Pioglitazone - the forgotten drug with multidirectional action

Introduction: Pioglitazone (PG) which belongs to thiazolidinedione class is a drug used in the treatment of type 2 diabetes. PG increases the insulin sensitivity of peripheral tissues. Type 2 diabetes mellitus (T2DM) is one of the most common and fastest developing diseases. The antihyperglycemic effect of pioglitazone (PG) is not its only one. This drug has a number of other metabolically beneficial effects. Many outcome trials indicate a positive impact of PG on the functioning of other systems. Aim of the study: The aim of this study is to summarize the current knowledge on the effectiveness and safety of pioglitazone based on the available scientific literature. Materials and methods: Literature review based on PubMed, Google Scholar database using the following phrases: pioglitazone, type 2 diabetes, pioglitazone in non-alcoholic fatty liver disease (NAFLD) therapy, pioglitazone and cardiovascular risk, pioglitazone nephroprotective effect, pioglitazone safety profile. State of knowledge: Pioglitazone is an oral antidiabetic drug used in the therapy of T2DM. PG belongs to the ‘insulin- sensitizers’. It is included in the treatment in the case of intolerance, contraindications to metformin or as part of combination therapy. Conclusions: Recently, interest in pioglitazone has waned due to the perception of significant side effects.  The analysis of the papers showed a positive effect of PG on the cardiovascular system, central nervous system, NAFLD and nephroprotection. The acceptable safety profile of pioglitazone with the appropriate selection of patients as well as its multidirectional action and effectiveness mean that clinicians should reconsider the use of this drug guided by the balance of profits and losses

Physical Activity in Patients with IBD - Challenge, Opportunity, or Both?

Introduction: Inflammatory bowel diseases (IBD) are a global public health problem, and their incidence is continuously increasing. IBD is characterized by a relapsing nature and is associated with symptoms such as abdominal pain, diarrhoea, malabsorption, and nutritional deficiencies. Patients affected by this disease are typically young individuals, and physical activity plays a significant role in this age group. Understanding the role of exercise and sports activities in individuals with IBD can help consider potential therapeutic interventions for these patients. Objective: The aim of this study is to summarize the knowledge regarding the role of physical activity in patients with IBD. Materials and methods: A literature review was conducted using the PubMed and Google Scholar databases, using the following keywords: IBD, physical activity, stress and fatigue in individuals with IBD, anxiety in patients with IBD. State of knowledge: The role of physical activity in promoting health and preventing various diseases is well-established. However, there is limited research on the association between exercise and IBD. Conclusions: Physical activity, by reducing fatigue and stress, has a positive impact on the functioning of patients with IBD. There are reports suggesting a reduction in gastroenterological symptoms in patients after engaging in exercise. With appropriate control of the underlying disease using pharmacological and other recommended methods, participating in sports activities does not pose a barrier for patients. Physicians should encourage patients to engage in exercise with tailored intensity due to its beneficial effects on various aspects of life for individuals with IBD. Further research is necessary to explore this topic more extensively

Impact of COVID-19 outbreak on the mental health in sport and among society

The COVID-19 pandemic has had a significant impact on global mental health, affecting individuals of all age groups and various demographic backgrounds including athletes. Anxiety disorders have become more prevalent during the pandemic, attributed to factors such as quarantine, social isolation, fear of the virus, job insecurity, and the psychological impact of a pandemic. This narrative review aims to summarize the existing literature addressing mental health issues related to the COVID-19 pandemic, as well as the associated risk factors and potential interventions. Additionally, the review explores the impact of COVID-19 on specific populations, including athletes, frontline healthcare workers, children and adolescents, and individuals with pre-existing mental health conditions. In addition, the review explores the long-term consequences of the pandemic on mental health, including the potential for a surge in post-traumatic stress disorder (PTSD) and other trauma-related disorders. Overall, this review underscores the urgent need for comprehensive mental health support and resources in response to the COVID-19 pandemic

Physicians' Perspectives on Vaccinations

Protective vaccinations are crucial for preventing infectious diseases and their complications, offering a high safety profile and minimal adverse effects. However, vaccine hesitancy has emerged as a public health concern, leading to outbreaks of communicable diseases. This study aims to investigate the attitudes towards vaccinations among doctors and nurses, as well as their knowledge level and vaccination frequency. The research employed a cross-sectional design and collected data using an anonymous questionnaire. The study was conducted in southern Poland, involving Primary Healthcare Centers and hospitals. A total of 878 paper surveys were collected among 542 doctors and 336 nurses

Inositol and herbal substances as elements of complementary therapy in patients with PCOS

Introduction: Polycystic ovary syndrome is a common hormonal disorder in women and the leading cause of female infertility. Traditional therapeutic methods often do not yield the expected results, hence the need to explore new treatment strategies. Promising results have been observed in studies on inositol. Objective: The aim of this study is to summarize the current knowledge regarding the effectiveness and safety of inositol and herbal preparations in the treatment of PCOS based on available scientific literature. Materials and Methods: A literature review was conducted using PubMed and Google Scholar databases, using search terms: inositol, PCOS treatment, herbal medicine in PCOS. Current knowledge: Inositol is an oral supplement used in the therapy of PCOS. It is characterised by high safety and minimal risk of side effects. Herbal extracts alleviate symptoms in patients with PCOS. Conclusions: Analysis of scientific research has provided evidence of the effectiveness of inositol, particularly myo-inositol, in complementary therapy for PCOS. Herbal medicine also appears to be an effective supportive treatment. However, these substances should not be considered as primary therapy but rather as an adjunct. Only both - primary medications and complementary treatment methods, can yield a therapeutic effect

Analysis of the relationship between serum sodium concentration and laboratory parameters in diabetic patients

Introduction: Diabetes is a chronic civilization disease that is associated with numerous complications and disturbances in laboratory parameters. One of the observed changes in laboratory studies of individuals suffering from diabetes is a significantly low level of sodium. Aim of study: The aim of study was to compare natremia with selected blood parameters determined on admission to hospital, and then to find correlation, if any, between those parameters. Materials and methods: We retrospectively reviewed the medical records of 169 patients with diagnosed type 2 diabetes and the average age of 72.43±11.62 years. We tested the correlation between natremia and: total, LDL and HDL cholesterol; creatinine; potassium; calcium; eGFRCKD-EPI and alanine aminotransferase levels in the patients. Statistical analysis was run on STATISTICA 13. The nonparametric Mann-Whitney, Spearmans’ rank correlation and the Shapiro-Wilk tests were used to analyse factors affecting laboratory test results for the patients, perform correlation analyses and check the conformity with normal distribution, respectively. Research results: A positive correlation was revealed between LDL level and natremia (p = 0.023), as well as between natremia and chloride ion concentration (p < 0.001) in the patients’ blood. No correlation was found between natremia and sex, age, eGFRCKD-EPI, alanine aminotransferase, HDL cholesterol, triglycerides, creatinine, as well as calcium and potassium concentrations. Conclusions: Statistically significant correlations were found exclusively between LDL level and natremia, and between chloride and sodium concentrations. High LDL level was correlated with high natremia, which requires further research due to the scant literature. The sodium, potassium and chloride concentrations are known to be interconnected by the need to ensure the electrolyte balance, as seen in the Gamble diagram. The remaining parameters were not statistically significant

Infertility in patients with Inflammatory Bowel Disease (IBD): a challenge to overcome

Introduction: Inflammatory bowel disease (IBD) is a group of chronic digestive disorders that affects an increasing number of people. As the peak incidence of IBD occurs during the reproductive age and affects young people, it is worth examining the impact of IBD on the fertility of patients. In view of the growing problem of infertility in society and the probable relationship between decreased reproductive function and the occurrence of chronic diseases, it is reasonable to examine this phenomenon in detail. Objective: The aim of this study is to summarize the current knowledge on the association between IBD and infertility based on available literature. Materials and methods: A literature review was conducted using PubMed and Google Scholar databases with the following search terms: IBD, infertility, infertility diagnosis, the relationship between IBD and infertility, drugs and infertility, psychological aspects of infertility in IBD. State of knowledge: There are few meta-analyses on the association between IBD and infertility in the literature, and this is due to the small number of studies on this topic. Conclusions: Infertility is becoming an increasingly common problem in people with IBD. Stress and anxiety disorders can have a negative impact on the course of the disease, and thus limit reproductive opportunities. Taking medications to control the course of the disease is crucial for patients to remain in remission, however, patients should be informed about the impact of some medications on reproduction and adjust their conception plans according to their current therapy. Treatment of the underlying disease, reducing anxiety levels, regular physical activity, and a healthy and balanced diet are all components of appropriate management in people with IBD who are trying to conceive. Without these pillars, it is difficult to guarantee successful pregnancy outcomes

The role of B lymphocytes in selected rheumatological and neurological diseases

Introduction: B lymphocytes are responsible for humoral immune response. They play a crucial role in the development of the immune response and are essential in preventing infections as well as autoimmune and neoplastic diseases. They also constitute an important therapeutic target and are used in genetic and immunological therapies. In some cases, B cells can contribute to the pathogenesis of various diseases. Aim of study: The aim of this study is to summarize the current knowledge on the diverse role of B lymphocytes in selected rheumatic and neurological diseases using available scientific literature. Materials and Methods: This  review was conducted using  Pubmed and Google Scholar databases from 2009-2023. The research strategy was based on the following terms: B lymphocytes, monoclonal antibodies, myasthenia gravis, multiple sclerosis, systemic lupus erythematosus, systemic sclerosis, central nervous system damage, optic neuritis, Devic's syndrome. Conclusion: B lymphocytes play a significant role in the pathogenesis of many rheumatic and neurological diseases, therefore they represent a target for modern therapies. Their role and potential use are complex and differ depending on the specific disease entity. Further research will allow for the development of new targeted therapies, giving hope for improving the effectiveness of patient treatment

Coexistence of Slipped Capital Femoral Epiphysis and multiple endocrine neoplasia type 2B (MEN2B) - a case report

Introduction: MEN 2B syndrome is distinguished by the occurrence of medullary thyroid cancer, pheochromocytoma, mucosal neuromas, marfanoid features, and skeletal anomalies, including kyphoscoliosis, joint laxity, pes cavus, and, in a smaller number of cases, slipped capital femoral epiphysis (SCFE). Case report: We describe a case report of a 15-years-old patient with the diagnosis of the MEN2B syndrome with a rare manifestation of Slipped Capital Femoral Epiphysis (SCFE). A 15-year-old female presented to the orthopedics out-patient department (OPD) with complaints of pain around the right hip and knee and walking with a limp for approximately four months. Additionally, the feeling of enlarged thyroid gland was reported. X-ray confirmed the presence of the SCFE, while thyroid biopsy revealed the presence of  medullary thyroid cancer (MTC). Thus, the diagnosis of MEN2B was made. Conclusion: Slipped capital femoral epiphysis (SCFE) can occasionally be a manifestation of MEN 2B syndrome. It is important for physicians to be aware of this association, as it can contribute to the early detection of a potentially life-threatening condition

Benefits and risks of vitamin D supplementation

Vitamin D deficiency is a common problem not only in Poland but also in the world. Studies from previous years indicate its pleiotropic effect and indicate the need for supplementation both in individual risk groups and in the general population. The main sources of cholecalciferol are skin synthesis and intestinal absorption. Vitamin D deficiency adversely affects the cardiovascular, immune and nervous systems. It is also associated with gastrointestinal, metabolic, cancer and autoimmune diseases. Through the immune system, it also affects the respiratory system. Prophylactic doses should depend on age, body weight, seasonal insolation and sun exposure, as well as individual factors such as diet and lifestyle. Excessive supply of vitamin D can lead to hypercalcemia and hypercalciuria, although it is not known how high doses cause toxic effects. Monitoring the exponents of calcium and phosphate metabolism is the basic method of preventing vitamin D toxicity