Bipolar Androgen Therapy in the management of prostate cancer

Introduction and purpose: Prostate cancer (PCa) as one of the most frequent neoplasms in men remains a challenge for oncologists. The main strategy of its treatment is the Androgen Deprivation Therapy (ADT) the principle of which is an inducement of hypogonadism. The lack of testosterone is not only a factor greatly contributing to a decrease of quality of life overall, but additionally it increases the odds of the complications, including low libido and erectile disfunction, metabolic abnormalities, high cardiovascular risk, osteoporosis, anaemia, or depression. ADT also has the potential of inducement of castration resistance (CRPC), which significantly worsen patients prognosis. The main purpose of this review is to explore the Bipolar Androgen Therapy (BAT), which has the potential to solve the aforementioned problems. State of knowledge: The mechanism of BAT action has been described. BAT is effective not only against CRPC, but androgen-dependant PCa as well. BAT reverses the hormone resistance in CRPC, thus allowing the rechallenging of the ADT. It has the direct cytotoxic effect on cancer cells. Additionally BTA increases the exponents of the general quality of life of the patients. There is a number of active clinical trials regarding BAT. Conclusions: BAT is a safe therapeutic strategy with the high efficacy in reversing hormone resistance in CRPC patients, thus significantly increasing their health prognoses and it allows to alleviate or avoid the adverse effects of ADT

Mechanisms of drug resistance in ovarian cancer

Ovarian cancer is the fifth most common cancer affecting women and the most lethal cancer among the gynecological cancers. Because of the lack of specific symptoms and no special screening tools, it is recognised in an advanced stage. In addition, drug resistance in ovarian cancer is so frequent, that genes and cross-talks between some important pathways are still analysed. In this review, the major and recently identified molecular mechanisms of drug resistance, including platinum, taxane, bevacizumab and PARPi resistance mechanisms in ovarian cancer from relevant literature have been investigated

Dealing with the most common side effect of statins

Statins are one of the key drugs in the treatment of cardiology patients. They lower LDL cholesterol levels, thereby reducing the risk of acute cardiovascular events. Statins are among the best studied drugs, and have been proven to be effective and safe in the treatment of dyslipidemia. Data presented in studies on the prevalence of statin intolerance (SI) varies widely, according to some studies, statin tolerance is the same as placebo, however, this is a common problem in clinical practice. The most common reported symptoms of SI include muscle pain. Patients are often afraid of starting satin treatment because of possible side effects. The appearance of myopathy in patients results in their discontinuation of therapy, which results in increased cardiovascular risk. In order to minimize the risk of SI, particularly statin-associated muscular pain (SI), a key role is played by discussion with the patient, exclusion of nocebo effects, identification of risk factors, dose modification and possible discontinuation of the drug. The purpose of this paper is to review the problem of the most common of the adverse effects of statins- myopathy, in terms of incidence, probable cause, and recommended treatment of patients

Microbial alterations of oral cavity and their association with Pancreatic Cancer

Introduction: Pancreatic Cancer (PC), while relatively infrequent, remains one of the deadliest cancers as a result of late diagnosis and absence of preventive measures. Over 50 % of patients diagnosed with PC already suffer metastasis. Combined with lack of effective treatment, the need arises for universal biomarkers specific to PC. In the last decades the importance of human microbiota in its upholding of the body homeostasis has been under radar, in special regards to its association to cancer. Several species of oral microbiome have been linked to increased or decreased risk of developing pancreatic cancer, most notably P.gingivalis and Fusobacteria.   Purpose of the study: The aim of this study is to collect and summarize existing evidence on connection of oral microbiome and pancreatic cancer, as well as to assess their potential use in diagnostics of PC .   Material and method: Literature review was performed, in English databases, using keywords : cancer, pancreatic cancer, pancreatic cancer prevention, oral microbiome, microbe variation, microbial biomarkers.   Results and conclusions: In our systematic review, evident differences between microbial architecture of PC patients and healthy individuals were observed. The data on association between microbiota and risk of developing cancer is limited, however it still provides evidence for relationship between microbial composition and incidence of pancreatic cancer

Is the perception of physicians based on the type and colour of attire?

Introduction:  Patients’ confidence in a physician is influenced by many factors. Recent studies suggest that there’s an association between doctor’s attire and the way patients view physician’s trustworthyness, competence and empathy in various specialties and contexts of care. Along with the developement of medical attire market comes a need to understand how the choice of professional clothes infulences patients’ perceptions. Purpose of the study: The aim of this study was to determine whether patients perception of physician and the confidence in professional skills is determined by the type and colour of doctor’s attire. Materials and methods: We carried out literature search using English based databases (PubMed, Springer, Google Scholar) using key words: physician attire, profesionalism, scrubs, patients perception, psychology of colour. Most recent studies matching this criteria were analysed and those most relevant were picked for this review. Results and conclusions: The assotiation between physician’s attire and patients’ perceptions is complex and depends on numerous factors including age, gender, geographic location and culture, as well as physician’s specialty and context of care. The white coat, despite latest research on it’s role in infections spread, remains an important attribute of a doctor.  Physicians who wear white coats are viewed as more trustworthy, knowledgeable, competent and more caring. Colour of scrubs may serve as a valuable hospital personel identification tool. Various colours evoke possitive emotions in patients, navy blue, light blue and green remain the the colours of scrubs that patients perceive as the most professional and appropriate

How do eating disorders can affect the endocrine system? - literature review

Introduction: Eating disorders (ED) are complex psychological disorders with low rates of detection and early intervention. High rates of morbidity and mortality in eating disorders, especially anorexia nervosa (AN), is still continued. ED mostly refers to adolescent and lead to many significant complications, including many changes in endocrine system. Hormonal disorders in AN occur among sex hormones, thyroid hormones, adrenal hormones, growth hormones, as well as the entire hypothalamic-pituitary axis. Purpose of the study: The aim of this study is to collect and summarize the latest views on endocrine dysregulation in anorexia nervosa and highlights the complications associated with it. Material and method: Literature review was performed in English different databases, using keywords: eating disorders, anorexia nervosa, menstruation, menses, irregular menstruation, estrogen, bone mineral density, cortisol, hipercortisolemia, insulin, leptin, ghrelin, growth hormone, thyroid, tyrosine. Results and conclusions: In our systematic review we would like to present the most significant hormone dysregulation in anorexia nervosa and how they can affect the whole organism, such as gonadal axis disregulation, menstrual disorders, bone mineral density, hipercortisolemia, hypoglycemia and other that anorexia nervosa may cause. The phenomenon of eating disorder is becoming more and more frequent – for this reason it is important to put attention to that and be aware of many complication ED can lead to, including hormonal changes

Abdominal aortic aneurysm surgery with a modern method - is there anything to fear?

Background: Endovascular surgery for abdominal aortic aneurysms using a stent graft is the modern method of supplying these life-threatening lesions in large arterial vessels. In recent years, there have been significant improvements in the technique of performing these procedures, despite which complications are still common. In order to make progress in dealing with this problem, it is important to understand in which areas of the treatment strategy appropriate changes have not yet been implemented. Various clinical cases that describe post-operative complications of stent-graft surgery, types of post-operative complications and methods of dealing with the complication that has occurred should be analysed. And also other research papers relating to this topic. The first step is to deepen the knowledge of existing post-operative complications and the types of complications that can occur after stent-graft implantation into the abdominal aorta, as well as contemporary methods of treating complications that have already arisen. Aim of the study: The aim of this study is to present the incidence of complications after endovascular surgery for abdominal aortic aneurysms using a stent graft, the repair methods used when a complication occurs, the types of complications and their different kinds based on a review of the literature. Material and methods: A literature review was conducted in English-language databases, based on original articles and case reports, on post-operative complications of abdominal aortic stent-graft surgery, together with treatment methods and different types of complications arising from this procedure published between 2022 and 2023. Using the keywords: "abdominal aortic stent-graft" and "complications"

How maternal obesity affects pregnancy? - literature review

Introduction: Obesity is a well-known risk factor for many health problems. Recently, the increasing number of obese pregnant patients deserves our special attention, because maternal obesity is associated with numerous complications during the antepartum, intrapartum, and immediate postpartum stages of pregnancy. Purpose of the study: The aim of this study is to collect and summarize the latest views on maternal obesity in pregnancy and highlights the complications associated with it. Material and methods: Literature review was performed in English different databases, using keywords: morbid obesity, super-obesity, maternal obesity, pregnancy, complications. Results and conclusions: In our systematic review we would like to present the most important threats of obesity among pregnant women such as: cardiovascular, respiratory, endocrinology and gestational weight gain problems; pregnancy loss; fetal anomalies; anesthetic and delivery problems; breastfeeding disorders; problems with contraception and long-distant effects in a child's adult life. Therapeutic success of such a pregnancy should consist of the cooperation of many specialists. This phenomenon of maternal obesity will certainly spread in the future and for this reason - awareness of this problem is very important for both patients and physicians taking care of them

Etiology of urinary tract infections in children with anatomic and functional abnormalities of urinary tract — single-center study

Wstęp. Zakażenie układu moczowego (ZUM) to jedno z najczęstszych zakażeń bakteryjnych u dzieci. Do czynników, które sprzyjają wystąpieniu ZUM, należą między innymi zaburzenia anatomiczne i czynnościowe układu moczowego. Znajomość etiologii ZUM u dzieci z zabu­rzeniami układu moczowego pozwala na wybór właściwej terapii empirycznej. Cel badania. Analiza etiologii bakteryjnych zakażeń układu moczowego u dzieci z zaburze­niami anatomicznymi i czynnościowymi dróg moczowych. Materiał i metody. Analizie retrospektywnej poddano dokumentację medyczną 106 dzieci z zaburzeniami anatomicznymi i czynnościowymi dróg moczowych, hospitalizowanych z po­wodu ZUM w Klinice Nefrologii Dziecięcej UM w Lublinie w latach 2009–2013. Pacjentów podzielono na cztery grupy: A — z odpływem pęcherzowo-moczowodowym, B — z innymi zaburzeniami anatomicznymi układu moczowego, C — z neurogenną dysfunkcją pęcherza moczowego i D — z nieneurogenną dysfunkcją pęcherza moczowego. Wyniki. Najczęściej izolowanym patogenem wywołującym ZUM była Escherichia coli. Stwierdzono istotnie częstsze występowanie Klebsiella spp. w grupie A , w porównaniu z grupami A oraz C. Pseudomonas aeruginosa była istotnie częściej hodowana w grupie C, w porównaniu z grupami B oraz D. W grupie A Escherichia coli i Enterococcus spp. wystę­powały istotnie częściej u dziewcząt niż u chłopców. Podobnie w grupach C i D Eschericha coli była istotnie częściej hodowana u dziewcząt niż u chłopców. Wnioski. 1. Głównym patogenem wywołującym ZUM u dzieci z zaburzeniami układu mo­czowego jest Escherichia coli, występująca częściej u dziewcząt. 2. U dzieci z odpływem wstecznym pęcherzowo-moczowodowym Klebsiella spp. była hodowana istotnie częściej niż u pacjentów z innymi zaburzeniami układu moczowego. 3. U dzieci z neurogenną dysfunkcją pęcherza moczowego zakażenia wywołane przez Pseudomonas aeruginosa występowały istotnie częściej niż u pacjentów z innymi zaburzeniami układu moczowego.Background. Urinary tract infection (UTI) is one of the most common bacterial infection in children. Anatomic and functional abnormalities of urinary tract increase the incidence of UTI. Knowledge about current etiological factors of UTI in children with urinary tract abnormalities enables to select the appropriate empiric therapy. Objectives. The occurrence of pathogens causing UTI in children with anatomic and func­tional abnormalities of urinary tract was analyzed. Material and methods. Medical records of children with UTI hospitalized in the Department of Pediatric Nephrology, Medical University of Lublin in 2009–2013 were studied. The patients were divided into four groups: A — with vesicoureteral reflux, B — with other anatomic abnormalities of urinary tract, C — with neurogenic bladder dysfunction and D — with non-neurogenic bladder dysfunctions. Results. In all children, Escherichia coli was the most common invading pathogen. Klebsiella spp. occured significantly more commonly in group A as compared to groups A and C. Pseudomonas aeruginosa was cultured significantly more commonly in group C in comparison with groups B and D. In group A, Escherichia coli and Enterococcus spp. were observed significantly more commonly in girls than in boys. Similarly, in group C and group D, Escherichia coli was cultured significantly more commonly in girls than in boys. Conclusions. 1. In all children, Escherichia coli was the most common invading pathogen. 2. In children with vesicoureteral reflux, Klebsiella spp. was cultured more commonly than in those with other abnormalities. 3. In children with neurogenic bladder, infections with Pseudomonas aeruginosa occurred more commonly than in those with other abnormalities