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

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

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

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

Tirzepatide - a novel dual GLP-1 and GIP receptor agonist used in pharmacotherapy of obesity: A literature review

Background: Obesity is a chronic disease, which along with its complications, poses a huge threat to both our health as individuals and our healthcare as a community. Objective: The aim of this work is to review efficacy and safety of Tirzepatide, a novel dual GIP/GLP-1 receptor agonist in the treatment of obesity Method: A literature review was conducted on databases such as PubMed and Google Scholar using terms “obesity”, “obesity treatment”, “glucagon-like peptide 1”, “Glucose-dependent insulinotropic polypeptide”, “Tirzepatide” as keywords. The review was performed in accordance with the PRISMA guidelines. Results:  Administration of tirzepatide once weekly provides a substantial and sustained reduction in bodyweight with little side effects. Conclusions: Clinical trials showed both high efficacy and safety of Tirzepatide in management of obesity. Due to its novel, broadened mechanism of action it seems to be the most effective drug for reducing bodyweight available on the market. Tirzepatide could be our answer to tackling the problem of world-wide obesity epidemic. &nbsp

Pancreatic Islet Transplantation in Patients suffering from Type 1 diabetes - Indications, methods, possible risks and future directions: A literature review

Introduction: Type 1 diabetes is a common and debilitating disease that requires regular glycemic control to prevent potentially fatal hypoglycemia. Objective: The aim of this study is to demonstrate the purpose, process, and consequences of pancreatic islet transplantation in patients with type 1 diabetes. Additionally, the results of the procedure after several years are described based on the available publications. Materials and Methods: The authors created a summary of available publications on pancreatic islet transplantation, based on databases such as PubMed and Google Scholar. Using the terms listed in the "key words" section, the authors searched for relevant information in other scientific papers to create the following review. Conclusions: Reducing the number of donors and developing alternative sources of pancreatic islet cells for transplantation is an active area of research, that promises to expand access and indications for pancreatic islet transplantation in future diabetes treatment

Inclisiran - hope in the fight against dyslipidemia

Introduction:Lipid disorders are one of the most common modifiable risk factors for cardiovascular disease. Until now, the mainstay of dyslipidemia treatment was the use of widely available statins. These drugs, despite significantly lowering cholesterol and bringing its concentration to desired values were associated with a number of side effects. In addition, the need for daily use of statins is inconvenient for patients and leads to their irregular use and, consequently, failure to achieve the desired effect. The new drug, inclisiran, which is a PCSK9 inhibitor, represents the future in the treatment of lipid disorders. Studies conducted to date have explored the drug's mechanism of action, frequency of administration to achieve the desired effect, and side effects. The results of these studies have confirmed the significant efficacy of inclisiran,which may become a major form of treatment for dyslipidemia in the future. Purpose of the work: This article reviews the state of knowledge based on available studies on inclisiran. The aim of the review is to present the most important information about this drug related to the mechanism of action, effects on the body or assessment of efficacy. Materials and methods: The authors, based on databases such as PubMed, Scopus and Google Scholar, created a paper summarizing a review of currently available publications, concerning a new drug in the treatment of dyslipidemia- inclisiran.  The authors searched for available information , using terms under the heading "key words" contained in other scientific papers. Summary Inclisiran is a novel drug that represents the future in the treatment of dyslipidemia. Due to the lack of systemic effect, it has insignificant side effects, and the need for such rare administration will allow to obtain the desired lipid concentrations even in patients who do not cooperate

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

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