Complaints of diarrhea and other gastrointestinal symptoms are common among endurance runners. These problems may interfere with athletic activities and be the main cause of underperformance during sports events. It is estimated that this difficulty affects 30 to 90 percent of long-distance runners. The most important pathophysiological factors affecting the occurrence of gastrointestinal symptoms are ischemia and mechanical damage to the intestines, as well as the secretion of neuroendocrine substances. The diet before physical exercise is also one of the most significant factors related to the appearance of gastrointestinal symptoms. Avoiding the intake of fat, caffeine, protein, fiber, non-steroidal anti-inflammatory drugs and dehydration before performance is one of the suggestions for preventing runner’s diarrhea. There are new recommendations for athletes, such as avoidance of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) and the intake of multiple transportable carbohydrates. It seems that a short-term gluten free diet has no effect on the performance of athletes but further research is needed. Mechanisms of runner’s diarrhea are still poorly understood, so more research needs to be conducted to improve the recommendations to runners.
Depression is one of the leading causes of disability worldwide. It affects, according to WHO, nearly 300 million people worldwide, a number close to 3,8 % of the world’s population. Depression is not exclusively a mental disorder limited to psychiatry, nowadays it is present in all medical fields. It has a significant association with many comorbidities, as an example cardiovascular diseases and metabolic disorders. Additionally, depression often is manifested with psychosomatic symptoms. Both aspects lead clinicians to major diagnostic and therapeutic challenges. Each one of dietary element: omega-3 fatty acids, zinc, selenium, iron, vitamin B12, vitamin D, folate, creatine was found to correspond with mental health in patients and the level of mentioned diet components is negatively correlated with depression risk of individuals. Each of the dietary aspect considered in the article has a significant correlation with depression disorder and might support the new multidisciplinary attitude toward it in mental health.
The medical use of botulinum toxin nowadays is widespread. Recent years show that use of botulinum toxin is not only used to control the muscular overactivity in bruxism, tension in temporomandibular disorders but also it can be applied for cosmetic reasons. The objective of this study was to view recent discoveries in this subject by conducting a systemic review of clinical trials published in the research works. Recent studies present efficacy in releasing pain in both: bruxism and temporomandibular disorders by minimizing symptoms and reducing the intensity of muscle contractions.The scientific works cited confirm a noticeable improvement in most symptoms occurring in the states mentioned above.
IntroductionIdiopathic pulmonary fibrosis (IPF) is a fatal pulmonary disease that leads to progressive fibrosis and extremely poor resaults.. Since the etiology is unknown, there are highly limited options of the IPF treatment. The researchers are trying to discover the most valuable targets, leading them to the agents registered in different conditions or not registered as any other treatment. This innovative approach can result in IPF being determined as not fatal. PurposeThe purpose of our review is to present possible future treatment of idiopathic pulmonary fibrosis and point out the promising targets that could lead the researchers to the development of better IPF management. Materials and methodsWe have reviewed the literature from the PubMed database searching for clinical trials, meta analysis and randomized controlled trials from the past 5 years. The keywords we agreed on offered us the most informative articles and made us hope for the further development of our article. ResultsOur review shows that there are new targets that could significantly benefit IPF treatment. However, the means we presented in our review need more research to prove its safeness, effectiveness in slowing down the decline of the FVC, improving patients’ physical efficiency, their saturation level and most importantly their ability to stop the continuous fibrosis of the lungs. ConclusionsThe only treatment registered for IPF are nintedanib and pirfenidone, but the researchers continue the exploration of new possible measures to improve the survival rate and quality of life of the patients suffering from this fatal disease.
Introduction and purpose: Eating disorders are an ever-growing problem, both in the general population and also in the population of pediatric patients with type 1 diabetes mellitus. However, for this specific group of patients, there is a twofold higher risk of developing eating disorders, the occurrence of additional distinct forms of these disorders, the so-called diabulimia - consisting of deliberate restriction of insulin delivery or skipping insulin doses, which can consequently lead to poor metabolic control of diabetes , and even threaten the lives of patients. The purpose of this work is to present the current state of knowledge on the diagnosis, prevention and treatment of eating disorders in children and adolescents with type 1 diabetes. The state of knowladge: The background of the onset of eating disorders in pediatric patients with type 1 diabetes mellitus includes the lowered self-esteem accompanying early adolescence, stress, excessive focus on external appearance, as well as difficulties in accepting the diagnosis and a rather strict dietary regime. Since the treatment of eating disorders is long and difficult, the most important goal becomes effective prevention and rapid selection of patients with a predisposition to develop such disorders. The first screening tools - SEEDS, m-SCOFF and DEPS-R questionnaires - have already been developed, and the effectiveness of therapy sessions aimed at this group of patients is also being studied. Summary: Therapy of eating disorders in patients with type 1 diabetes should be targeted at this specific patient population. It requires cooperation and communication of teams dealing separately with these diseases, education of the staff and their thorough knowledge of the background of the problem, prompt action and, above all, the development of specific guidelines for management, methods of prevention and the earliest possible start of treatment, which will also include the patient's caregivers.
Due to the increasing number of patients suffering from celiac disease (CD) and difficulties in diagnosing, scientists raise awareness of different symptoms that patients might present. CD is an autoimmune, genetical disease of small intestine however, symptoms might be related to many different systems apart from gastrointestinal one, for instance nervous system. A common and non-specific symptom of untreated CD might be depression. A gluten intake by patients with genetical predisposition results in antibodies production which can affect central nervous system causing depression. Moreover, we observe imbalance between amino acids and its metabolites, for example serotonin, which lead to mood disorder. In those patients who suffer from drug-resistant depression, testing for CD should be done and if they are positive, the patient should immediately start a gluten-free diet. This action could reduce symptoms of depression. The following article is a review of current knowledge related to correlation between CD and depression, its pathomechanism and gluten-free diet as a possible way of treatment. This article is based on available publications in Pubmed and Google Scholar databases.
Introduction and purpose: According to WHO 15 million people suffer from stroke, one-third of which dies and the other one-third is permanently disabled. For this reason, this condition is a very important medical and social problem. It is one of the leading causes of death, after cardiovascular diseases and cancer. It is also one of the most common causes of disability in the adult population. The economic aspects are related not only to the costs of hospital treatment, but above all to rehabilitation and chronic treatment. The aim of this article is to present the most important stroke risk factors and, based on them, to describe recommendations for effective stroke prevention. A brief description of the state of knowledge: In recent years, numerous studies have been conducted on the relationship between various factors and the risk of stroke. It turned out that many stroke risk factors are modifiable and by using various methods we are able to significantly reduce the risk of its occurrence. The most important risk factor is the patient's hypertension. Others are cardiovascular diseases such as atrial fibrillation; diabetes, obesity, low level of physical activity, improper diet, consumption of alcohol and tobacco products. Summary: Through education and promotion of a healthy lifestyle in society (high physical activity, healthy diet, lack of addictions, taking care of mental health and avoiding excessive stress), as well as regular blood pressure and glucose control and effective treatment of conditions leading to stroke, the incidence of stroke among people can actually be reduced. This issue still requires further research and constant expansion of our knowledge.
Introduction and purpose: Chimeric antigen receptor‐T (CAR‐T) cells have achieved inspiring outcomes in the treatment for lymphoid malignancies, especially diffuse large B-cell lymphoma (DLBCL) and acute lymphoblastic leukemia (ALL), providing alternative therapeutic options for patients who failed to respond to conventional treatments. CAR-T are based on the patient's T lymphocytes, which through genetic modification, gain new abilities to detect and fight cancer cells. Although the percentage of complete remissions after standard treatment of B-cell malignancies is quite high, methods that could have an even better result regarding patient survival by reducing the side effects of treatment are still being sought to improve the quality of patients' lives. CAR-T is a culmination of many years of research in the dynamically developing area of immunotherapy as a revolutionary therapy of hematological cancers treatments. State of knowledge: In order to explore the topic, analysis included research available in the PubMed database. The research focused on the possibility of using CAR-T cell therapy in selected hematological cancers. Conclusion: CAR-T is one of the most advanced and personalized methods of immunotherapy. Despite the side effects of this method, there is still scope for improvement. Our overview summarizes all the issues that have been overcome in designing this therapy, as well as highlighting all the challenges that still need to be addressed.
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