Ehlers-Danlos Syndrome - living with chronic pain. Current knowledge of the disease

Ehlers Danlos Syndrome (EDS) is a group of the most common inherited connective tissue disorders. The main symptoms of this syndrome are excessive skin flexibility, joint hypermobility and blood vessels fragility. The diagnosis is based on clinical symptoms, but to confirm the type of EDS, it is necessary to identify the collagen-encoding gene or protein interacting with it. The group of Ehlers and Danlos diseases include fourteen types, the most common are classic, vascular, hypermobile, arthrochalasis, kyphoscoliotic and dermatosparaxis. [15] Connective tissue plays a key role in the process of movement, constituting the main component of bones, joint cartilage, tendons, ligaments and intervertebral discs. In addition, connective tissue is a part of every internal organ including the intestines and parenchymal organs and the cardiovascular system.[19] For this reason, patients with EDS show symptoms of many diseases, including respiratory, muscular, skeletal and vascular. Women suffering from EDS often struggle with complications during their pregnancies. Psychological and emotional issues are also common.[6] However, the most noticeable and debilitating symptom of EDS is pain, which is often severe and chronic. The pain occurs in approximately 90% or more of EDS patients.[8] Successful pain management in patients with EDS is a major challenge for specialists. The treatment involves non-steroidal anti-inflammatory drugs, acetaminophen, opioids and physiotherapy. Also marijuana, traditional chinese treatments, herbal remedies are considered to reduce the severity of the symptoms. [9] During the creation of this article, the authors analyzed the clinically relevant knowledge of EDS treatment and management based on research published on Pubmed

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

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

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

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

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

Ehlers-Danlos Syndrome - living with chronic pain. Current knowledge of the disease

OLSZAK, Joanna, KAPŁAN, Wojciech, RACHWAŁ, Dominika, PIĄTEK, Ewa, ZALEWA, Karolina, BARTOSZEK, Lidia, CZELEJ, Magdalena, STACHOWICZ, Hubert and MAZUREK, Joanna. Ehlers-Danlos Syndrome - living with chronic pain. Current knowledge of the disease. Journal of Education, Health and Sport. 2023;19(1):158-169. eISSN 2391-8306. http://dx.doi.org/10.12775/JEHS.2023.19.01.015 https://apcz.umk.pl/JEHS/article/view/45798 https://zenodo.org/record/8349787 The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of 17.07.2023 No. 32318. Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences). Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 17.07.2023 Lp. 32318. Posiada Unikatowy Identyfikator Czasopisma: 201159. Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu). © The Authors 2023; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, 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: 19.08.2023. Revised: 15.09.2023. Accepted: 15.09.2023. Published: 19.09.2023. Ehlers-Danlos Syndrome - living with chronic pain. Current knowledge of the disease Joanna Olszak1, Wojciech Kapłan2, Dominika Rachwał1, Ewa Piątek3, Karolina Zalewa1, Lidia Bartoszek1, Magdalena Czelej4, Hubert Stachowicz2, Joanna Mazurek2 1Medical University of Warsaw, Faculty of Medicine, Warsaw, Poland 2Medical University of Lublin, Faculty of Medicine, Lublin, Poland 3Medical University of Lublin, Faculty of Dentistry, Lublin, Poland 4Samodzielny Publiczny Szpital Kliniczny SPSK4 w Lublinie, Polska Joanna Olszak ORCID: 0009-0004-0211-1449 E-mail: [email protected] Wojciech Kapłan ORCID: 0000-0003-2270-0318 E-mail: [email protected] Dominika Rachwał ORCID: 0009-0001-9104-0459 E-mail: [email protected] Ewa Piątek ORCID: 0009-0000-9051-5777 E-mail: [email protected] Karolina Zalewa ORCID: 0009-0004-0610-6866 E-mail: [email protected] Lidia Bartoszek ORCID: 0009-0000-1656-7325 E-mail: [email protected] Magdalena Czelej ORCID: 0000-0002-3717-4261 E-mail: [email protected] Hubert Stachowicz ORCID: 0009-0003-5906-1350 E-mail: [email protected] Joanna Mazurek ORCID: 0009-0005-0300-7798 E-mail: [email protected] Abstract Ehlers Danlos Syndrome (EDS) is a group of the most common inherited connective tissue disorders. The main symptoms of this syndrome are excessive skin flexibility, joint hypermobility and blood vessels fragility. The diagnosis is based on clinical symptoms, but to confirm the type of EDS, it is necessary to identify the collagen-encoding gene or protein interacting with it. The group of Ehlers and Danlos diseases include fourteen types, the most common are classic, vascular, hypermobile, arthrochalasis, kyphoscoliotic and dermatosparaxis. [15] Connective tissue plays a key role in the process of movement, constituting the main component of bones, joint cartilage, tendons, ligaments and intervertebral discs. In addition, connective tissue is a part of every internal organ including the intestines and parenchymal organs and the cardiovascular system.[19] For this reason, patients with EDS show symptoms of many diseases, including respiratory, muscular, skeletal and vascular. Women suffering from EDS often struggle with complications during their pregnancies. Psychological and emotional issues are also common.[6] However, the most noticeable and debilitating symptom of EDS is pain, which is often severe and chronic. The pain occurs in approximately 90% or more of EDS patients.[8] Successful pain management in patients with EDS is a major challenge for specialists. The treatment involves non-steroidal anti-inflammatory drugs, acetaminophen, opioids and physiotherapy. Also marijuana, traditional chinese treatments, herbal remedies are considered to reduce the severity of the symptoms. [9] During the creation of this article, the authors analyzed the clinically relevant knowledge of EDS treatment and management based on research published on Pubmed. Keywords: Ehlers-Danlos syndrome, chronic pain, joint hypermobility, multidisciplinary therapy Abstrakt Zespół Ehlersa Danlosa (EDS) to grupa najczęstszych dziedzicznych chorób tkanki łącznej. Głównymi objawami tego zespołu są nadmierna elastyczność skóry, nadmierna ruchomość stawów oraz kruchość naczyń krwionośnych. Rozpoznanie stawia się na podstawie objawów klinicznych, jednak w celu potwierdzenia typu EDS konieczne jest zidentyfikowanie genu kodującego kolagen lub białka wchodzącego z nim w interakcję. Grupa chorób Ehlersa i Danlosa obejmuje czternaście typów, z których najczęstsze to typ klasyczny, naczyniowy, hipermobilny, artrochalasis, kifoskoliotyczny i dermatosparaksja. [15] Tkanka łączna odgrywa kluczową rolę w procesie ruchu, stanowiąc główny składnik kości, chrząstki stawowej, ścięgien, więzadeł i krążków międzykręgowych. Ponadto tkanka łączna jest częścią każdego narządu wewnętrznego, w tym jelit i narządów miąższowych oraz układu sercowo-naczyniowego.[19] Z tego powodu pacjenci z EDS wykazują objawy wielu chorób, w tym układu oddechowego, mięśniowego, kostnego i naczyniowego. Kobiety cierpiące na EDS często borykają się z powikłaniami podczas ciąży. Częste są również problemy psychologiczne i emocjonalne.[6] Jednak najbardziej zauważalnym i osłabiającym objawem EDS jest ból, który często jest ciężki i przewlekły. Ból występuje u około 90% lub więcej pacjentów z EDS.[8] Skuteczne leczenie bólu u pacjentów z EDS jest dużym wyzwaniem dla specjalistów. W leczeniu stosuje się niesteroidowe leki przeciwzapalne, paracetamol, opioidy oraz fizjoterapię. Uważa się, że marihuana, tradycyjne chińskie metody leczenia, leki ziołowe zmniejszają nasilenie objawów. [9] Podczas tworzenia tego artykułu autorzy przeanalizowali klinicznie istotną wiedzę na temat leczenia i zarządzania EDS na podstawie badań opublikowanych w Pubmed. Słowa kluczowe: Zespół Ehlersa-Danlosa, ból przewlekły, nadmierna ruchomość stawów, terapia wielodyscyplinarn

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