Polski Merkuriusz Lekarski最新文献

Cannabidiol, due to its multidirectional action, raises hope for effective therapy and improvement of the quality of life of patients in many fields of medicine. The aim of the study is to analyze selected scientific publications in terms of the possibility of using cannabinoids in the treatment of common diseases. Currently, intensive research is underway on the use and therapeutic indications of cannabinoids. The research carried out for this study is based on experiments carried out on animals, therefore further, in-depth research is needed that will definitely answer the question in the title of the presented work.

Objective: Aim: To evaluate primary health physicians' clinical and behavioral practices towards antibiotics administration in a specific region in Greece.

Patients and methods: Materials and methods: A cross sectional study was conducted using a questionnaire in all structures of primary health care (PHC) of the Peloponnese Region. The study was conducted in May-October 2020.

Results: Results: In total, 306 out of 404 primary healthcare physicians completed the questionnaire (response rate of 75.8%). Our results showed that most of physicians used to prescribing antibiotics empirically in common diseases, except for the prevention of secondary respiratory tract infection. Overall, 66.3% answered that they do not feel diagnostic uncertainty that would lead them to prescribe antibiotics. Approximately 40% of the physicians stated an increase on antibiotics use and patients demand for antibiotic prescribing, however 71.4% "rarely/never" affected by this requirement. 51.9% of the sample used to prescribed brand name antibiotics. Statistically significant differences were found between demographic and professional characteristics, and physicians' clinical and behavioral practices (p≤ 0.05).

Conclusion: Conclusions: Our findings could provide decision makers with information on how to manage antibiotic prescribing in primary health care in the country, focusing mainly on the use of specific diagnostic tests as well as relevant guidelines and protocols for changing prescription behavior.

Takotsubo syndrome (TTS) has been reported in various clinical conditions. Coronary artery fistula (CAF) is diagnosed in 0.2- 0.4% of patients undergoing coronary angiography. Pathologic communication between coronary artery (e.g., left anterior de¬scending coronary artery - LAD) and cardiac chambers (e.g., left ventricle - LV) is cameral type of CAF which particularly predis¬pose to myocardial ischemia due to a steal syndrome. Eight cases of coexistent TTS and CAF have been reported so far; in 6 of them LAD cameral fistulas drained LV, in 2 others communications between coronary arteries and pulmonary artery were found. The authors describe a case of a 75-year-old female, admitted due to chest pain and dyspnea. Her clinical picture with ST-segment elevation in ECG, moderately increased troponin I and apical ballooning in echocardiography, was more typical for TTS than for myocardial infarction; besides that, color doppler imaging was suggestive of multiple CAF to LV. Coronary angiography showed communication between all (normal) coronary arteries and LV. Throughout the conservative therapy, first, an improve¬ment and then normalization of LV function were observed after 2 and 6 days, respectively. Chest x-ray and computed tomogra¬phy revealed mediastinal tumor (eventually diagnosed as lung cancer). Cardiac magnetic resonance performed after one month did not show late gadolinium enhancement. During the course of 24 months follow-up, she was taking bisoprolol and ramipril and her cardiologic state remained stable, even during chemotherapy and radiotherapy. The authors collected the clinical data of all 9 cases with concomitant TTS and CAF. Specific TTS triggering factors/predisposing conditions were present in all patients, which has indicated that coexistence of TTS and CAF is rather coincidental.

The paper presents a case of progressive paraparesis in a 66-year-old man with no history of tick bite, who was finally diagnosed with neuroborreliosis on the basis of the performed tests. Proper diagnosis and introduction of causal treatment resulted in rapid improvement of the patient's condition.

Atherosclerotic Cardiovascular Diseases (ASCVD) are the most common cause of death worldwide. Among the well-known con¬tributors to atherosclerosis are less common ones, such as trimethylamine oxide (TMAO). This substance is formed from the oxida¬tion of trimethylamine (TMA) with the participation of flavin oxidases in the liver. TMA is produced with the involvement of the intestinal microbiota from foods rich in choline and carnitine. TMAO promotes the production of foam cells, enhances platelet aggregation, affects endothelial inflammation, and promotes atherosclerosis development. However, further research is needed to determine the effect of dietary changes on reducing TMAO levels and thus reducing incident ASCVD.

Objective: The aim: To assess the structural and functional state of bone tissue in terms of gender and age.

Patients and methods: Materials and Methods: 108 people aged 54.7±14.8 years, who were divided into two groups according to gender, participated in the retrospective cohort study. All patients underwent ultrasound densitometry to assess bone mineral density (BMD) on the radial bone with an assessment of T-score, Z-score, and speed of ultrasonic wave propagation (SoS).

Results: Results: The study found that T-score and Z-score values, which corresponded to osteoporosis, were recorded in the age group > 50 years, regardless of the gender of the subjects. All women older than 35 years had a decrease in BMD below -1.0 SD by T-score. It was determined that osteoporosis criteria clearly prevail in women of the > 50-year-old group. In osteoporosis, the SoS is significantly lower than in individuals with normal indicators of the T-criterion. According to the results of the T-score comparison, BMD disorders were determined in postmenopausal women which emphasize the importance of the level of female sex hormones in the formation of osteopenic syndrome, in contrast to men, in whom no changes in the state of bone tissue were recorded.

Conclusion: Conclusions: The results of the research prove the prevalence of osteopenic syndrome in terms of age and gender, with an emphasis on women aged 50 years and older. Screening for BMD disorders using ultrasound densitometry is appropriate and allows taking measures to prevent the progression of osteoporosis in the early stages.

Objective: Aim: Analysis of trends in the microbial communities of the genitourinary system in patients with urolithiasis.

Patients and methods: Materials and Methods: 165 urine samples from patients with urolithiasis was examined. The quantitative isolation of microflora was carried out using the bacteriological method. Microorganisms were identified using API biochemical test systems (bioMerieux, France). The percentage of the various types of microorganisms was determined. The reliability of differences in the frequency of various types of microorganisms isolation in a monoculture and the composition of microbial associations was determined by two-field tables with Fisher's Exact criterion. The GraphPad Prism 7 software was used.

Results: Results: 198 bacterial cultures of various types were isolated. In one case, a Candida culture was isolated. E. faecalis was the most frequently isolated culture (29.1% of the isolated strains number); E. coli (18.1% of the total number of isolated cultures; K. pneumoniae (11.1%). There were no significant differences in the rate of E. faecalis compared to E. coli. K. pneumonia was isolated significantly less frequently than E. faecalis. These types of microorganisms were also leaders in the formation of bacterial mixes. In addition, these species are involved in the urease activity of bacteria (directly or indirectly), which contributes to the formation of stones in the genitourinary system.

Conclusion: Conclusions: E. faecalis is the species most often isolated from patients with purulent-inflammatory processes in patients with urolithiasis, both in the case of mono-infection and as part of mixed bacterial cultures.

Objective: Aim: The aim of the study was to reveal the peculiarities of reparative osteogenesis in experimental lower jaw defect under the conditions of hydroxyapatite-containing osteotropic material application and electrical stimulation.

Patients and methods: Materials and Methods: An experiment was conducted on 48 mature male rats of the WAG population. All animals were divided into 4 groups (12 animals in each group). Group 1 included rats that were not subjected to any manipulations. Group 2 included rats that were modeled with a perforated defect of the lower jaw body. Group 3 included rats that were modeled with a perforated defect similar to group 2, the cavity of which was filled with synthetic bone graft "Biomin GT" (RAPID, Ukraine). Group 4 included animals that were modeled with a perforated defect similar to groups 2-3, the cavity of which was filled with synthetic bone graft "Biomin GT". In animals of group 4, a microdevice for electrical action was implanted subcutaneously in the neck area on the side of the simulated bone defect. Morphological and statistical methods were used.

Results: Results: The research carried out by the authors proved that the use of the above-mentioned bone replacement material helps to increase the regenerative potential of the bone tissue of the lower jaw, but does not lead to the formation of a full-fledged bone regenerate, as evidenced by the results of the morphometry of the regenerate (the specific volume of lamellar bone tissue accounted for 54.9%); disordered localization of bone beams, which were characterized by reduced signs of mineralization; the presence in connective, osteogenic fibroreticular and lamellar bone tissues the encapsulated bone graft granules with the presence of inflammatory cell infiltration. In cases the combined use of synthetic bone graft "Biomin GT" and electrical stimulation, the authors noted more intensive reparative osteogenesis processes in the bone defect of the lower jaw compared to cases when only one bone graft was used, but they also did not lead to the formation of a full-fledged bone regenerate.

Conclusion: Conclusions: The experimental and morphological study conducted by the authors proved that the use of hydroxyapatite-containing osteotropic material ("Biomin GT"), especially in cases of its combined use with electrical stimulation, significantly activates reparative osteogenesis in the bone defect of the lower jaw, which does not lead to the formation of a full-fledged bone regenerate.

Objective: Aim: To evaluate the theoretical binding affinities of four synthetic compounds that target the carbonic anhydrase IX enzyme in solid tumors.

Patients and methods: Materials and Methods: To accurately depict the molecular structure, we utilized the Chem Draw Professional 12.0 program. We downloaded the carbonic anhydrase IX enzyme (29.25 KDa) (PDB code: 4YWP) from the Protein Data Bank into the Molecular Operating Environment software. Then, the S-score and rmsd were calculated for the proposed compounds.

Results: Results: The theoretically synthesized compounds demonstrated good binding affinities with the receptor active pockets Sa, Sb, and Sd, with S-scores of -7.6491, -8.3789, and -8.3218, respectively. Substitutions improve compound orientation. The substituted triazoles ring increases flexibility and receptor interaction. In addition, the benzyl chloride derivatives play an important role in the interaction, with varying effects dependent on the groups substituted at position 4 of the benzene ring.

Conclusion: Conclusions: The synthesized compounds Sb with para Br substitution (S-score = -8.37) and Sd with para Cl substitution (S-score = -8.32) are considered the best ones as they exhibit a high affinity for the receptor.

Objective: Aim: To determine prevalence of Aerobic Vaginitis (AV) after gynecologic surgery, risk factors and antimicrobial resistance of responsible pathogens, and adverse pregnancy outcomes in Ukraine.

Patients and methods: Materials and Methods: Multicenter retrospective cohort study was conducted from January 2020 to December 2022 in fifteen medical clinics from eight regions of Ukraine. Smears were analyzed using Donders' classification method and Dong's modified AV diagnosis for Gram stains. Definitions of HAIs were adapted from the CDC/NHSN. Antibiotic susceptibility testing of bacteria was determined by Kirby-Bauer disc diffusion test according to the protocol of the EUCAST.

Results: Results: Prevalence of AV among women's undergoing gynecologic surgery in Ukraine was 68.7%. Of the total AV cases, 70.3% were in non-pregnant and 29,7% in pregnant women. The most common pathogen of AV was Escherichia coli, followed by Enterococcus faecalis, Streptococcus agalactiae, Staphylococcus aureus, Enterococcus faecium, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Among the S. aureus strains, 11,6% of MRSA (Methicillin resistant S.aureus) were isolated whereas none of the CoNS were cefoxitin resistant. History of vaginal infection, history of post-operative infection and antibiotic use acted as an important risk factor of AV incidence rate. The presence of AV worsened pregnancy outcomes, by increasing the incidence of preterm birth, the premature rupture of membranes, miscarriage, neonatal jaundice, and neonatal infection.

Conclusion: Conclusions: Aerobic Vaginitis after gynecological surgeries in Ukraine is a common medical problem in women that is associated with significant morbidity, adverse pregnancy outcome, and hence frequent medical visits.