Mirogabalin - the use of a new gabapentinoid in the treatment of diabetic neuropathy and postherpetic neuropathy and other conditions

Introduction: Mirogabalin is a new drug from the gabapentinoid group first registered in Japan in 2019. It has found use in the treatment of peripheral neuropathic pain in diabetic neuropathy and postherpetic neuropathy. Purpose: In this article, we review studies on the efficacy and safety of mirogabalin in the treatment of registered indications and its potentially new applications. Materials and Methods: We reviewed the literature available in the PubMed database, using the key words: "mirogabalin", "neuropathy" "pregabalin". Results: Mirogabalin has been registered for the treatment of neuropathic pain in diabetic neuropathy and postherpetic neuropathy. The literature shows that it is effective and safe in the above-mentioned indications.  Its use has also been described: in the treatment of neuropathic pain of other etiologies with intolerance to pregabalin, as a coanalgesic in the treatment of pain in the course of cancer, and in neuropathy caused by chemotherapy. It has been shown to be effective in all of the aforementioned cases. Studies have shown no clinically significant effect of mirogabalin in the symptomatic treatment of fibromyalgia pain.  It has a good safety profile and a low number of adverse effects. Conclusions:. Mirogabalin is a drug that has the potential to improve the efficacy of treatment of neuropathic pain due to various causes.  There is a need to continue conducting studies on larger groups of patients in order to make wider use of its potential in clinical practice

The impact of using probiotics on metabolic disorders of women with polycystic ovary syndrome

Introduction: Polycystic ovary syndrome is a common endocrine and metabolic disorder affecting women of reproductive age. The course is primarily associated with menstrual disorders, obesity, insulin resistance and hyperandrogenism. The gut microbiota dysbiosis theory (DOGMA), established in 2012, suggests a link between the composition of gut bacteria and the development of metabolic disorders. Other studies confirm this relationship. This article analyzes the effect of probiotic supplementation on the alteration of gut microbial flora and the course of PCOS. Aim of the study: Aim of our study was to review the available studies on the effect of probiotic use on the course of polycystic ovary syndrome. We considered the influence of supplementation on body weight, insulin resistance and lipid profile of the women studied. Methods and materials: This article is based on the literature found in PubMed Database with use of keywords such as “PCOS”; „polycystic ovary syndrome”; “probiotics”; „gut microbiota”; „gut microbiome”. Results: The collective results of the reviewed literature indicate that probiotics may have a beneficial effect on the course of polycystic ovary syndrome. In a number of studies, their supplementation resulted in a decrease in weight, insulin, triglycerides and VLDL cholesterol. For fasting glucose, HOMAR-IR, total cholesterol and LDL fraction, the results were inconclusive. Conclusion: Probiotics may have a positive effect on metabolic disorders in women with PCOS, but more research is needed to confirm the good effects of their use in treatment

Ashwagandha (Withania somnifera) - influence on sleep: review

Introduction: Ashwagandha (Withania somnifera) is a plant found on the Indian subcontinent. The health-promoting properties attributed to it have been largely verified in numerous studies over the past 20 years. This article reviews studies on the effects of ashwagandha supplementation on sleep, its deprivation, and studies analyzing the mechanisms determining such effects. Materials and methods: A review of the literature available in the PubMed database was carried out, using the key words: "ashwagandha" ; "sleep" ; "insomnia", "withania", "somnifera", "withanolide", "withaferin". Results: Ashwagandha has a positive effect on the quality and length of sleep. It is indicated that it improves sleep parameters among both insomniacs and healthy people. In addition, it has been proven to reduce oxidative stress under conditions of sleep deprivation. Ashwagandha's positive effects on sleep have been shown to be related to its effects on GABA-nergic transmission, and the chemical responsible for the plant's sleep induction is triethylene glycol. Its regular use increases dopamine levels in the brain and could potentially be useful in treating the sleep-related disorder restless legs syndrome. Conclusions: The use of ashwagandha is a potential direction for treating sleep disorders and improving sleep quality in healthy individuals. There is a need for further development and studies on larger groups of patients to exploit its potential

Vitamin D supplementation in Polycystic ovary syndrome

Introduction and Purpose. Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age worldwide. Patients may present with a wide range of symptoms. According to the most commonly used Rotterdam criteria, the presence of 2 out of 3 criteria is required for diagnosis: clinical and/or biochemical markers of hyperandrogenism (HA); ovulation disorders (oligo- or anovulation); polycystic ovaries on ultrasound (PCOM); and exclusion of disorders mimicking the clinical features of PCOS. The basis of treatment are birth control pills, metformin and antiandrogens. The pathogenesis of the syndrome is not fully understood. The aim of the study is to summarize the potential health benefits of vitamin D supplementation for women with PCOS based on publications from the last 10 years available on Pubmed. State of knowledge. Vitamin D receptors have been identified not only in calcium-regulating tissues, but also in many reproductive organs, such as the ovary (especially granulosa cells), uterus, placenta, testes, as well as hypothalamus and pituitary gland. In recent years, there have been studies analyzing the effect of vitamin D supplementation on the hormonal balance, metabolism and clinical symptoms in women with PCOS. Summary. The results of studies on vitamin D supplementation in women with PCOS are mixed. Some of them are promising and confirm a beneficial effect on glucose metabolism and insulin resistance, lipid metabolism, hormonal balance, alleviation of HA-related symptoms, improvement of menstrual frequency; while the results of other studies do not show significant improvement and do not confirm these effects. Therefore, there is a need for further research on the relationship between the pathogenesis of PCOS and vitamin D and the impact of its supplementation

GLP-1 agonists in treatment of obesity

Background: Obesity is a major problem nowadays. It has correlation with metabolic and cardiovascular diseases. Due to that it is very important to diagnose and treat obesity properly. Objective: The purpose of our work is to show effectiveness of GLP1 agonist in treating obesity.  Method: A literature review was conducted in PubMed database using the key words: „Semaglutide obesity” „Tirzepatide obesity” „Liraglutide obesity” „obesity”. Results: Using particular drug in addition to lifestyle modification appears to be more effective than using placebo with lifestyle modification.  Conclusions: Trials showed effectiveness of GLP1 analogs in treatment of obesity. These drugs might be a future of managing with obesity, but we do not know yet how long lasting is the effect of these drugs. The upcoming years will bring us more trials, but in this moment we can say that they have a lot of potential.&nbsp

The role of vitamin D in the human body and the benefits and risks of its supplementation

The prevalence of vitamin D deficiency in society and the growing awareness of related health problems have resulted in the widespread use of vitamin D supplementation. The source of vitamin D is skin synthesis with the participation of ultraviolet radiation (UVB) and its supply with the diet. The inability to cover the daily requirement for vitamin D without an additional source of vitamin D means that the society most often reaches for dietary supplements that do not have the properties of a medicinal product. The use of over-the-counter supplements, where the actual dose of the vitamin may differ from the dose declared by the manufacturers, may result in a lack of benefit from the food product when the vitamin D content is too low or lead to hypervitaminosis when the content is too high

Trichotillomania – therapeutic possibilities

Introduction: Trichotillomania is a mental disorder in which the patient persistently and recurrently pulls out his own hair, which results in varying degrees of hair loss. This causes considerable suffering and impairs quality of life, but patients rarely seek specialist help. It affects 0.5–3% of the general population, but data may be underestimated due to low reporting. Aim of the study: The aim of our study is to summarize the current state of knowledge on the treatment of trichotillomania. Materials and methods: The literature available in the PubMed and Google Scholar database was reviewed using the following keywords: "trichotillomania", "trichophagia", "trichobeozar", "trichotillomania treatment". Results: Treatment of TTM is difficult and involves many methods. The division of therapeutic methods focuses mainly on psychotherapy and pharmacological treatment. The greatest effectiveness is attributed to cognitive-behavioral therapy, especially habit reversal training. Medications can help reduce symptoms, especially in the presence of other disorders, e.g. depression, anxiety disorders. Conclusions: Trichotillomania contributes to significant suffering and negatively affects functioning in social and professional life. The basis of its treatment is psychotherapy, but there are many reports on the effectiveness of selected drugs (SSRIs, clomipramine, antipsychotics, N-acetylcysteine, naltrexone, lamotrigine, bupropion, dronabinol, inositol), but they require further research on a larger group of patients

Effect of mediterranean diet on non-alcoholic fatty liver disease (NAFLD)

Introduction and purpose of the work: Non-alcoholic fatty liver disease (NAFLD) is a common condition in the general population. In its course, excessive fatty acids are deposited in liver cells. The best way to prevent it is to reduce weight by being physically active and eating a proper low-calorie diet. The purpose of this study is to describe the potential health benefits of the mediterranean diet in people with NAFLD. For this purpose, the literature available in the PubMed database was reviewed using the following keywords: mediterranean diet; non-alcoholic fatty liver disease (NAFLD); non-alcoholic steatohepatitis (MASH). State of the knowledge: The mediterranean diet is rich in fruits, vegetables, nuts, fish, olive oil and whole-grain products. It has the effect of decreasing insulin resistance, which is a major cause of NAFLD. In addition, it exerts anti-inflammatory and antioxidant properties. In recent years, numerous clinical studies have been conducted analyzing the effects of this diet on laboratory results, liver steatosis and progression to steatohepatitis (MASH) in patients with NAFLD. Conclusions: The results of the studies show that following a mediterranean diet can prevent as well as alleviate the course of this disease. However, there is a need for more clinical studies, on larger groups of people to recognize the mediterranean diet as an effective form of NAFLD therapy

Side effects of long-term treatment with chloroquine for rheumatoid arthritis - a review of the literature

Background: Chloroquine is a 4-aminoquinoline derivative. Initially the substance was used as an antimalarial drug, but now chloroquine is also used to treat connective tissue diseases. It is a widely used drug in rheumatological diseases, especially in rheumatoid arthritis and systemic lupus erythematosus. A number of side effects have been reported in the public literature among patients using this drug. This article reviews side effects during long-term treatment of patients with rheumatoid arthritis. Materials and methods: A review of the literature available in the PubMed database was performed, using the key words: "Chloroquin" ; "Chloroquin rheumatoid" ; "Chloroquin toxicity" ; "Chloroquine" ; "Chloroquine rheumatoid" ; "Chloroquine toxicity". Results: Chloroquine is a quinine derivative, originally used in the prevention and treatment of malaria. It is now being successfully used to treat patients with certain connective tissue diseases, including rheumatoid arthritis. A number of publications have described various side effects of this drug. Serious and major problems arise from the drug's toxicity with long-term use, such as in the treatment of rheumatoid arthritis. Long-term use of the drug results in retinopathy and cardiotoxicity (conduction disturbances, cardiomyopathy). The available literature also mentions neuromyotoxicity which is rarely reported by patients. Conclusion: Long-term use of chloroquine carries serious side effects. The main complications of long-term use of the drug affect the visual, cardiovascular and nervous systems. The use of chloroquine in patients with rheumatoid arthritis should emphasize the need for accurate dosing and periodic cardiovascular, ophthalmologic and neurologic monitoring

Ovarian sclerosing stromal tumor - benign neoplasm of the young. A case study with literature review

Sclerosing stromal tumor (SST), located in the ovary, is a very rare disease entity. To date, only a few hundred cases of ovarian SST have been confirmed worldwide. Preoperative diagnosis of stromal tumor is difficult, as clinically and radiologically it resembles other types of ovarian tumors. These tumors present nonspecific symptoms, with irregular menstrual bleeding, lower abdominal pain and palpable pelvic lesions being the most common. Differentiation and diagnosis is possible only thorough histopathological examination and immunophenotyping. In the present study, we presented a case report of a young, 20-year-old patient with an oligosymptomatic  ovarian stromal tumor. We compared and summarized the diagnostic and therapeutic process, as well as the tumor immunophenotypes, with recent cases reported in the literature