An Uncommon Cause of Dyspnea: Usefulness of Multimodality Cardiac Imaging

Tomografia computada; Falta d'alè; EcografiaComputed tomography; Shortness of breath; UltrasoundTomografía computarizada; Falta de aliento; EcografíaPericardial lipomas are very uncommon benign primary cardiac tumors. We describe the case of a patient with symptomatic large pericardial mass who presented with heart failure. Multimodality cardiac imaging helped us in the diagnosis of this unusual entity. (Level of Difficulty: Intermediate.

Health behaviors of people over the age of 65 residing in the home environment

Admission. Lifestyle elements favorably affect health in old age include proper diet and eating habits, the optimal level of physical activity, adequate sleep, satisfying social relationships, skillful use of free time and knowledge of health prevention.Aim of the study. Assessment of health-related behaviors in a group of people over the age of 65 living in the home environment in selected socio-demographic conditions.Material and methods. The study was conducted in February and March 2014. The material consisted of 110 people over 65 years of age. The research method was used in the job diagnostic survey. It was used as a research tool original questionnaire assessing the behavior of seniors in the area: diet, physical activity, sleep and rest, the use of stimulants and sources of stress and ways of coping with stress.Results. The study results, that the majority of respondents eat 4-5 meals a day (50.9%; n = 43). Daily activity declares 29.1% (n = 32) tested. The most popular form of physical activity among respondents over 65 years of age are walking (75.4%; n = 83). Smoke 28.2% (n = 32) tested. In most of the subjects they consume alcohol occasionally (83.6%, n = 92) or several times per week (16.4%, n = 18). Sources of stress in the population of seniors are primarily conflicts in the family (24.5%; n = 27), loneliness (21.8%; n = 24) and financial problems (20%; n = 22).Conclusions. Studies have shown that socio-demographic factors significantly influence health-related behaviors presented by seniors. Assessment of the level and quality of health behavior allows you to make educational activities, care and treatment for people in aging and old age

Impact of severe aortic stenosis on quality of life

Stenosis; Quality of life; QuestionnairesEstenosis; Calidad de vida; CuestionariosEstenosi; Qualitat de vida; QüestionarisIntroduction Among individuals ≥ 65 years old, aortic stenosis is highly prevalent and the number of cases is expected to increase in the coming decades, due to the increased life expectancy. Nevertheless, the actual aortic stenosis burden is not well known in population settings and the impact of aortic stenosis on quality of life has not been studied. The aim of this study was to evaluate aortic stenosis impact on health-related quality of life in patients > 65 years old. Methods An epidemiological case-control study was carried out to compare quality of life in patients ≥65 years old with severe symptomatic aortic stenosis. Demographical and clinical information was prospectively obtained and quality of life information was collected with the Short Form Health Survey_v2 (SF-12) questionnaire. The association between quality of life and aortic stenosis was determined using multiple logistic regression models. Results Patients with severe aortic stenosis self-perceived worse quality of life on all dimensions and summary components of the SF-12 questionnaire. In the final multiple logistic regression model a significant inverse association was observed between the dimensions ‘physical role’ and ‘social role’ (p = 0.002 and p = 0.005) and an association close to significance with ‘physical role’ (p = 0.052) of the SF-12 questionnaire. Conclusion The use of quality of life scales allows the assessment of the impact of aortic stenosis on quality of life and may improve the therapeutic approach to severe aortic stenosis, providing evidence for patient‐centered care

Do the benefits outweigh the risks? Potential dangers associated with long-term therapy of proton pump inhibitors

Introduction:Proton pump inhibitors (PPIs) are one of the most popular and also one of the most commonly prescribed medications worldwide. In many conditions associated with excessive secretion of hydrochloric acid in the stomach, they are the first-line treatment. When they are used in a balanced manner in strict indications, they have a high level of efficacy and a favorable safety profile. The low rate of side effects refers mainly to their short-term use.  With the over-the-counter availability of PPIs, increasing dangerous trend of their abuse has provided new evidence suggesting the presence of numerous, more serious side effects of long-term PPI therapy. Purpose:The purpose of this review is to summarize current reports regarding the potential risks and causal relationship of adverse effects occurring as a consequence of long-term use of proton pump inhibitors. Material and methods:This literature review based on the available scientific literature, published between 2015 and 2023 in the Pubmed database, searched using the terms, listed under "keywords”. Conclusion:PPIs are relatively safe drugs. However, they are not completely free of side effects. There are a lot of reports suggesting a potential connection between their long-term use and the development of complications, such as: various infections, decreased absorption of nutrients, kidney disease, liver disease, pancreatic disease, musculoskeletal disease, nervous system disease, cardiovascular disease, dementia, hypergastrinemia and even cancer. However, some of them are fraught with errors, and another often provide contradictory results. More precisely designed studies are needed to draw clear conclusions, especially in view of the ever-increasing abuse of PPIs worldwide. It is worth noting that patients with strictly defined indications for long-term PPI therapy, may benefit significantly outweighing the potential dangers

Transcranial magnetic stimulation as a promising method of treatment in depression and various neuropsychiatric conditions. A literature review

Background: Transcranial magnetic stimulation (TMS) is a method of non-invasive and painless brain stimulation with an electromagnetic field, which induces changes in the electric field in the brain leading to the cortical activity modulation and stimulation of neurons. Currently, transcranial magnetic stimulation is increasingly used in the diagnosis and treatment of various neuropsychiatric conditions, such as depression, schizophrenia, neurodegenerative diseases, and more. TMS can be used as a method of enhancing the effect of pharmacotherapy as well as a regular treatment. Aim of the study: The study's aim is to summarize the current state of knowledge on transcranial magnetic stimulation as a method of treatment in depression and various neuropsychiatric conditions. Material and methods: The study is based on the literature available in scientific databases such as PubMed, using the following keywords: „transcranial magnetic stimulation”, „tms”, “depression” and “treatment-resistant depression”. Results and conclusions: Transcranial magnetic stimulation is a non-invasive, painless and generally safe method of diagnosis and treatment of many neuropsychiatric diseases, such as depression, schizophrenia, obsessive-compulsive disorders, neurodegenerative diseases, tinnitus, addiction to psychoactive substances and many more. TMS is a well-documented, approved, and recommended treatment primarily for treatment-resistant depression due to its effectiveness, mild side effect profile and good tolerability. Recently there are more and more reports on the effectiveness of TMS in the diagnosis and treatment of other neuropsychiatric conditions, but further research and setting guidelines are needed, so is increasing the availability of the method for patients

Diabetics suffer in silence – about sexual dysfunction and modern therapeutic possibilities in diabetes mellitus

Introduction Nowadays, the global incidence of diabetes is on the rise, indicating a growing medical concern due to the persistent increase in cases. This disease is insidious and silent. Despite its long-term asymptomatic course, it secretly damages many organs, leading to distant and often irreversible complications. Early diagnosis of asymptomatic patients with risk factors, the use of screening tests, as well as appropriate control of the disease can significantly delay the process of developing complications; ensuring a longer and better quality of life for patients. A seriously problematic, but rarely discussed, disorder, experienced by some within the male patient group, is erectile dysfunction. Understanding the pathophysiology and the mechanism responsible for this disorder enables early prevention and taking appropriate steps, implementing effective therapy; thus – enhancing and prolonging sexual function and enhancing quality of life of patients with diabetes. Purpose of the work This article reviews the state of knowledge based on available research on sexual dysfunction in men with diabetes. The purpose of this review is to present the general issues, pathophysiology, risk factors and contemporary therapeutic options for sexual dysfunction disorders in this group of patients. Materials and methods The authors based on databases such as PubMed, Scopus anf Google Scholar, created a work summarizing review of currently available publications on the issue of erectile dysfunction in patients with diabetes mellitus. The authors using the terms contained in the „keywords” column, searched for available information contained in other scientific works, on the basis of which they created the above review

Cardiac rehabilitation in the Comprehensive Cardiac Care program in the time of a COVID – 19 pandemic

Introduction and purpose: Cardiac rehabilitation in patients after myocardial infarction is an established form of therapy. Its main tasks in the context of the implementation of the KOS program are to improve quality of life, consolidate the effects of hospital treatment and ensure better functioning after a cardiovascular incident. The purpose of this paper is to analyze the current level of knowledge regarding cardiac rehabilitation of patients during the COVID-19 pandemic. Description of the state of knowledge: COVID-19 poses a significant threat to patients with cardiovascular disease. Physiotherapy in the Cardiac Rehabilitation Unit involves a step-by-step, individualized rehabilitation plan in accordance with the patient's condition. An important tool for clinical evaluation is capacity tests, the results of which provide key information for the rehabilitation team in selecting exercise intensity. These tests are performed on the first and last days of rehabilitation. In Polish conditions, the most common tests examining capacity are an exercise test on a treadmill or bicycle cycler or a 6-minute walk test. Due to the diversion of a significant number of specialists and health care teams to treat COVID - 19 patients, access to the possibility of implementing the various stages of the Coordinated Specialized Care program after myocardial infarction has been limited. Summary: Post-infection patients are often forced to live a sparing lifestyle. They show reduced exercise tolerance and easier fatigability. With these aspects in mind, improving the quality of life of patients after cardiovascular incidents in the era of the pandemic requires even greater involvement of the entire rehabilitation team

Multifaceted therapeutic options for stress urinary incontinence in women

 Stress urinary incontinence (SUI) affects many women worldwide in every age group. Involuntary leakage of urine during abdominal pressure increase significantly reduces the quality of life. The choice of treatment depends on the patient's expectations, the doctor's experience and the severity of symptoms. Aim of the study: The aim of this study is to discuss the therapeutic methods of stress urinary incontinence (SUI). Material and method: The work was based on a review of the available literature in the PubMed, Google and Google Scholar databases using the following keywords: stress urinary incontinence; SUI; urinary incontinence in women; Surgical treatment; TOT; TVT. Results and conclusions: We use conservative and surgical methods in the treatment of stress urinary incontinence. Conservative treatments such as physiotherapy, pharmacotherapy, and behavioral therapy are first-line treatments. In the case of severe symptoms of stress urinary incontinence, surgical treatment is used. The most common method is the Burch operation and TVT and TOT sling operations. Treatment of stress urinary incontinence (SUI) in women requires an approach that takes into account the patient's goals, severity of symptoms, desired effect, physician experience and complications, therefore there is no single effective management

Peripartum cardiomyopathy: current theories about etiopathogenesis, potential biomarkers and treatment - a literature review

Background: Peripartum cardiomyopathy (PPCM) is a form of an idiopathic systolic heart failure, which occurs the most often in the last weeks of pregnancy or in the early postpartum period. Symptoms of this disease include exertional dyspnea, orthopnoea, paroxysmal nocturnal dyspnoea and edema. They are typical for a heart failure, but also can be attributed to late pregnancy or the effects of labor, which is a cause of common misdiagnosis or its delay and significantly affects the worsening of the prognosis and the high mortality rate. In more severe cases, cardiogenic shock, arrhythmias, thromboembolic complications may occur, leading to death. Aim of the study: The study aim is to summarize the current state of knowledge and the recent scientific reports on the potential etiopathogenesis, diagnostics including new biomarkers, and treatment of the peripartum cardiomyopathy. Material and methods: The study is based on the scientific literature available in the PubMed and Google Scholar databases, using the following keywords: „peripartum cardiomyopathy”, „pregnancy-associated cardiomyopathy” and “16-kDa prolactin”. Results and conclusions: The diagnosis of peripartum cardiomyopathy should be considered in every pregnant or postnatal woman with symptoms of heart failure. Despite great advances made in understanding and diagnosing PPCM over the last few years, the pathogenesis and complex interactions of genetics and the vascular and hormonal balance of late pregnancy are still unclear. Further research is needed to determine the benefits and risks of bromocriptine treatment and the use of new markers in the diagnostics of PPCM

Sudden infant death syndrome (SIDS) - How to reduce the risk?

Sudden infant death syndrome (SIDS) is a complex, multifactorial phenomenon with an etiology that has not been fully clarified to this day. Despite a noticeable decrease in the number of SIDS cases worldwide, sudden infant death syndrome remains one of the most common causes of death among children in infancy. Sudden infant death syndrome is still the subject of scientific research aimed to clearly determine and identify potential pathogenetic factors responsible for the occurrence of SIDS. Many years of efforts to clarify the etiology of the discussed issue have made it possible to characterize important factors that increase the risk of sudden infant death syndrome. In addition, research has made it possible to develop important approaches that make a significant contribution to reduce the risk of SIDS in an infant. Complete knowledge of the specific conditions that have a protective effect against SIDS will significantly reduce the risk of sudden infant death syndrome, so a very important aspect is not only their precise analysis, but also their propagation among the public