Background. Irritable bowel syndrome (IBS) is a prevalent disorder of gut-brain interaction (DGBI) affecting 5-20% of children worldwide, with the microbiota-gut-brain axis (MGBA) playing a central pathophysiological role [7, 8, 21]. Aim. This narrative review evaluates MGBA-targeted therapeutic interventions in pediatric IBS. Materials and methods. A systematic search of PubMed/MEDLINE (2021-2025) following PRISMA guidelines identified 31 eligible studies from 45 initially screened articles. Results. Pediatric IBS pathophysiology involves intestinal dysmotility, visceral hypersensitivity, dysbiosis, and altered central processing of visceral signals [14, 15, 26]. The low-FODMAP diet has demonstrated efficacy in adults; however, pediatric evidence remains limited to five randomized trials with inconsistent results [25]. Probiotic supplementation with Lactobacillus rhamnosus GG and Limosilactobacillus reuteri DSM 17938 shows strain-specific efficacy [3, 4]. Cognitive-behavioral therapy and gut-directed hypnotherapy effectively target central signal processing [5, 21]. Pharmacological options, including neuromodulators, remain understudied in pediatric populations, with off-label use predominating [2, 12]. Psychological comorbidities, particularly anxiety and depression, significantly influence treatment response [1, 18]. Conclusions. The MGBA represents the primary therapeutic target in pediatric IBS, supporting multimodal approaches, but limitations in pediatric-specific evidence suggest the need for high-quality randomized controlled trials with standardized outcome measures and adequate long-term follow-up [6, 31].
Introduction and objective: Epinephrine is the most important and primary drug that resuscitation team use to reverse cardiac arrest. The provision of epinephrine is currently suggested by both the American Heart Association and the European Resuscitation Council. It is vital to improving the return of spontaneous circulation (ROSC), however the evidence for the use of adrenaline in resuscitation is inconclusive. Materials and methods: The literature was reviewed in the Pubmed database, in the Via Medica Journals database, and in the guidelines of the Polish Society of Anesthesiology, European Resuscitation Council and the American Heart Association with the use of keywords. State of knowledge: There is a clear evidence of an association between epinephrine and increased return of spontaneous circulation (ROSC). Its action is based on stimulation of alpha- and beta-adrenergic receptors. Epinephrine have a role in resuscitation, during CPR it increases the probability of restoring cardiac activity with pulses, which is intermediate step toward long-term survival. However, there are conflicting results regarding long-term survival and functional recovery, particularly neurological outcome. Conclusions: Research shows that epinephrine administration in patients with cardiac arrest increases the chance of restoring spontaneous circulation and patient survival to hospital admission and discharge. However, there are arguments questioning the validity of using epinephrine in resuscitation. Publications show that the compound contributes to post-resuscitation syndrome, which reduces a patient's chance of long-term survival. There are a number of conflicting studies that vary widely in the results presented. The current evidence is insufficient to either confirm or exclude the efficacy of epinephrine, which is why it is still recommended in the latest resuscitation guidelines by the European Resuscitation Council (ERC 2021) and the American Heart Association (AHA 2020).
Background:Dementia is a progressive and irreversible disease entity that affects memory, verbal fluency, thinking and the performance of daily activities.The most common type of dementia is alzheimer's disease(AD).Currently, there are no specific therapies with established efficacy against cognitive decline or AD.Objective:The aim of this study is to summarize the current knowledge about the effectiveness of SGLT2 inhibitors(SGLT2i) in the treatment of cognitive disorders.Method and material:The article was created based on the PubMed database and the Polish Journal of Endocrinology.Articles were searched in English using the following keywords: SGLT2ihibitors;dementia;Alzheimer type 3 diabetes mellitus.State of knowledge:Patients with type 2 diabetes (TD2) are 1.5-2 times more likely to develop dementia than the general population.Dementia among diabetic patients is characterized by an earlier age of onset, slightly worse overall cognitive status and a higher prevalence of cognitive impairment in male patients.Diabetes and pre-diabetes shorten the time from the onset of mild cognitive impairment (MCI) to the development of full-blown dementia.Conclusions:The use of SGLT2i is associated with reduced mortality from dementia, in contrast to insulin and sulfonylurea derivatives.SGLT2 inihibitors prevent cognitive impairment more potently than dipeptidylpeptidase-4 inhibitors. Taking empagliflozin for one month, is associated with improved cognitive function and increased scores on the Montreal Cognitive Assessment scale.
