - increased risk of depression development. Links and risk factors

PCOS is a common endocrine disorder affecting up to 6-10% of women in reproductive age. Patients suffer from many manifestations of this disease including symptoms of hyperandrogenism (hirsutism, acne, androgenetic alopecia), ovulation disorders, infertility, overweight and obesity, glucose-insulin homeostasis disorders (insulin resistance, type 2 diabetes). Many studies emphasize the relationship between the presence of PCOS in patients and the appearance of depression. The median incidence of depression in women with this syndrome was 36.6%, while in the group of women without PCOS it was 14.2%. The exact mechanism of this relationship is still unknown, but many factors may play an important role in it, e.g. increased BMI, infertility, high cortisol levels, body image, vitamin D deficiency or elevated inflammation markers

Basal cell carcinoma in the elderly Cryosurgery or surgery – a case study with reference to the literature

Introduction The aging of society leads to an increase in the occurrence of basal cell carcinoma (BCC). BCC includes both superficial and nodular lesions with a good prognosis as well as foci that are difficult to treat and require a multidisciplinary approach. There are two basic methods of treating BCC, surgery to remove the tumor and cryosurgery. The paper presents a case of an 82-year-old female patient suffering from BCC in a non-advanced stage of the disease with the presentation of subsequent stages of treatment.Aim of the studyAn attempt was made to confront an alternative method of BCC treatment by cryosurgery with the first-choice procedure - surgical excision of the tumor with a margin of healthy tissues.Description of the caseAn individual clinical case study including the patient's medical records.ConclusionsThe work emphasizes the importance of comprehensive care for a patient diagnosed with BCC.Individualization of the diagnostic and therapeutic process is the basis for dealing with the elderly patient

Association between caesarean section and childhood asthma development

According to the World Health Organization (WHO), the rates of caesarean section delivery, which is the most common surgical procedure in gynecology and obstetrics, are increasing globally and amount to 21%. In Poland percentage of caesarean sections (CS) is one of the highest in Europe and amount to 42.2%. The reason for this is the extension of medical indications, but also an increase in the number of CS at the request of pregnant women. Although CS can be a lifesaving procedure, it can also cause many health complications for both - the woman and the child. Numerous studies indicate that caesarean delivery is associated with childhood asthma. Several hypotheses of the pathogenesis of this relationship have been presented. One of them, which is based on the hygiene hypothesis indicates that mode of delivery can cause different bacteria colonization in infants. Lack of contact of fetus with the mother’s vaginal flora during CS labor may cause improper immune system maturation. Another hypothesis is that reduced exposure to stress hormones and mechanical forces during CS labor can indicate infant respiratory complications such as respiratory distress syndrome (RDS) or transient tachypnea of the newborn (TTN). It is suggested that these abnormalities have an impact on asthma development in later life. On the other hand, there are studies which do not confirm that mode of delivery has an influence on the induction of asthma. Due to the significant heterogeneity of studies and unclear risk factors and pathomechanism of the childhood asthma it is impossible to strong confirm the association between caesarean section and asthma developing