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

New treatment strategies for bipolar disorder in the elderly

Introduction and objective: The purpose of this paper is to systematically review articles and new research in the context of bipolar geriatric patients. Materials and methods: PubMed searches were completed using the key terms bipolar disorder, bipolar elderly, bipolar depression, bipolar elderly treatment and review articles. In addition, references in these resources were searched. Search dates: 2010 to 2022. Description of the state of knowledge: Mental disorders in the context of the elderly concern all depressive disorders. A problem with other disorders such as bipolar disorder is also increasingly recognized. In the elderly, it is quite rare in the general cross-section of society, but it may have a higher percentage, e.g. in nursing homes and care institutions. This review article shows both the difference and the similarities in the course of this disease in older and younger patients. The most important and common aspect for both age groups is psychotherapy with parallel pharmacological treatment. The greatest difficulty in pharmacotherapy in the elderly is polypharmacy and numerous drug interactions, as well as different pharmacodynamics and pharmacokinetics of the drugs used compared to younger patients. Attention should also be paid to the differentiation of bipolar disorder from different types of dementia and other cognitive disorders. Therefore, one should strive to carefully assess the patient's need for a given treatment, establish appropriate periodic monitoring of treatment, and assess the risk of taking or not intervening. This article also aims to review new research and drugs that seem promising, while the individualized and interdisciplinary approach to a geriatric patient with BD is the most important finding of this review. Summary: Bipolar disorder in older people, compared to the younger population, should be treated pharmacologically in combination with psychotherapy. The elderly patient population requires a multidisciplinary approach due to the number of drugs used in a large number of diseases

Tarcza nerwu wzrokowego u chorych z AMD w skaningowej tomografii laserowej siatkówki (HRT)

Aneksy

Oxidative Stress Level in the Testes ofMice and Rats during Nickel Intoxication

The genotioxic and carcinogenic effect of nickel probably results from its capacity to produce reactive oxygen species (ROS) and disturb the redox balance. The aim of the study was to find out if rats lacking spermatic protamine 2 are less susceptible to Ni(II) than mice. Consequently, the levels of malondialdehyde + 4 hydroxynonenal (MDA+4HDA) − markers of lipid peroxidation, as well as the level of reduced glutathione (GSH) were measured within the rat and mouse testes. Our results showed that the levels of lipid peroxidation markers were elevated in testicular homogenates of intoxicated mice without any changes in rats. GSH level was lower in the group of intoxicated mice comparing to the control without statistically significant changes in rats’ homogenates. Moreover, the level of GSH in the testes of intoxicated mice was lower than in rats. On the basis of our results, it appears that Ni(II) can initiate oxidative stress in the testes of mice but not of rats and can reduce GSH level. Consequently, the antioxidative defense of the testes is reduced. Ni(II) that causes oxidative stress in the testes may also contribute to infertility

Proprioceptive Neuromuscular Facilitation and Mirror Therapy Methods Are Comparable Methods of Rehabilitation after a First-Ever Ischemic Stroke: A Randomized Study

Stroke is a serious cause of premature death among adults and the reason for much long-term disability. Understanding the mechanisms of disability and the potential for recovery of stroke patients should be one of the highest priorities of the health care system. Neurorehabilitation of post-stroke patients focuses on functional recovery by activating mechanisms of natural reorganization. Proprioceptive neuromuscular facilitation (PNF) and mirror therapy (MT) are neurorehabilitation methods activating brain plasticity, and their clinical utility for stroke survivors is still under studied. This study compared two neurorehabilitation methods using PNF or MT on functional recovery in patients after a first-ever ischemic stroke. This prospective and interventional randomized clinical study involved a group of 50 patients (34 males and 16 females) with first-ever ischemic stroke, aged 48–82 years being in the recovery-compensation stage and admitted to the unit for early post-stroke rehabilitation. Patients were randomly enrolled into two groups in terms of rehabilitation method used: PNF (n = 26) or MT (n = 24). Barthel Index (BI) was used for assessing functional status at baseline (M0), and 3 (M1) and 6 weeks (M2) after intervention), and modified Rankin Scale (mRS) was used for assessing a disability level at baseline (M0), and 6 weeks (M2) after the intervention. Statistically significant differences were noted in the two study groups in BI (main effect: <0.05). There was an improvement in the MT group between M1 and M2 by 3.6 points, M1 and M3 by 6.9 points, and M2 and M3 by 6.9 points. For the PNF group, there were differences between M1 and M2 by 4.1 points, M1 and M3 by 7.2 points, and M2 and M3 by 3.1 points. Moreover, statistically significant differences were noted in both groups in mRS (main effect: p < 0.05). There was a decrease of 2.2 points in the MT group between M1 and M2 measurements. For the PNF group, there were differences between M1 and M2 by 2.3 points. There were no statistically significant differences between the MT and PNF groups in both BI and mRS scores (p < 0.05). In conclusion, both PNF and MT neurorehabilitation methods could be useful for improving functional status and reducing disability level in patients after first-ever stroke during the regenerative-compensatory stage

Proprioceptive Neuromuscular Facilitation and Mirror Therapy Methods Are Comparable Methods of Rehabilitation after a First-Ever Ischemic Stroke: A Randomized Study

Stroke is a serious cause of premature death among adults and the reason for much long-term disability. Understanding the mechanisms of disability and the potential for recovery of stroke patients should be one of the highest priorities of the health care system. Neurorehabilitation of post-stroke patients focuses on functional recovery by activating mechanisms of natural reorganization. Proprioceptive neuromuscular facilitation (PNF) and mirror therapy (MT) are neurorehabilitation methods activating brain plasticity, and their clinical utility for stroke survivors is still under studied. This study compared two neurorehabilitation methods using PNF or MT on functional recovery in patients after a first-ever ischemic stroke. This prospective and interventional randomized clinical study involved a group of 50 patients (34 males and 16 females) with first-ever ischemic stroke, aged 48–82 years being in the recovery-compensation stage and admitted to the unit for early post-stroke rehabilitation. Patients were randomly enrolled into two groups in terms of rehabilitation method used: PNF (n = 26) or MT (n = 24). Barthel Index (BI) was used for assessing functional status at baseline (M0), and 3 (M1) and 6 weeks (M2) after intervention), and modified Rankin Scale (mRS) was used for assessing a disability level at baseline (M0), and 6 weeks (M2) after the intervention. Statistically significant differences were noted in the two study groups in BI (main effect: p p < 0.05). In conclusion, both PNF and MT neurorehabilitation methods could be useful for improving functional status and reducing disability level in patients after first-ever stroke during the regenerative-compensatory stage

Assessment of Changes in Serum C-Reactive Protein Levels in Patients after Ischemic Stroke Undergoing Rehabilitation&mdash;A Retrospective Observational Study

Inflammation plays a key role in the pathogenesis and prognosis of ischemic stroke. C-reactive protein (CRP) is an inflammatory biomarker of inflammation and may reflect the progression of vascular disease. Using a biomarker such as CRP to predict recovery rather than mortality may present clinical value in providing rehabilitation. The primary aim of the study was to analyze changes in serum CRP levels in patients after ischemic stroke during the regenerative-compensatory period and to assess the usefulness of CRP as a potential biomarker during the rehabilitation period. The project was carried out as a retrospective analysis of prospectively collected data from post-stroke patients from the Department of Neurological Rehabilitation of the Regional Specialist Hospital in Wroc&#322;aw. A group of 52 patients, after their first-ever ischemic stroke with subsequent hemiplegia, was finally qualified to participate in the study. Serum CRP levels were determined during blood laboratory tests. The Modified Rankin Scale (mRS) and Barthel Index (BI) were used to assess functional outcomes. Rehabilitation using neurophysiological methods was applied five days a week (each session lasted 60 min, and the entire period was 42 days). At the first test, serum CRP levels were found to be above 5 mg/L in 19 patients, the second test in 12 patients, the third test in five patients, and the fourth test in 9 patients. Only three patients had values higher than 5 mg/L in all consecutive assessments (p &gt; 0.05). There was a statistically significant increase in BI scores after therapy (p &lt; 0.001) as well as a decrease in the mRS score by 2.2 points (p &lt; 0.001), in CRP values by 5.02 mg/L (p = 0.019), and in cortisol levels by 2.5 nmol/L (p = 0.002). Statistically significant relationships were observed between the CRP levels after rehabilitation and the corresponding mRS scores (rs = 0.29, p = 0.038). Furthermore, the effect of BMI on CRP levels was demonstrated (B = 0.20, p = 0.038). In conclusion, despite demonstrating a significant relationship between CRP levels and corresponding mRS scores, CRP levels alone may not serve as an independent predictor of long-term functional outcomes in ischemic stroke patients undergoing rehabilitation

Tyrosol and Hydroxytyrosol: Their Role in Cardioprotection

Introduction: Recent research are focused on natural compounds for preventing cardiovascular diseases, with emphasis on tyrosol and hydroxytyrosol in olive oil. Cardiovascular diseases are linked to risk factors, and adopting a Mediterranean diet rich in these compounds is recognized for reducing risks.  Understanding these compounds' actions may inform new strategies for preventing and treating cardiovascular diseases.  Aim: The aim of this paper is a systematic review of articles and research regarding the Role of tyrosol and hydroxytyrosol in Cardioprotection  Review methods: An systematic review of scientific literature was conducted using the following keywords: Tyrosol, hydroxytyrosol, cardioprotection, cardiovascular diseases, olive oil cardioprotective role. Thirty-four articles published until 2023 were searched and analyzed.  Abbreviated description of the state of knowledge: Tyrosol and hydroxytyrosol, prominent in olive oil, are studied for their potential cardioprotective properties. Linked to a Mediterranean diet, these compounds show promise in reducing cardiovascular disease risk. They counter oxidative stress, improve lipid profiles, and modulate inflammatory processes. Clinical studies suggest their positive impact, with tyrosol also explored as a potential anticoagulant. Ongoing research aims to uncover optimal doses and mechanisms, highlighting their significance in cardiovascular health.  Conclusions: Tyrosol and hydroxytyrosol, found in olive oil, show promise in cardioprotection by combating oxidative stress, improving lipid profiles, and modulating inflammation. Clinical studies suggest their positive impact on cardiovascular health. Tyrosol has potential as a anticoagulant and exhibits antioxidant effects. These compounds present a compelling avenue for future therapeutic interventions, with emphasis on understanding mechanisms and optimizing supplementation.