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.
<b>Introduction:</b> 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. <br><b>Meterial and Methods:</b> 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. <br><b>Results:</b> 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. <br><b>Conclusions:</b> 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.
Introduction: The human gut microbiota has become the subject of extensive research in recent years and the knowledge of the species inhabiting the gut is growing rapidly. Microbiota plays an important role in human health and diseases. It takes part in obtaining and storing energy, as well as in metabolic functions. The aim of the study: The purpose of the study is to collect and review scientific publications about the impact of gut microbiota on human health. Material and method: The paper uses standard criteria as the research method. The articles used to create the reviews were published on the PubMed and Google Scholar platforms. Description of the state of knowledge: Numerous studies suggest that composition of intestinal microbiota has impact on the long-term functioning of the human organism. Depressive disorders appear to be associated with changes in the microbiota. In depressed patients, fewer bacteria of the type Bacteroidetes and higher level of Alistipes are found. A few studies have demonstrated a link between gut microbial signatures and hypertension. Studies have shown that T2DM patients may have an altered composition of gut microbiota, mainly a decreased Bacteroidetes/ Firmicutes ratio and decrease in some functional bacteria when compared to healthy people. Intestinal microorganisms are also a key element in the proper functioning of the immune system by influencing the maturation process of the immune system's cells. Summary: To sum up, numerous studies indicate that abnormal composition of the intestinal microflora is the cause of not only faster development of metabolic syndrome, but also other diseases. It influences the development of circulatory, nervous or immune system diseases. Its abnormal composition is influenced by many factors such as diet, lifestyle or antibiotic therapy.
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 purpose: COVID-19 is a highly contagious disease that is caused by a new strain of SARS-CoV-2 coronavirus (type 2 acute respiratory syndrome virus). Globally, as of 14 July 2021, there have been more than 4 million deaths and almost 190 million confirmed cases of infection. Mental health disorders are sets of behaviours, ways of thinking or perceiving and other mental activities and relations with other people which are a source of suffering or impediments to the individual functioning of the affected person. The most common mental health disorders are anxiety disorders, insomnia, depression and somatic disorders. State of knowledge: The COVID-19 pandemic has disrupted people's lives around the world through the rapid spread of the disease, high mortality and negative health effects. Over time, there is growing public concern that health systems may become overburdened and that adequate medical care will not be available to everyone affected by the disease. There are also concerns that isolation and reduced mobility will be long-term with serious consequences for mental health and well-being. Summary: There is already evidence of the negative psychological effects of the COVID-19 pandemic on children and adolescents, as well as the elderly who have been isolated, making these individuals more susceptible to developing long-term psychiatric disorders.
Moreover, recently developed "IBS food pyramid" is based on actual recommendations and knowledge a visual and user-friendly tool helping patients in everyday diet changes. Unfortunately, still there is insufficient evidence of studies about dietary approaches. Well designed and randomized control trials are needed to improve efficacy, safety and knowledge about dietary modifications.
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