Glioblastoma is the most common histologic type of all gliomas and contributes to 57.3% of all cases. Despite the standard management based on surgical resection and radiotherapy, it is related to ...poor outcome, with a 5-year relative survival rate below 6.9%. In order to improve the overall outcome for patients, the new therapeutic strategies are needed. Herein, we describe the current state of knowledge on novel targeted therapies in glioblastoma. Based on recent studies, we compared treatment efficacy measured by overall survival and progression-free survival in patients treated with selected potential antitumor drugs. The results of the application of the analyzed inhibitors are highly variable despite the encouraging conclusions of previous preclinical studies. This paper focused on drugs that target major glioblastoma kinases. As far, the results of some BRAF inhibitors are favorable. Vemurafenib demonstrated a long-term efficacy in clinical trials while the combination of dabrafenib and trametinib improves PFS compared with both vemurafenib and dabrafenib alone. There is no evidence that any MEK inhibitor is effective in monotherapy. According to the current state of knowledge, BRAF and MEK inhibition are more advantageous than BRAF inhibitor monotherapy. Moreover, mTOR inhibitors (especially paxalisib) may be considered a particularly important group. Everolimus demonstrated a partial response in a significant proportion of patients when combined with bevacizumab, however its actual role in the treatment is unclear. Neither nintedanib nor pemigatinib were efficient in treatment of GBM. Among the anti-VEGF drugs, bevacizumab monotherapy was a well-tolerated option, significantly associated with anti-GBM activity in patients with recurrent GBM. The efficacy of aflibercept and pazopanib in monotherapy has not been demonstrated. Apatinib has been proven to be effective and tolerable by a single clinical trial, but more research is needed. Lenvatinib is under trial. Finally, promising results from a study with regorafenib may be confirmed by the ongoing randomized AGILE trial. The studies conducted so far have provided a relatively wide range of drugs, which are at least well tolerated and demonstrated some efficacy in the randomized clinical trials. The comprehensive understanding of the molecular biology of gliomas promises to further improve the treatment outcomes of patients.
Introduction and purpose: Cardiovascular diseases (CVD) are the leading cause of death worldwide. The classic cardiovascular risk factors include age, gender, obesity, diabetes, hypertension, ...dyslipidemia, smoking and genetic factors. Some dermatological disorders are also potential risk factors for the development of CVD. The aim of the study is to review recent knowledge on the impact of dermatological diseases on cardiovascular risk.
Description of the state of knowledge: The relationship between skin diseases and cardiovascular risk is influenced by various common dependencies such as: shared pathophysiological basis of disorders, risk factors, presence of a chronic inflammatory process, genetic susceptibility and environmental influences. Increased cardiovascular risk has been reported for several dermatological conditions, including psoriasis, systemic lupus erythematosus, systemic sclerosis, pemphigus, hidradenitis suppurativa, rosacea, atopic dermatitis. Chronic systemic inflammation, typically present in skin conditions, is a cardiovascular risk factor, because inflammation accelerates atherosclerosis, and furthermore may predispose patients to the development of metabolic syndrome, insulin resistance and diabetes mellitus. In patients who are initially metabolically unbalanced, these processes may be even more intense. Cardiovascular disorders, the frequency of which increases in patients with skin diseases, include atherosclerosis, coronary artery disease, ischemic heart disease, cardiac dysfunction, arrhythmias, heart failure, cerebrovascular disease (stroke, TIA) and peripheral arterial disease.
Summary: Many cutaneous disorders, in addition to significantly increasing cardiovascular morbidity and mortality, also reduce the patient's quality of life. The cooperation of dermatologists and cardiologists in the care of patients with dermatological diseases is crucial for the proper treatment of the disease and prevention of cardiovascular complications.
Congenital CMV-cCMV- infection is the most common congenital viral infection in the world, especially in developing countries. It is a serious problem because it can contribute to the development of ...severe neurodevelopmental disorders and is also the main cause of sensorineural hearing loss. A high risk of adverse effects on the fetus occurs with CMV infection in early pregnancy, but infection can be transmitted from mother to fetus also in cases of secondary infections. Despite the high prevalence of up to 2% of all births, screening for CMV has not yet been established and diagnostic and therapeutic strategies have not been standardized. The aim of this article is to review the current reports on the early detection of congenital CMV, as well as effective methods of its prevention and the best treatment.
Unfortunately, the literature review shows that there are no preventive measures other than proper hygiene during pregnancy. However, many clinical trials are currently underway to develop a CMV effective vaccine. Currently, the infection can be detected already at the stage of fetal life using PCR tests detecting the genetic material of the virus in the amniotic fluid. However, the treatment of already diagnosed congenital CMV is based on antiviral therapy for a period of 12 months, but only in symptomatic infants due to side effects such as neutropenia. Currently, the effectiveness of such treatment reduces the percentage of children with hearing loss and neurological disorders. Pregnant mothers should be educated on how to prevent infections, and doctors' task is to update data on the latest diagnostic and therapeutic recommendations.
Introduction and objective: Hypertension is the main preventable risk factor for both cardiovascular disease and premature death globally. Estimates suggest that almost one in three adults suffered ...from hypertension in 2010. This clinical entity can lead to different severe complications such as heart failure or stroke. Data shows that blood pressure(BP) reduction below currently recommended leads to a significant decrease of the risk of cardiovascular disease. The aim of the study is to review recent knowledge and beneficial impacts of Dietary Approaches to Stop Hypertension(DASH) diet, which is considered to decrease blood pressure. The information used in the presented analysis was obtained by searching academic research databases: Google Scholar and PubMed.
An abbreviated description of the state of knowledge: The DASH diet is one of well known dietary patterns. It is rich in fruits, whole grain and low-fat diary products. Basing on the data, it can significantly decrease BP, what leads to a reduction of cardiovascular disease risk. Furthermore, high adherence to the DASH diet is associated with a lower risk of mortality from all cancer types and lower risk of colon cancer development, as well as with a lower risk of type 2 diabetes development.
Summary: The DASH diet is a commonly prescribed dietary pattern, which is known of its effectiveness in BP reduction. Additional research confirms its several different health benefits including decrease of the cardiovascular risk. Finally, the research give the recommendation, that the DASH diet should be pursued to increase the antihypertensive drug treatment effectiveness, but also to delay hypertension onset.
In March 2020, World Health Organization (WHO) declared the outbreak of the coronavirus disease 2019 (COVID-19) a pandemic. Pediatric inflammatory multisystem syndrome temporally associated with ...COVID-19 (PIMS-TS) also known as multisystem inflammatory syndrome in children (MIS-C) is a new phenomenon highly correlated with COVID-19. Recent research suggests that this new disease in children and adolescents is associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It is a generalized inflammatory reaction suggestive of a likely autoimmune etiology. Symptoms of PIMS-TS are diverse and wide ranging. The disorder develops in children and adolescents as a result of dysregulation of the immune system, but the exact pathogenesis of PIMS-TS remains unknown. Consequently, the most effective types of therapy include supportive care, symptomatic and immunomodulating treatment. The ongoing international study of this condition may provide information on the treatment options, clinical trials and management process.
Preeclampsia (PE) is a pregnancy complication that affects 5% to 8% of all pregnancies. It is a leading cause of maternal mortality that contributes annually more than 60,000 maternal deaths all over ...the world. Data submitted so far by clinicians are still insufficient to completely understand the disease. Despite many researches, the prediction of patients suffering from PE remains difficult. Moreover therapeutic methods are also limited and concentrated on symptomatic treatment and early termination of pregnancy. The aim of the presented article is to review current research on the PE and its long-term effects on mother and child. PE is defined as a hypertension developing after 20 weeks of gestation with at least one of the following symptoms: proteinuria, maternal organ dysfunction or foetal growth restriction. Because initially patients may be completely asymptomatic, the diagnosis is usually difficult. Untreated PE may lead to the death of both mother and neonate. In later life it predisposes woman and child to cardiovascular and metabolic diseases. Maternal consequences are related to increased risk of hypertension, stroke, thrombosis or chronic kidney disease, whilst offspring implications are directly correlated with hypertension, increased body mass index, hormonal changes and reductions in cognitive functions. In the future there is a need to develop more effective diagnostic methods of PE. Comprehensive understanding of the pathophysiology would allow to avoid many negative long-term effects and reduce its mortality rate.
Introduction and objective: Pneumonia is defined as an acute infection of the lung parenchyma caused by various pathogens. It remains a leading cause of morbidity and mortality in the paediatric ...population globally. The aim of this study was to disclose most common aetiology of pneumonia among children hospitalized in the University Children’s Hospital in Lublin, Poland, from 2010–2020. Material and methods: This retrospective study included 2,250 patients in the age rage from 2–227 months, hospitalized in the Department of Paediatric Pulmonology and Rheumatology of University Children’s Hospital in Lublin from 2010–2020 due to pneumonia. All necessary information were obtained from electronic medical records. According to the International Classification of Diseases Version 10 (ICD-10), patients were divided into 20 groups in terms of aetiology of pneumonia. Subsequently collected data were submitted to statistical calculations. Results: A seasonality of pneumonia admissions was observed with predominance in the winter. Based on ICD-10 codes, the most common aetiology of pneumonia was unspecified bacterial pneumonia (J15.9) related with 30.2% of all cases. Moreover, based on IgM serology tests, Mycoplasma pneumoniae was the main identified pathogen (18.8% of all cases). Average duration of hospitalization oscillated around 7.4 days; the most common administered antibiotic was amoxicillin + clavulanic acid. Chest imaging was performed in 88.8% of patients. Conclusions: Pneumonia dominated in the bacterial aetiology of children. Younger groups of children were more prone to the development of pneumonia. In many casus, there were observed difficulties with the identification of an exact pathogen.
Introduction
Young people find themselves in stressful situations more and more frequently. Mental health and access to professional psychical help is necessary. Unfortunately, the availability of ...the psychologist's offices, as well as knowledge about mental health, is very limited.
Aim of the study
We aimed to check factors that cause stress and the access to psychological help in Poland.
Material and method
In order to analyze the issue, an Internet survey was prepared and disseminated in February and March 2022.
Results
Over 80% of respondents claimed that sometime in their life they needed psychological help, although the majority of them did not seek professional help. 41,1% of people who took part in the survey could get help from psychologists in their place of work or study, but over 83% of them did not seek help there. Everyday problems and situations in work, school or university were mentioned as the most stressful situations (63,7%). According to the respondents' opinion, problems with concentration and nervousness (80,6% and 76,6% respectively) due to stress have a negative influence on their health. 74,2% of young people consider themselves as not stress-resistant. The best option to deal with stress is to listen to music or to converse with their closest ones.
Conclusion
Everyone should have ensured good access to psychological help. There is a great demand for it, regardless of gender or age. Despite the need to see an expert, the majority of people do not ask for help.
Introduction: Ischemic heart disease is the most common cause of death in the world. The lives of patients with vascular defects can be saved by coronary artery bypass grafting (CABG). However, it is ...associated with an increased risk of developing depression after surgery. Meterial and Methods: The aim of the study is to present the results of the latest research on postoperative depression after CABG, including studies describing the course of the disease, its consequences for the patient’s prognosis and treatment. The publications available on the PubMed platform published after 2011 were reviewed. Results: Depression before and after CABG affects 30–40% of patients, mostly women. Established after surgery and untreated, it persists for many years. The level of anxiety in patients decreases systematically after surgery. Indicators that may correlate with the patient’s postoperative depression, including cortisol, high sensitivity C-reactive protein (hsCRP) and oxidative stress biomarkers, are being investigated. The occurrence of depression in patients after CABG has a number of negative consequences. Those include: weaker response to treatment, greater chance of relapse, and increased readmission frequency and mortality. Treatment of patients with this disorder involves the use of antidepressants (most often SSRIs – selective serotonin reuptake inhibitor) and/or various types of psychotherapy with cognitive behavioral therapy (CBT) at the forefront. Conclusions: Depression following CABG decreases the quality of life and worsens patient prognosis. It is necessary to detect this condition early after surgery and to apply treatment, taking into account the cardiological disorders of the patient.
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