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Cel pracyCelem realizowanego projektu była ocena częstości występowania zaburzeń poznawczych oraz ustalenie związków pomiędzy ich występowaniem a zmiennymi klinicznymi i socjodemograficznymi u dzieci i młodzieży z wertykalnym zakażeniem HIV.MetodaW badaniu udział wzięło: 50 dzieci z wrodzonym zakażeniem HIV (PHIV+), w wieku 6-18 lat, 24 zdrowych dzieci urodzonych przez matki zakażone HIV (PHEU) oraz 43 zdrowych dzieci zdrowych rodziców (HIV-nA). Do oceny zaburzeń poznawczych użyto baterii testów CANTAB Research Suite.WynikiU osób z grupy PHIV+ stwierdzono, istotnie gorsze wyniki w porównaniu z grupą HIV-nA w zakresie przełączania uwagi, elastyczności poznawczej, wykorzystywania informacji zwrotnych oraz pamięci roboczej, a w stosunku do grupy PHEU - dłuższy czas planowania podczas wykonania zadania. Analiza wyników dla grupy wiekowej 12-18 lat wskazuje na pogorszenie funkcji wykonawczych w grupie PHIV+ w stosunku do grupy HIV-nA, widoczne dla każdego z testów. Wyższy logarytm wiremii na początku wdrożonego leczenia ARV związany był ze słabszymi wynikami w zakresie korzystania z informacji zwrotnej, przerzutności uwagi i elastyczności poznawczej oraz z wolniejszym przetwarzaniem.WnioskiWyniki badań wskazują na gorsze funkcjonowanie poznawcze młodzieży PHIV+, przy czym deficyty te są związane z zaawansowaniem infekcji przed leczeniem oraz narastają wraz z czasem trwania neuroinfekcji.

The purpose of the paper was to present the importance of regional and tourism books f or t he tourism market on the example of the town of Grudziądz, Poland. The paper discusses the concept of and the motivations for heritage tourism as well as the role of the tourism product, which includes tourism and heritage books. Also, the reasons for purchasing tourism products are discussed and different types of tourism books are presented based on the example of the publishing market in Grudziądz. Finally, the paper presents different types of tourism publications related to the Kujawsko-Pomorskie region of Poland, specifically the town of Grudziądz. Celem artykułu jest zaprezentowanie znaczenia książki regionalnej i turystycznej dla rynku turystycznego na przykładzie miasta Grudziądza. W artykule omówiono zagadnienie turystyki krajoznawczej, motywy jej uprawiania oraz rolę tzw. produktu turystycznego, do którego można zaliczyć książkę turystyczną i krajoznawczą. Zwrócono uwagę na motywy zakupu produktu turystycznego oraz przedstawiono typy książek turystycznych na przykładzie rynku wydawniczego Grudziądza. Na koniec zaprezentowano przykładowe typy publikacji związanych z turystyką w obszarze województwa kujawsko-pomorskiego, ze szczególnym uwzględnieniem Grudziądza. Artykuł został oparty o analizę bibliograficzną, analizę literatury oraz dane zaczerpnięte w jednostkach samorządu terytorialnego zajmujących się udzielaniem informacji.

Objectives: Our study evaluates the impact of adjuvant treatment with external beam radiotherapy (EBRT) combined with vaginal high-dose-rate brachytherapy (HDR BT) on health-related quality of life (HRQL) in patients with early-stage endometrioid endometrial carcinoma. Material and methods: We assessed HRQL of patients based on the EORTC QLQ-C30 questionnaire, with endometrial cancer specific HRQL module — EORTC QLQ-EN24. From March 2019 to April 2020 we enrolled 20 patients with early-stage endometrioid endometrial carcinoma, qualified for adjuvant treatment after hysterectomy. We compared the scores measured with the questionnaires at the beginning and at the end of the treatment. Results: There was a statistically significant decrease in the mean of global health status/quality of life assessed according to the EORTC QLQ-C30 scale, from 62.25 ± 13.12 at the beginning of the adjuvant radiotherapy to 55.85 ± 14.68 at the end of the treatment (p = 0.047). The mean appetite loss score was higher at the onset of the treatment as compared to its value after EBRT, 19.9 ± 27.33 vs 11.6 ± 19.52 (p = 0.043). Similarly to the mean constipation score, which was 29.85 ± 30.40 vs 11.6 ± 19.52 (p = 0.013). The mean diarrhoea symptom scale increased from 16.55 ± 20.16 to 56.75 ± 36.10 (p = 0.001). In the EORTC QLQ-EN24 scales, gastrointestinal symptoms scores were higher at the end of the treatment, (with the mean of 26.45 ± 22.76) as compared to 14.30 ± 16.52 at the beginning of EBRT (p = 0.003). Conclusions: Patients who receive adjuvant radiotherapy have decreased quality of life during the treatment reporting more serious gastrointestinal symptoms. The potential risk of treatment-related toxicity should be taken into account during the treatment planning process in order to minimize the deterioration of HRQL.

Paradoxical vocal fold movements is a complex and heterogenic syndrome. It is a functional disorder manifesting itself as a pathological adduction of vocal folds in the inspiratory and/ or expiratory phase, resulting in airway obstruction and dyspnoea. This pathology may appear as an extreme form of psychosomatization involving otolaryngological organs, leading to dyspnoea and stridor. The paper presents the case of a young woman who was admitted to hospital due to dyspnoea, stridor and hoarseness. The paper presents the clinical picture, diagnostics and therapeutic procedures which were used. Paradoksalne ruchy fałdów głosowych (ang. paradoxical vocal fold movements – PVFM) to kompleksowy, heterogenny zespół objawów o zróżnicowanej etiologii i manifestacji klinicznej. Jest to zaburzenie czynnościowe, które oznacza patologiczne przywiedzenie fałdów głosowych w fazie wdechowej i/lub wydechowej, co skutkuje obturacją dróg oddechowych i dusznością. Jednostka ta może być klinicznie skrajną postacią psychosomatyzacji, w zakresie laryngologicznym prowadzącą do objawów zwężenia głośni. W artykule zaprezentowano przypadek młodej kobiety, która zgłosiła się do szpitala z powodu duszności ze stridorem oraz chrypki. Przedstawiono obraz kliniczny, diagnostykę i postępowanie terapeutyczne.

Cel pracyOcena częstości występowania zaburzeń psychicznych, behawioralnych, emocjonalnych oraz ustalenie związków ze zmiennymi klinicznymi i socjodemograficznymi u dzieci i młodzieży z wertykalnym zakażeniem HIV.MetodaW badaniu udział wzięło 56 dzieci z wrodzonym zakażeniem HIV (grupa PHIV+), 24 zdrowych dzieci urodzonych przez matki zakażone HIV (grupa PHEU) oraz 43 zdrowych dzieci zdrowych rodziców (grupa HIV-nA), w wieku 6-18 lat. Do oceny zaburzeń behawioralnych i emocjonalnych zastosowano Kwestionariusz dla Rodziców CBCL/4-18 oraz Kwestionariusz Samooceny YSR, do oceny objawów zaburzeń psychicznych półustrukturyzowany wywiad diagnostyczny K-SADS-PL.WynikiWykazano wyższą częstość występowania zaburzeń psychicznych w ciągu życia w grupie PHIV+ oraz grupie PHEU w porównaniu z grupą HIV-nA. Najczęściej diagnozowano zaburzenia lękowe oraz zaburzenia nastroju. Występowanie objawów zaburzeń emocjonalnych i behawioralnych w grupie PHIV+ oraz w grupie PHEU było związane z podobnymi zmiennymi socjodemograficznymi (m.in. płeć męska, niezamieszkiwanie z opiekunem biologicznym, doświadczenie stresującego wydarzenia w życiu). Zaburzenia psychiczne występowały częściej u osób, u których leczenie antyretrowirusowe (ARV) rozpoczęto dopiero po 12 m.ż. Stwierdzono dodatnią korelację pomiędzy wynikiem dla części skal YSR i CBCL/4-18, a liczbą limfocytów CD4 w momencie przeprowadzania badania oraz wyższym logarytmem wiremii na początku leczenia ARV i w momencie ustalenia rozpoznania zakażenia HIV.WnioskiW grupie dzieci PHIV+ oraz PHEU, stwierdzono wyższą częstość występowania zaburzeń psychicznych. Cięższy przebieg zakażenia HIV i jego nasilenie przed rozpoczęciem leczenia wiąże się z większym nasileniem problemów internalizacyjnych.

Introduction. The aim of this prospective study was to estimate the perception and popularity of complementary and alternative medicine (CAM) subtypes and the reasons for usage among adult Polish cancer patients. Material and methods. The validated questionnaire was conducted among 310 patients. 24.1% of the patients used CAM during their oncological treatment. Risk factors for CAM usage were: female gender, university degree and radical treatment. The most common reasons for CAM usage were: boosting the immune system (46.1%), improving well-being/ counteracting the ill effects of cancer and its treatment (40.8%). The average level of satisfaction with CAM was high (≥3/5 on a Likert scale). Nearly half of the patients (46.6%) admitted not informing their doctors about their CAM usage. Conclusions. The growing popularity and heterogeneity of CAM methods make it an important issue for patient–doctor relations in Poland and other Central European countries. The results of this study indicate what topics should be covered while introducing patient education programs.

One of the commonly applied methods in the case of median to advance stages of liver cancer is the transarterial chemoembolization (TACE) procedure. It involves the administration of relatively high doses of cytostatics to the tumour-supplying artery followed by the embolization of the vessel. It limits the drug action almost only to the tumour mass. However, this also reduces the availability of oxygen, which stimulates cell migration. Therefore, the study aimed to assess how the introduction of an additional drug — dexamethasone and its combination with doxorubicin will impact the viability and migration of HepG2 cells under hypoxia-mimic conditions. To assess the basic response of the cells to the drugs and evaluate the interaction between them MTT assay and apoptosis assay were used. To analyse the migratory potential transwell migration assay was applied. Epithelial-mesenchymal transition (EMT) markers and apoptosis-related proteins were studied using Western blot assay. Hypoxia-mimic conditions were induced using pretreatment with cobalt chloride. The obtained results suggest that the developed doxorubicin: dexamethasone combination limits hypoxia-induced increase in the migratory potential of HCC cells, which is connected with the inhibition of the EMT process and directing cells to death on the cellular level.

Purpose The aim of the prospective study was to assess changes during treatment and prognostic significance of cervical vascularization density in patients with cervical squamous cell carcinoma (SCC) staged II B and III B and to find relationship of cervical vascularization density with tumour diameter, grading, staging and age of patients. Methods The study group included 50 patients who underwent transvaginal Doppler ultrasonography prior to chemoradiotherapy, after external beam radiation therapy (EBRT) and 6 weeks after HDR brachytherapy. The colour Doppler (CD) vascularity index (CDVI) and the power Doppler (PD) vascularity index (PDVI) in cervical tumour were examined. Results CDVI and PDVI values decreased significantly during radiotherapy (0.13 (95% CI 0.09–0.16); 0.09 (95% CI 0.07–0.11) and 0.05 (95% CI 0.03–0.06) for CDVI (p p p = 0.041). The higher (above median) PDVI values before EBRT were associated with superior DFS (p = 0.011) and OS (p Conclusions In the study group, cervical vascularization density evaluated in CD and PD functions did not depend on tumour diameter, grading, staging and age of patients and decreased during radiotherapy. The prognosis for our patients with CDVI and PDVI before the treatment above the median value was better than compared to patients with these parameters below the median value.

Introduction Sodium-glucose cotransporter (SGLT2) inhibitors may additionally benefit patients with diabetes by improving their erythropoiesis followed by the elevation of hemoglobin and hematocrit levels. Reason for the report In the case described, severe normocytic normochromic anemia was resolved when empagliflozin had been introduced to the therapy. Case summary A 78-year-old male patient was admitted to our hospital with a non-ST-segment elevation myocardial infarction. His past medical history included diabetes, right coronary artery angioplasty, myocardial infarction and paroxysmal atrial fibrillation which required anticoagulant treatment. When examined, severe normocytic normochromic anemia was also diagnosed. About two years prior to his admission, the patient began suffering from persistent anemia despite the modification of his anticoagulant therapy with warfarin, rivaroxaban and dabigatran. An extensive evaluation failed to provide an explanation for his anemia. Outcome Eventually, only the introduction of empagliflozin successfully increased the values of hemoglobin and hematocrit. Therefore, it transpires that SGLT2 enhances erythropoietin (EPO) secretion which subsequently raises hematocrit levels in patients with severe anemia. Graphic abstract

Introduction The article describes the design assumptions and the practical implementation of the educational project called Malopolska Educational Cloud. It is an example of an innovative solution using modern technology in the field of education. The problem and purpose of the research The implementation of the project resulted from the observation of unfavorable phenomena occurring in the area of education at the junction of upper secondary and higher schools, which were confirmed in the research described in the paper. Successively, the issues covering the project's objectives were discussed, the target group: recipients, was characterized and the project's innovation was assessed. State of knowledge Then the issue of a disabled person as a user of the Educational Cloud was presented. The assessment indicated that the project implementation allows for greater activation of people with disabilities, including thanks to the possibility of participating in virtual classes, lectures and laboratories, and thus remote learning using the created network, without the need to move. It has been shown that the project implements the principle of equal opportunities and non-discrimination, including accessibility for people with disabilities, has a positive impact on it and is made in accordance with the principle of universal design. Summary The described project consists in incorporating technology into improving the course of cognitive processes and the importance of this research for education, including increasing the effectiveness of the learning and teaching process by virtualizing education. The conclusions drawn concern the most difficult group in terms of education: disabled students as users.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has affected the health of the entire population. Neoplastic diseases of the immune system are associated with increased COVID-related mortality. Vaccination is the only effective way to reduce morbidity and mortality, yet vaccine hesitancy has been observed. The aim of this study was to assess attitudes towards vaccination among lymphoma patients and to identify vaccine hesitancy predictors. Material and methods: The study was conducted on 280 patients with lymphoma who took part anonymously in a web-based survey prepared by the Pokonaj Chloniaka Foundation. The survey assessed: attitude to and perception of COVID-19 vaccines, the perceived likelihood of COVID-19 infection, personal experiences with COVID-19, and demographic data. Results: In our sample, almost one patient in three was vaccine-hesitant. The percentage was higher among patients living in the countryside, villages and smaller towns and in those not educated beyond high school level. The acceptance of vaccination increased with patient age. The high number of skeptical patients could be potentially dangerous, with regard to the high COVID-related complications and mortality. Conclusions: Clear and easily understood information on COVID vaccines can reduce the risk of COVID-related issues. This subject should be addressed in educational campaigns focused particularly on the identified groups of vaccination skeptics.

Przeobrażenia naszej codzienności, które nastąpiły za sprawą ogólnoświatowej pandemii wywołanej przez COVID-19, mocno zreorganizowały wiele płaszczyzn naszego życia, do których specyfiki dotychczas przywykliśmy. Zagadnienie to jest wyraźnie widoczne także na płaszczyźnie artystycznej. Przez brak możliwości organizowania wydarzeń, wspólnych spotkań kulturalnych mocno przekształcił się charakter popularyzowania kultury, wydobywając nowe metody działań, niejednokrotnie wchodzących w silną dygresję z pierwotnym celem twórczości, jakim jest bezpośredni kontakt odbiorcy ze sztuką. Artykuł stanowi próbę odpowiedzi na pytanie: „Jak sobie z tym poradziliśmy?”.Artykuł zgłębia problem, skupiając się na analizie retrospektywnej i bieżącej wybranych działań w zakresie rozpowszechniania i promocji sztuki różnego rodzaju, odbywających się w obliczu przemodelowania rzeczywistości wywołanej wprowadzonymi obostrzeniami epidemiologicznymi. Analiza poparta jest przykładami aktywności sektora popularyzacji kultury i sztuki, zaistniałymi w reakcji na nagły lockdown, między innymi także działań odbywających się w Galerii Fashion Start-up Gallery, funkcjonującej przy Wydziale Architektury Wnętrz Akademii Sztuk Pięknych im. Jana Matejki w Krakowie, powstałej dzięki realizacji projektu „Projektowanie Przyszłości – program rozwoju Akademii Sztuk Pięknych im. Jana Matejki w Krakowie na lata 2018–2022”. W wyniku analizy określone zostały zmiany, narzędzia i ich rodzaje, które posłużyły w przemodelowaniu aktywności w sferze upowszechniania kultury, polegające na wielorakiej ekspozycji dzieła dla odbiorcy.

IntroductionWaterpipe smoking is gaining popularity among the youth in Poland and is evaluated for the first time in this work. The authors address the social and demographic factors that motivate young people to smoke and attempt to determine which of them contribute to habit formation.Material and methodsThe data were collected among school and university students in Poland during a global survey on various forms of tobacco use. Multivariable regression models were applied for odds-ratio evaluation. The data concern waterpipe and cigarette smoking habits.ResultsThe survey was completed by 19,097 respondents. The survey included 144 schools and 32 universities from 16 voivodeships in Poland. Respondent gender exhibited the highest ORs (95% Cl), both in the case of current and ever WP users: 2.11 (2.10–2.12) and 2.16 (2.15–2.17), respectively. The other important factor was a place of living: 1.83 (1.82–1.84) and 2.17 (2.16–2.18), respectively. All ORs were statistically significant for p = 0.05.ConclusionsThe prevalence of tobacco smoking among Polish youths is high. Waterpipe tobacco smoking was found to be the second most popular habit after cigarette smoking. Moreover, young smokers use other non-tobacco products in waterpipes, and drink alcohol during smoking sessions. Many young people try waterpipe smoking without previous experience with cigarettes.

Background. Since the emergence of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) in Wuhan, China, it has been extensively studied by many scientists. Susceptibility to SARS-CoV-2 infection is shown by people of all ages, especially those with different comorbidities. Our goal was to describe the clinical characteristics, treatment, course, and outcome of COVID-19 in patients with pre-existing neurological disorders. Method. We retrospectively studied 70 patients with COVID-19 and previous neurological diseases who were treated in the Central Clinical Hospital of the Ministry of the Interior and Administration from 16 March to 15 June 2020. Demographic data, symptoms, image data, laboratory results, treatment methods and results, clinical signs and symptoms of patients hospitalised due to CNS diseases with COVID-19 were collected. Results. The average age of hospitalised patients was 72, and the majority (63%) were women (44/70). The most common neurological disease was dementia, which was present in almost a third of patients (30.76%), followed by ischaemic stroke (24.61%). Chest imaging showed the presence of interstitial changes in 47% (33) of patients. Laboratory tests revealed increased total blood cells, increased levels of C-reactive protein, procalcitonin, D-dimers, liver indicator markers and IL-6 in the most severely affected patients. The treatment of patients was focused on monitoring their clinical condition, and supporting respiratory inefficiency with passive oxygen therapy and mechanical ventilation. According to the guidelines of the Hospital Therapeutic Committee, pharmacological treatment (Arechin®, Kaletra®) was introduced in cases without contraindications. In patients with moderate COVID-19, antimalarial or antiviral agents were applied (78%). 30% of our observed patients died during the hospitalisation. Conclusions. We studied a select group of patients (elderly, with comorbidities, and moderate or severe COVID-19 course). Pre-existing neurological disorders were additionally associated with a poorer prognosis and a high fatality rate (30%). Dementia and CNS vascular disorder were the most frequent pre-existing neurological conditions. The neurological symptoms of COVID-19 were various. We observed impaired consciousness, dizziness, headache, nausea, myalgia, psychomotor agitation and slowness, delirium, and psychoses. Further analysis is needed to elucidate the incidence of COVID-19 neurological complications.

We evaluated cervical volume and spectral Doppler parameters: peak systolic velocity (PSV), resistance index (RI) and pulsatility index (PI) in the tumour dominant vessel of 50 patients with cervical squamous cell carcinoma (SCC) staged IIB and IIIB and their changes during treatment. The patients underwent transvaginal Doppler ultrasonography prior to treatment, after external beam radiation therapy (EBRT) and 6 weeks after brachytherapy. Radiotherapy decreased cervical volume and PSV values of the tumour dominant vessel. The PSV values before EBRT in G1 + G2 tumours were higher than in G3 tumours. No correlations between cervical volume, PSV, RI and PI values with disease-free survival (DFS) and overall survival (OS) were found. We concluded, that sonographic assessment of changes in cervical volume of patients with locally advanced cervical SCC during treatment did not allow to predict treatment results. Spectral Doppler parameters PSV, RI and PI of tumour dominant vessel did not predict prognosis for these patients.Impact Statement

Cel pracy: Porównanie charakteru obrażeń części twarzowej i mózgowej czaszki skutkujących zgonem lub ciężkim uszczerbkiem na zdrowiu, powstałych w wyniku uderzania pięścią w część twarzową czaszki. Ocena i konfrontacja obu grup w zakresie ostatecznej prawno-karnej kwalifikacji czynu. Analiza uzasadnień wyroków sądów pod kątem strony podmiotowej czynu zabronionego. Próba zweryfikowania hipotezy zakładającej możliwość spowodowania zgonu albo ciężkiego uszczerbku na zdrowiu przez jedno uderzenie pięścią w część twarzową czaszki. Materiał i metody: Prawomocne orzeczenia Wydziałów Karnych Sądów Powszechnych dotyczące sytuacji, w których przyczynę zgonu lub ciężkiego uszczerbku na zdrowiu stanowiły obrażenia części twarzowej i mózgowej czaszki powstałe wyłącznie od uderzania pięścią w część twarzową czaszki. Ocena poszczególnych przypadków w obrębie każdej z grup pod kątem podobieństw i różnic. Analiza porównawcza obu grup. Wyniki: W przypadkach obrażeń części twarzowej czaszki przyczynę zgonu stanowiło uduszenie gwałtowne w przebiegu aspiracji krwi do dróg oddechowych, jednak prawno-karna kwalifikacja działania sprawców w tych przypadkach była zróżnicowana. W jednej sytuacji śmierć była wynikiem obrażeń części mózgowej czaszki, które niezwykle rzadko występują jako następstwo uderzenia pięścią w część twarzową czaszki. Ciężki uszczerbek na zdrowiu spowodowany był utratą widzenia w oku, zwykle wskutek pęknięcia gałki ocznej. Wnioski: Pomimo zbliżonych okoliczności urazu inny mechanizm odpowiadał za doprowadzenie do zgonu, a inny za spowodowanie ciężkiego uszczerbku na zdrowiu. Za spowodowanie najpoważniejszych skutków (śmierć i ciężki uszczerbek na zdrowiu) w ani jednym przypadku nie odpowiadało takie samo obrażenie. Jedno uderzenie pięścią w część twarzową czaszki może doprowadzić zarówno do śmierci, jak i do ciężkiego uszczerbku na zdrowiu. Prawno-karna ocena uderzania pięścią w twarz może być bardzo zróżnicowana. Opinion-related difficulties related to severe injuries of the facial and cerebral parts of the skull resulting from punching Aim: Comparison of injuries to the facial and cerebral parts of the skull causing death and grievous bodily harm, resulting solely from punches to the facial area of the skull. Assessment and confrontation of both groups in terms of the final criminal-legal classification of the perpetrator’s acts. Review of reasons for court judgements with a focus on the subjective elements of the prohibited act. Attempt to verify the hypothesis assuming that death or grievous bodily harm can be caused by a single punch to the facial part of the skull. Material and methods: Final judgements passed by criminal divisions of common courts of law in cases where death or grievous bodily harm was caused by injuries to the facial and cerebral parts of the skull resulting solely from punches to the facial area of the skull. Assessment of individual cases within each group to determine similarities and differences. Comparative analysis of both groups. Results: The cause of death in cases involving injuries to the facial part of the skull was rapid suffocation following blood aspiration into the respiratory tract. However, the criminal-legal classification of the perpetrators’ actions in these cases was varied. In one case, death resulted from injuries to the cerebral part of the skull, which are extremely rare as a result of a punch to the facial area within the skull. Grievous bodily harm was due to the loss of vision in the eye, typically due to eyeball rupture. Conclusions: Even though the circumstances of the injuries were similar, different mechanisms were responsible for causing death and grievous bodily harm in the victims. The most severe consequences (death and grievous bodily harm) were not caused by injuries of the same type in any of the cases studied. A single punch to the facial part of the skull may be enough to lead to either grievous bodily harm or death, but the criminal-legal assessment of punching to the face can vary greatly.

The broad spectrum of disorders of the long head of the biceps (LHBT) can be divided into 3 main categories: inflammatory reactions, degenerative conditions, and instability. More than 90% of patients with LHB tendinopathy have an additional shoulder pathology. Thus, a detailed radiological and histopathological evaluation is crucial for a complete and accurate diagnosis. The pathology of the LHBT starts from its ultrastructure with the alterations of both tenocytes and extracellular matrix. Furthermore, this is reflected in the light microscopy investigation, with marginal inflammatory response. The ultrasonography is useful in the detection of LHBT instability, hypoechogenic areas, increased tendon diameter, and dynamic examination of the tendon. A standard non-contrast magnetic resonance imaging (MRI) of the shoulder is a useful tool in the diagnostics of advance tendinopathy; however, it is essentially limited in the detection of partial tears. Based on current knowledge, ultrasound and MRI diagnostics modalities should be simultaneously used in the examination of LHBT disorders.

Congenital heart defects are often accompanied by defects in great vessels, such as aortic coarctation with various forms of aortic arc hypoplasia, vascular rings and positional anomalies. Surgical treatment and the choice of optimal defect correction technique in the child may affect the restoration, maintenance or the arrest of blood supply by the aorta to arterial vessels given off by the aortic arch. Proper, closest physiological vascularisation of individual parts of the body and organs is necessary for proper development and maintenance of physiological function. The consequence of the use of various strategies for correcting congenital defects of the aorta and the use of available surgical techniques may be perfusion disorders, also in the field of vessels supplying upper limbs, most often the upper left limb. In this article, we have attempted to develop a universal strategy for assessing the development and function of the upper extremities in children. It consists of cardiac methods of cardiovascular evaluation and physiotherapeutic function tests of the upper limbs adapted to the age of patients. Confirmation of the long-term importance of maintaining or restoring the blood supply by the aorta on the basis of objective function tests of the upper extremities may be an additional argument while choosing the optimal surgical method in the youngest children.

Introduction Paradoxically, the literature lacks an assessment of the impact of various factors on subsequent coronary interventions in patients with coronary artery disease (CAD). Aim To assess the impact of various factors on subsequent percutaneous transluminal coronary angioplasty (PTCA), as well as to characterize the clinical profile of people undergoing repeated diagnostic coronary angiography without significant coronary artery changes. Material and methods We investigated retrospective data from 4041 subjects according to the clinical factors which may affect the occurrence of unplanned future PTCA. Results The strongest risk factors for subsequent PTCA were significant stenosis of left descending artery (OR = 2.17, 95% CI: 1.09-4.32) during baseline coronary angiography, the atherosclerotic burden (number of critically narrowed vessels) (OR for narrowing lesions in 3 epicardial arteries 12.13, 95% CI: 5.40-27.27), and restenosis in a previously implanted stent (OR = 4.34, 95% CI: 1.96-9.62). A strong positive relationship between total mortality and the number of critically narrowed coronary arteries (during baseline hospitalization) was observed. Patients without significant coronary artery stenosis in two diagnostic angiographies (control group) differed from subjects with hemodynamic relevant CAD in: higher creatinine levels, more frequent presence of chronic obstructive pulmonary disease and more frequent symptoms of intermittent claudication. Conclusions The results of the study are in accord with real clinical practice. The arteriosclerotic burden is a major cause of recurrent PTCA, but an important clinical issue is the qualification for recurrent coronary-angiography in those patients whose previous coronary angiography did not show significant stenosis, because other clinical causes may explain their symptoms.

Purpose: To test the NAL and eNAL correction protocols using daily patient setup displacements. Methods and material: In total, the analysis was performed for 749 and 797 kV CBCT images for gynecological and prostate patients, respectively, each of 30 patients. After the planning procedure, patients were set up on the treatment table in the treatment position every day. The on-line correction protocol was applied. KV CBCT images were acquired by means of x-ray lamp mounted orthogonally on Linac. Patient setup displacement was assigned. NAL and eNAL corrections protocols were simulated using daily data from online corrections for these two groups of patients. The overall systematic error and random error were calculated for each direction. Results: For the prostate group, the random errors for daily Raw data (no correction) in LAT, LONG, and VERT directions were 2.0 mm, 1.6 mm, and 3.2 mm, respectively. For NAL and eNAL protocols, they were in the range of 1.8 mm to 3.2 mm. For the gynecological group, the random errors were: for daily Raw data 2.2 mm, 1.7 mm, and 3.2 mm, respectively. For NAL and eNAL protocols, they were in the range of 2.0 to 3.4 mm. For the prostate group, values of systematic errors 1.8 mm, 1.8 mm, and 3.3 mm, respectively for Raw data. For NAL and eNAL protocols, these values were less than 1.8 mm. For the gynecological group, the systematic errors were 2.6 mm, 2.3 mm, and 2.8 mm, respectively, for Raw data. For NAL ana eNAL protocols less than 1.8 mm. For the gynecological group, for Raw data, 45% of the total displacement vectors exceeded 5 mm, whereas only 25% did after the NAL procedure and 29% after the eNAL procedure. For the prostate group, for Raw data, 34% of the total displacement vectors exceeded 5 mm, whereas only 22% did after NAL procedure and 28% after eNAL procedure Conclusions: For gynecological and prostate cancer patients, the NAL and eNAL correction protocols can be safely applied to substantially reduce setup errors.

The long life gluten-free diet is the most effective method of preventing symptoms in celiac disease. Thus, awareness of 160 patients suffering from the disorder was examined, as a crucial paramete...

Iatrogenic nerve injury during surgery is a major source of concern for both patients and surgeons. This study aimed to identify the nerves most commonly injured during surgery, along with the commonly associated operative procedures. A literature search was conducted using the PubMed database to identify nerves commonly injured during surgery, along with the surgical procedure associated with the injury. The following 11 nerves, ranked in order with their associated surgical procedures, were found to be the most commonly injured: (a) intercostobrachial nerve in axillary lymph node dissections and transaxillary breast augmentations, (b) vestibulocochlear nerve in cerebellopontine tumor resections and vestibular schwannoma removals, c) facial nerve in surgeries of the inner ear and cheek region, (d) long thoracic nerve in axillary lymph node dissections, (e) spinal accessory nerve in surgeries of the posterior triangle of the neck and cervical lymph node biopsies, (f) recurrent laryngeal nerve in thyroid surgeries, (g) genitofemoral nerve in inguinal hernia and varicocele surgeries, (h) sciatic nerve in acetabular fracture repairs and osteotomies, (i) median nerve in carpal tunnel release surgeries, (j) common fibular nerve in varicose vein and short saphenous vein surgeries, and (k) ulnar nerve in supracondylar fracture surgeries. Although the root cause of iatrogenic nerve injury differs for each nerve, there are four unifying factors that could potentially decrease this risk for all peripheral nerves. These four influencing factors include knowledge of potential anatomical variations, visual identification of at-risk nerves during the procedure, intraoperative nerve monitoring, and expertise of the surgeon.

The implementation of precision farming technologies into agricultural practice requires, among other things, precise determination of the extent and intensity of insect infestation in the farmer' fields. Manual insect identification is time-consuming and has low efficiency, especially for large fields. Therefore, scientists and practitioners devote much effort to the automatization of this process. There are two complementary approaches to insect identification: (i) direct, in which the insect (ultimately the species) is determined, and (ii) indirect, in which the damage caused by the insects is monitored and forms the basis on which to formulate the information about insect infestation. A mini-review of both approaches is presented in this work. Additionally, the advantages and disadvantages of each are briefly described. Methods of insect identification are still characterized by relatively small selectivity and efficiency, therefore it is necessary to keep searching for new methods and improve the development of existing ones. The goal of such systems should be to work in real time and be inexpensive to run, enabling widespread use amongst farmers. A possible solution seems to be integrating various techniques (sensor fusion) into a single measurement system. © 2020 Society of Chemical Industry.

Kosz Katarzyna, Zarankiewicz Natalia, Zielińska Martyna, Kuchnicka Aleksandra. Changes in management of patients with cancer during COVID-19 pandemic. Journal of Education, Health and Sport. 2020;10(9):577-590. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.09.070 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.09.070 https://zenodo.org/record/4046094 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 17.09.2020. Revised: 23.09.2020. Accepted: 23.09.2020. Changes in management of patients with cancer during COVID-19 pandemic Katarzyna Kosz, Natalia Zarankiewicz, Martyna Zielińska, Aleksandra Kuchnicka Katarzyna Kosz ORCID iD: https://orcid.org/0000-0001-6848-0598 Affiliation: Student Scientific Group of Oncological Surgery, Radziwiłłowska 13 (SPSK Nr 1) 20-080 Lublin Medical University of Lublin Natalia Zarankiewicz ORCID iD: https://orcid.org/0000-0001-9203-3376 Affiliation: Student Scientific Group of Oncological Surgery, Radziwiłłowska 13 (SPSK Nr 1) 20-080 Lublin Medical University of Lublin Aleksandra Kuchnicka ORCID iD: https://orcid.org/0000-0001-8481-7592 Affiliation: Student Scientific Group of Oncological Surgery, Radziwiłłowska 13 (SPSK Nr 1) 20-080 Lublin Medical University of Lublin Martyna Zielińska ORCID iD: https://orcid.org/0000-0001-8886-8274 Affiliation: Student Scientific Group of Oncological Surgery, Radziwiłłowska 13 (SPSK Nr 1) 20-080 Lublin Medical University of Lublin ABSTRACT Introduction: As of March 11, 2020, COVID-19 has been declared as a global pandemic. It has spread rapidly and profoundly impact the function of health care system all around the world. As a result, management and organisation of oncology units had to be altered in order to provide security measures and safe care for patients. Purpose: The aim of this paper is to review current knowledge involving management of patients with malignancies during COVID-19 pandemic. Particular attention has been paid to changes in diagnosis, treatment and follow-up of patients with cancer. Material and methods: The review includes publications released in 2019 and 2020. The data has been collected by the use of PubMed, WHO website and other online published guidance. Results: As a lot of clinical trials has been suspended, current therapy options for patients with cancer has been also limited. Moreover, patients became fearful of becoming infected by SARS-CoV-2 and accordingly they were less likely to attend screening programmes. Additionally, as the amount of surgeries has been reduced, the need for radiotherapy service has increased. Chemotherapy has been found to be risky for patients with cancer as it may favour them to SARS-CoV-2 infection. Conclusions: Appropriate security measures need to be implemented in order to protect against SARS-CoV-2 infection but optimal health care access should be provided as well. There is a high necessity to share knowledge and experience on the impact of pandemic on patients with malignancies. However, a lot of patients are fearful of COVID-19, adverse effects of delayed diagnosis, treatment and follow-up should not be diminished. Key words: cancer; covid-19; malignancy

Introduction Cervical cancer is the fourth most common cancer among women. It is related to persistent HPV infection. In order to improve diagnostic methods, a lot of research has been focused on detecting HPV DNA. A test known as a high-risk HPV test or HPV primary screening provides very encouraging results. Objective The aim of this review is to present the actual knowledge about the possibilities of cervical cancer screening methods. Particular attention is paid to the question concerning the effectiveness of detecting viral DNA as a screening programme, compared to pap smear. State of knowledge The HPV primary screening has higher sensitivity than the cervical smear test and it is able to detect lower-stage lesions, which are considered clinically irrelevant. Nonetheless, many HPV infections recede naturally. Therefore, relying only on the results of this test may expose women to unnecessary colposcopies and stress. Due to this fact, women under 30 years should not be screened with the hrHPV test. In view of its limitations, the HPV primary screening strategy is still tested worldwide as a pilot project. In Poland in 2019, a pilot project with the hrHPV test started at the National Institute of Oncology. Conclusions Detecting viral DNA has its advantages and disadvantages. Further research is still required, but the hrHPV test has a great opportunity to become one of the main screening programmes worldwide, or at least, a valuable addition to cervical smear test.

The lack of a uniform method for determining unacceptable HLA mismatches (UAMs) for organ transplantation worldwide has resulted in many different algorithms for donor-recipient matching. Here we present our proposal for changes to the current algorithm for immune evaluation of potential kidney recipients in Poland based on the experience of various transplantation centers. The most important finding of this article is an algorithm that stratifies the pretransplant immunologic risk based on strict laboratory criteria, enabling harmonization between transplant centers in Poland. This is because of a step-by-step algorithm for alloantibody assessment using solid-phase assays (SPA) and clearly defined technical issues, as well as cutoffs for reporting UAMs. Our novel approach focuses on a laboratory testing extension in the scope of HLA typing; detection and characterization of alloantibodies before transplantation; desensitization; and post-transplant monitoring. The proposed changes will allow for the assessment of clinically relevant anti-HLA antibodies with complement binding properties; the determination of UAMs in the potential donor; the calculation of virtual panel reactive antibodies (vPRA); the calculation of the recipient's immunologic rejection risk stratification; the assessment of the donor-recipient virtual cross-match (vXM); and the determination of the final recipient's selection for the biological cross-match testing. Collectively, the optimized algorithm permit for UAM verification is based on laboratory proofed data and will firmly improve organ allocation and transplant outcomes in Poland. We hope that this novel approach also improves the individual patient's risk stratification and future personalized treatment.

Introduction and purpose: Ovarian cancer (OC) takes the 7th place among most common female malignancies worldwide. There are almost 240 thousand of new cases diagnosed each year and the number is constantly growing. Defining risk factors of OC is essential to provide good education among women and predict this malignancy better. The aim of this review is to analyze the current data on risk factors of OC concentrating on family history, obesity andoral contraceptives use. Material and method: This review was based on articles from 2010 to 2020 collected in PubMed and concerning the impact of several risk factors on developing OC. Results: The best described risk factor of OC is genetics and family history. 75% or hereditary OCs are associated to BRCA genes mutations, especially BRCA1. Other mutations increasing the risk of OC are MSH2 and MLH1 genes mutations. Diverse risk factors correlate with different histological subtypes of OC. Obesity increases the levels of estrogens, androgens and leptin, which may promote the proliferation of ovarian epithelial cells. Using oral contraceptives is related to 20% decreased risk of OC for each 5 years of use. Conclusions: BRCA1/2, MSH2 and MLH1 mutations and obesity are well-defined risk factors of ovarian cancer. The first-choice risk-reducing procedure among BRCA carriers is bilateral salpingo-oophorectomy. On the contrary, using oral contraceptives results in decreased risk of OC. Promoting knowledge about OC risk factors among women and healthcare professionals is crucial in order to reduce the number of ovarian cancer.

Delayed diagnosis of oral cavity and oropharyngeal cancer is associated with a poor prognosis. Despite progress in systemic therapy and radiotherapy, there has only been a slight improvement in the five-year survival rate. A non-invasive diagnostic method that consists of an assessment of specific proteins in saliva samples may significantly facilitate assessment of treatment results in patients diagnosed with oral and oropharyngeal cancer. The aim of this study was to assess the levels of IL-17 and TNF-α in the saliva of patients with oral and oropharyngeal cancer. The study was conducted prior to treatment in patients hospitalized in the Frederic Chopin Provincial Specialist Hospital No. 1 in Rzeszów, Poland. Saliva samples were collected from subjects on an empty stomach. Cytokine concentrations in the saliva were measured with ELISA and Luminex Multiplex Assays. The higher salivary concentrations of IL-17A, IL-17F, and TNF-α were significantly associated with disease advancement. Lower levels of IL-17A were associated with colonization of the oral cavity with aerobic bacteria. On the other hand, higher concentration of TNF-α was observed in patients with positive aerobic culture of oral swabs. Our results suggest that IL-17A, IL-17F, and TNF-α measured in the saliva may be a potential biomarker for cancer of the oral cavity and oropharynx.

Halina Zielińska-Więczkowska, Katarzyna Sas Department of Social and Medical Sciences, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz, Bydgoszcz, PolandCorrespondence: Katarzyna SasDepartment of Social and Medical Sciences, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, ul Świętojańska 20, Bydgoszcz 85077, PolandEmail katarzyna.sas@hotmail.comPurpose: The aim of the study was to assess the relationship between the sense of coherence and self-perception of aging and the risk of depression among attendees of the University of the Third Age (U3A). The influence of socio-demographic factors was studied.Participants and Methods: The study involved 315 attendees of the U3A aged on average 68.4 years, age range 60– 82 years old. The overwhelming majority were women (91.7%). Cross-sectional research was conducted using standardized questionnaires – the SOC-29 scale, the Geriatric Depression Scale (GDS – brief version) and the author’s own questionnaire regarding self-perception of aging.Results: The study participants showed an average level of sense of coherence (130.7± 23.2). The highest number of people obtained average results of sense of coherence, both in terms of global SOC (75.2%) and its components. The highest scores on the SOC-29 scale were found for the sense of comprehensibility (41.3%). The mean value of the self-perception of aging was 69.0± 16.0 and indicates the lower range of results for positive attitude. Nearly ¾ (72.1%) of the respondents had a positive self-perception of aging. The values of the scale of self-perception of aging showed a statistically significant relation to the global level of sense of coherence and its components (p< 0.001). In people without depression, positive self-perception of aging was significantly more frequent than among participants with depression of increasing intensity. Education was significantly correlated with the results of the SOC-29 scale, the self-perception of aging scale and the GDS scale.Conclusion: From the U3A research group, better educated elderly people have a higher sense of coherence and show a more positive self-perception of aging. Moreover, these people are less likely to show signs of senile depression.Keywords: sense of coherence, SOC, self-perception of aging, depression, socio-demographic factors, University of the Third Age, U3A

Introduction . Strokes often cause dysfunctions in the reception and transmission of speech, which may be aphasia or dysarthria. These disorders can lead to disability, which imposes limitations on the patient, even leads to a complete breakdown of roles and social bonds. Aim . The main aim of the study was to assess the impact of the type and degree of apathetic disorders on the quality of life of patients after ischemic stroke. Material and Methods . The research was carried out at the Neurological Department of the Provincial Specialist Hospital in Wloclawek. On average 68 patients with apathetic disorders and diagnosed ischemic stroke were qualified for the study. The study was conducted using the method of diagnostic survey. It consisted in the assessment of patients using the generally available SODA diagnostic tool — the Aphasia Dynamics Assessment Scale and a standardized tool, the WHOQOL-BREF questionnaire by Krystyna Jaracz. Results . When assessing the impact of the degree of aphasia on the quality of life, a statistically significant difference was observed in the overall quality of life in patients with complete (p = 0.012), significant (p = 0.012) and moderate (p = 0.031) aphasia. In self-assessment of health status, a statistically significant difference was found only in patients with complete aphasia (p = 0.048). In the physical, psychological and environmental domains, a statistically significant differences was observed in patients with severe aphasia (p = 0.05). Conclusions . The type and degree of apathetic disorders has been shown to affect the quality of life of patients. Each type of aphasia worsens the overall quality of life, and in addition, motor and sensory aphasia negatively affects functioning in the psychological field. It has also been shown that the more advanced the degree of apathetic disorders, the worse the overall quality of life, self-esteem of health, and worse physical, psychological and environmental functioning. (JNNN 2020;9(3):108–113)

Introduction Psoriasis is a chronic skin disease which can have a detrimental impact on the patient’s life. The correlation between depression, psoriasis and inflammation is a subject of many publications. The depressive and psoriatic symptoms, unhealthy coping strategies and stigmatization might be presented in the mechanism of the vicious circle. The appropriate understanding of this phenomenon might be extremely useful for specialists to improve their bedside manner. Objective The aim of this review is to analyze the current data about the worldwide presence of the major depressive disorder – psoriasis, and the occurrence of depression in patients suffering from psoriasis. Research and analysis were based on searching sources such as PubMed, UpToDate and World Health Organization pages for the integrative publications collected mainly from last 10 years. The data about the origin of the psoriasis disease was taken from as 1979 publication. State of knowledge The study demonstrated that the link between psoriasis and depression is bi-directional. The pro-inflammatory cytokine, such as IL-6, TNF-α, CRP and IL-17, are elevated in both cases, which provokes the exacerbation of sickness symptoms. The inflammation dangerously disturbs the functioning of neuronal system and human homeostasis. Summary According to the cited research, the prevalence of depressive disorders in psoriatic patients is higher in comparison to people without psoriasis. Inflammation plays an essential role by being a peculiar connector between psoriasis and depression. Stress and inflammation are crucial factors in pathogenesis of those two disorders and triggers the pathological mechanisms.

Introduction and objectives Breast cancer (BC) is the most common malignancy and the leading cause of cancer death among women. About 15–20% of all BCs are HER2-positive. Proper assessment of HER2 status is crucial to choose appropriate treatment. The review summarizes data on anti-HER2 drugs used to treat HER2-positive BC and provides basic information on new agents under investigation. Brief description of the state of knowledge. Specific HER2-targeting drugs are available or are being evaluated in clinical trials. Anti-HER2 agents include: monoclonal antibodies, tyrosine kinase inhibitors, antibody-drug conjugates, bispecific antibodies, PI3K/AKT/mTOR inhibitors and heat shock protein 90 inhibitors, HER2-targeting vaccines and CDK4/6 inhibitors. The advent of anti-HER2 therapies increased the time of progression free survival and overall survival in BC patients. Results Final analysis of the CLEOPATRA trial shows that the combination of trastuzumab, pertuzumab and taxane significantly improved outcomes in metastatic HER2-positive BC and it is currently preferred first-line treatment. The recommended second-line treatment is based on trastuzumab emtansine or on the combination of lapatinib and capecitabine. Some promising agents such as margetuximab or trastuzumab deruxtecan are still under investigation. Conclusions Anti-HER2 directed treatment undoubtedly improves outcomes among patients with HER2-positive BC. Access to drugs such as trastuzumab, pertuzumab, lapatinib and T-DM1 improves prognosis even in patients with advanced disease. Further studies and clinical trials on novel anti-HER2 therapies are required. Nevertheless, BC treatment is becoming more effective and, hopefully, one day it may be possible to cure patients even with metastases.

Purpose The aim of this study was to assess the levels of selected markers in patients who underwent planned or emergency coronary angiography and to examine if they correlated with the occurrence of AKI. Methods The study included 52 patients who underwent planned or emergency coronary angiography and received contrast agent. Serum levels of markers (NGAL, L-FABP, KIM-1, IL-18) were analyzed in all patients using ELISA tests, at baseline, after 24 and 72 h from angiography. Results 9.62% of patients developed CI-AKI. No significant differences were observed between markers levels in patients who developed CI-AKI and those who did not. After 24 h, serum levels of IL-18 were higher in patients with CI-AKI, however, this difference was on the verge of significance. Increase in serum NGAL, KIM-1 and IL-18 was observed after 24 h. Serum levels of biomarkers were insignificantly higher in group with CI-AKI. Significant changes in levels in time (baseline vs. 24 h vs. 72 h) were observed only for NGAL [157.9 (92.4–221.0) vs. 201.8 (156.5–299.9) vs. 118.5 (73.4–198.7); p Conclusion Obtained results do not allow for the indication of efficient AKI biomarkers. Their further validation in large studies of CI-AKI patients is required.

Aim: Sudden sensorineural hearing loss (SSNHL) involves acute unexplained hearing loss, nearly always one-sided of 30dB or greater over at least three contiguous audiometric frequencies. The aetiology of SSNHL is mostly unknown. According to the literature, the causes include vascular, microbial and autoimmune problems. There is still no agreed standard treatment. The aim of the paper was to evaluate the results of combined pharmacotherapy and hyperbaric oxygen therapy in patients with idiopathic sudden deafness. Material/Methods: The study was carried out on 40 patients with SSNHL. The patients were divided into two groups: group I – 24 patients treated with the combined pharmacotherapy and hyperbaric oxygen therapy and group II – 16 patients treated only pharmacologically. The patients from Group 1 were treated in the Centre of Hyperbaric Therapy CREATOR Ltd. in Lodz, Poland. Each patient underwent 15 sessions in a hyperbaric chamber. In all patients, the percentage of hearing loss for the selected frequencies was assessed before and after the therapy according to Sabine and Fowler. Results: The group of 40 patie nts aged from 33 to 77 years (mean 52.4) included 21 females and 19 males. Group I consisted of 24 patients, 11 females and 13 males, group II consisted of 16 patients, 10 females, and 6 males. After therapy, the mean hearing level in all patients improved by 27.14%, in Group I – by 34.34%, in Group II – by 16.3%. Conclusions: Early hyperbaric oxygen therapy combined with steroid therapy improves prognosis and shows good results in sudden hearing loss treatment.

Background: The role of sleep disturbances in patients with inflammatory bowel disease (IBD) remained relatively unknown. The aim of this study was to identify the adipokine profile in the patients...

BackgroundIrritable bowel syndrome (IBS) is a chronic condition with recurring gastrointestinal (GI) symptoms: altered motility and abdominal pain. As endogenous opioid system participates in pain perception and in the control of GI peristalsis, opioids have been proposed as a promising therapy in IBS. In a previous study, we observed that morphiceptin derivative, P-317 (Dmt-cyclo-(d-Lys-Phe-d-Pro-Asp)-NH2), presents promising features to be applied in IBS. In this project, we tested whether modifications in cyclic morphiceptin-based structure: fluorination (compound1) or peptide bond reduction (compound2) improve pharmacological effect.MethodsWe evaluated tested derivatives in the mouse GI system under physiological (GI transit) and pathophysiological (castor oil diarrhea, stress-induced hypermotility, visceral pain) conditions.ResultsBoth compounds prolonged GI transit. Compound1and P-317 inhibited upper GI transit and motility of the colon; compound2remained inactive. Compound1and P-317 inhibited hypermotility in stressed mice and delayed the acute diarrhea in comparison to control. Only P-317 exerted antinociceptive effect. None of tested derivatives, similar to P-317, affected locomotor activity.ConclusionsCompound1is equally effective as P-317 in the mouse GI tract. The peptide bond reduction decreased the activity of compound2. Fluorination appears to be an efficient way to increase the effects of morphiceptin analogs in the GI tract.

Photoepilation has become a very popular epilation procedure in esthetic and cosmetic practice. There are some types of lasers and other light sources used for epilation.The purpose of our study was to compare an IPL device with an IPL plus RF in one device, using a within-patient, right-left controlled study design.Thirty-three patients completed four treatment sessions and the follow-up period of the study.Hair reduction was effective after the first treatment, but similar results were achieved using the IPL system alone, and with IPL combined with RF. The degree of hair reduction increased after the following treatments, but the two methods yielded similar effects. Three months after the last treatment, some hair had regrown in both treatments, the combined IPL with RF treatment gave significantly better results than the IPL treatment alone.In conclusion, IPL and IPL-RF are effective hair reduction therapies, yielding similar effects in patients with skin phototypes II or III. However, IPL-RF can be more effective in long-term observations. These therapies are also safe and regarded be quite comfortable in this population.

The article discusses the potential impact of sustainable finance initiatives on financial stability. A careful literature review on the subject of sustainable development and stability of the financial sector is performed in order to identify potential gaps in policies and regulations. Existing considerations around the impact of sustainable development efforts focus exclusively on the consequences of climate change for the portfolio of assets held by the financial sector, whereas the author examines the growing market for sustainable financial instruments as a potential threat. The results indicate that sustainability features of new financial instruments are not methodically evaluated in the context of their credibility and may therefore suffer from sudden loss of value that is not accounted for under the existing supervisory mechanisms. Inconsistent definitions and no single perception of sustainability further enhance the risk for investors and issuers and that risk needs to be accounted for under the mechanisms safeguarding financial stability.

TRPV1 are involved in the control of the gastrointestinal (GI) functions and pain sensation. Their activation induces pain but it is followed by desensitization, which in turn causes analgesia. The studies from the last two decades indicate that TRPV1 are involved in visceral hypersensitivity in the GI tract and pathogenesis of irritable bowel syndrome (IBS). Therefore, the aim of this study is to assess the action of fast desensitizing agonist of TRPV1, palvanil (N-palmitoyl-vanillamine), in the murine GI tract and on nociception to evaluate its potential application in the therapy of IBS. The effect of palvanil on smooth muscle contractility was evaluated using organ baths. The impact of palvanil on intestinal secretion was assessed in Ussing chambers. In vivo, the action of palvanil (0.1–1 mg/kg) was assessed in whole GI transit, fecal pellet output, and colonic bead expulsion tests. The antinociceptive potency of palvanil was tested in the mustard oil-induced pain test. Palvanil inhibited colonic contractions (evoked by electrical field stimulation, EFS) and decreased the ion transport in the colon stimulated with forskolin. It did not affect secretion in experiments with veratridine. In vivo, palvanil prolonged whole GI transit at all doses tested. At the lower dose tested, it accelerated colonic motility during first 60 min following injection. By contrast, at the dose of 1 mg/kg, colonic motility was inhibited. Palvanil induced antinociceptive action at all tested doses in mustard oil-induced pain test. TRPV1 fast-desensitizing compounds, i.e., palvanil, may be promising agents in the therapy of IBS since it modulates intestinal motility and reduces visceral pain.

Metastasis is one of the most urgent issues in breast cancer patients. One of the factors necessary in the migration process is the remodeling of the extracellular matrix (ECM). Metalloproteinases (MMPs) can break down the elements of the ECM, which facilitates cell movement. Many highly aggressive tumors are characterized by high levels of MMPs. In the case of breast cancer, the association between MMP-9 and the migration potential and invasiveness of cells has been demonstrated. In addition, reports indicating increased migration of breast cancer cells after the administration of the commonly used cytostatic cyclophosphamide (CP) are particularly disturbing. Hence, our research aimed to assess the effect of CP treatment on MDA-MB-231 and MCF-7 cells and how this response is influenced by the downregulation of the MMP-9 level. The obtained results suggest that CP causes a decrease in the survival of breast cancer cells of various invasiveness, and the downregulation of MMP-9 enhances this effect, mainly by inducing apoptosis. Moreover, in the group of MMP-9 siRNA-transfected CP-treated cells, a more severe reduction in invasion and migration of cells of both lines was observed, as indicated by the migration and invasion transwell assays and Wound healing assay. Hence, we suggest that CP alone may not result in satisfactory therapeutic effects. On the other hand, the use of combination therapy targeting MMP-9, together with the CP, could improve the effectiveness of the treatment. Additionally, we confirmed a relationship between the levels of MMP-9 and cytokeratin 19 (CK19).

Hyperproliferative skin diseases (HSD) are a group of diseases that include cancers, pre-cancerous lesions and diseases of unknown etiology that present different skin manifestations in terms of the degree and distribution of the injuries. Anti-proliferative agents used to treat these diseases are so diverse, including 5-aminolevulinic acid, 5-fluorouracil, imiquimod, methotrexate, paclitaxel, podophyllotoxin, realgar, and corticosteroids in general. These drugs usually have low aqueous solubility, which consequently decreases skin permeation. Thus, their incorporation in lipid nanocarriers has been proposed with the main objective to increase the effectiveness of topical treatment and reduce side effects. This manuscript aims to describe the advantages of using lipid nanoparticles and liposomes that can be used to load diversity of chemically different drugs for the treatment of HSD., This research was funded by the Portuguese Science and Technology Foundation (FCT/MCT), European Funds (PRODER/COMPETE)—project UIDB/04469/2020 (strategic fund), co-financed by FEDER, under the Partnership Agreement PT2020. The work is also supported by the National Science Centre within the MINIATURA 4 for a single research activity (grant no: 2020/04/X/ST5/00789) and by the START 2021 Program of the Foundation for Polish Science (FNP) granted to Aleksandra Zielínska, info:eu-repo/semantics/publishedVersion

The challenges of the modern world require transformations in the energy market towards the possible reduction of consumption and greater use of renewable sources. The conducted research of consumers of this market confirms that the behaviour in the field of increased use of renewable energy is burdened with cognitive errors and motivational factors, which makes it difficult to conduct quantitative research. Electricity demand forecasting can be modelled using selected quantitative methods. In this way, not so much the behaviour, but the result of the consumer’s behaviour is predicted. The research presented in the article has been divided into two parts. The aim of the first one is to study the prospects of a greater share of renewable sources in obtaining energy in Poland, based on the attitudes and opinions of consumers on the retail energy market, legal regulations and the energy balance. The aim of the second part is to build forecasts of daily, weekly, monthly and quarterly electricity consumption in Poland, including the prediction of the RES share, using selected machine and deep learning methods. The analyses used the time series of daily electricity consumption in Poland from 2015–2021; the ENTSO-E data was obtained from the cire.pl website. Depending on the adopted forecast horizon, the forecasting method with the lowest MAPE error was exponential smoothing, SARIMA and NNETAR. An evolution of energy consumers’ attitudes towards pro-ecological and pro-social sensitivity and understanding of the importance of RES for the economy was also observed.

Background: This study aimed to evaluate the efficacy and safety of secukinumab 150 mg compared with placebo in the management of spinal pain and disease activity in patients with axial spondyloarthritis (axSpA) at Week 8 and up to Week 24. Methods: Patients ( n = 380) with active axSpA were randomized (3:1) to secukinumab 150 mg (Group A) or placebo (Group B). At Week 8, patients from Group A with an average spinal pain score Results: At Week 8, the odds of achieving an average spinal pain score of Conclusion: Secukinumab provided rapid and significant improvement in spinal pain at Week 8 which was sustained or increased further up to Week 24 in patients with axSpA. Trial Registration: ClinicalTrials.gov: NCT03136861. Registered May 2, 2017.

INTRODUCTION AND OBJECTIVE Systematic monitoring of physical activity of young populations from different regions may be useful for making international comparisons, better understanding trends in physical activity and designing public health interventions to increase physical activity. Thus, the aim of the study was to comprehensively review studies examining the level of physical activity of children and adolescents from the Visegrad countries, and indicate the percentage of children and adolescents meeting the recommended level of physical activity. MATERIAL AND METHODS A systematic search of the published literature was conducted. Included were reports with original research that consisted of the proportion of children and adolescents who met physical activity recommendations or guidelines. To provide a current picture of physical activity of children and adolescents, the review was restricted to studies published between January 2015 - November 2018. RESULTS Moderate-to-vigorous physical activity recommendations were met by between 7.5% - 69.4% of children and adolescents. Vigorous physical activity recommendations were met by between 33.6% - 64.5% of children and adolescents. Daily recommendations for the number of steps taken were fulfilled by between 11.6% - 69.0% of children and adolescents. Differences between age categories, genders and countries were observed. CONCLUSIONS Public health interventions to increase physical activity are required to decrease insufficient levels of physical activity in children and adolescents, especially in girls. The review also highlights the need for studies with representative random samples that use validated measurement methods.

Simple Summary Heat exchange between the body surface and the external environment plays an important role in the regulation of body temperature in animals. Previous studies on the effect of exercise on the distribution of body surface temperature in dogs have been conducted on a variety of breeds and did not employ specific defined regions of interest. The aim of our research was to assess the influence of high-speed treadmill exercise on body surface temperature using infrared thermography in selected body regions of healthy Beagle dogs, taking into account gait and recovery time. The study was based exclusively on the Beagle breed, which presents short, uniform, and straight hair, conducting heat more readily from the skin. Statistical analysis indicated the highest temperature at the upper forearm and thigh, and the lowest on the croup, back, and neck. The peak surface temperature values in all examined areas were observed after the canter and the post-gallop walk, and the lowest were observed 2 h after exercise. Our study confirms that the body surface temperature of Beagle dogs is influenced by high-speed physical exercise on a treadmill as a result of muscle activity and changes in blood flow. The proximal forelimb and hindlimb were the most influenced by exercise. Abstract Evaluation of body surface temperature change in response to exercise is important for monitoring physiological status. The aim of the study was to assess the influence of high-speed treadmill exercise on body surface temperature using infrared thermography (IRT) in selected body regions of healthy Beagle dogs, taking into account gait and recovery time. Thermographic images of the dogs were taken before exercise (BE), after walk (AW), after trot (AT), after canter (AC), just after second walk (JAE), 5 min after exercise (5 AE), 15 min after exercise (15 AE), 30 min after exercise (30 AE), 45 min after exercise (45 AE), and 120 min after exercise (120 AE). Body surface temperature was measured at the neck, shoulder, upper forearm, back, chest, croup, and thigh. Statistical analysis indicated the highest temperature at the upper forearm, shoulder, and thigh, and the lowest on the croup, back, and neck. The peak values of surface temperature in all ROIs were at AC and JAE and the lowest at 120 AE. The study demonstrated that body surface temperature was influenced by high-speed physical exercise on a treadmill and IRT was a viable imaging modality that provided temperature data from specific body regions. The proximal forelimb and hindlimb were the most influenced by exercise.