Background: Acute ischemic stroke (AIS) in the paediatric population is a significant disability-related health problem. Although the incidence of AIS in children is much lower than in adults, a child who has suffered a stroke may struggle with serious health consequences and long-term neurological deficits. Aim of the study: The purpose of this study is to make a comprehensive analysis of the latest research on acute ischemic stroke in children. Material and methods: The search was conducted using PubMed, Scopus and The Wiley Library databases. Of the 10,744 results, those that were the summary, were not in Polish or English, not human studies. Finally, forty-five articles in Polish or English were selected, with emphasis on the most recent information on the topic published no earlier than 2017.Results: The results of the article show the main risk factors and symptoms, which are sometimes difficult to spot, in children with ischaemic stroke. The paper emphasises the importance of rapid diagnosis, for example using MRI imaging, which allows faster recognition than traditional methods such as CT. It also points out that the use of thrombolytic therapy and mechanical thrombectomy in selected cases can improve prognosis.Conclusions: Raising parental awareness, early detection and successful treatment can significantly improve prognosis. Further research is essential and necessary to optimise the management of AIS in children for more effective therapeutic and preventive interventions.

Background: Mercury, as one of the heavy metals, is present in the environment, and various sources contribute to mercury entering the human body. Continuous exposure or high doses of mercury have a detrimental impact on human health, causing serious and long-term effects. However, in today's society, awareness of the negative consequences has led to efforts to avoid high doses of exposure. It is important to examine how current research trends present the effects of low-dose mercury exposure, both in everyday life and in specific environments.Aim of the Study: The objective of this study was to conduct a comparative analysis of the current knowledge about the negative effects of mercury exposure on human health. Material and Methods: A literature review was conducted on research published between 2000 and 2024, with additional criteria including English language publications and online availability. The review performs results obtained from the PubMed database by searching the terms: "mercury toxicity," "mercury poisoning," and ("mercury" AND "human health").Results: Our review indicates that studies from the last twenty years do not point to alarming mercury doses resulting from daily exposure. Occupational exposure to mercury vapors (e.g., among hairdressers and dentists) is often more detrimental than the impact of a fish included diet or dental fillings. The effects of mercury also vary depending on genetic variability and taken dose.Conclusions: Diet and amalgam fillings increase mercury levels; however, these are mostly not alarming doses. Daily exposure to mercury vapors or methylmercury can negatively affect neurobehavioral factors in children. Although it is difficult to exceed permissible levels through additional fish consumption, it does increase the total mercury levels in blood and THHg (total hair Hg).

Background: Sleep has both immediate and long-term impacts on health. Aim of the study: This study aimed to evaluate the relationship between the quality of biological night-time regeneration, socio-economic status, health behaviors, nutritional status, and fat tissue distribution among adult women (n=46, aged 45-65 years). Material and methods: Socio-economic and lifestyle data were collected through a questionnaire, while anthropometric measurements were obtained using standard instruments. Statistical analyses were performed using the STATISTICA software package. Results: The study found no significant associations between socio-economic status, and the frequency of well-slept (participants satisfied with night-time regeneration) or sleep-deprived (respondents dissatisfied with night-time regeneration) individuals. However, an increased frequency of beer consumption was associated with dissatisfaction with night-time regeneration. There was no significant relationship between BMI categories and fat distribution types in relation to self-reported sleep sufficiency. Nonetheless, the analysis indicated that both BMI and WHR were higher in women who reported dissatisfaction with night-time regeneration compared to those who reported satisfaction. The trends suggest that women with higher education, white-collar occupations, residing in large cities, and consuming weak alcoholic beverages reported poorer sleep quality more frequently. This pattern is associated with a higher risk of excessive weight and central fat distribution, potentially due to increased psychosocial stress. Conclusions: Further research is necessary to verify these trends and elucidate the underlying mechanisms.

BackgroundMultiple sclerosis (MS) is the most common immune-mediated inflammatory demyelinating disease of the central nervous system. MS usually affects individuals between the ages of 20 and 40 and is 3 times more common among women than among men. This disease presents with a vast range of neurological symptoms and, in some cases, cognitive impairment. Aim of the studyThe purpose of this review was to assess whether the anti-CD20 antibody ocrelizumab has proven effective in treating MS since its introduction.Material and methodsThe PubMed database was searched for original papers on the effects of ocrelizumab in the treatment of MS. The inclusion criterion was a comparison of the clinical or radiological effectiveness of ocrelizumab versus placebo or other MS therapies. For this purpose, the phrase "Ocrelizumab AND Multiple Sclerosis" was used, marking only studies such as "Randomised Clinical Trial" and "Clinical Trial". The cut-off point for publishing the work was 2016.Results43 works were found, of which 15 met the conditions for inclusion in the work. The analysed studies investigated the efficacy and safety of ocrelizumab in Relapsing Multiple Sclerosis, Primary Progressive Multiple SclerosisConclusionsThe effectiveness of ocrelizumab treatment shows that the use of newly developed targeted factors may significantly improve the clinical status of MS patients. Preliminary real-world data on the efficacy of ocrelizumab are promising and align with clinical trial findings. Although ocrelizumab is generally well tolerated, it is essential to monitor and assess its long-term safety.

Background: Empty sella syndrome (ESS) is a rare condition associated with loss of pituitary gland volume. ESS has a heterogeneous clinical manifestation including endocrine, neurological, and visual deficits. The most common symptoms include chronic headaches and hormonal disturbances associated with hypopituitarism.Aim of the study: To emphasize the role of ophthalmologists in the initial management of intracranial hypertension and the significance of a multidisciplinary approach in the management of ESS.Case report: Primary complete ESS was reported in a 32-year-old male presenting nonspecific ophthalmologic symptoms including ophthalmalgia and subjective worsening of the visual acuity. The ophthalmological exam revealed bilateral optic disk elevation. The subsequent MRI identified a suprasellar cistern invaginating within sella turcica with resulting pituitary gland flattening. A complete empty sella syndrome was confirmed. In addition, idiopathic intracranial hypertension was suspected. The patient was proposed hospitalization in the neurology department for additional testing however, he refused due to personal reasons.Conclusions: To date, only a few papers reported ESS with preliminary ophthalmological symptoms. All patients with nonspecific eye symptoms should have a complex ophthalmological examination. Bilateral optic disk elevation requires urgent imaging of the brain and orbits, and the golden-standard approach remains MRI. During the diagnostic process, the secondary causes of intracranial hypertension including tumor, bleeding, abscess, hydrocephalus, or venous sinus thrombosis must be excluded. Due to the heterogeneous clinical course of ESS, patients require multidisciplinary management and follow-up by endocrinologists, neurologists, neurosurgeons, and ophthalmologists.

Background: The frequency of hospitalisation of patients with morbid obesity (Body Mass Index - BMI ≥ 40 kg/m2) is constantly increasing. The hospitalisation in the Intensive Care Units (ICUs) of such a group of patients, in addition to the common problems in care and treatment encountered in the rest of the hospital wards, additionally brings distinct challenges to be faced by the staff.Aim of the study: This review aims to clarify the distinctive physiological characteristics of morbidly obese patients and the resulting challenges during ICU hospitalisation, while also presenting appropriate therapeutic approaches and interventions.Material and methods: Based on the available medical literature and the authors' clinical experience, we have selected articles using PubMed, NIH (National Institutes of Health), SpringerMedizin, and Semantic Scholar, along with guidelines from the Medycyna Praktyczna website, WHO data, and book sources. We reviewed 693 articles, 3 books, and the websites of WHO and Medycyna Praktyczna. The final selection comprised 34 articles (32 in English, 1 in German, 1 in Polish), published between 2004 and 2023, with 12 published after 2020.Results: Morbid obesity disrupts the physiological homeostasis of the body, noticeably affecting the respiratory, cardiovascular or gastrointestinal systems, and is associated with the occurrence of a number of diseases. This necessitates specific distinctions in the intubation procedure, mechanical ventilation strategy as well as drug dosing. In addition, it should be noticed that life-threatening conditions such as acute respiratory distress syndrome (ARDS) or sepsis occur among patients hospitalised in the ICU, requiring additional modifications to the therapy.Conclusions: Morbidly obese ICU patients due to their anatomical and physiological characteristics belong to individuals at risk of difficult intubation requiring specific positioning, preoxygenation and the use of videolaryngoscopes, as well as implementing an appropriate mechanical ventilation strategy. Additionally, altered drug metabolism and distribution in these patients necessitate distinct dosing protocols for effective treatment.

Background: With the development of medicine, people's life expectancy is increasing, and consequently, there is interest in improving the quality of life, which is affected by, among other things, cognitive functions. Cognitive functions are represented by memory, the ability to absorb new information, speech, attention, reading comprehension, and communication. Many researchers have shown that physical activity (PA) can affect these processes. Aim of the study:The study aims to review the latest scientific studies on the effects of PA on cognitive functions in the broadest sense, specifically on the memory and attention of people of different ages. The paper also explains some of the processes that occur during PA and their impact on cognitive function.Material and methods:A literature review of recent scientific studies in Google Scholar, PubMed, and National Library of Medicine databases published from 2016 to 2024. The inclusion criteria were that the article had a thorough research methodology, publication language English or Polish, and open access.State of knowledge: PA, thanks in part to its effect on the release of beta-endorphins during exercise, promotes neurogenesis in adults and improves broader brain health. PA also improves brain function by affecting astrocytes - the star cells that maintain brain homeostasis. Researchers have shown that acute PA improves attention, while regular PA, lasting at least several weeks, improves academic performance. Studying adults, it has been observed that regular PA can slow progressive cognitive impairment during aging. In studies involving children, PA has been shown to have a positive effect on attention and learning.Conclusions: PA has a positive effect on improving cognitive function in people of all ages, both healthy and those with already established cognitive impairment. More research is needed.

Background: The integration of AI, numerical algorithms, and expert approaches in nephrology shows promise for enhancing patient care. Traditionally, nephrology relied on clinician expertise, but the growing volume of data requires innovative methods. AI, fueled by vast datasets, can uncover patterns and improve diagnostic accuracy and treatment optimization. Numerical algorithms enable computational modeling of renal physiology and disease progression, aiding in treatment prediction and optimization. Expert systems codify nephrologists' knowledge into decision support tools, aiding in diagnosis and treatment selection. Embracing these technologies can revolutionize nephrological practice, improving patient outcomes.Aim of the study: The aim of the research is to review scientific works on the use of artificial intelligence (AI), numerical algorithms, and expert algorithms in diagnosis, decision support and prediction of selected disease states and issues related to nephrology.Material and methods: The study rigorously retrieved relevant publications from esteemed academic databases, Scopus and PubMed, and screened them based on predefined criteria. Through keyword-based searches, it analyzed the intersection of nephrology and artificial intelligence, offering insights into emerging trends and advancements. This approach facilitated a comprehensive exploration of the integration of artificial intelligence in nephrology research, paving the way for future developments in the field.Results: Artificial intelligence in nephrology and medicine uses various technologies such as machine learning, deep learning and natural language processing to improve diagnosis, treatment and patient care. Analyzes clinical, laboratory, imaging and genetic data to accelerate the identification of kidney diseases. By integrating health information systems and research data, artificial intelligence enables pattern recognition, outcome prediction and treatment optimization, ultimately having the potential to permanently improve patient care.Conclusions: Numerical algorithms, artificial intelligence, and expert algorithms show promise in nephrology, improving patient care and research.

Background: The sudden change of life situation caused by a cancer diagnosis and mastectomy disturbs the psychosomatic balance and the functioning of a woman's previous life and leads to a reduced quality of life. Many women adapt to their new situation, but a very large group cannot adapt and cope with their illness.Aim of the study: Evaluation of disease acceptance and quality of life (QoL) in women after mastectomy.Material and methods: A total of 171 post-mastectomy women were studied. The study was conducted by means of a diagnostic survey using a questionnaire technique. The Acceptance of Illness Scale (AIS) and the Quality of Life Assessment Questionnaire (WHOQOL-BREF) were used.Results: The mean disease acceptability was 25.68 7.978. A group of 42.69% (72/171) had moderate disease acceptability, 32.75% (56/171) had high disease acceptability and 20.47% (35/171) had low disease acceptability. 4.09% (8/171) of the women had no acceptance of the disease. The mean value for the perception of QoL was 3.65 0.71. The best values were obtained for QoL in the psychological domain (14.1 3.1) and the worst in the physical domain (13.0; 2.7). Place of residence (p = 0.081) and education level (p = 0.196) did not significantly influence the acceptance of illness. Women living in village areas had a lower quality of life in the environmental domain (p = 0.036) than those living in the city. The absence of complications after mastectomy determined a higher level of QoL in the physical (p < 0.001), psychological (p = 0.029) and environmental (p = 0.010) domains, as well as greater acceptance of the disease (p = 0.001). Disease acceptance was associated with an improvement in the quality of life of women who had undergone a mastectomy, across all domains. Conclusions: It is important to increase interventions to support the adjustment process of women after mastectomy, as acceptance of the disease improves the QoL of these women.

Background: Nowadays, back pain is a global health, social, and economic problem, considered a disease of civilization. The problem affects about 80-85% of the population in Poland and 70% worldwide. It occurs in people of all ages, regardless of gender or type of work. Among the many physiotherapy methods used for acute and chronic spinal pain is therapeutic massage. Aim of the Study: The purpose of the study was to evaluate the effectiveness of tensegrity massage for back pain. Material and methods: The study material consisted of a group of 25 patients with back pain, ranging in age from 22 to 78 years (mean M = 54 years). Sixteen women and nine men participated in the study. Before and immediately after therapy, palpation of selected tissues, pain assessment using the VAS scale, and assessment of disability using the Oswestry Low Back Pain Disability Questionnaire were performed. Massage therapy lasted 3 weeks, twice a week, with treatments lasting 45 minutes at a time. Results: After therapy, pain complaints (visual analog scale – VAS) decreased (p>0.001), and scores on the Oswestry questionnaire decreased (p>0.001), indicating less physical disability. A statistically significant asymmetry in perceived pressure sensitivity on palpation was observed both before and after therapy. In both studies, the level of pressure pain experienced on the right side was significantly higher (p < 0.05). A statistically significant (p = 0.01) negative correlation was observed between the change in the level of physical disability and the change in tissue sensitivity in palpation assessment as a result of therapy (rho = -0.539).Conclusions: Tensegrity massage is an effective method of relieving spinal pain. It can be used in the treatment of chronic spinal conditions.

Background: The Internet is becoming increasingly important in providing medical knowledge. Students facing such information-rich environment, may not pay adequate attention to appropriate use of information sources. Aim of the study:The study aimed to evaluate the use of Internet for obtaining medical information by high school students (HSS) and medical students (MS), especially during the COVID-19 pandemic.Material and methods:Two anonymous online surveys were distributed through social media among Polish HSS and MS. The questionnaires of 562 HSS and 332 MS, representing 12 medical universities, were analysed.Results:33,7% MS and 12,6% HSS use Internet to obtain medical knowledge several times a day. 63% of all students believe that the COVID-19 pandemic increased this frequency. To accomplish that, 76% MS and 61.6% HSS frequently use search engines. 61% MS and 30,4% HSS often use Wikipedia. News websites are often used by 58.7% HSS and 19,3% MS. Medical databases e.g. PubMed are usually used by 28% MS. Both MS and HSS rated the author's specialty overlapping with the issue as the most important factor affecting the reliability of medical information sources (4.14 and 5.51 points on a 0-5 scale, respectively). 62,4% MS believe medical studies have significantly changed their perception of the credibility of medical knowledge sources. 50% HSS and 42,5% MS, when encountering incorrect medical information, never take any action to clarify it. 87,4% MS and 70% HSS express the need for additional classes on COVID-19 in their school curriculum.Conclusions:The Internet is widely used by HSS and MS as a source of medical knowledge. It is important to emphasize the need to develop the ability to select reliable medical information among users of the virtual world. Students understand the need to evaluate the credibility of sources, however they often do not take any action when confronted with erroneous information.

Background : Vulvar cancer is a rare type of cancer that accounts for 1% of all cancers in women and about 3-8% of all gynecological cancers in the world. Although resection of the lesion is the first choice for treatment, reconstructive methods of the vulva have been increasingly used recently. Flaps are most commonly used for this purpose. However, it is important to remember that the reconstruction must be adjusted to the patient's needs, taking into account the geometry of the wound, as well as potential secondary complications.Aim of the study: The aim of this study is to present the different methods of plastic surgery for vulvar cancer, which included V-Y, VRAM, ALT, DIEP and lotus flaps. The following article focuses on describing the above methods, presenting their advantages and disadvantages, in which cases they can be used, and potential complications.Material and methods: The literature review was conducted in the PubMed database. The inclusion criteria used in the review included compliance with topic, publication date after 2015 and English language. Articles of low credibility, duplicated, not in English language and with abstracts unrelated to the topic were excluded. Results: Of the articles found, 32 studies were eventually to be reviewed. The research shows that the choice of reconstruction method can be difficult, while there is no single correct approach in vulvar cancer cases.Conclusions: In summary, the interdisciplinary collaboration between the gynecologist oncologist, the surgeon and the radiotherapist, plays a key role in the treatment process.

Background: The undertaking of hip joint endoprosthesis surgery carries the inherent risk of complications. During the perioperative and early postoperative phases, septic complications take precedence, notably those associated with infection. Conversely, aseptic complications encompass issues unrelated to infection. Accurate risk stratification for complications following hip prosthesis implantation should be grounded in research adhering to the principles of Evidence-Based Medicine.Aim of the study: This paper aimed to present a critical literature review Material and methods: The literature review was conducted using international medical databases such as PubMed, Scopus, and PEDro. The review was based on criteria that included clinical studies and full-text publications published in English. The search period covered the last decade, spanning from 2014 to 2024.Results: The review highlights aseptic loosening and dislocation as the predominant causes of early THA failures. Addressing these complications requires a multifaceted approach, including patient education, meticulous surgical techniques, and robust postoperative rehabilitation programs. Future research should focus on improving implant materials and techniques to further reduce the incidence of aseptic failures. Dislocation and loosening of the hip joint prosthesis are direct reasons for qualifying the patient for revision surgery and reconstruction of the damaged prosthesis components. Individual biomechanical characteristics of the patient, genetic predispositions, obesity, or improper positioning of the prosthesis in relation to the limb axis are also potential risk factors for dislocation.Conclusions: Aseptic complications remain a significant challenge in THA. By understanding the causes and implementing effective preventative strategies, the incidence of early failures can be reduced, improving patient outcomes and prosthesis longevity. The gradual introduction of a well-planned and individualized rehabilitation program, along with the patient's adherence to treatment recommendations, is crucial for minimizing the risk of mechanical damage.

Background: The epidemic of obesity and type 2 diabetes poses a growing challenge to global public health, necessitating effective intervention strategies. Currently conducted research on novel pharmacotherapeutic approaches to obesity treatment is yielding promising results. Among them are the triple agonists of GIP/GLP/GCG (glucose-dependent insulinotropic peptide/ glucagon-like peptide/ glucagon) receptors, representing the latest discovery. Preclinical studies and phase I and II trials demonstrate significant clinical prospects for GIP/GLP/GCG receptor agonists. Aim of the study: This paper aims to summarize and analyze the current knowledge on triple agonists of GIP/GLP-1/GCG and their impact on body weight based on clinical studies conducted in recent years and currently ongoing. Material and methods: The search was conducted using the PubMed, Google Scholar, and NIH databases. Articles published between 1971 and 2022 were analyzed. The keywords used were "triple agonists," "obesity," "GIP," "GLP-1," and "glucagon." Results: According to our best knowledge, there are currently clinical trials underway for four GIP/GLP-1/ glucose-dependent insulinotropic peptideagon triagonists, including NN9423NC9204-1706, efpegtrutide, SAR441255, and retatrutide. Studies on retatrutide have shown promising results, with observed weight reduction of up to 17 kg. Additionally, another triagonist, efocipegtrutyd, besides its effects on weight loss, demonstrates the ability to prevent liver fibrosis and has neuroprotective effects. Conclusion: The action of GIP/GLP-1/GCG triple agonists is multifaceted, and preliminary research results are encouraging further exploration of their potential. Despite promising outcomes, continued research is necessary to gain a deeper understanding of their mechanism of action and to assess their long-term effects. Such studies will be crucial in providing information to support the development of personalized therapeutic strategies and optimizing their clinical utility in diverse patient populations.

Background: Healthcare professionals of emergency department (ED) is particularly vulnerable to incidents of aggression from patients.Aim of the study: To determine the opinions of medical staff regarding the aggressive behavior of patients admitted to an ED and to assess the impact of incidents of aggression on the professional burnout level.Material and methods: A diagnostic survey was conducted among 102 medical employees of the ED from September 2023 to February 2024. Maslach Burnout Inventory (MBI) and self-developed questionnaire were used.Results: A group of 100% (n=102) of the respondents experienced aggressive behavior from a patient hospitalized in ED. The respondents most often experienced aggression several times a week" (38.24%; 39) or several times a month" (29.41%; 30). The main forms of aggressive behavior presented by patients were: raised voice (93.14%; 95), use of profanity (86.27%; 88), and insults (76.47%; 78). When faced with aggressive behavior, staff most commonly experienced the following emotions: stress 63.73% (n=65), anger 63.73% (n=65), and helplessness 45.10% (n=46). 47 (46.08%) members of the medical staff had a high level of emotional exhaustion, 31 (30.39%) had a high level of depersonalization, and 48 (47.06%) presented a high level of lack of personal achievement. A significant correlation was observed between negative emotions aroused in ED medical staff by patients presenting aggressive behavior and domains of professional burnout.Conclusions: There is a need to train ED medical staff how to effectively deal with anger and feelings of humiliation caused by patients' aggressive behavior.

Background: The number of individuals with work-related musculoskeletal disorders is increasing in Poland. Aim of the study: The aim of this study was to analyze and evaluate pain symptoms among upholsterers and to compare these ailments with a group of employees who do not perform physical work, as well as to examine the associations between pain intensity and frequency with age, length of employment, and somatic characteristics in both research groups.Materials and methods: Ninety-four men were examined, including 50 upholsterers and 44 non-physical workers, who were the control group. Pain location was assessed using the Nordic Musculoskeletal Questionnaire, pain intensity lower back was measured using a Visual Analog Scale (VAS), and the frequency of lower back pain was determined using the Jackson-Moskowitz Scale. Participants also provided information regarding their age, length of employment, and education. Body mass and height were measured.Results: Among the study participants, 94% of the upholsterers and 73% of the control group experienced pain in at least one area of the body. The largest percentage of the study participants from both groups reported pain in the lower back. Upholsterers experienced pain in their elbow joints and hands/wrists significantly more often than control group. The control group experienced pain in the upper back, neck, and hip joints significantly more often than upholsters. Significant positive correlations were found between age, length of employment, and the results of the VAS and Jackson-Moskowitz Scale in both groups.Conclusions: The locations of pain complaints in the group of upholsterers and in the group of employees who do not perform physical work differ. In both groups, lower back pain predominates. Working as an upholsterer promotes pain in the elbow joints, and wrists/hands. Performing mental and mixed work is associated with neck, upper back and hips/thighs pain. Future studies should aim to assess the prevalence and analyze the risk factors for work-related musculoskeletal disorders.

Background: Nursing students are affected by stressors related to academic activities and those related to clinical activities. Aim of the study: To analyze the stressors and the level of anxiety and depression among bachelor’s degree students of nursing.Material and methods: An observational study was conducted between July 2023 to February 2024 among 167 bachelor's degree nursing students. Hospital Anxiety and Depression Scale (HADS) and self-report survey were used.Results: Respondents considered stressors related to learning theoretical subjects (M=3.85, SD=1), stressors related to learning in the practical classes lab in the Medical Simulation Center (M=3.06, SD=1.08), and stressors related to patient care to be the strongest. (M=2.91, SD=0.91) A group of 79 (47.31%) participants had a severe anxiety disorder, 56 respondents (33.53%) had a borderline state of this disorder. A group of 56 (33.53%) had a borderline state of depressive disorders and 42 (25.15%) - severe depressive disorders. The mean score for the presence of anxiety was M=10.43 (SD=3.26) and for depression was M=8.2 (SD=3.42). Conclusions: The lecturers and the decision-makers should take these results into consideration and pay special attention to the stressors that students consider to be the worst. It is recommended that positive coping strategies for stress management be reinforced and that students be encouraged to participate in programs or workshops designed to teach them effective stress management techniques. It is similarly crucial to maintain communication with students, provide them with encouragement and assistance during challenging periods within the academic and clinical settings, and acknowledge and reinforce their strengths.

Background: A cholecystectomy is one of the most common surgical procedures, primarily used to treat patients with symptomatic gallstone disease. There are three main methods for performing this surgery: open, laparoscopic, and robotic access. Currently, laparoscopic cholecystectomy is considered the gold standard for treating symptomatic cholelithiasis. However, robotic cholecystectomy represents an advancement in minimally invasive techniques. Aim of the Study: The aim of this study is to review and compare the different approaches to cholecystectomy—open, laparoscopic, and robotic—and to evaluate the benefits and drawbacks of each method. Material and Methods: A literature search was conducted using publicly available databases, PubMed and Google Scholar, with the following keywords: “open cholecystectomy,” “laparoscopic cholecystectomy,” and “robotic cholecystectomy.” The search included articles published between January 2002 and March 2024. A total of 37 articles were ultimately included in this review. Results: In the analyzed publications, the approaches to cholecystectomy were compared, including open, laparoscopic, and robotic surgery. Laparoscopic and robotic cholecystectomy are generally preferred over open cholecystectomy due to their minimally invasive nature, which results in faster recovery times and fewer complications. However, the choice of surgical method should be tailored to the individual patient's needs, the surgeon's expertise, and the financial implications of each technique. Conclusion: While minimally invasive techniques offer significant advantages, there remain certain clinical scenarios where open cholecystectomy is indicated and necessary. Therefore, a comprehensive evaluation of each patient's condition is crucial to determine the most appropriate surgical approach of cholecystectomy.

Background: Multiple myeloma (MM) is a hematologic malignancy, which causes accumulation of plasma cells in the bone marrow. The symptoms of MM are associated with organ dysfunction and include hypercalcemia, renal failure, anaemia and bone destruction. A relatively new and promising therapeutic option for MM is CAR-T therapy. Aim of the study: The study aimed to outline the role of CAR-T therapy in MM treatment.Material and methods: We conducted a literature review containing 24 articles. We described the role of CAR-T in MM therapy, its therapeutic points, the effectiveness of therapy, and its side effects.Results: CAR-T cells transduced with CAR can recognize specific antigens and kill the cancer cells. For MM these specific antigens are integrin β7, SLAMF7, CD138, BCMA, GPRC5D and FCRL5. Integrin β7 in its active form, can be found in MM cells, whereas in other blood cells, integrin β7 is in the inactive form. The expression of SLAMF7 on MM cells is high and uniform, but its function is not clear: expression of SLAMF7 in MM is suspected to increase the survival and adhesion of MM cells to bone marrow stromal cells. CD138's strong expression on MM cells is contributing to their development and proliferation. BCMA expression was not detected in other human tissues, only in MM cells. GPRC5D is highly expressed in bone marrow samples from MM patients, and minimally expressed in other hematologic malignancies. FCRL5 is a protein marker found specifically on plasma cells in MM, its increased expression promotes B cell proliferation. The AlloCAR-T therapy also seems to be an effective method.CAR-T therapy has also adverse effects including cytokine release syndrome, neurological toxicity, haematological disorders and infusion fever. Conclusions: The effects of CAR-T therapy in MM are really promising and give real benefits to patients. For this reason, it should be further developed and subjected to further research.

Background: The coronavirus disease-19 (COVID-19) pandemic significantly affected maternal care services.Aim of the study: This study aimed to identify the level of changes in care experienced by pregnant women during the first wave of the COVID-19 pandemic and to compare responses between three major modes of maternity care financing (public, fee-for-service and private healthcare subscriptions). Material and methods: This cross-sectional study of 685 pregnant women in Poland used the author’s questionnaire, which included questions on demographic data, maternity care mode of financing, and different aspects of care.Results: The vast majority (n=608, 95.6%) of respondents experienced during the COVID-19 pandemic. The most frequently reported modification was no possibility of a partner being present during prenatal consultations and medical examinations (n=558, 87.7%). Those who used a private healthcare subscription experienced more frequent medical appointment cancellations (p=0.000), a decrease in the number of consultations (p=0.000), reduced healthcare service duration (p=0.019). Over half of respondents used teleconsultations or e-consultations. The respondents who used a healthcare subscription had lower satisfaction with maternity care across all issues than women who used public and fee-for service care.Conclusions: The COVID-19 pandemic affected women’s maternity care experiences, with the financing mode differentiating their experiences. An increase in the use of telemedicine for maternity care during the SARS-CoV-2 pandemic may provide a beneficial solution for future crises.

Background: Mucopolysaccharidoses (MPS) are a group of rare genetic diseases with a metabolic background. Currently, there are no effective methods of treating MPS, and new ways of treating patients are constantly being sought.Aim of the study: The purpose of this article is to review the available literature on clinical trials of new treatments for mucopolysaccharidoses.Material and methods: The review of research literature published between 1999 and 2023 was conducted, with a specific focus on the last ten years. The literature for this article was selected from publications available online in databases such as Google Scholar or PubMed. Research was based on keywords like: mucopolysaccharidoses, clinical trials, gene therapy, MPS. Results: A total of 104 publications were considered in the study, including 95 scientific articles and 9 clinical trial reports (consisting of 1 FDA approval). Out of those 104 articles, 82 discussed potential future therapies for patients with MPS. Among them, as many as 51 focused on gene therapy.Conclusions: The only currently approved treatments for mucopolysaccharidoses are enzyme replacement therapy and hematopoietic stem cell transplantation, which are not suitable for all types of MPS and have their limitations. In addition, there is no single therapy for all types of MPS, as they are the result of mutations in different genes and result from the deficiency of different enzymes. Numerous preclinical and clinical studies are being conducted on therapies for mucopolysaccharidoses. These include therapies that allow manipulation of cellular pathways, substrate reduction, or gene therapy, which is the most promising form of treatment. Some of the studies have successfully passed the first and second research phases.

Background: Pilot projects in healthcare serve as strategic tools for introducing innovations, including new diagnostic methods, therapies, and technologies. Ensuring patient safety and treatment efficacy is paramount, making effective risk management essential. Failure in this area can jeopardize the reputation and trust of the medical community. Aim of the study: This study presents and discusses risks and risk management strategies in a pilot project implementing telemedicine solutions in geriatrics. Materials and Methods: Key risks and remedial actions in a pilot telemedicine project in geriatrics were analyzed. Systematic analyses covered various areas such as technological, financial, legal, organizational, external, clinical, and competency domains. Results: The telemedicine project targets geriatric syndromes like frailty, sarcopenia, and malnutrition, aiming to improve care for the elderly. The paper discusses risk management aspects, remedial actions, and potential implications for further research and practices. Conclusions: Collaboration among medical teams, primary care physicians, geriatric specialists, and assistants, supported by strong administrative coordination, is crucial for effective risk management. This collective effort enables swift deployment of remedial actions and ensures project success.

Background: The Active Rehabilitation Camps (ARC) provide access to comprehensive rehabilitation. The main goal is to provide wheelchair users achieving the maximum possible independence in performing activities of daily living, to help them accept a new lifestyle, as well as comprehensive rehabilitation in the social and vocational fields. Higher self-esteem in wheelchair users help them overcome barriers in everyday living, increase initiative, improve their mental health and well-being.Aims of the study: The aim of the research was to evaluate the impact of Active Rehabilitation Camps on self-esteem of wheelchair users.Material and methods: 95 adult wheelchair users aged 18 to 75 took part in the study. 92 participants were included in the analysis (31 women and 61 men). The research tool was a questionnaire including first part with personal data and a second part - an international and validated questionnaire the Rosenberg Self-Esteem Scale (RSES). All participants filled the questionnaire at the beginning of the ARC and after two-week camp.Results: The results showed a significant improvement in self-esteem among participant after camps, total self-esteem according to RSES increased from 28.32 4.99 before a camp, to 30.8 4.85 after a camp (p<0.0001). Our results showed that apart from general self-esteem, SE in such domains as “on the whole, I am satisfied with myself”, “I am able to do things as well as most other people” or “I take a positive attitude towards myself” increased significantly after the ARC (p<0.001).Conclusions: The activities of the Active Rehabilitation Camp including access to physical activity, health-promoting education, experience exchange and integration of wheelchair users, increase the level of self-esteem of Active Rehabilitation Camp participants. Systematic physical activities, social and emotional support, as well as appropriate education should be provided in everyday rehabilitation among wheelchair users to improve their self-esteem and everyday life functioning.

Reakcje stresowe są odpowiedzią na wszelkie zmiany przystosowawcze w codziennym funkcjonowaniu, które wywoływać mogą np.: niespodziewane zdarzenia, niezdrowy styl życia, osiąganie ważnych dla nas celów, borykanie się z codziennymi drobnymi wyzwaniami a nawet mentalne wracanie do trudnych chwil i przeżyć lub negatywne myślenie. W licznych przypadkach występowanie wielu zaburzeń i powikłań różnych chorób wynika m.in. ze zbyt silnego i/lub chronicznego doświadczania stresu. Współczesny świat stawia przed człowiekiem tyle wyzwań i oczekiwań, że bez rozwijania jednych z kluczowych umiejętności życiowych – radzenia sobie ze stresem – nie jest w stanie na dłuższa metę „równoważyć”/utrzymywać zasobów zdrowia a tym samym ich wzmacniać czy pomnażać aby efektywnie zaspokajać bieżące potrzeby i prowadzić satysfakcjonujące życie. W pracy przedstawiono wybrane, przystępne i efektywne działania ukierunkowane na redukcję odczuwanego poziom stresu jak i siłę reakcji na rozpoznawane przez organizm stresory, uelastyczniające i wzmacniające tym samym autonomiczny układ nerwowy będący fundamentem dostępu do codziennej energii i sił psychofizycznych oraz rozwija-jące/wzmacniające osobistą resiliency.