Obesity treatment - overview of pharmacological and surgical methods

Introduction and purpose of the work: Obesity is a chronic disease that leads to many complications. Almost a third of the world's population is now classified as overweight or obese. This is a huge global problem. The base of treatment is diet and physical activity, but fortunately nowadays we also have pharmacological and surgical treatment - which are increasingly used. The aim of this study is to draw attention to obesity disease which may lead to serious complications and compare available pharmacological and surgical treatment. State of knowledge (brief description): Treating obesity is a difficult and often multidisciplinary challenge. Currently many drugs with different mechanisms and different efficiencies has been approved for treatment. All of them show efficiency, but the available studies show that surgical treatment produces better results than pharmacological treatment.  Summary: We currently have a huge range of obesity treatment options available. Surgical treatment produces better results than pharmacological treatment. Nevertheless, not every patient qualifies for bariatric surgery. Pharmacological methods are also effective. The treatment method should be individually selected for the patient

Urinary incontinence in women - the overview of pharmacological and surgical methods

Introduction and purpose of the work: Urinary incontinence (UI) is a common problem among women and the incidence increases with age. It is estimated that about 50% of women will be affected by this problem. There are 5 types of urinary incontinence: exercise, pressure, mixed, overflow and functional. Stress UI is the most common cause among young women, while stress UI is the second most common cause among older women. The widespread use of this phenomenon makes it a significant economic burden. State of knowledge (brief description): Due to the different types of UI and its many causes, treating this disorder becomes a significant challenge. It is important to use combination therapy, starting with pelvic floor muscle strengthening exercise, lifestyle modification, weight loss, and smoking cessation, followed by drug therapy and surgery as necessary. Summary: Currently, many drugs are used in the treatment of urinary incontinence, with different mechanisms of action, which allow the treatment of various types of UI, but pharmacotherapy often does not bring the expected benefits. Surgical treatment appears to be a promising form of treatment, but more research is needed on the long-term effects

The effect of obstructive sleep apnea on the cardiovascular system

Introduction: Obstructive Sleep Apnea is a disease entity that affects many aspects of life, but is often overlooked and underdiagnosed. OSA is defined as episodes of apnea-hypopnea that disturbs not only sleep, but also daytime functioning. Symptoms can be divided into night symptoms (not breathing, snoring, gasping, fragmented sleep) and daytime symptoms (fatigue, low concentration, morning headaches, decreased libido). Moreover, OSA through many mechanisms affects the cardiovascular system and leads to its dysfunction. Purpose: The aim of this study is to draw attention to the often underdiagnosed disease entity, which is OSA, which, if left untreated, may lead to serious complications. Material and methods: In 2022, the PubMed and Google Scholar databases were searched using the following keywords: OSA, apnea, cardiovascular disorders, arrhythmias and heart disease. Works in English with the most recent data have been selected. Summary: OSA is strongly associated with cardiovascular disorders, moreover, in both cases, we find similar risk factors for these disorders. A correlation has been demonstrated between OSA and atrial fibrillation, hypertension, and arrhythmias. On the other hand, OSA is still underdiagnosed and more research is needed to understand the correlation between these diseases

Depression in the elderly as a significant clinical problem

Introduction: Depression is a very common mental disorder among older people. It limits life activity and interests. It causes difficulties in making decisions or actions. It introduces somatic and emotional changes, which in older people becomes a problem on a large scale. Diagnosis of depressive disorders has very high clinical value.Depression is often associated with chronic diseases that often accompany the elderly. Material and Methods: The paper reviews literature using the EBSCO and Google Scholar databases. Articles have been analyzed using the keywords depression, depression of the elderly, care for the elderly, treatment of depression, diagnosis of depression, clinical symptoms. The article presents depression as a problem among older people, its symptoms, treatment and care for such people. Results: Treatment of depressive disorders is based on pharmacology and psychotherapy. Care and the presence of loved ones are very important. Commitment to physical activity improves emotional balance. Conclusions: Depression in older people creates a problem in terms of diagnosis and clinical aspect. Depression reduces the quality of life, which means that older people cannot perform basic life activities on their own. Reduces motivation and interest in the environment. Correct diagnosis enables quick implementation of treatment that will allow you to recover. Key words: depression, treatment, care, old age, diagnosis, epidemiology, SSRI, NSRI, helplin

Causes of hoarseness - systematic review

Introduction and purpose of the work: Hoarseness is a symptom of a disease characterized by a hoarse, tense or hoarse voice resulting from disturbance of the vibration of the vocal folds. It is a common symptom of the disease in patients during medical consultations in primary health care, and the causes of its occurrence can be varied. State of knowledge (brief description): Treating hoarseness depends on what causes it. For this reason, during the diagnosis, various causes that may be the cause of hoarseness should be taken into account, such as infections, structural changes caused by the use of the voice organ, psychogenic causes, autoimmune diseases, systemic diseases or neoplastic diseases. Summary: In-depth diagnosis and an interdisciplinary approach are necessary to identify the cause of chronic hoarseness and initiate effective treatment

Drugs increase the risk of suicide in the elderly

The purpose of this paper is a systematic review of articles and research in the context of drugs used and suicide in elderly patients. Suicide in the elderly may be much more frequent than in the younger population. In addition to factors such as mental illness, dementia, deteriorating health, or problems with adapting to old age, the impact of chronic and reliever medications in this age group should also be considered. The greatest challenge of pharmacotherapy in the elderly is polypharmacy, drug interactions, different metabolism, pharmacokinetics and pharmacodynamics of the drugs used, as well as the side effects appearing in chronic therapy. In elderly patients, strong groups of drugs such as benzodiazepines and opioids are used extensively and sometimes too often. These drugs can cause addiction and overdose. Prescribing benzodiazepines alone carries a high risk of suicide. On the other hand, opioids often lead to addiction and abuse of these drugs, which may be associated with the development of respiratory depression. According to estimates by the Centers for Disease Control and Prevention (CDC), suicide accounts for approximately 7% of all opioid overdose deaths. Therapy should be carefully selected with regard to the use of other medications, drug interactions, and possible dependence and drug abuse by patients.The use of some classes of drugs in the elderly requires increased vigilance and control in the context of depression and episodes of suicide attempts. Drugs such as B blockers, digitalis glycosides, NSAIDs, opioids, ACEIs, calcium channel blockers, corticosteroids, diuretics, levodopa, and benzodiazepines can cause symptoms of depression. Older people are more susceptible to side effects of drugs, for example because of polypharmacy and the chronicity of treatment

Pharmacotherapy of depression in palliative patients

Introduction: Depression often affects people suffering from serious illnesses, including oncological and palliative patients. It reduces their quality of life and worsens their prognosis. This is why it is so important to properly treat depression in palliative patients. Material and Methods: The information provided was collected as a result of analysis of various articles and textbooks on development, diagnosis and treatment, as well as prevention of depression in terminally ill patients using Google Scholar and PubMed databases. Results: The results show that the most common drug in therapy for palliative patients with depression are the sluggish serotonin reuptake inhibitors (SSRIs). SSRIs inhibit serotonin transporter reducing serotonin reuptake. This raises the level of neurotransmitter - serotonin - in the synaptic cleft. They are well tolerated and have fewer side effects than older antidepressants (tricyclic antidepressants and monoamine oxidase inhibitors). Tricyclic antidepressants may relieve neuropathic pain and they are also beneficial for patients with insomnia. Mirtazapine in addition to antidepressant effects also causes increasing appetite, reducing nausea and sedative effect. In cancer-diagnosed patients particular attention should be paid to side effects such as nausea and vomiting that may occur in patients undergoing radiotherapy and chemotherapy using SSRIs or TCAs. SSRI therapy have a good safety profile and also interacts less frequently, while atypical antipsychotics may reduce the discomforts of taking chemotherapy. An alternative method of treating depression is the use of psychostimulants such as methylphenidate. Another way to treat depression is psychotherapy. Conclusions: There are several options for treating depression in palliative patients. It is important to pay attention to the side effects of prescribed medicines. Nevertheless, the best results are obtained by combining pharmacotherapy with psychotherapy

Atherosclerosis as a problem in postmenopausal women

Introduction: Atherosclerosis is defined as a disease in which plaque, consisting of fat, cholesterol and other substances found in blood, builds up in arteries. This leads to stiffness and narrowing of the blood vessels resulting in limiting the flow of the blood rich in oxygen to tissues. The negative effect of atherosclerosis among women can be opposed by the female hormones. The aim of the article is to review clinical approach to atherosclerosis in post-menopausal women. Material and methods: Articles in the Google Scholar, Pub Med database have been analysed using keywords: atherosclerosis, plaque, cardiovascular diseases, menopause, postmenopausal women, female hormones, estrogens, older people. Results: Atherosclerosis process in the arterial walls is based on accumulation of lipids accompanied by inflammatory factors. One of the most important risk factors of this disease are quantitative and qualitative changes of the plasma lipoprotein, especially increasement of LDL cholesterol after menopause, which can be evaluated during lab tests. The diagnosis of atherosclerosis and its progress can be performed by using different methods, including physical examination and medical imaging. Development of atherosclerosis leads to peripheral artery disease connected with cardiovascular diseases, such as stroke or heart attack, which be life-threatening and should be immediately treated. Conclusions: This risk of the negative effects of atherosclerosis can be decreased by both lifestyle change and pharmacological treatment. The usage of estrogen-based hormone replacement therapy combined with statins in postmenopausal women presents benefits by the decreasement of LDL cholesterol and the increasement of HDL cholesterol and reduction of calcification of coronary vessels, which reduces the risk of cardiovascular diseases. However, the time of the start of hormone replacement therapy is crucial – performed too late can result in additional development of atherosclerotic plaque and increasement of the inflammatory processes in the arteries with advanced atherosclerotic changes

Multiple sclerosis and dizziness in the elderly

Background:The essence of sclerosis disseminated, characteristics of the symptoms of this disease and familiarization with the main difficulties that sick people face. Material and methods:The methods used to treat balance disorders and dizziness are pharmacotherapy, vestibular rehabilitation, lifestyle changes and surgical treatment. Results: The results are not very optimistic, treatment is not too easy symptoms are manifested in motor dysfunction leading to even disability Conclusions:Multiple sclerosis is a disease affecting the nerve center of unknown etiology which makes treating difficult. The onset of the disease is often dizziness or headache

Inclisiran—Safety and Effectiveness of Small Interfering RNA in Inhibition of PCSK-9

Dyslipidemia is listed among important cardiovascular disease risk factors. Treating lipid disorders is difficult, and achieving desirable levels of LDL-cholesterol (LDL-C) is essential in both the secondary and primary prevention of cardiovascular disease. For many years, statins became the basis of lipid-lowering therapy. Nevertheless, these drugs are often insufficient due to their side effects and restrictive criteria for achieving the recommended LDL-C values. Even the addition of other drugs, i.e., ezetimibe, does not help one achieve the target LDL-C. The discovery of proprotein convertase subtilisin/kexin type 9 (PCSK9) discovery has triggered intensive research on a new class of protein-based drugs. The protein PCSK9 is located mainly in hepatocytes and is involved in the metabolism of LDL-C. In the beginning, antibodies against the PCSK9 protein, such as evolocumab, were invented. The next step was inclisiran. Inclisiran is a small interfering RNA (siRNA) that inhibits the expression of PCSK9 by binding specifically to the mRNA precursor of PCSK9 protein and causing its degradation. It has been noticed in recent years that siRNA is a powerful tool for biomedical research and drug discovery. The purpose of this work is to summarize the molecular mechanisms, pharmacokinetics, pharmacodynamics of inclisiran and to review the latest research