The Impact of the War in Ukraine on the Epidemiological Situation of Tuberculosis in Europe.

Ukraine is at the forefront of one of the largest outbreaks of tuberculosis (TB) in Europe, including multidrug-resistant tuberculosis. Due to the ongoing armed conflict in this area, there is a significant number of refugees from Ukraine to other European countries. The aim of the study is to emphasize the essence of the problem of the increased incidence of tuberculosis, taking into account the impact of the armed conflict in Ukraine, resulting in the intensification of migration movements. A descriptive epidemiological method was used as the research method. The material was collected by analyzing source statistical data from WHO and statistical yearbooks of selected European countries. Particularly, Ukrainian refugees in Poland, Germany, the Czech Republic, and Slovakia are at higher risk of contracting tuberculosis due to factors like migration stress, poor nutrition, and comorbidities. Epidemiological data from these countries show a rise in tuberculosis cases among foreigners, emphasizing the need for European specialists to be more vigilant in this unique situation, focusing on refugees and other vulnerable populations. More research and collaborative efforts are essential to closely monitor and prevent the severe outcomes of tuberculosis transmission.

Impact of Triclosan on Female and Male Reproductive System and Its Consequences on Fertility: A Literature Review.

Objective: Triclosan is an aromatic organic compound with antibacterial and fungicidal properties, most often used in soaps, toothpaste and other cosmetics. The study aimed to analyze the influence of triclosan on the female and male reproductive systems and the consequences on fertility. Materials and methods: A review of the latest literature derived from PubMed and Google Scholar platforms has been made. After following the search strategy, applying inclusion criteria and analysis of the obtained results assessed by two independent analysts, 45 studies were included in the review. Results: Due to the similar structure of triclosan (TCS) to anthropogenic estrogens, TCS can interact with hormone receptors, affect hormone balance, and influence reproductive health and carcinogenesis. It has been noted that TCS might affect luteal cell progesterone production and disrupt ovarian function. Prenatal exposure to the chemical can have an impact on the reproductive system of newborns. TCS might be a risk factor for endometrial physiology and impair reproduction. TCS negatively affects the male reproductive system via interrupting steroidogenesis mediated miRNA (micro-ribonucleic acid) pathways. Negative effects of TCS on early development and embryogenesis in animals were evidenced. Moreover, TCS has the potential to promote carcinogenesis in human breast, ovarian, and prostate cells. Conclusion: Potential impact of TCS on the reproductive system raises concern about its safety, due to its similar structure to anthropogenic estrogens and detection in the environment. TCS-induced disruption of hormone levels in the female and male reproductive systems may be the cause of impaired reproductive health, resulting in subfertility. Further investigations are required to evaluate the mechanisms and effect of TCS on human reproductive health.

Magnetic resonance spectroscopy as a promising modality for assessing ketogenic diet impact on the level of cerebral metabolites in the treatment of certain neurological disorders.

INTRODUCTION AND OBJECTIVE: The ketogenic diet (KD) is a high-fat, adequate-protein, low-carbohydrate diet that is getting more and more widespread in medicine. This dietary intervention causes changes in cerebral metabolism, which are considered potentially beneficial in patients with neurological disorders, but its impact should be controlled and assessed individually. The aim of this review is to provide an update of existing evidence concerning the utility of magnetic resonance spectroscopy (MRS) in monitoring shifts in the cerebral metabolism during ketogenic diet in patients with neurological disorders. REVIEW METHODS: The latest available literature was reviewed by May 13, 2021 using the PubMed, Web of Science and Google Scholar databases. There were 13 papers selected for analysis after reading the title, abstracts and whole text, meeting the assumed criteria. ABBREVIATED DESCRIPTION OF THE STATE OF KNOWLEDGE: MRS is a non-invasive imaging method providing information about the metabolism of brain tissues and playing an increasingly important role in monitoring the concentrations of cerebral metabolites in the course of such neurological disorders as primary brain tumour, epilepsy during KD. Recent trials prove that inverse correlation between serum ß-hydroxybutyrate levels and N-acetylaspartate in brain tissue confirm antiepileptogenic properties of KD. Furthermore, ketone concentrations including ß-hydroxybutyrate and acetone in both lesional and contralateral brain are referred to as correlating with average ketonuria in patients with primary brain tumou. SUMMARY: MRS is a feasible tool for detecting cerebral metabolic shifts linked to a ketogenic diet. However, further studies confirming MR spectroscopy utility in monitoring ketogenic diet treatment in patients with neurological disorders are needed.

Effect of Spirulina Supplementation on Systolic and Diastolic Blood Pressure: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Spirulina is a microalga that presents various important pro-health properties, for instance lowering blood pressure in the research. The study aims to appraise the efficacy of Spirulina administration on systolic (SBP) and diastolic blood pressure (DBP). Randomized controlled trials (RCTs) were retrieved by a systematic search of PubMed, Web of Science, and the Cochrane Library databases from inception to June 2021 according to a standardized protocol. The effect size of each study was counted from mean and standard deviation before and after the intervention and shown as Un-standardized mean difference and 95% confidence interval. Sensitivity analyses were performed. Meta-analysis on 5 RCTs with 230 subjects was eligible. The amount of Spirulina ranged from 1 to 8 g per day, and intervention durations ranged from 2 to 12 weeks. Data analysis indicated that Spirulina supplementation led to a significant lowering of SBP (Mean Difference (MD): -4.59 mmHg, 95% Confidence Interval (CI): -8.20 to -0.99, I square statistic (I2) = 65%) and significant lowering of DBP (MD: -7.02 mmHg, CI: -8.86 to -5.18, I2 = 11%), particularly in a subgroup of hypertensive patients. Spirulina administration might have a supportive effect on the prevention and treatment of hypertension. More exact randomized controlled trials are needed to clarify the effect of Spirulina supplementation on blood pressure.

The smoker's paradox during the COVID-19 pandemic? The influence of smoking and vaping on the incidence and course of SARS-CoV-2 virus infection as well as possibility of using nicotine in the treatment of COVID-19 - Review of the literature.

AIM OF THE STUDY: The study aims to present the current state of knowledge on the impact of traditional cigarettes and the nicotine contained in them on the incidence and course of SARS-CoV-2 infection. Moreover, we decided to exhibit the possibility of using this substance to treat COVID-19 infections. MATERIAL AND METHODS: The latest available scientific publications were reviewed until November 14, 2020, from the PubMed platform. RESULTS: Nicotine is a cholinergic agonist and pro-inflammatory cytokines inhibitor. Some authors present that smoking and nicotine reduce the amount of the ACE2 receptors which are used by the novel coronavirus to enter cells, while others claim that ACE2 receptors are upregulated in smokers. Moreover, the interaction of SARS-CoV-2 with nAChR is suspected of dysregulation of the nicotinic cholinergic system, which is associated with the pathophysiology of COVID-19. Due to the harmfulness of cigarettes, a high frequency of smokers is suspected among people suffering from COVID-19. However, some studies report that the number of current smokers hospitalized for SARS-CoV-2 infection is lower than expected, considering the prevalence of smoking in individual countries. Nicotine could restore the impaired function of the nicotine cholinergic system and possibly mitigate the cytokine storm. CONCLUSIONS: There is no clear attitude regarding the impact of smoking on the new coronavirus infection now. Researchers do not recommend smoking as a tool to combat the pandemic and show the importance of fighting addiction to reduce the adverse health effects of smoking. Both the relationship between cigarettes and the morbidity and severity of COVID-19, as well as the possibility of using nicotine in the treatment of the disease, require further analysis.

The influence of vaccination against tuberculosis with the Bacillus-Calmette-Guérin(BCG) vaccine on COVID-19 incidence and mortality - review of the literature.

THE AIM OF THE STUDY: Is to present the state of knowledge from April and May 2020 about the influence of Bacillus-Calmette-Guérin vaccination against tuberculosis on incidence and mortality due to COVID-19. MATERIAL AND METHODS: A review of the latest literature till 9 May 2020 has been made. PubMed and ResearchGate databases and WHO reports were used. RESULTS: Immunomodulatory properties of the tuberculosis vaccine which protects against severe cases of tuberculosis and partly against other infections are indicated, including viral and respiratory infections. The BCG vaccine induces heterologous immunity and trained innate immunity. It was noted that in countries which maintain obligatory BCG vaccination COVID-19 incidence and mortality are lower than in countries that have stopped or never introduced BCG as mandatory vaccination. Most analysis confirmed this relationship, but they indicated the possible impact of other factors, such as genetics in the population, the type of strain from BCG vaccine, the level of health care and the wealth of a nation, the structure of migration, co-morbidities and a policy of introducing social distance. CONCLUSIONS: At the moment, we do not have enough evidence to support or deny the hypothesis of COVID-19 reduction in incidence and mortality in countries maintaining obligatory BCG vaccination. Other factors that might affect the results should be considered in further analysis. The results of clinical trials will provide more reliable proofs than analysis of epidemiological data. WHO does not recommend BCG vaccination to prevent COVID-19 and recommends it to newborns from areas with a higher incidence of tuberculosis.

Impact of level of vitamin D in the body on the severity of COVID-19 - review of the literature.

INTRODUCTION: The aim of the study is to present the current state of knowledge on the influence of vitamin D levels on the severity of the course of COVID-19. MATERIAL AND METHODS: The latest available literature was reviewed until October 30, 2020 from the PubMed database. RESULTS: The literature reports that vitamin D has immunomodulatory and anti-inflammatory effects. It reduces the expression of cytokines such as IL-6, TNF-α and INF-γ, regulates the activity of T helper lymphocytes, and other elements of the immune system at the molecular level. The deficiency of this vitamin promotes the activation of the renin-angiotensin-aldosterone system, contributing to the development of acute respiratory distress syndrome. The severity of the course of SARS-CoV-2 infection depends on comorbidities, the development and course of which may also be affected by vitamin D levels (coagulopathies, pulmonary, cardiological, metabolic diseases). Most of the analyzed research studies from different countries indicated a relationship between insufficient vitamin D levels and a more severe course of COVID-19 and an increase in mortality due to it, especially among the elderly. Researchers agree that further analyzes are necessary concerning both the influence of the vitamin D blood serum levels on the morbidity and mortality due to COVID-19 as well as the use of its supplementation in the struggle against SARS-CoV-2 virus. There are reports of possible beneficial interactions of vitamin D with other substances, such as quercetin, estradiol, some microelements, and other vitamins. CONCLUSIONS: Maintaining an adequate level of vitamin D has a positive effect on the functioning of the immune system. At the moment, there is insufficient evidence to establish a clear relationship between vitamin D levels and the severity of COVID-19. It is necessary to conduct further research on a larger study group. The literature does not mention the use of vitamin D as a medication for COVID-19. People at risk of vitamin D deficiency should consider vitamin D supplementation at the current time of the pandemic.