The consequences of long-term therapy with proton pump inhibitors

Introduction and purpose: Proton pump inhibitors (PPIs) were first developed in the late 1970s and introduced to the market in 1989. They are one of the most commonly prescribed medications worldwide. PPIs reduce gastric acid secretion in the stomach by inhibiting the hydrogen-potassium ATPase enzyme. They have revolutionized the treatment of diseases related to excessive stomach acid secretion. Among the drugs belonging to this class, we should mention omeprazole, esomeprazole, pantoprazole, lansoprazole, dexlansoprasole and rabeprazole.  A brief description of the state of knowledge: Since the 1990s, the use of proton pump inhibitors has been consistently increasing. Doctors prescribe these drugs more frequently, in higher doses, and for longer durations, although such practices are only sometimes fully justified. Although using them for a short period (less than eight weeks) is relatively safe, there is growing evidence of possible risks linked to their extended use. Many studies highlight the impact of long-term therapy on the development of tumors, deficiencies in micronutrients, the functioning of the skeletal, urinary, nervous, and cardiovascular systems, and the development of infections and diabetes.  Summary (conclusions): Indeed, long-term therapy with proton pump inhibitors has an impact on the functioning of the body. Considering the increasing popularity of proton pump inhibitors and their expanding use, it is worth contemplating a more prudent prescription of these drugs by doctors. It should also be noted that the majority of studies are based on prescription PPIs. Future researchers must also take over-the-counter (OTC) medications into account

Chronic Pelvic Pain Syndrome among women - challenge in diagnostics and management. Current literature review

Introduction and purpose: Chronic Pelvic Pain Syndrome (CPPS) is characterized as intermittent or constant pain located in the lower abdomen or pelvis, persisting continuously for at least 6 months [1]. Reports on the prevalence of chronic pelvic pain indicate the occurrence of this condition at a level of 5.7–26.6% in women of reproductive age. However, only a third of women suffering from chronic pelvic pain, seek medical care [2]. Clinical picture of CPPS consists of various patterns and symptoms, often as the intersection of the multiple systems, which additionally complicates and delays the diagnostic process. The aim of this review is to summarize existing literature about the diagnostics and management of Chronic Pelvic Pain Syndrome among women and create an awareness about the challenges which this condition poses for healthcare professionals.  A brief description of the state of knowledge: Chronic Pelvic Pain Syndrome is a multifaceted condition and the pathophysiology of it has not yet been comprehensively studied. Clinical picture often involves dysfunctions in pelvic floor, urinary tract, or gastrointestinal system. Treatment involves a multidisciplinary approach including non-pharmacological and pharmacological interventions.  Summary (conclusions): Chronic Pelvic Pain is a complex condition involving symptoms affecting the psychological, gastrointestinal, musculoskeletal systems. The most successful treatment approach emphasizes the role of collaboration among a diverse team of specialists such as gynecologists, gastroenterologists, psychiatrists, psychologists, and physiotherapists. More research focused on multimodal strategies in management of the CPP is needed to match patients most effectively with the most suitable combination of treatment and reduce the systemic consequences of chronic pain

The Condyloma acuminata - the review of the treatment methods

Introduction and purpose: Condyloma acuminata, a benign manifestation of HPV infection, is a common sexually transmitted disease. Condyloma acuminata most commonly affects the anogenital area, but can also occur in the oral cavity. Macroscopically the lesions present as raised, fleshy papules, sometimes flat and broad, pedicled or cauliflower-like. Generally, the lesions are multiple, and as they grow, tend to coalesce into larger ones. Due to the lack of symptoms, condyloma acuminata are often found incidentally during routine medical appointments, e.g. in gynecologist’s offices. Additional symptoms and signs are pain, minor bleeding and pruritus. Patients suffering from condyloma acuminata are often in psychological and psychosexual distress.  This work aims to provide a summary of the currently available treatment options based on scientific reports to date. A brief description of the state of knowledge: Among the factors that increase the risk of the HPV infection are age, lifestyle, promiscuity, smoking, HIV infection, a history of chlamydia or gonorrhea infections. To date, no treatment algorithm has been developed for condyloma acuminata. Two vaccines are on offer as primary prevention, Gardasil and Cervarix. The available treatment options are divided into two main groups: patient-administered and physician administered. Surgical methods have the highest therapeutic efficacy. Condyloma acuminata has a high recurrence rate. Usually, a multi-session combination treatment is needed to reach total remission. Summary (conclusions): The treatment of condyloma acuminata includes personalized targets due to their diverse clinical picture and the limitations of certain patient groups. The available treatment options do not exhaust the needs of patients suffering from condyloma acuminata. Further research into the effectiveness of specific treatments is advisable

Role of Metformin in Polycystic Ovary Syndrome

Introduction and purpose: PCOS is identified by the presence of underdeveloped follicles in the ovaries caused by a lack of ovulation, and it is linked to heightened production of androgens in the ovaries. The observable symptoms of PCOS encompass irregular or absent menstrual cycles, obesity, and indications of excess androgens such as acne or oily skin. Metformin could be advantageous for a specific group of women with PCOS. The aim of this study is to summarize the current knowledge regarding the effectiveness of metformin in the treatment of PCOS based on available scientific literature. A brief description of the state of knowledge:Metformin indirectly aids in enhancing ovulation and alleviating long-term metabolic issues, although its impact is considered moderate. Metformin also diminishes the levels of particular markers linked to arterial issues and chronic inflammation beneath the surface. This indicates a potential decrease in the continual risks of type 2 diabetes (DM) and cardiovascular disease (CVD) for women dealing with PCOS. Summary (conclusions): Managing PCOS involves personalized targets due to its diverse nature. In clinical practice, metformin is a recommended first step for managing PCOS in overweight or obese patients, particularly when oral contraceptives are not suitable or insulin resistance is evident

Examination of novel diagnostic approaches and contemporary strategies for preventing acute mountain sickness

Introduction and purpose: Acute mountain sickness is caused by hypoxia, of which the brain is the most sensitive. The frequency of occurrence at altitudes above 2500 m above sea level may reach up to 75% of travelers. Prevention of altitude sickness mainly concerns the travel plan and pharmacology.  Our study aimed to assess the current literature on altitude sickness, and discuss the possible pathophysiology, epidemiology, and symptoms. Moreover, we underline new guidelines for the treatment, prevention, and diagnosis of altitude sickness in the context of the last guidelines and research.   We conducted a PubMed literature review using keywords like "mountaineering sickness" and "altitude sickness".  All article types were taken into account: clinical trial, meta-analysis, case report, case series, systematic review, randomized controlled trial, observational study, clinical study, books, and documents in the last 5 years.A brief description of the state of knowledge: In recent years, there has been a surge in the accessibility and popularity of high-altitude tourism, emphasizing the need to disseminate information about altitude sickness among travelers. This heightened accessibility has sparked a push for comprehensive research and viable solutions, aiming to address the ramifications of the increased risk associated with such endeavors. Furthermore, there's a growing call for additional research focusing on the unique medical demands posed by tourist excursions and extreme expeditions. Conclusions:It underscores the necessity for healthcare professionals equipped with specialized knowledge and expertise in both preventing and treating medical conditions arising in exceptional circumstances

Factors influencing the length of the recovery period after blepharoplasty: a review of the latest data

Introduction and purpose Blepharoplasty is a surgical procedure aimed at restoring the functionality and/or aesthetics of the eyelids. The aim of the study is to draw attention to the factors influencing the recovery period at successive stages of therapeutic procedures. A brief description of the state of knowledge: Preoperative consultation is important in selecting patients, planning surgical procedures, identifying potential complications and meeting patients' expectations. In patients with hypertension, diabetes, smoking, and anticoagulant treatment, a worse scar assessment, longer recovery period and more complications have been observed. Patients who have undergone refractive surgery within the last 6 months are not suitable candidates for blepharoplasty. Nutrition status has a significant impact on wound healing and tissue repair after aesthetic medicine procedures. The use of continuous sutures compared to tissue glue results in similar wound healing time and postoperative discomfort level. Postoperative wound care is essential for the healing process. Electrostimulation of the wound does not accelerate edema reduction. We have focused on many complications, such as swelling, bleeding, infections, eyelid malposition, dry eye syndrome, wound dehiscence, ways to cope with these problems, and the role of lasers.  Summary (conclusions): Important is the proper preparation of the patient for the procedure. A detailed interview and examination influence therapeutic decisions, allowing the doctor to choose the most optimal treatment methods that will shorten the recovery time. Blepharoplasty is one of the most commonly performed aesthetic procedures, so we propose the development of publicly accessible standards that should be included in the initial interview

The Review of pharmacological treatment registered for obesity in Poland

Introduction: Obesity is a persistent chronic condition. It is associated with an increased riskof premature death and the development of accompanying diseases. According to statisticaldata, half of the population struggles with excessive body weight, with one in five Polesbeing obese. [2]Aim: Our study aimed to evaluate the current literature on pharmacotherapy for obesityavailable in Poland using the PubMed database. We emphasize the crucial importance of anindividualized patient approach to attain therapeutic success, aligning with the latestguidelines and scientific research.A brief description of the state of knowledge: In Poland, we have three registeredmedications intended for the treatment of obesity: naltrexone/bupropion, liraglutide, andorlistat. It's crucial that they assist in weight reduction, hence they should be used alongsidea proper diet and physical activity, not as the sole form of treatment. Using them assists inachieving therapeutic targets determined in partnership with the patient, and lowers levels ofparticular indicators linked to chronic inflammation and arterial issues. Moreover, theydiminish the chances of complications and early mortality due to the advancement of thecondition.Summary: Obesity is a serious condition, and there should be no fear in incorporatingpharmacotherapy in patients with it. It is incredibly important to effectively treat this diseaseand take proactive health measures, even at the stage of overweight, considering it as aprecursor to obesity

The vicious circle mechanism in atopic dermatitis: psychological distress as cause and effect of atopic dermatitis

Introduction and purpose:  Atopic dermatitis (AD) is chronic inflammatory skin disorder. It typically begins in infancy or childhood and might persist into adulthood. AD is characterized by dry, itchy, eczematous skin. The lesions can vary in intensification from mild to severe according to patient age or body region. AD requires ongoing management to control the symptoms. Skin manifestations along with the demand of treatment and care regimens significantly impact quality of life (QOL) in patients with AD. Individuals suffering from this condition are more prone to developing mental health disorders, which are often linked to emotional stress they experience. Exposure to stress exacerbates AD and stimulates skin changes, which in turn leads to intensification of treatment regimens. This cause-and-effect chain can be considered as a vicious circle mechanism. The aim of the review is to highlight the phenomenon by examining current literature on this topic in order to raise the awareness of healthcare professionals regarding this subject as well as implement appropriate and complete support for patients struggling with AD.  A brief description of the state of knowledge:  The pathophysiology of AD is multifactorial. Numerous studies explore the impact of stress on the deterioration of AD symptoms and delve into its pathogenic concepts. Simultaneously, researchers highlight increased psychological distress in AD patients, which surpass that observed in many other chronic conditions. Summary:  Psychological factors play a significant role in AD. It demands considering mental health screening and support as a part of clinical practice, treating AD patients. Further research is necessary to provide efficient and comprehensive interventions.&nbsp

Critical Analysis of the Efficacy and Limitations of GLP-1 Pharmaceuticals in Obesity Management: A Comprehensive Literature Review

Introduction and purpose Obesity, a pervasive global pandemic intricately linked to various comorbidities, necessitates a comprehensive and nuanced approach. This article delves into the intricate realm of obesity guidelines, underscoring the significance of lifestyle modifications, preventive measures for childhood obesity, population-based strategies, clinical management protocols, and vigilant monitoring. GLP-1 drugs, originally designed for type 2 diabetes management, exhibit multifaceted effects beyond glycemic control. They influence appetite regulation, gastric emptying dynamics, and potentially contribute to cardiovascular health improvements. However, the commendable effects come with a caveat - potential side effects necessitating careful consideration in clinical decision-making. Despite gaining popularity through celebrity endorsements, this article firmly underscores the need to view GLP-1 pharmacotherapy as a recommended intervention rather than a miraculous solution. A brief description of the state of knowledge Integral to the obesity discourse is the imperative to address weight stigma, demanding evidence-based approaches in both clinical and public health domains. The narrative extends into the future landscape of obesity pharmacotherapy, contemplating the potential role of probiotics. Emphasizing the necessity for long-term studies and randomized trials, it positions probiotics as a low-risk alternative with significant potential in mitigating obesity while simultaneously addressing concerns related to antibiotic resistance. Summary The pursuit of a balanced and effective approach to obesity management necessitates a nuanced understanding of medical interventions, consideration of societal perceptions, and exploration of innovative possibilities within the evolving landscape of healthcare

Diagnostic possibilities in peritonsillar abscess and the significance of transcutaneous ultrasound - Systematic Review of the Literature

Introduction and purpose: A peritonsillar abscess is one of the most common complications of tonsillitis, especially among adolescents and young adults. Its diagnosis can pose a challenge, and overlooking it may pose a life-threatening risk. Various diagnostic methods have their advantages and disadvantages. The aim of this publication is to compare and identify the best diagnostic approach currently described in the literature, contributing to improved clinical decision-making and patient outcomes with particular attention to the significance of transcutaneous ultrasound as a diagnostic method. A brief description of state of knowledge:Beyond clinical symptoms imaging options include transcutaneous and oral ultrasound, computed tomography, and magnetic resonance imaging. Ultrasound has been gaining importance in the diagnosis of PTA for an extended period due to its easy accessibility, cost-effectiveness, non-invasiveness and a relatively high anticipated specificity and sensitivity.Simultaneously, the use of CT as a tool in primary diagnosis is being called into question and new proposals for the use of MRI are emerging. Summary: Currently, the use of both intraoral and transcutaneous ultrasound represents the optimal first-line solution in diagnosing peritonsillar abscess. In cases of uncertainty, a more specific diagnostic tool would be MRI, although for various reasons, CT is more commonly chosen