The incidence of postoperative cognitive dysfunction (POCD) in orthopedic patients varies from 16% to 45%, although it can be as high as 72%. As a consequence, the hospitalization time of patients who developed POCD was longer, the outcome and quality of life were worsened, and prolonged medical and social assistance were necessary. In this review the short description of such biomarkers of brain damage as the S100B protein, NSE, GFAP, Tau protein, metalloproteinases, ubiquitin C terminal hydrolase, microtubule-associated protein, myelin basic protein, α-II spectrin breakdown products, and microRNA was made. The role of thromboembolic material in the development of cognitive decline was also discussed. Special attention was paid to optimization of surgical and anesthetic procedures in the prevention of postoperative cognitive decline.

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(Prof. E. Babicz-Zielińska) trition…, 2003]. Obesity is a chronic non-infectious disease, which signifi cantly deteriorates the quality of life, shortens its length and constitutes a risk factor for many other metabolic diseases such as type 2 diabetes, cancer of uterus, colon and breast cancer, hypertensive disease, degenerative arthritis, stroke and coronary heart disease. The increase in relative body mass index (BMI) by a single unit increases the risk of diabetes by 20-50% and the risk of cancer by 3-10% [Comparative quantifi cation..., 2004].According to estimates by WHO experts in the world more than 1 billion people have an excessive body weight, i.e. more than 300 million are obese and more than 750 million have overweight [World health statistics, 2010]. The overweight affects more men, and obesity more women, therefore women may experience more negative effects of excessive body fat. In Poland, the excessive body weight is observed in 40% to 60% of adults, depending on a survey, including obesity typical of 15% to 20% of adults [Wądołowska, 2009]. The occurrence of excessive weight among children and adolescents does not exceed 15%.The eating disorders seem to be very likely the social problem, even if the data on the extent of the irregularity is fragmented. The eating disorders have morbidity and mortality rates that are among the highest of any mental disorders [Herpertz-Dahlmann et al., 2012]. It is estimated that in the U.S. The eating disorders have been reviewed based on state-of-art of contemporary psychology, medicine and nutrition science, with a special emphasis put on different symptoms and forms, origins and testing methods. Among promoting eating disorders, bulimia nervosa, binge eating disorder, night eating disorder, sleep-related eating disorder are among offi cially approved and investigated. Among disorders resulting from lack of acceptance of own appearance, anorexia nervosa and bigorexia nervosa are the most serious improper ones. Disorders arising from health care include orthorexia nervosa and recently pregorexia. Different origins of eating disorders are considered, divided into three groups: social, psychological and pathological. The desire to possess a slim shapely silhouette and young appearance, usually under pressure of a social group, may result in disorders such as anorexia nervosa, pregorexia, ageorexia, and bigorexia nervosa. On the other hand, the focusing on eating mainly the biologically pure food, being a purely psychological and individual problem, may be a source of orthorexia nervosa. Majority of disorders have a psychological background constituting the escape and an answer to everyday life problems diffi cult to overcome. Recently, pathology is often considered as an additional and important determinant, which may cause or enhance the appearance of binge eating or night eating disorder. The eating disorders, if not subject to proper therapy and advising, can tend to incline and develop. The further research in order to properly recognise the eating disorders,...

Background: The effect of etomidate administration on the adrenal cortex in obese patients is still unclear. The objective of the study was to determine the influence of a single dose of etomidate on cortisol secretion in the morbidly obese. Methods: 127 healthy patients were enrolled into the study. Data from 82 patients scheduled for elective laparoscopic surgery were analyzed. 62 of them were morbidly obese, while 20 had normal body mass. The participants were divided equally into etomidate and thiopental groups, depending on the kind of intravenous anaesthetic used for the induction of anaesthesia. Each patient's serum cortisol concentration was measured five times: on the day before surgery (sample A), two hours after the induction of anaesthesia (sample B), after a short tetracosactide test (sample C), 24 hours after the induction of anaesthesia (sample D), and after a second short stimulation test (sample E). Results:The mean cortisol concentration in obese patients in the etomidate group was lower two hours after the induction of anaesthesia (sample B, P < 0.001), and 30 minutes after the first tetracosactide test (sample C, P < 0.001) compared to obese patients in the thiopental group. There were no differences between the groups in sample A (P = 0.833), D (P = 0.614) and E (P = 0.769). We found no changes in haemodynamic parameters between both groups. Conclusions: Etomidate decreased serum cortisol concentration and decreased reactivity to tetracosactide both in morbidly obese and in normal weight patients. This effect was reversible within 24 hours.

Background. Infections in critically ill patients are the main reasons for a lack of therapeutic success and increased mortality in intensive care units (ICUs). There have been many analyses of the incidence of infections in ICUs; however, no large studies of this kind have been conducted either in Poland or in Eastern and Central Europe. Objectives. The aim of the research was to undertake a one-day study of the prevalence of infections in ICUs in Warszawa and the Mazovian region of Poland. Material and methods. A prospective questionnaire survey analysis − a one-day prevalence study of infections − was carried out on June 25, 2014, in 28 ICUs in Poland. Results. Among 205 ICU patients (193 adults and 12 children), 134 infections were found in 101 patients (99/193 adults (51.30%) and 2/12 children (16.70%)), and bacterial colonization in 19/205 (9.3%) patients. In 66.42% of the cases, more than 1 site of infection was diagnosed. On the day of the study, 75.40% of the diagnosed infections had positive microbiological results. The most frequent were respiratory tract infections (53.73%), wound infections (18.65%) and bloodstream infections (14.92%). Most of the infections (64. 10%) were caused by Gram-negative bacteria (GN), followed by Gram-positive bacteria (GP; 31.80%) and fungi (4. 10%). The most frequently reported GN microorganisms were Enterobacteriaceae (44.7%). Methicillinresistant Staphylococcus aureus (MRSA) infections were found in 8.80% of the patients. Antibiotics were administered to 75.60% of the adult patients, in 69.20% as targeted treatment. Mechanical ventilation, central vein catheterization and urinary bladder catheterization were used in 67.80%, 85.85% and 94.63% of the patients, respectively. Conclusions. On the day of the study, more than half of the patients had infections, mostly from GN bacteria. Respiratory tract infections were the main type found. In about 2/3 of the patients, antibiotics were administered, mainly as targeted therapy.