Hyponatremia is one of the most common water–electrolyte imbalances in the human organism. A serum sodium concentration threshold of less than 135 mmol/L is diagnostic for hyponatremia. The disorder is usually secondary to various diseases, including infections. Our review aims to summarize the diagnostic value and impact of hyponatremia on the prognosis, length of the hospitalization, and mortality among patients with active infection. The scientific literature regarding hyponatremia was reviewed using PubMed, ClinicalKey, and Web of Science databases. Studies published between 2011 and 2020 were screened and eligible studies were selected according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and specific inclusion criteria. The most common infections that were associated with hyponatremia were viral and bacterial infections, including COVID-19 (coronavirus disease 2019). The etiology varied according to the infection site, setting and patient cohort it concerned. In several studies, hyponatremia was associated with prolonged hospitalization, worse outcomes, and higher mortality rates. Hyponatremia can also play a diagnostic role in differentiating pathogens that cause a certain infection type, as it was observed in community-acquired pneumonia. Although many mechanisms leading to hyponatremia have already been described, it is impossible with any certainty to ascribe the etiology of hyponatremia to any of them.

Allergen immunotherapy has been shown to be successful in numerous clinical trials, even leading to complete relief of allergic symptoms. However, the molecular mechanisms behind these outcomes remain unclear, substantially hindering introduction of more efficient and safer protocols. The current gold standard of assessing the effects of allergen immunotherapy is a challenge test, which might be both unpleasant and dangerous for patients. Better understanding of the molecular background of allergen immunotherapy would allow us to substitute challenge tests with biomarkers. These might also be used to predict a patient's response to the treatment. Here, we review current knowledge regarding immune responses to allergen immunotherapy and its potential biomarkers. StreszczenieImmunoterapia alergenowa wykazała skuteczność w licznych badaniach klinicznych, prowadząc nawet do całkowitego ustąpienia objawów alergii. Mimo to, precyzyjne mechanizmy jej działania są niewyjaśnione, co wyraźnie utrudnia wdrożenie nowych, skuteczniejszych i bezpieczniejszych protokołów terapeutycznych. Obecnie złotym standardem w ocenie skuteczności immunoterapii jest przeprowadzenie próby prowokacyjnej z danym alergenem, co może być zarówno niekomfortowe, jak i niebezpieczne dla pacjenta. Lepsze zrozumienie komórkowych podstaw immunoterapii umożliwiłoby zastąpienie prób prowokacyjnych zastosowaniem biomarkerów, które mogłoby również posłużyć do przewidywania odpowiedzi danego pacjenta na leczenie. W niniejszej pracy autorzy dokonują przeglądu obecnej wiedzy na temat mechanizmów działania, przyczyn niepowodzenia, a także potencjalnych biomarkerów immunoterapii alergenowej.

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Nowadays, the incidence of food allergies is increasing. While strict allergen avoidance remains the most important therapeutic approach, oral immunotherapy is increasingly being used to desensitize and induce tolerance in children. Oral immunotherapy is a possible treatment for food allergies, which includes the administration of gradually increasing doses of the allergen. While most children can be desensitized, or even gain sustained unresponsiveness, oral immunotherapy involves a high risk of side effects or allergic responses with a need to use epinephrine, and the long-term effectiveness is unknown. In this paper, we summarize recent clinical trials in which oral immunotherapy has been used to treat common food allergies: to cow's milk, peanuts, and chicken eggs. StreszczenieCzęstość występowania alergii pokarmowych wzrasta w dzisiejszych czasach. Wydaje się, że jedyną aktualnie możliwością terapeutyczną dla pacjentów jest ścisłe unikanie alergenów. Immunoterapia doustna zaczyna być coraz częściej stosowana do odczulania i tworzenia tolerancji u dzieci. Immunoterapia doustna to leczenie alergii pokarmowych, które obejmuje podawanie stopniowo rosnących dawek alergenu. Gdy większość dzieci udaje się odczulić, a nawet można uzyskać u nich trwałą tolerancję na alergen, terapia ta wiąże się z wysokim ryzykiem wystąpienia działań niepożądanych oraz reakcji alergicznych, z koniecznością zastosowania adrenaliny, a długoterminowa skuteczność jest nieznana. W artykule podsumowano ostatnie badania kliniczne, w których zastosowano immunoterapię doustną w leczeniu powszechnych alergii pokarmowych -na białka mleka krowiego, orzeszków ziemnych i jaja kurzego.

Introduction and Objective.In Poland, during their education at medical universities students are obligated to do internships in a hospital facility. Unfortunately, situations sometime occur when, during the contact with their patients, students commit an error. This may be caused by lack of appropriate knowledge, or due to following wrong patterns. The aim of the study was to present the number and types of medical errors most commonly committed by students. Materials and method. 506 medical students participated in the study. An anonymous on-line survey was conducted and distributed among students of medical universities in Wrocław,