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Introduction: Comorbid insomnia and obstructive sleep apnea (COMISA) is not a well-identified sleep disorder, despite having a significant impact on health. This study investigates the relationship between sleep bruxism (SB) and sleep architecture in patients with COMISA, obstructive sleep apnea (OSA), and in those without any sleep disorders. Methods: 119 patients were included in the study and divided into three groups: OSA, COMISA, and a control group. Polysomnographic (PSG) examination provided parameters related to sleep architecture, OSA, and characteristics of SB. Results: The bruxism episode index (BEI) and other SB parameters were not found to be statistically different between the three groups (p > 0.05). There was no statistical difference in measured sleep architecture between the COMISA and OSA groups (p > 0.05). In comparison to the control group, participants in the COMISA group were found to have an increased apnea–hypopnea index (AHI), oxygen desaturation index (ODI), respiratory disturbance index (RDI), all arousals (AA), and respiratory arousals (RA) (p < 0.05). Among COMISA patients, AA and RA were shown to have a positive linear correlation with the number of bradycardia events per hour (r = 0.49, r = 0.48, p < 0.05). Conclusions: SB does not occur in patients with COMISA more frequently than in patients with OSA or those without any sleep disorders. PSG parameters are not specific for COMISA; therefore, in order to differentiate this disorder from OSA alone, a comprehensive patient assessment has to be performed.

(1) Background: Gilles de la Tourette Syndrome (TS) is a neurodevelopmental disorder characterized by motor and vocal tics. Attention deficit and hyperactivity disorder (ADHD) is a common comorbidity of TS that adds further impairment. Cognitive-behavioural therapy (CBT) has shown efficacy in treating tics, yet its effectiveness in individuals with TS and comorbid ADHD remains unclear. Also, it is suggested that ADHD characteristics like executive dysfunction and inattention could hinder the response to CBT. This study aims to compare the response to CBT for tics and its maintenance six months post-therapy among TS individuals with and without ADHD symptoms. (2) Methods: In this study, 55 TS participants who completed 14-week CBT for tics were split into high (TS+) or low (TS−) ADHD symptomatology groups. Outcomes were evaluated using the Yale Global Tic Severity Scale (YGTSS) regarding global tic severity and motor and vocal tic frequency post-CBT and at a 6-month follow-up. (3) Results: No significant group difference was found regarding improvements post-CBT (n = 55), nor the maintenance six months later (n = 45). (4) Conclusions: ADHD symptoms may not hinder the response to CBT or its maintenance, suggesting that TS individuals with ADHD symptoms may not require specialized CBT interventions.

The number of people suffering from diabetes, including type 1, is constantly increasing both in Poland and worldwide. Type 1 diabetes is a chronic disease characterized by uncertain prognosis and relapses, as well as permanent, irreversible, and progressive changes in health status. The ongoing disease results in dysfunction or disability, and the patient requires specialized supervision, care, and rehabilitation. However, the success of therapy does not depend solely on the perfection of treatment, but also on the patient’s readiness to change their lifestyle and cooperate with the therapeutic team. The patient’s constant alertness in making therapeutic decisions does not always lead to expected treatment results, and the risk of hypoglycemia associated with intensive insulin treatment depletes the patient’s motivation for treatment, leading over time to the development of ‘therapeutic burnout’ and psychiatric disorders. This narrative review is an attempt to summarize the knowledge and possible future solutions in diabetes type 1 in Poland as well as highlight the importance of comprehensive care, including psychological care, which appears fundamental in a chronic disease such as type 1 diabetes. Therefore, the aim of the study was to present generational changes and psychosocial problems of patients with type 1 diabetes and to identify urgent challenges in diabetic care. Attention should be paid to the deteriorating mental condition of the young generations, who, in the course of diabetes, are exposed to additional psychological and psychiatric health problems. The next generation of patients will require more psychological care, which is why the challenge of the future is to create psychodiabetology centers.

Background: Sleep bruxism (SB) is a common sleep-related movement behavior with a multifaceted etiology and a deficiently understood pathophysiology. A recent hypothesis suggests a link between SB and systemic inflammation. The scope of the study was to determine whether bruxers have altered sleep structure and different levels of inflammatory parameters compared to nonbruxers. Methods: A total of 83 adults underwent full-night polysomnography. The polysomnograms were evaluated using the American Academy of Sleep Medicine (AASM) guidelines. Then, the blood samples were obtained from the participants by venipuncture and the analyses were performed. The study group was divided based on bruxism episode index (BEI) into two groups: BEI ≤ 4 and BEI > 4. Results: In comparison with nonbruxers, the oxygen desaturation index (ODI) was significantly higher in severe bruxers (7.5 ± 11.08 vs. 3.33 ± 5.75, p < 0.005), as well as the arousal parameters (7.77 ± 4.68 vs. 4.03 ± 2.97, p < 0.001), and the mean oxygen desaturation (3.49 ± 0.69 vs. 3.01 ± 0.67, p < 0.05). Moreover, the differences in sleep architecture and deprivation of the deep sleep phase were observed, the non-REM sleep stage 3 was significantly shorter in severe bruxers (p < 0.03). Differences were also noted in non-REM sleep stage 1 and REM sleep phase. In the investigated group, there were no statistical differences in inflammatory cytokines levels between bruxers and nonbruxers. Conclusions: Sleep bruxism is associated with sleep structure alterations and may be associated with deep sleep phase deprivation. The inflammatory markers are not linearly correlated with the severity of sleep bruxism expressed as BEI.

Atopic dermatitis (AD) prevalence in Poland is more frequent in individuals who live in a city. There are more studies demonstrating that long-term exposure to air pollutants is an independent risk factor for developing AD. The aim of the study was to assess the epidemiology of AD and food allergy (FA) in school children and adolescents living in Krakow, and to find a potential relationship between the incidence of atopic dermatitis with exposure to polluted air. In this paper, we presented the incidence of AD and FA between 2014 and 2018. We analyzed data collected from nearly 30,000 children aged 7–8 and adolescents aged 16–17 from the population of children and youth in Krakow. We correlated it with annual mean concentrations of PM10 and PM2.5, which indicated a gradual improvement in the air quality in Krakow. As our research results show that the prevalence of atopic dermatitis decreased with food allergy prevalence depending on the age group. We can suspect that this is the result of children growing out of a food allergy. It may be also influenced by more consequential eating habits in a group of adolescents and the elimination of allergenic foods from the diet. The decreasing incidence of atopic dermatitis appears to be also related to improvement in air quality.

Cadmium is a heavy metal that accumulates in the body due to environmental and occupational exposure. The main form of environmental exposure to cadmium is related to cigarette smoking. The primary aim of this study was to evaluate the effect of cadmium on numerous sleep parameters with the use of polysomnography. The secondary aim of this study was to investigate if environmental exposure to cadmium is a risk factor for the intensity of sleep bruxism (SB). Methods: A total of 44 adults underwent a full night of polysomnographic examination. The polysomnograms were assessed according to guidelines set out by the American Academy of Sleep Medicine (AASM). The concentration of cadmium in the blood and urine was determined spectrophotometrically. Results: The polysomnographic examination confirmed that cadmium, age, male gender and smoking status are independent risk factors for an increase in the apnea–hypopnea index (AHI). Cadmium alters sleep architecture by favoring sleep fragmentation and decreasing the duration of the rapid eye movement (REM) phase of sleep. However, cadmium exposure is not a risk factor for the development of sleep bruxism. Conclusions: In summary, this study demonstrates that cadmium affects sleep architecture and is a risk factor for the development of obstructive sleep apnea; however, it does not affect sleep bruxism.

This study: (a) compared executive functions between deficit (DS) and non-deficit schizophrenia (NDS) patients and healthy controls (HC), controlling premorbid IQ and level of education; (b) compared executive functions in DS and NDS patients, controlling premorbid IQ and psychopathological symptoms; and (c) estimated relationships between clinical factors, psychopathological symptoms, and executive functions using structural equation modelling. Participants were 29 DS patients, 44 NDS patients, and 39 HC. Executive functions were measured with the Mazes Subtest, Spatial Span Subtest, Letter Number Span Test, Color Trail Test, and Berg Card Sorting Test. Psychopathological symptoms were evaluated with the Positive and Negative Syndrome Scale, Brief Negative Symptom Scale, and Self-evaluation of Negative Symptoms. Compared to HC, both clinical groups performed poorer on cognitive flexibility, DS patients on verbal working memory, and NDS patients on planning. DS and NDS patients did not differ in executive functions, except planning, after controlling premorbid IQ and negative psychopathological symptoms. In DS patients, exacerbation had an effect on verbal working memory and cognitive planning; in NDS patients, positive symptoms had an effect on cognitive flexibility. Both DS and NDS patients presented deficits, affecting the former to a greater extent. Nonetheless, clinical variables appeared to significantly affect these deficits.

This study aimed to analyze the differences in severity and clinical characteristics of COVID-19 in infants hospitalized in Poland in 2021, when the dominance of variants of concern (VOCs) alpha and delta was reported, compared to 2020, when original (wild) SARS-CoV-2 was dominant (III–IV vs. I–II waves of the pandemic, respectively). In addition, the influence of the presence of comorbidities on the clinical course of COVID-19 in infants was studied. This multicenter study, based on the pediatric part of the national SARSTer database (SARSTer-PED), included 940 infants with COVID-19 diagnosed between March 1, 2020, and December 31, 2021, from 13 Polish inpatient centers. An electronic questionnaire, which addressed epidemiological and clinical data, was used. The number of hospitalized infants was significantly higher in 2021 than in 2020 (651 vs. 289, respectively). The analysis showed similar lengths of infant hospitalization in 2020 and 2021, but significantly more children were hospitalized for more than 7 days in 2020 (p < 0.009). In both analyzed periods, the most common route of infection for infants was household contact. There was an increase in the percentage of comorbidities, especially prematurity, in children hospitalized in 2021 compared to 2020. Among the clinical manifestations, fever was predominant among children hospitalized in 2021 and 2020. Cough, runny nose, and loss of appetite were significantly more frequently observed in 2021 (p < 0.0001). Severe and critical conditions were significantly more common among children with comorbidities. More infants were hospitalized during the period of VOCs dominance, especially the delta variant, compared to the period of wild strain dominance, even though indications for hospitalization did not include asymptomatic patients during that period. The course of COVID-19 was mostly mild, characterized mainly by fever and respiratory symptoms. Comorbidities, particularly from the cardiovascular system and prematurity, were associated with a more severe course of the disease in infants.

Urinary incontinence (UI) is a serious health issue that affects both women and men. The risk of UI increases in men with age and after treatment for prostate cancer and affects up to 32% of men. Furthermore, UI may affect up to 69% of men after prostatectomy. Considering such a high incidence, it is critical to search for effective methods to mitigate this issue. Hence, the present review aims to provide an overview of physiotherapeutic methods and evaluate their effectiveness in treating UI in men. This systematic review was performed using articles included in PubMed, Embase, WoS, and PEDro databases. A total of 6965 relevant articles were found. However, after a risk of bias assessment, 39 studies met the inclusion criteria and were included in the review. The research showed that the available physiotherapeutic methods for treating men with UI, including those after prostatectomy, involve pelvic floor muscle training (PFMT) alone or in combination with biofeedback (BF) and/or electrostimulation (ES), vibrations, and traditional activity. In conclusion, PFMT is the gold standard of UI therapy, but it may be complemented by other techniques to provide a personalized treatment plan for patients. The effectiveness of the physiotherapeutic methods varies from study to study, and large methodological differences make it difficult to accurately compare individual results and draw unequivocal conclusions.

This study compared cognitive domains between deficit schizophrenia (DS) and non-deficit schizophrenia (NDS) patients and healthy controls (HC), analyzing relationships between psychopathological dimensions and cognitive domains. A total of 29 DS patients, 45 NDS patients, and 39 HC subjects participated. Cognitive domains were measured using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Battery. Psychopathological symptoms were evaluated with the Positive and Negative Syndrome Scale. Clinical groups performed poorer than HC groups in regards to speed of processing, attention/vigilance, working memory, verbal and visual learning and memory, reasoning and problem solving, and social cognition. DS patients scored poorer than NDS patients in terms of all cognitive domains and the overall score, except for reasoning and problem solving. Positive, negative, disorganization, and resistance symptoms were related to cognitive functions only in NDS patients. Our findings suggest that the MCCB battery is sensitive to detecting cognitive dysfunctions in both deficit and non-deficit schizophrenia.

Evidence suggests a role of the immune system in the pathogenesis of a number of mental conditions, including schizophrenia (SCH). In terms of physiology, aside from its crucial protective function, the complement cascade (CC) is a critical element of the regeneration processes, including neurogenesis. Few studies have attempted to define the function of the CC components in SCH. To shed more light on this topic, we compared the levels of complement activation products (CAP) (C3a, C5a and C5b-9) in the peripheral blood of 62 patients with chronic SCH and disease duration of ≥ 10 years with 25 healthy controls matched for age, sex, BMI and smoking status. Concentrations of all the investigated CAP were elevated in SCH patients. However, after controlling for potential confounding factors, significant correlations were observed between SCH and C3a (M = 724.98 ng/mL) and C5a (M = 6.06 ng/mL) levels. In addition, multivariate logistic regression showed that C3a and C5b-9 were significant predictors of SCH. There were no significant correlations between any CAP and SCH symptom severity or general psychopathology in SCH patients. However, two significant links emerged between C3a and C5b-9 and global functioning. Increased levels of both complement activation products in the patient group as compared to healthy controls raise questions concerning the role of the CC in the etiology of SCH and further demonstrate dysregulation of the immune system in SCH patients.

(1) Background: Gilles de la Tourette Syndrome (TS) is a neurodevelopmental disorder characterized by motor and vocal tics. Attention deficit and hyperactivity disorder (ADHD) is a common comorbidity of TS that adds further impairment. Cognitive-behavioural therapy (CBT) has shown efficacy in treating tics, yet its effectiveness in individuals with TS and comorbid ADHD remains unclear. Also, it is suggested that ADHD characteristics like executive dysfunction and inattention could hinder the response to CBT. This study aims to compare the response to CBT for tics and its maintenance six months post-therapy among TS individuals with and without ADHD symptoms. (2) Methods: In this study, 55 TS participants who completed 14-week CBT for tics were split into high (TS+) or low (TS−) ADHD symptomatology groups. Outcomes were evaluated using the Yale Global Tic Severity Scale (YGTSS) regarding global tic severity and motor and vocal tic frequency post-CBT and at a 6-month follow-up. (3) Results: No significant group difference was found regarding improvements post-CBT (n = 55), nor the maintenance six months later (n = 45). (4) Conclusions: ADHD symptoms may not hinder the response to CBT or its maintenance, suggesting that TS individuals with ADHD symptoms may not require specialized CBT interventions. [ABSTRACT FROM AUTHOR]

Chronic subclinical inflammation is believed to be an important factor in the pathogenesis of schizophrenia. Meta-analyses confirm the presence of increased levels of peripheral inflammatory markers (IM) in schizophrenia and its prodromal stages. Peripheral cytokines may affect the brain microstructure through chronic activation of microglia. Disruptions in the integrity of the superior longitudinal fasciculus (SLF) and inferior longitudinal fasciculus (ILF) are commonly seen in patients with schizophrenia spectrum disorders. We therefore attempted to verify in a cross-sectional study whether there is a correlation between levels of peripheral IM and the integrity of these brain regions in healthy controls, from prodromal states and first episode psychosis to long-term schizophrenia. The integrity of white matter was measured using diffusion tensor imaging. Despite a broad analysis of six IM (CRP, IL-6, IL-8, IL-10, TNF-α, and IFN-γ), we did not find any correlations with the integrity of the SLF or ILF in any of the analyzed groups (after correction for multiple comparisons). In conclusion, our study does not support the existence of a link between disrupted levels of peripheral IM and reduced integrity of ILF and SLF in schizophrenia spectrum disorders. However, prospective studies are needed to verify this over a long period of time.

Patients with systemic autoimmune rheumatic disease (SARD) have increased susceptibility to viral infections, including SARS-CoV-2. The aim of this study was to analyse the SARD patient population with COVID-19 (coronavirus disease 2019) in terms of baseline characteristics, severity, course and outcomes of the disease compared with the non-SARD group, and to identify factors associated with prognosis, including remdesivir therapy efficacy. Retrospective study comprised 8220 COVID-19 cases from the SARSTer database, including 185 with SARD. Length of hospitalisation, duration of oxygen therapy, mortality and the need for HFNO (high-flow nasal oxygen) and/or NIV (noninvasive ventilation) were significantly higher in the SARD versus non-SARD group. There was no difference in clinical features on admission to hospital. Patients with SARD were older and more likely to have cardiovascular, pulmonary and chronic kidney diseases. Age, the presence of cardiovascular disease, more severe conditions on admission and higher inflammatory marker values were found to be risk factors for death in the SARD group. In patients with SARD treated with remdesivir, there was a trend towards improved mortality but without statistical significance. Length of hospitalisation, 28-day mortality and the need for HFNO and/or NIV were higher in the SARD group. These patients often had other chronic diseases and were older.

Background: Sleep bruxism (SB) is a common sleep-related movement behavior with a complex etiology. A recent hypothesis suggests psychoactive substance usage, tobacco smoking, and alcohol intake are risk factors for SB. This study aimed to evaluate SB intensity in tobacco smokers and alcohol drinkers. Methods: A total of 133 adults underwent full-night audio- and video-polysomnography, and the polysomnograms were evaluated using the American Academy of Sleep Medicine guidelines. The study group was divided into smoker and nonsmoker groups as well as drinker and non-drinker groups. Results: The results of the polysomnographic analysis confirmed that tobacco smoking has a significant effects on SB. Tobacco smokers showed increased bruxism intensity (5.50 ± 4.71 vs. 3.83 ± 3.26, p < 0.05), especially the mixed phenotype (0.93 ± 1.00 vs. 0.59 ± 0.59, p < 0.05), in the N1 sleep stage (22.84 ± 20.45 vs. 15.66 ± 13.60, p < 0.05) and the nonsupine position (4.93 ± 5.56 vs. 2.50 ± 2.31, p < 0.05). They also showed a higher number of bruxism episodes with arousal compared with nonsmokers (2.91 ± 2.83 vs. 1.61 ± 1.49, p < 0.05), indicating increased sleep fragmentation. However, no significant effect of alcohol on SB intensity was observed, and the bruxism episode index was similar in alcohol drinkers and nondrinkers. In addition, electrolyte disturbances and lipid disorders were evaluated. Compared with nonsmokers, tobacco smokers showed a higher concentration of plasma triglycerides (177.67 ± 106.9 vs. 129.18 ± 65.61) and lower levels of iron and magnesium (96.68 ± 43.58 vs. 123.83 ± 52.36 and 1.85 ± 0.22 vs. 1.96 ± 0.21, respectively). Conclusions: In summary, this study showed that tobacco smoking, but not alcohol consumption, is related to bruxism intensity and lipid and electrolyte disturbances in individuals with sleep disorders.

Peripheral cytokines may affect the brain through chronic activation of microglia and, as a result, can potentially lead to decreased integrity of white matter of cingulum bundle (CB). Therefore, the aim of the study was to analyze the relationships between peripheral inflammatory markers and the integrity of the CB in various states: from healthy controls, through prodromal states and first-episode psychosis, to long-term schizophrenia. The integrity of the CB was measured using diffusion tensor imaging. We analyzed six parameters: CRP, IL-6, IL-8, IL-10, TNF-α, and IFN-γ. We found that levels of IL-6 and IFN-γ differed significantly between groups. Initial analysis showed some correlations between the inflammatory markers and CB integrity, in particular a correlation with IL-6 that was present in several groups. However, none of the analyzed parameters were associated with the integrity of the CB after correction for multiple comparisons. Conclusions: Our results supported our hypothesis that there are increased levels of inflammatory markers in psychotic disorders, but did not allow to confirm our hypothesis that there is a link between increased peripheral inflammatory markers and decreased integrity of the CB. However, we found some interesting trend levels that need to be verified in larger studies.

In patients with acutely changing kidney function, equations used to estimate glomerular filtration rate (eGFR) must be adjusted for dynamic changes in the concentrations of filtration markers (kinetic eGFR, KeGFR). The aim of our study was to evaluate serum creatinine-based KeGFR in patients in the early phase of acute pancreatitis (AP) as a marker of changing renal function and as a predictor of AP severity. We retrospectively calculated KeGFR on day 2 and 3 of the hospital stay in a group of 147 adult patients admitted within 24 h from the onset of AP symptoms and treated in two secondary-care hospitals. In 34 (23%) patients, changes in serum creatinine during days 1–3 of the hospital stay exceeded 26.5 µmol/L; KeGFR values almost completely differentiated those with increasing and decreasing serum creatinine (area under receiver operating characteristic curve, AUROC: 0.990 on day 3). In twelve (8%) patients, renal failure was diagnosed during the first three days of the hospital stay according to the modified Marshall scoring system, which was associated with significantly lower KeGFR values. KeGFR offered good diagnostic accuracy for renal failure (area under receiver operating characteristic—AUROC: 0.942 and 0.950 on days 2 and 3). Fourteen (10%) patients developed severe AP. KeGFR enabled prediction of severe AP with moderate diagnostic accuracy (AUROC: 0.788 and 0.769 on days 2 and 3), independently of age, sex, comorbidities and study center. Lower KeGFR values were significantly associated with mortality. Significant dynamic changes in renal function are common in the early phase of AP. KeGFR may be useful in the assessment of kidney function in AP and the prediction of AP severity.

Background: Clinical guidelines are lacking for the use of orthodontic mini-implants (OMIs) in terms of scientific evidence referring to the choice of proper mini-design. Thus, the present study aimed to investigate to what extent orthodontic mini-implant thread design influences its stability. Methods: Search was conducted in five search engines on 10 May. Quality assessment was performed using study type specific scales. Whenever possible, meta-analysis was performed. Results: The search strategy identified 118 potential articles. Twenty papers were subjected to qualitative analysis and data from 8 papers—to meta-analysis. Studies included were characterized by high or medium quality. Four studies were considered as low quality. No clinical studies considering the number of threads, threads depth, or TSF have been found in the literature. Conclusions: Minidesign of OMIs seems to influence their stability in the bone. Thread pitch seems to be of special importance for OMIs retention—the more dense thread—the better stability. Thread depth seems to be of low importance for OMIs stability. There is no clear scientific evidence for optimal thread shape factor. Studies present in the literature vary greatly in study design and results reporting. Research received no external funding. Study protocol number in PROSPERO database: CRD42022340970.

Hepatitis C infection is one of the main reasons for liver cirrhosis and hepatocellular carcinoma. In recent years, more and more is being heard about extrahepatic manifestations of the hepatitis C infection including its possible influence on the development of hypertension and cardiovascular diseases. In the given work, the frequency analysis of the incidence of hypertension and cardiovascular diseases among 2898 HCV-infected patients treated in Poland and the assessment of their relevance to the HCV genotype and the progression of liver fibrosis can be found. The prevalence of hypertension in the group of analyzed patients was 39% and was significantly associated with old age (OR = 1.08 (1.07–1.08)) and female sex, as well as the progression of liver fibrosis (OR = 1.54 (1.29–1.85)). Hypertension was found in 47.6% of patients with F4 fibrosis, 42.1% of patients with F3 fibrosis, and 25% of patients with F1 fibrosis. The incidence of cardiovascular disease in the studied group of patients was as follows: all incidents, 131 (4.52%); including ischemic heart disease 104, (3.95%); stroke, 2 (0.07%); atherosclerosis, 21 (0.72%); and aneurysms, 4 (0.14%). The obtained results prove that the prevalence of cardiovascular diseases is significantly associated with the advanced age of patients and the progression of liver fibrosis. The relevance of sex and the HCV genotype to the prevalence frequency of cardiovascular diseases in the study group has not been proven. This being the case, no differences in the frequency of their incidence depending on the HCV genotype, including genotype 3, was found. Hepatitis C infection as a non-classical risk factor for cardiovascular disease and hypertension does require further studying.

Obstructive sleep apnea syndrome (OSAS) is an under-recognized clinical condition and is correlated with sleepiness and impaired cognitive function. Objectives: The primary aim of this systematic review, developed within the Sleep@OSA project, was to determine the correlations of obstructive sleep apnea syndrome, daytime sleepiness and sleep-disordered breathing with the risk of car accidents in adult working populations; a secondary aim was to analyze the epidemiologic data with a gender-based approach to identify differences between women and men in the data and in associated risk factors. Methods: Clinical trials and studies reporting data on the frequency of car accidents involving adult working population with daytime sleepiness and/or OSAS compared with a control group of participants were included. Literature searches of free text and MeSH terms were performed using PubMed, Google Scholar, the Cochrane Library and Scopus from 1952 to 3 May 2021. Results and Conclusions: The search strategy identified 2138 potential articles. Of these, 49 papers were included in the qualitative synthesis, and 30 were included in the meta-analysis. Compared with controls, the odds of car accidents were found to be more than double in subjects with OSAS (OR = 2.36; 95% CI 1.92–2.91; p < 0.001), with a similar risk between commercial motor vehicle drivers (OR = 2.80; 95% CI 1.82–4.31) and noncommercial motor vehicle drivers (OR = 2.32; 95% CI 1.84–2.34). No significant correlation was found between sleepiness and car crashes, but subjects with sleep-disordered breathing were at increased risk of car accidents (OR = 1.81; 95% CI 1.42–2.31; p < 0.001). To our surprise, although epidemiological studies on the risk of road accidents in the adult population with OSAS and daytime sleepiness are currently very abundant, specific data on the female population are not available.

Optimal body weight and body composition for age are relevant to child development and healthy life. Changes in lean mass and fat mass as well as its distribution are associated with alterations in the secretion of myokines and adipokines by muscle and adipose tissues. These factors are very important for bone health. The aim of the study was to assess serum leptin, adiponectin, resistin, visfatin and omentin as adipokines and myostatin and irisin as myokines with regard to their associations with bone parameters in healthy normal weight and thin children. We studied 81 healthy prepubertal children (aged 5 to 9 years) divided into three groups: group A—35 children with a BMI z-score between +1 and −1 SD; group B—36 children with a BMI z-score between −1 and −2 SD; and group C—10 thin children with a BMI z-score of p < 0.001) lower fat mass, fat/lean mass ratio and bone mineral density (BMD) across weight status with the lowest values in the group of thin children. We noticed significantly (p < 0.05) lower concentrations of 25-hydroxyvitamin D, resistin and high-molecular-weight (HMW) adiponectin but higher levels of myostatin as the BMI z-score deceased. We found that BMI and leptin levels were directly correlated with fat mass, lean mass, bone mineral content (BMC) and BMD. Resistin levels were negatively associated with lean mass, while visfatin concentrations were positively related to total BMD. In healthy prepubertal children there were differences in body composition and in bone mineral density across decreasing BMI status. We suggest that changes in serum myostatin and 25-hydroxyvitamin D levels may play a role in bone status of thin children. Moreover, significant relations between adipokines and bone parameters may confirm crosstalk between fat tissue and bone in these children.

Functional point-of-care tests (POCTs) have evolved into useful tools for diagnosing disorders of blood coagulation and fibrinolysis. We aimed to describe the in vivo association between standard and functional parameters of coagulation and fibrinolysis in the setting of acute hemodilution induced by an infusion of balanced crystalloid or synthetic gelatine solutions. This prospective randomized crossover in vivo study included healthy male volunteers aged 18–30 years. Enrolled participants were randomly assigned to receive either the Optilyte® or Geloplasma® infusion. Laboratory analysis included conventional coagulation parameters and rotational thromboelastometry (ROTEM) assays. A total of 25 healthy Caucasian males were included. ROTEM viscoelastic assays presented moderate to strong correlations with conventional coagulation tests, regardless of the fluid type utilized. Irrespectively of the extent of hemodilution, significant correlations remained unaffected. The strongest associations were found between the ROTEM clot formation and clot strength and the fibrinogen concentration and platelet count, and between the ROTEM clotting time and the APTT and PT. This in vivo experimental study in healthy male volunteers demonstrated that ROTEM may be used as a credible alternative to standard laboratory tests to assess blood coagulation and fibrinolysis in the setting of fluid resuscitation with both crystalloid and colloid solutions. The study was registered online in the ClinicalTrials.gov database (NCT05148650).

(1) Background: Sleep bruxism (SB) is a common sleep behavior. Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder with potential long-term major neurocognitive and cardiovascular sequelae. Although the co-occurrence of SB and OSA has been described previously, the exact relationship remains unclear. The present study aimed to evaluate the incidence of SB in different phenotypes of OSA. (2) Methods: The participants of this study were adult patients referred to the Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology at the Wroclaw Medical University. They underwent a single-night video polysomnography in a sleep laboratory. The data related to common OSA phenotypes were analyzed in two separate groups of patients: body position related (n = 94) and rapid eye movement (REM) related (n = 85). (3) Results: The obtained results showed that the incidence of SB and severe SB was higher for body position-related OSA phenotype (p < 0.05 for all comparisons). No statistically significant differences were observed for REM-related OSA phenotype (p > 0.05 for all comparisons). (4) Conclusions: Body position-related OSA phenotype seems to be associated with higher SB and severe SB incidence, but the relationship is not independent. However, in the light of the unclear relationship between SB and sleep-disordered breathing, the topic needs further study.

In the original publication [...]

Sleep bruxism (SB) is a repetitive jaw muscle activity characterized by clenching or grinding of the teeth, which is classified under sleep-related movement disorders in the International Classification of Sleep Disorders—Third Edition. Because the potential common pathomechanism of SB and arterial hypertension is the activation of the sympathetic system as well as an increase in inflammatory factors, we aimed to examine the intensity of SB and the sleep architecture among patients with arterial hypertension. The study included a total of 91 Caucasian adult patients, among whom 31 had arterial hypertension diagnosed according to the current European Society of Cardiology/European Society of Hypertension (ESC/EHS) hypertension guidelines. The control group consisted of 61 normotensive patients. Patients with obstructive sleep apnea were excluded. A single full-night polysomnographic examination was conducted in the Sleep Laboratory, and then the results were analyzed based on the guidelines of the American Academy of Sleep Medicine. Bruxism episode index (BEI) was higher in the hypertensive group compared to normotensives. The groups also showed statistically significant differences in polysomnographic sleep indexes. Similar to BEI, arousal index, apnea–hypopnea index, and snoring were higher in hypertensives compared to normotensives. On the other hand, the mean and minimal oxygen saturation were lower in hypertensives compared to normotensives. A statistically significant positive correlation was observed between oxygen desaturation index and BEI in the hypertensive group, whereas this correlation was not statistically significant in the case of normotensives. In summary, nonapneic hypertensives had higher SB intensity, altered sleep architecture, decreased mean oxygen saturation, and increased snoring compared to normotensives. The results suggest that dental screening is necessary for patients with arterial hypertension, especially those presenting with the symptoms of SB.

Impairments in cognitive functions are one of the main features of schizophrenia. A variety of factors can influence the extent of cognitive deficits. In our study, we examined the severity of cognitive deficits at different stages of the disease and the relationship between psychopathological symptoms and cognitive functions. We recruited 32 patients with first-episode psychosis (FEP), 70 with chronic schizophrenia (CS), and 39 healthy controls (HC). Psychopathological symptoms were evaluated with the Positive and Negative Syndrome Scale (PANSS) and cognitive functions were measured with the MATRICS Cognitive Consensus Battery (MCCB). Cognitive deficits were present in both FEP and CS participants. CS individuals had lower overall scores and poorer working memory; however, clinical variables appeared to play a significant role in these scores. In FEP, disorganization correlated negatively with verbal and visual learning and memory, social cognition, and overall score; negative symptoms negatively correlated with social cognition. In CS participants, disorganization correlated negatively with speed of processing, reasoning, problem solving, and overall score; negative symptoms were negatively correlated with speed of processing, visual learning, memory, and overall score; positive symptoms were negatively correlated with reasoning and problem solving. Our findings indicate that psychopathological symptoms have a significant impact on cognitive functions in FEP and CS patients.

The prevalence of asthma and allergies among children has become an increasing problem in the last few decades. Data on the population of children and adolescents, especially living in polluted cities, are limited and based on studies carried out in small groups. In our study, we analyzed the incidence of asthma and allergic rhinitis between 2014 and 2018. We analyzed data collected from nearly 30,000 children aged seven to eight and adolescents aged 16–17, which allowed us to assess the frequency of allergic diseases in the population of children and youth in Krakow. More than 40% of respondents reported allergic symptoms, and nearly 50% of them were not diagnosed and treated. In the group of seven- and eight-year-olds with a positive history of allergies, 52% had allergic rhinitis and 9.1% had asthma. In the group of 16–17-year-olds, allergic rhinitis was diagnosed in 35.8%, while asthma was found in 4.9% of cases. The results obtained over the course of 10 years has shown the reduction in the frequency of asthma (from 22% in the case of asthma in both age groups) and allergic rhinitis cases (from 63.9% in adolescents). In our opinion, this can be considered a positive effect of the preventive measures taken in Kraków after 2010. Although there is still a higher incidence of allergic diseases among children and young people living in urban areas compared to rural areas, the trend apparently has reversed for some diseases.

Basigin (BSG, CD147) is a multifunctional protein involved in cancer cell survival, mostly by controlling lactate transport through its interaction with monocarboxylate transporters (MCTs) such as MCT1. Previous studies have found that single nucleotide polymorphisms (SNPs) in the gene coding for BSG and MCT1, as well as levels of the soluble form of BSG (sBSG), are potential biomarkers in various diseases. The goal of this study was to confirm BSG and MCT1 RNA overexpression in AML cell lines, as well as to analyse soluble BSG levels and selected BSG/MCT1 genetic variants as potential biomarkers in AML patients. We found that BSG and MCT1 were overexpressed in most AML cell lines. Soluble BSG was increased in AML patients compared to healthy controls, and correlated with various clinical parameters. High soluble BSG was associated with worse overall survival, higher bone marrow blast percentage, and higher white blood cell count. BSG SNPs rs4919859 and rs4682, as well as MCT1 SNP rs1049434, were also associated with overall survival of AML patients. In conclusion, this study confirms the importance of BSG/MCT1 in AML, and suggests that soluble BSG and BSG/MCT1 genetic variants may act as potential AML biomarkers.

HCV infection is one of the main reasons for liver cirrhosis and hepatocellular carcinoma. In recent years, one finds more and more extrahepatic manifestations of HCV infection, including its possible influence on the development of diabetes. In the presented work, one finds the frequency analysis of the incidence of diabetes among 2898 HCV infected patients treated in Poland, and the assessment of their relevance to the HCV genotype and the progression of fibrosis. The results indicate that the hepatitis C infection seems to be a risk factor for diabetes in persons with more advanced liver fibrosis, for older people, and for the male gender. Thus, one found no differences regarding the frequency of its incidence depending on HCV genotype, including genotype 3.

Introduction: Sleep bruxism (SB) is a widespread masticatory muscle activity during sleep and affects approximately 13.2% of the general population. Telomerase reverse transcriptase (TERT) plays a role in preventing the shortening of the telomere. This prospective, observational study aimed to investigate the relationship between single nucleotide polymorphism (SNP) of TERT and the severity of SB and to identify the independent risk factors for SB. Methods: A total of 112 patients were diagnosed by performing one-night polysomnography based on the guidelines of the American Academy of Sleep Medicine. TERT SNP was detected by real-time quantitative polymerase chain reaction (qPCR). Results: Statistical analysis showed the lack of relationship between the rs2853669 polymorphism of TERT and severity of SB (p > 0.05). However, the study showed that patients with allele T in the 2736100 polymorphism of TERT had a lower score on the phasic bruxism episode index (BEI). Based on the receiver operating characteristic (ROC) curve, the value of phasic BEI was 0.8 for the differential prediction for the presence of allele T in the locus. The sensitivity and specificity were 0.328 and 0.893, respectively. The regression analysis showed that lack of TERT rs2736100 T allele, male gender, and arterial hypertension are the risk factors for the higher value of phasic BEI. Conclusion: The SNP of the TERT gene affects phasic SB intensity. The absence of TERT rs2736100 T allele, male sex, and arterial hypertension are independent risk factors for phasic SB.

The increasing mortality and morbidity in patients with diabetes mellitus constitute a severe public health problem. The condition is recognized as a cause of impaired quality of life, high costs, and diminished productivity. In this study, we performed a cross-sectional analysis among 300 Polish participants with type 1 and type 2 diabetes to determine and classify risk factors associated with increased incidences of hypoglycemia. Including an open-access knowledge about the correlations between diabetes rates and human’s lifestyle, we confirm that the frequency of smoking and drinking alcohol, low BMI, inappropriate diet, low physical activity, lack of vaccination against influenza and pneumococci, and co-existence of other comorbidities such as cardiovascular diseases, thyroid diseases, hyperlipidemia, retinopathy, and asthma elevate the risk of hypoglycemia. Furthermore, hypoglycemic patients were more often malnourished, depressed, irritated, and exposed to stress. In sum, the analysis of the interaction between diabetes and sociodemographic, environmental, or other disease-related risk factors provides strategies to optimize glycemic control and reduce the incidence of hypoglycemia. Furthermore, we believe our findings may constitute a basis for promoting health by adjusting available and implementing new preventive services reducing hypoglycemic episodes in diabetic patients.

Long-term analyses of demographical and clinical characteristics of COVID-19 patients can provide a better overview of the clinical course of the disease. They can also help understand whether changes in infection symptomatology, disease severity, and outcome occur over time. We aimed to analyze the demographics, early symptoms of infection, laboratory parameters, and clinical manifestation of COVID-19 patients hospitalized during the first 17 months of the pandemic in Poland (March 2020–June 2021). The patients’ demographical and clinical data (n = 5199) were extracted from the national SARSTer database encompassing 30 medical centers in Poland and statistically assessed. Patients aged 50–64 were most commonly hospitalized due to COVID-19 regardless of the pandemic period. There was no shift in the age of admitted patients and patients who died throughout the studied period. Men had higher C-reactive protein and interleukin-6 levels and required oxygenation and mechanical ventilation more often. No gender difference in fatality rate was seen, although the age of males who died was significantly lower. A share of patients with baseline SpO2 < 91%, presenting respiratory, systemic and gastrointestinal symptoms was higher in the later phase of a pandemic than in the first three months. Cough, dyspnea and fever were more often presented in men, while women had a higher frequency of anosmia, diarrhea, nausea and vomiting. This study shows some shifts in SARS-CoV-2 pathogenicity between March 2020 and July 2021 in the Polish cohort of hospitalized patients and documents various gender-differences in this regard. The results represent a reference point for further analyses conducted under the dominance of different SARS-CoV-2 variants.

The prevailing COVID-19 pandemic has dramatically affected the mental health and well-being of individuals. This cross-sectional study aimed to assess the perceived fear of COVID-19 among older adults in Poland and identify subpopulations with the highest risk of potential mental health disorders. The study was conducted in November–December 2020 on 500 people aged ≥60 years (mean M = 67.9, standard deviation SD = 4.2). In order to collect information on participants’ characteristics and COVID-19-related information, they were asked to complete a questionnaire based on recorded telephone calls. Perceived fear of COVID-19 was measured using Fear of COVID-19 Scale (FCV-19S), which ranges from 7 to 35. Multiple linear regression was performed to identify factors associated with the perceived fear of COVID-19. Our results showed that the highest level of fear of COVID-19 infection was observed among women (p = 0.025) and patients taking anticoagulants (p = 0.004). Moreover, older adults with higher anxiety levels were more likely to be fearful of COVID-19 (according to the GAS-10 scale; p < 0.001). These findings may help policy makers and healthcare workers to adapt and implement better mental health strategies to help the elderly fight fear and anxiety during the prevailing pandemic.

The incidence of endometrial cancer (EC), which coexists with such civilization diseases as diabetes, obesity or hypertension, is constantly increasing. Treatment includes surgery as well as brachytherapy, teletherapy, rarely chemotherapy or hormone therapy. Due to the good results of the treatment, the occurrence of side effects of therapy becomes a problem for the patients. One of the large groups of side effects includes the pelvic organ prolapse, urinary and fecal incontinence. The aim of this study was to present current knowledge on the occurrence of pelvic floor dysfunction in women treated for EC. A literature review was conducted in the PubMED and WoS databases, including articles on pelvic floor dysfunction in women with EC. PRISMA principles were followed in the research methodology. A total of 1361 publications were retrieved. Based on the inclusion and exclusion criteria, 24 papers were eligible for the review. Mostly retrospective studies based on different questionnaires were evaluated. No prospective studies were found in which, in addition to subjective assessment, clinical examination and objective assessment of urinary incontinence were used. Studies show a significant increase in the incidence of pelvic floor disorders, including urinary incontinence, after various forms of EC treatment. We believe that assessment of complications after endometrial cancer treatment is clinically relevant. The review emphasizes the importance of programming prospective studies to prevent and address these disorders at each stage of oncologic treatment.

Patients with diagnosed frailty syndrome (FS) represent a special group of patients with chronic disease. In the classic definition, frailty syndrome includes such parameters as reduced muscle strength, subjective feeling of fatigue, unintentional weight loss, slow gait, and low physical activity. Frailty syndrome leads to an increased incidence of adverse events, such as falls, hospitalizations, and the need to place patients in care and health institutions associated with the loss of independence; frailty syndrome is also associated with an increased incidence of death. In European countries, the frequency of frailty syndrome in the geriatric population is estimated to be 17% with a range from 5.8% to 27%, and its incidence increases with age. A much higher percentage of frailty syndrome patients is also observed among hospitalized patients. The incidence of frailty syndrome is influenced by many socio-economic factors, but also medical factors. Materials and Methods: A total of 120 patients, >65 years of age, participated in the study. During the study, anthropometric measurements, surveys, laboratory determinations of basic biochemical parameters, and iron status were investigated; 5 mL of peripheral blood in EDTA was also collected for further laboratory tests of hepcidin and soluable transferrin receptor (sTfR) using ELISA. Then, the statistical analysis was performed based on survey and clinical data. Results: Among the patients >65 years of age, the incidence of frailty syndrome was 27.5%. It was found that its occurrence was associated with socio-economic factors, malnutrition, multiple morbidities, reduced muscle strength and gait speed, and polypharmacotherapy. The relationship between reduced iron concentration and the occurrence of frailty syndrome was confirmed. Conclusions: According to the analysis, it was found that a decrease in iron concentration was associated with frailty syndrome.

Background: Pleural metastasis in lung cancer found at diagnosis has a poor prognosis, with 5–11 months’ survival. We hypothesized that prognosis might be different for patients who have had curative-intent surgery and subsequent pleural recurrence and that survival might differ based on the location of the first metastasis (distant versus pleural). This may clarify if pleural recurrence is a local event or due to systemic disease. Methods: A database of 5089 patients who underwent curative-intent surgery for lung cancer was queried, and 85 patients were found who had biopsy-proven pleural metastasis during surveillance. We examined survival based on pattern of metastasis (pleural first versus distant first/simultaneously). Results: Median survival was 34 months (range: 1–171) from the time of surgery and 13 months (range: 0–153) from the time of recurrence. The shortest median survival after recurrence was in patients with adenocarcinoma and pleural metastasis as the first site (6 months). For patients with pleural metastasis as the first site, those with adenocarcinoma had a significantly shorter post-recurrence survival when compared with squamous cell carcinoma (6 vs. 12 months; HR = 0.34) and a significantly shorter survival from the time of surgery when compared with distant metastases first/simultaneously (25 vs. 52 months; HR = 0.49). Conclusions: Patients who undergo curative-intent surgery for lung adenocarcinoma that have pleural recurrence as the first site have poor survival. This may indicate that pleural recurrence after lung surgery is not likely due to a localized event but rather indicates systemic disease; however, this would require further study.

This prospective multicenter cohort study aimed to analyze the epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19) in children. The study, based on the pediatric part of the Polish SARSTer register, included 1283 children (0 to 18 years) who were diagnosed with COVID-19 between 1 March 2020 and 31 December 2020. Household contact was reported in 56% of cases, more frequently in younger children. Fever was the most common symptom (46%). The youngest children (0–5 years) more frequently presented with fever, rhinitis and diarrhea. Teenagers more often complained of headache, sore throat, anosmia/ageusia and weakness. One fifth of patients were reported to be asymptomatic. Pneumonia was diagnosed in 12% of patients, more frequently in younger children. During the second wave patients were younger than during the first wave (median age 53 vs. 102 months, p < 0.0001) and required longer hospitalization (p < 0.0001). Significantly fewer asymptomatic patients were noted and pneumonia as well as gastrointestinal symptoms were more common. The epidemiological characteristics of pediatric patients and the clinical presentation of COVID-19 are age-related. Younger children were more frequently infected by close relatives, more often suffered from pneumonia and gastrointestinal symptoms and required hospitalization. Clinical courses differed significantly during the first two waves of the pandemic.

Myokines are cytokines secreted by muscle and exert autocrine, paracrine, or endocrine effects. Myokines mediate communication between muscle and other organs, including adipose tissue. The aim of the study was to assess serum myokines and their relationships with adipokines and anthropometric and nutritional parameters in children following vegetarian and omnivorous diets. One hundred and five prepubertal children were examined. Among them there were 55 children on a vegetarian diet and 50 children on an omnivorous diet. Concentrations of myokines (myostatin, irisin) and adipokines (leptin, adiponectin, omentin, visfatin) in serum were determined by enzyme-linked immunosorbent assay (ELISA). We observed comparable median values of serum myokines and adipokines (except of leptin concentration) in both of the studied groups of children. We also found several correlations between myokine and adipokine levels and certain nutritional parameters. Serum myostatin was positively correlated with omentin levels in vegetarians and omnivores (p = 0.002). Serum irisin was positively associated with omentin (p = 0.045) levels in omnivores and inversely with visfatin concentration (p = 0.037) in vegetarians. Myostatin concentration was negatively correlated with the percentage of energy from protein (p = 0.014), calcium (p = 0.046), and vitamin A (p = 0.028) intakes in vegetarians and with dietary vitamin C (p = 0.041) and vitamin E (p = 0.021) intakes in omnivores. In multivariate regression analyses, positive correlations of serum myostatin with omentin levels were revealed in both study groups (β = 0.437, p < 0.001 for vegetarians; and β = 0.359, p = 0.001 for omnivores). Consuming a lacto-ovo-vegetarian diet did not influence serum levels of myokines (myostatin, irisin) and adipokines such as adiponectin, visfatin, and omentin in prepubertal children. However, leptin levels were significantly lower in vegetarians compared with omnivores. The observed significant positive correlations between myostatin and omentin concentrations might suggest tissue cross-talk between skeletal muscle and fat tissue. Further studies, carried out in a larger group of children following different dietary patterns, could be important to fully understand the relations between muscle, adipose tissues, and nutrition.

Due to the prevailing pandemic of the coronavirus disease COVID-19, we are experiencing emotional and social isolation, which negatively affects mental and physical health, particularly among the elderly population. In this study, we performed a cross-sectional analysis based on computer-assisted telephone interviews of 500 Polish adults aged 60 years or older in order to determine the impact of the SARS-CoV-2 pandemic on the older population’s behavior, life activity, and delivery of healthcare services. According to our study, COVID-19 infection entailed a substantial change in older people’s behavior. Over 50%, nearly 80%, and more than 25% of the surveyed participants reduced their social, recreational, and professional activities, respectively. The most significant change in senior’s behavior due to the fear of COVID-19 infection was observed in patients (1) with cardiac and pulmonary problems, (2) being on multi-drug therapy, (3) vaccinated against influenza, and (4) with several mental difficulties including loneliness, social isolation, and depression. Furthermore, we demonstrated that 10% of participants canceled planned hospitalization due to the fear of COVID-19 infection. This was observed primarily in patients suffering from chronic heart and lung diseases, vaccinated against influenza, exhibiting the reluctance to carry out more complex daily activities, and with a higher level of anxiety, social loneliness, and malnutrition. Thus, these groups of seniors require more attention; hence, we propose telemedicine as a strategy directed to them that provides clinical healthcare and information regarding measurements, control, and protection against SARS-CoV-2 during the prevailing COVID-19 pandemic. We believe this strategy may improve treatment outcomes, reduce comorbidities-related complications and unnecessary hospitalizations.

Frailty syndrome (FS) often coexists with many diseases of the elderly, including arterial hypertension, and may affect the disease course and adherence to therapeutic recommendations. This study aimed to evaluate the relationship between frailty and adherence to therapeutic recommendations in elderly hypertensive patients. The study included 259 patients hospitalized between January 2019 and November 2020 due to exacerbation of hypertension symptoms. Medical records were used to obtain basic sociodemographic and clinical data. The study was based on the Tilburg Frailty Indicator (TFI) and the Hill–Bone Scale (HBCS). The obtained data were analyzed within a cross-sectional design. The mean frailty score indicated by the TFI questionnaire was 7.09 ± 3.73. The most prominent FS component was associated with the physical domain (4.24 ± 2.54). The mean overall adherence measured with the HBCS was 20.51 ± 3.72. The linear regression model testing the Hill–Bone “reduced sodium intake” score against the TFI domains showed no relationships between the variables. Another regression model for the Hill–Bone “appointment-keeping” subscale indicated significant predictors for physical and social TFI domains (p = 0.002 and p < 0.0001, respectively). For the Hill–Bone “taking antihypertensive drugs” variable, the regression model found significant relationships with all TFI domains: physical (p < 0.0001), psychological (p = 0.003) and social (p < 0.0001). Our study suggests that frailty in patients with arterial hypertension can negatively impact their adherence to therapeutic recommendations.

Pediatric inflammatory multisystem syndrome (PIMS) is a new entity in children, likely associated with previous coronavirus disease 19 (COVID-19) infection. Most of the reports about PIMS come from countries particularly hit by the COVID-19 pandemic. Our aim was to investigate the nature of inflammatory syndromes in Poland (country with low COVID-19 prevalence) and to perceive the emergence of PIMS in our country. On 25 May 2020, we launched a nationwide survey of inflammatory syndromes in children for retrospective (since 4 March 2020) and prospective data collection. Up to 28 July, 39 reported children met the inclusion criteria. We stratified them according to age (

This narrative review presents recent developments in virtual reality (VR)-based interventions for alcohol use disorders (AUDs). The latest advances in mental healthcare hail an imminent cyber revolution, ushering in novel treatment options, with immersive virtual technology at the very forefront of expected change. With an aim to (a) provide a background on VR use in mental healthcare of AUD patients, (b) summarize existing evidence on conventional approaches to the treatment of AUDs and a trending paradigm shift towards VR applications in their management, and (c) describe key issues and future directions in research on craving assessment and VR cue-induced therapy in AUDs, a search for experimental and meta-analytic evidence was performed in six databases: PubMed and EBSCO (Medline, ERIC, PsychINFO, Academic Search Ultimate, and Health Source: Nursing/Academic Edition). Pooled results were screened for eligibility, and relevant papers were selected for inclusion. The analysis revealed VR’s promising effects in the treatment of AUDs. Its remarkable potential to simulate cues underlying subsequent addictive behaviors makes its application in the assessment and treatment of AUDs an attractive alternative to researchers and clinicians alike. Nevertheless, more evidence is needed before virtual reality cue exposure therapy (VR-CET) can become a clinical standard of care.

There is a paucity of reports examining the relationship between the integrity of the corpus callosum (CC) and different aspects of cognitive functioning in patients with first-episode (FES) and chronic schizophrenia (CS) simultaneously; furthermore, what results exist are inconclusive. We used diffusion tensor imaging tractography to investigate differences in integrity in five regions of the CC between FES, CS, and healthy controls (HC). Additionally, we analyzed correlations between these regions’ integrity and working memory, planning, and speed of processing. Eighteen patients with FES, 55 patients with CS, and 30 HC took part in the study. We assessed cognitive functions with four tasks from Measurement and Treatment Research to Improve Cognition in Schizophrenia. Patients with CS showed lower fractional anisotropy (FA) in Region 5 (statistical trend) and higher mean diffusivity (MD) in Regions 4 and 5 than HC, and patients with FES had higher MD in Region 3 (statistical trend) than HC. Both clinical groups performed worse on working memory and speed of processing tasks than HC, and patients with CS scored worse than HC on independent planning, and worse than FES and HC on dependent planning. Moreover, in patients with CS, MD in Region 3 was correlated with verbal working memory. Our results suggest that patients with FES and CS are characterized by impaired integrity of the middle and posterior CC, respectively. We confirmed that both clinical groups have cognitive impairments. Moreover, the integrity of the middle CC may influence planning in patients with CS.

There is still limited data available from real-world experience studies on the pangenotypic regimens in patients with genotype (GT) 3 hepatitis C virus (HCV) infection and liver cirrhosis. The current study aimed to evaluate the efficacy and safety of pangenotypic regimens in this difficult-to-treat population. A total of 236 patients with mean age 52.3 ± 11.3 years and male predominance (72%) selected from EpiTer-2 database were included in the analysis; 72% of them were treatment-naïve. The majority of patients (55%) received the combination of sofosbuvir/velpatasvir (SOF/VEL), 71 without and 58 with ribavirin (RBV), whereas the remaining 107 individuals were assigned to glecaprevir/pibrentasvir (GLE/PIB). The effectiveness of the treatment following GLE/PIB and SOF/VEL regimens (96% and 93%) was higher compared to SOF/VEL + RBV option (79%). The univariate analysis demonstrated the significantly lower sustained virologic response in males, in patients with baseline HCV RNA ≥ 1,000,000 IU/mL, and among those who failed previous DAA-based therapy. The multivariate logistic regression analysis recognized only the male gender and presence of ascites at baseline as the independent factors of non-response to treatment. It should be emphasized that despite the availability of pangenotypic, strong therapeutic options, GT3 infected patients with cirrhosis still remain difficult-to-treat, especially those with hepatic impairment and DAA-experienced.

Background: Patients with kidney failure are at an increased risk of progression to a severe form of coronavirus disease 2019 (COVID-19) with high mortality. The current analysis was aimed to assess the impact of renal failure on the severity of COVID-19 and identify the risk factors of the fatal outcome in this population. Methods: The analysis included patients from the SARSTer database, a national real-world study evaluating treatment for COVID-19 in 30 Polish centers. Data were completed retrospectively and submitted online. Results: A total of 2322 patients were included in the analysis. Kidney failure was diagnosed in 455 individuals (19.65%), of whom 373 presented moderate stage and 82 patients, including 14 dialysis individuals, presented severe renal failure. Patients with kidney failure were significantly older and demonstrated a more severe course of COVID-19. The age, baseline SpO2, the ordinal scale of 4 and 5, neutrophil and platelet count, estimated glomerular filtration rate, and C-reactive protein concentration as well as malignancy and arterial hypertension were the independent predictors of 28-day mortality in logistic regression analysis. Conclusions: Underlying kidney disease in patients with COVID-19 is among the leading factors associated with a higher risk of severe clinical presentation and increased mortality rate.