Ectopic pregnancy, that is, a blastocyst occurring outside the endometrial cavity of the uterus, affects nearly 2% of pregnancies. The treatment of ectopic pregnancy is surgical or pharmacological. Since surgical management is associated with numerous serious side effects, conservative treatment is sought. The treatment of choice in the majority of cases is based on pharmacotherapy with methotrexate (MTX) in a single- or multi-dose regimen. Although the efficacy of methotrexate reaches between 70 and 90%, its use requires specific conditions regarding both the general condition of the patient and the characteristic features of the ectopic pregnancy. Moreover, MTX can cause severe adverse effects, including stomatitis, hepatotoxicity and myelosuppression. Therefore, clinicians and researchers are still looking for a less toxic, more effective treatment, which could prevent surgeries as a second-choice treatment. Some studies indicate that other substances might constitute a good alternative to methotrexate in the management of ectopic pregnancies. These substances include aromatase inhibitors, especially letrozole. Another promising substance in EP treatment is gefitinib, an inhibitor of EGFR tyrosine domain which, combined with MTX, seems to constitute a more effective alternative in the management of tubal ectopic pregnancies. Other substances for local administration include KCl and absolute ethanol. KCl injections used in combination with MTX may be used when foetal heart function is detected in cervical ectopic pregnancies, as well as in heterotopic pregnancy treatment. Absolute ethanol injections proved successful and safe in caesarean scar pregnancies management. Thus far, little is known about the use of those substances in the treatment of ectopic pregnancies, but already conducted studies seem to be promising.
Introduction: The COVID-19 pandemic negatively affected the mental health of the Polish population. Students are the group with a high risk of developing mood disorders. The scientific data suggest the usefulness of biological substances as potential biomarkers of psychiatric disorders. Saliva is non-invasive, quick to obtain material and a promising fluid for measuring stress and depression severity. In this paper, we present the protocol of our study, which aims to assess the utility of concentrations of biological fluids as potential biomarkers of the stress response and risk of developing depression and anxiety disorders among students of Lublin. Materials and methods: Total number of 80 students were included in the study. Participants were asked to collect saliva samples simultaneously with responding to the questionnaires concerning their mental state. Afterwards, the samples were examined with an ELISA test to assess the level of fibroblast growth factor (FGF-2), cortisol and chromogranin A (CgA). The relationship between biomarkers and severity of stress, depression, anxiety will be examined. Results: Cortisol on its own is not a good material to investigate the stress reaction in saliva due to its variable levels among people during stressful situations. Scientific data indicate the usefulness of other biomarkers or their combination to indicate the potential risk of developing depression and/or anxiety. Conclusions: Introducing objective tests, helpful for mood symptoms recognition, would improve the prevention and diagnosis of psychiatric disorders in vulnerable populations.
Introduction: According to the neurodevelopmental theory, schizophrenia is a cognitive-behavioral manifestation of the non-physiological development of the CNS, which was caused by the interaction of genetic and environmental factors during its formation. Aim, material and methodology: The aim of this article is to present a clinical case in which exposure to numerous adverse environmental factors in the pre and postnatal period could cause the development of schizophrenia in adulthood. The analysis of the clinical case and the medical records of a patient diagnosed with paranoid schizophrenia, suffering from numerous perinatal complications, was performed. Case report: A woman, 23 years old, unmarried, studying at post-secondary school - archivistics. Currently, psychiatrically hospitalized for the second time. A patient from the first, twin, fraternal pregnancy. The delivery took place by caesarean section, complicated. In the APGAR scale, she scored 4 points in the 1st minute, and 6 points in the 3rd minute. By day 30, the patient had experienced preterm retinopathy, viral infection, salmonella, jaundice and anemia. In the second month of her life, she was treated with surgery due to intestinal obstruction. Psychomotor development was disturbed. At 9 years of age, there was a retinal detachment. Until the end of junior high school, she was educated in a special school for the visually impaired. Conclusions: The neurodevelopmental theory assumes that the increased risk of developing schizophrenia is associated with unfavorable factors in the developmental period. Identifying the causes underlying the development of the disease is a key step towards prevention, more efficient diagnosis, and improvement of the effectiveness of treatment of patients suffering from this disease.
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