Subjective and family factors determining parental attitudes in parents of children with primary immunodeficiency treated with immunoglobulin substitute

This paper presents the results of aquestionnaire about parental attitudes carried out on 47 parents of children with primary immunodeficiency hospitalized at the University Children’s Hospital in Kraków-Prokocim, Poland, and treated with intravenous immunoglobulin substitute. The following questionnaires were used in the study: the Parental Attitudes Scaleby Plopa, NEO-Five Factor InventorybyCosta and McCrae, FACES-IV SOR (adapted into Polish by Margasiński), and Coping Inventory for Stressful Situations. The quantitative research was supplemented by qualitative methods such as psychological inquiries. The study revealed differences with normalized groups across all techniques. Empirical analysis was aimed at testing which of the variables adopted in the study explain parental attitudes in parents of children with primary immunodeficiency. In order to do this, aprogressive stepwise regression analysis was conducted. As aresult, several interesting multiple regression models were isolated for parental attitudes, which Plopa describes in his typology as dependent variables. The variables specified in the FACES-IV SOR turned out to be statistically significant predictors for autonomy (balanced flexibility: β = 0.406; p = 0.007) and inconsistency (rigidity: β= 0.573; p = 0.005)

A painless fracture of a phalanx of the left hand in a patient with type 1 diabetes – case report

The aim of our study is to present a case report of a patient who, due to advanced symmetrical peripheral diabetic polyneuropathy, was unaware of the fracture of the fifth finger of the left hand and even tried to restore it to its previous position. The 53-year-old patient with type 1 diabetes at the age of 9, who, due to non-compliance with medical recommendations and poor metabolic control (over the last 15 years, HbA1c has never fallen below 8.1%, reaching 11.1% in May 2017), developed  complications such as: ischemic heart disease, diabetic retinopathy, nephropathy and peripheral neuropathy. In February 2019, in the morning, when unscrewing the fuel filler cap in the car, the patient suffered a finger fracture. He remained unaware of this fact all day due to the lack of any pain symptoms. It was only in the evening that he noticed the wrong placement of the fifth finger on his left hand. On the next day, there was a slight soreness with pressure, and the swelling deepened, which prompted him to visit the emergency room. An X-ray examination was performed there, which showed a fracture of the shaft of the proximal phalanx of the fifth finger of the left hand with angular setting of the fragments. The finger was immobilized in a plaster cast and the patient was referred for further check-up in a specialist outpatient clinic. Fortunately, the attempt to set the finger on his own did not cause any significant complications, and after removing the plaster cast, the patient regained the use of the broken finger. A recent electromyographic study confirmed the existence of a very advanced peripheral neuropathy. In summary, improperly treated, poorly controlled type 1 diabetes has serious consequences. It is very important that people suffering from it conduct regular self-monitoring of blood glucose levels and lead a healthy lifestyle

Beta-blockers used in cardiac failure and blood glucose level impairment - a literature review

Introduction: Blood sugar level impairment, especially diabetes mellitus (DM) is a significant problem. DM leads to many serious complications. Patients suffering from cardiac failure (HF) and diabetes have a risk of hospitalization increased 1.5 times compared to the control group without DM. That is why it is very important to keep appropriate glycemic control. β-blockers, are considered to cause a blood glucose level impairment. The relationship between the use of β-blockers and the development of DM is one of the most interesting and controversial issues in diabetology. Despite many benefits, some doctors are reluctant to prescribe β-blockers because of perceived negative metabolic effects.Aim of study: The purpose of the study was to review the literature describing oral β-blockers, used in HF, influence on glucose metabolism and to discover the best β-blocker treatment for cardiac failured diabetics and prediabetics. Methods: A systemic review was conducted using PubMed, ScienceDirect, Google Scholar databases. The search strategy was based on the following terms: beta-blocker, blood glucose level, metoprolol, nebivolol, carvedilol, bisoprolol. Results: β-blockers differ in terms of their mechanism of action and their effects on glucose metabolism. Metoprolol is associated with a worsening of glucose and lipid control. Bisoprolol have a neutral impact on glucose metabolism. Vasodilating β-blockers may improve glycemic profile.Conclusions: All four β-blockers used in HF have similar blood pressure lowering effect but different metabolic effect. Metoprolol should not be used as a drug of choice in patients with impaired glucose metabolism. Bisoprolol, nebivolol or carvedilol may be recommended as a drug of choice in patients with cardiac failure and impaired carbohydrate metabolism. The choice between bisoprolol and vasodilating β-blockers in patients with glycemic disorders is still an unresolved issue

Human Gut Microbiome – how intestinal bacteria influence our health

Introduction: Gut microbiome is composed of hundreds of different bacterial species.Possibly every type of bacteria can affect many different aspects of human healthGut bacterial composition varies immensely between healthy and sick people and there are many factors which can influence micriobiota balance in our intestines. Aim of study: The purpose of the study was to review the latest literature on the gut bacteria importance and to discover what factors can influence gut microbiome composition. Matherials and methods: A systemic review was conducted using Google Scholar, PubMed and ScienceDirect databases and the search was limited to studies published between 2000 and 2023. The search strategy was based on following terms: microbiome, gut bacteria, health and microbiome, gut microflora, human intestinal microbiota Results: We found many different studies which show importance of gut microflora in various different ailments and diseases, we have also found many showing  factors that influence intestinal microbiota composition.Conclusions: Gut microbiota is very broad topic – it can affect many different aspects of human health, starting from lowering the risk of developing allergy or affecting weight loss to affecting risk of colorectal cancer development . It can be affected by many different factors – lots of them are still uknown and need further studies

Linking major depressive disorder pathogenesis with kynurenine pathway - a literature review

Introduction: Depressive disorders are a significant problem. They lead to suffering, loss of interest and may contribute to suicide attempts. Despite the large number of available medications, 10-35% of patients fail to achieve remission. Therefore, for these ongoing researches are underway to thoroughly understand the pathophysiology of depression. Aim of study: The purpose of the study was to review the latest literature on the kynurenine pathway importance in depression, and to discover its links with theories relating to the pathogenesis of depression. Matherials and methods: A systemic review was conducted using PubMed, ScienceDirect, Google Scholar databases and it was limited to studies published between 2000 and 2023. The search strategy was based on following terms: kynurenine, depression, kynurenine pathway in depression, treatment resistant depression, tryptofan metabolites. Results: Animal studies confirm the importance of the kynurenine pathway in animal models of depression. Peripherally directed inflammatory stimuli in humans lead to peripheral activation of the kynurenine pathway. The regulation of the kynurenine pathway in the brain is specific to a particular region as well as to a given type of depression.Conclusions: Further studies of the kynurenine pathway targeting different regions of the brain are necessary. Conducting a simultaneous analysis of many central and peripheral tryptofan metabolites will be helpful to accurately determine their mutual impact in both compartments. Understanding changes in kynurenine pathway transmission in a particular type of depression may be helpful in developing new, more effective drugs

Exercise and pregnancy - review of literature and current recommendations

Introduction: Regular physical activity benefits everyone, regardless of age, considering individual abilities and health conditions. Pregnancy is a special time for women as well as an appropriate time to reassess lifestyle choices and introduce better habits. Aim of the study: Summary of the current state of knowledge about exercise in pregnancy, recommended forms of physical activity and benefits for health and well-being. Methods and Materials: A review was conducted in PubMed, ScienceDirect and GoogleScholar including publications from the last 5 years. Literature was searched using the following terms: “physical activity”, “exercise”, “pregnancy”, “resistance exercise”, “aerobic exercise”. Results: The number of studies focused on benefits of prenatal exercise is escalating. It has been proven that physical activity can prevent gestational diabetes, help in blood glucose, and blood pressure control, improve the mental state of a mother, and contribute to the improvement of placental function. It can also affect a parturition and child postnatal development. At the same time, it turned out that many women do not have the appropriate knowledge and do not undertake the recommended activity during pregnancy. Conclusion: Interest in the topic of physical activity during pregnancy has increased significantly in recent years, yet further research is needed to dispel the existing doubts and to understand thoroughly the significance of physical activity during pregnancy on maternal and child health. Future educational interventions aimed at pregnant women in terms of safety and recommended forms of activity during pregnancy are necessary to update their knowledge and to help them implement recommendations

Beta-blockers used in cardiac failure and blood glucose level impairment - a literature review

Introduction: Blood sugar level impairment, especially diabetes mellitus (DM) is a significant problem. DM leads to many serious complications. Patients suffering from cardiac failure (HF) and diabetes have a risk of hospitalization increased 1.5 times compared to the control group without DM. That is why it is very important to keep appropriate glycemic control. β-blockers, are considered to cause a blood glucose level impairment. The relationship between the use of β-blockers and the development of DM is one of the most interesting and controversial issues in diabetology. Despite many benefits, some doctors are reluctant to prescribe β-blockers because of perceived negative metabolic effects.Aim of study: The purpose of the study was to review the literature describing oral β-blockers, used in HF, influence on glucose metabolism and to discover the best β-blocker treatment for cardiac failured diabetics and prediabetics. Methods: A systemic review was conducted using PubMed, ScienceDirect, Google Scholar databases. The search strategy was based on the following terms: beta-blocker, blood glucose level, metoprolol, nebivolol, carvedilol, bisoprolol. Results: β-blockers differ in terms of their mechanism of action and their effects on glucose metabolism. Metoprolol is associated with a worsening of glucose and lipid control. Bisoprolol have a neutral impact on glucose metabolism. Vasodilating β-blockers may improve glycemic profile.Conclusions: All four β-blockers used in HF have similar blood pressure lowering effect but different metabolic effect. Metoprolol should not be used as a drug of choice in patients with impaired glucose metabolism. Bisoprolol, nebivolol or carvedilol may be recommended as a drug of choice in patients with cardiac failure and impaired carbohydrate metabolism. The choice between bisoprolol and vasodilating β-blockers in patients with glycemic disorders is still an unresolved issue

Is nicotine vaporization a better alternative to traditional cigarette smoking? E-cigarettes harmful effects summary and the management of EVALI based on the latest literature

Introduction: Electronic cigarettes are battery-powered devices that allow users to inhale vapor produced by heating a liquid (e-liquid) containing nicotine and other substances. The first such devices were introduced in China in 2003, and subsequently approved for use in the European Union in 2006 and the United States in 2007. The number of e-cigarette users is constantly growing, with the largest increases observed in the 18-24 age group. Various modifications led to the emergence of a new disease entity in 2019 called EVALI (e-cigarette or vaping product use-associated lung injury). Aim of the study: To summarize the current state of knowledge about harmful substances contained in e-cigarettes and to systematize the latest methods of management in cases of suspected EVALI. Methods and materials: A literature review was conducted using PubMed, Google Scholar, and ScienceDirect, including publications from the last 8 years, using the following keywords: "E-cigarette," "Electronic cigarette," "EVALI," "THC," "Vitamin E." Results: Electronic cigarettes contain a number of substances harmful to health. E-cigarettes have not been approved as nicotine replacement therapy. The presence of vitamin E breakdown products in the respiratory tract of EVALI patients has been confirmed. Vitamin E was primarily used to increase the volume of e-liquids containing THC. Conclusions: Electronic cigarettes should not be used due to the numerous harmful substances they contain. When using e-cigarettes, both the devices and the e-liquids should be purchased from reputable sellers approved in the respective country. EVALI is a potentially fatal disease, and prompt diagnosis facilitates treatmen

Neuropathy and neuroarthropathy as a complication of diabetes and other diseases, with particular emphasis on painless fractures - a review of the literature

Diabetes is now one of the most common chronic diseases. Its incidence is increasing, and thus the number of people suffering from its health complications is increasing. In 2015, 3 million people in Poland suffered from diabetes, and it is estimated that this number will increase to 4 million by 2040. Acute complications of diabetes include i.a. hypoglycemic or lactate and hypermolar comas. Chronic complications include, for example, microangiopathies (retinopathies, nephropathy) as well as macroangiopathies and neuropathies. Neuropathy is the result of too much glycemia and can affect as many as 2/3 of diabetic patients. Everyday pain sometimes makes it impossible to perform the simplest activities, and an optimal treatment plan is difficult to develop. At the same time, it can be prevented with regular exercise, regular glycemic control and a proper diet. In this paper, we present a literature review on neuropathy and neuroarthropathy as a complication of diabetes and other diseases, with particular emphasis on painless fractures

Treatment of perianal fistulas in Crohn’s disease - review of literature and current recommendations

Introduction: Crohn's disease is an idiopathic inflammatory disorder of unknown etiology, associated with genetic, immunological, and environmental factors. The incidence of this disease continues to rise in developed countries. In almost 25% of patients, perianal fistulas occur during the course of the disease, which are difficult to treat and significantly impair the patient's quality of life. Aim of the study: To summarize the current state of knowledge on the treatment of Crohn's disease with perianal fistulas, with a particular focus on biological therapies and stem cell treatments. Methods and Materials: A systemic review was conducted using PubMed, Google Scholar, and ScienceDirect databases and it was limited to studies published in last 5 years. The search strategy was based on following terms: "Crohn's disease", "perianal fistula", "biological treatment", and "inflammatory bowel disease". Results: In recent years, there has been intensive research into new treatment options for perianal fistulas in Crohn's disease. Infliximab remains the first-line therapy, best controlled by monitoring the drug concentration in the serum. Alternatively, other drugs such as ustekinumab and vedolizumab may be considered. The combination of biological and surgical treatment is a recognized standard of care and modern, minimally invasive techniques that preserve sphincters, such as the FiLaC™ laser procedure, are increasingly being used. A novel and very promising therapeutic approach is based on mesenchymal stem cells, which may offer hope for patients who do not improve with standard treatment. Conclusion: Perianal disease in patients with Crohn's disease poses a significant therapeutic challenge and has a substantial negative impact on the physical and emotional well-being of patients. Despite the existence of various therapeutic options, a certain percentage of patients still fails to achieve clinical remission. Further research into new therapies is necessary