Medical University of Silesia

Curcumin is known for its potential health benefits; however, the evidence remains inconclusive regarding its necessity as a supplement for athletes during the preparatory phase of training. This study aimed to assess the effect of 6-week curcumin supplementation at a dose of 2g/day on selected inflammatory markers, blood count, and brain-derived neurotropic factor (BDNF) levels in middle-aged amateur long-distance runners during the preparatory period of a macrocycle. Thirty runners were randomly assigned to either a curcumin-supplemented group (CUR, n = 15) or a placebo group (PLA, n = 15). Venous blood samples were collected at rest, immediately post-exercise, and 1h post-exercise. The participants underwent a graded exercise stress test, with an increasing inclination angle after reaching a speed of 14 km/h, both before and after the 6-week supplementation period. Blood samples were collected at rest, 3 minutes post-stress test, and after 1 hour of recovery. The results showed no significant changes in C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), interleukin-1 β (IL-1β), or blood morphology due to curcumin supplementation. However, BDNF levels increased by 21% in the CUR group post-supplementation, while a 5% decrease was observed in the PLA group. These findings do not support a significant effect of curcumin supplementation on inflammatory markers, blood count, or BDNF concentration. Further research is warranted to determine the potential benefits of curcumin supplementation for endurance athletes during the preparatory period for a training cycle.

A working group convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society, the Polish Society of Family Medicine, and the Polish Society of Vaccinology has developed a consensus on supplementary data to the recommendations of the expert group of the Polish Society of Vaccinology, the Polish Society of Family Medicine, the Polish Dermatological Society, the Polish Association for the Study of Pain, and the Polish Neurological Society, and ECTRIMS/EAN of 2023 with regard to the currently available in Poland recombinant herpes zoster vaccine (RZV). It is intended for the prevention of herpes zoster and postherpetic neuralgia in individuals aged > 50 and individuals aged ≥ 18 who belong to herpes zoster risk groups. In Poland it is available with 50% reimbursement exclusively for patients aged 65 and older who have an increased risk of developing herpes zoster. This statement is based on the literature available as of 12 July 2024. The guidance will be updated as new data emerges. All data regarding the above-mentioned vaccine comes from clinical trials which have been reviewed, published and approved by the regulatory authorities and an increasing number of recommendations that might have an impact on real world data.

Purpose Robot-assisted (RAS) surgery is increasingly used in pediatric and adolescent posterior-approach spine surgery. However, current literature often focuses on pairwise comparisons, limiting comprehensive evaluation of robotic effectiveness across diverse conditions. This single-arm meta-analysis aimed to evaluate the effectiveness of RAS in pediatric and adolescent spine surgery. Methods A systematic search was conducted across PubMed, Embase, Scopus, Web of Science, and Cochrane Library from inception to December 2024. Studies were included if they reported outcomes of RAS for pedicle screw placement in patients under 25 years with spinal deformities. The primary outcome was the accuracy of pedicle screw placement, assessed using the Gertzbein and Robbins (GR) grading system. Secondary outcomes included intraoperative metrics and deformity correction. A random-effects model was applied for meta-analyses. Results Fifteen studies encompassing 13,325 screws and 920 patients were included. The pooled rate of clinically acceptable screws (GR A+B) was 95.66% (95% CI: 94.04-97.28), with 88.54% (95% CI: 83.60-93.48) achieving perfect placement (GR A). The incidence of heavily misplaced screws (GR D+E) was 0.59% (95% CI: 0.18-1.16). Blood loss averaged 687.85 mL (95% CI: 534.27-841.43), and the mean operation time was 306.03 minutes (95% CI: 273.19-338.88). Curve correction rates and Cobb angle improvements were consistent with existing scoliosis treatment benchmarks. Heterogeneity was observed, likely due to variability in study designs, robotic systems, and patient populations. Conclusion RAS demonstrates high accuracy and safety in pediatric and adolescent spine surgery, with low rates of screw misplacement and acceptable secondary outcomes. While these ndings highlight the clinical bene ts of robotics, high heterogeneity and limited long-term data necessitate further research. Standardized reporting, longitudinal studies, and comparative analyses are essential to fully realize the potential of robotic systems in pediatric spine surgery.

Background Budd–Chiari syndrome is a rare and severe vascular liver disease. We presented patient with fulminant liver failure secondary to leiomyosarcoma of the IVC and thrombosis Case presentation A 44-year-old female presented with fulminant liver failure secondary to inferior vena cava (IVC) thrombosis. Contrast-enhanced computed tomography subsequently revealed a thrombus within the IVC, extending cranially to the right atrium and caudally to the renal veins. The patient’s condition, characterized by early comatose symptoms, necessitated surgical intervention. Under extracorporeal circulation, a right atriotomy with thrombus lesion removal and descending thrombectomy of the IVC was performed. Hepatic congestion resolved after the thrombus was removed. A pathological examination of the excised thrombus revealed the presence of high-grade leiomyosarcoma. Conclusions In cases where a thrombus extends from the IVC to the right atrium, urgent surgical intervention with extracorporeal circulation should be considered.

Background Hypertension is a common condition among the elderly and is frequently accompanied by frailty syndrome (FS). The coexistence of hypertension and FS poses significant challenges in patient management and negatively impacts the quality of life (QoL). This study aimed to analyze the relationship between FS and QoL in elderly patients with suspected hypertension. Methods A cross-sectional study was conducted involving 201 patients aged 65 years or older, referred to a Hypertension Clinic for diagnostic evaluation. Frailty was assessed using the Tilburg Frailty Indicator (TFI), and QoL was evaluated with the World Health Organization Quality of Life Instrument (WHOQOL-BREF). Sociodemographic and clinical data were collected, and statistical analyses were performed to identify correlations between FS and QoL. Results The study found that 79.60% of the patients were identified as frail (TFI ≥ 5). FS was significantly negatively correlated with all domains of QoL, including physical health (r = -0.634, p < 0.001), psychological health (r = -0.675, p < 0.001), social relationships (r = -0.528, p < 0.001), and environmental factors (r = -0.626, p < 0.001). Multivariate analysis revealed that physical (β = -0.091, p < 0.001) and psychological components of FS (β = -0.128, p = 0.016), as well as age (β = -0.022, p = 0.004), were significant predictors of lower QoL scores. Loneliness (β = -0.235, p = 0.049) was also a significant predictor of lower QoL. Conclusions The study demonstrated a strong association between FS and reduced QoL in elderly hypertensive patients, emphasizing the need for comprehensive assessments and personalized management strategies. Routine evaluation of frailty and the implementation of targeted interventions aimed at improving physical, psychological, and social well-being could substantially enhance QoL in this vulnerable population. Clinical trial number Not applicable.

Objectives The study evaluated the impact of lifestyle and environmental exposure on the etiology of multiple myeloma (MM). Methods A multicenter case–control study was conducted in 20 hematology centers and in 5 outpatient clinics in Poland. The questionnaire on exposure to potential risk factors including sociodemographic data, lifestyle, and environmental factors was completed. Results A total of 274 patients with newly diagnosed MM and 208 patients from primary healthcare centers in the control group were enrolled in the study. Regarding lifestyle, sports practiced systematically for at least half a year play a protective role in the development of myeloma (OR = 0.40, 95% CI, 0.28–0.58, p < 0.001). Among environmental factors harmful exposures that increase the likelihood of the development of MM include pesticides (OR = 3.29, p < 0.001), asphalt (OR = 2.42, p = 0.026), coal dust (OR = 2.27, p = 0.004), organic vapors (OR = 2.11, p = 0.001), metal dust (OR = 2.07, p = 0.023), exhaust fumes (OR = 2.03, p < 0.01), and chemicals (OR = 1.80, p < 0.01). Conclusions The pathogenesis of MM is complex with the impact of modifiable factors. Lifestyle, with physical activity, seems to play a key role.

Twardzina głęboka jest rzadką formą twardziny ograniczonej, charakteryzującą się występowaniem głębokich stwardnień, mogących obejmować mięśnie, powięzi, tkankę podskórną oraz głębokie warstwy skóry. Zmiany zwykle występują w linii przykręgosłupowej, a do ich powstawania mogą predysponować czynniki wyzwalające, takie jak infekcje, urazy, ekspozycja na promieniowanie lub stosowanie używek. Ze względu na niedostateczny poziom świadomości pracowników opieki zdrowotnej diagnoza może być znacznie opóźniona, a w konsekwencji może dochodzić do nieodwracalnych i okaleczających deformacji. W pracy przedstawiono opis przypadku 67-letniej pacjentki z twardziną głęboką, u której zmiany chorobowe występują w nietypowej lokalizacji w obrębie przedniej powierzchni klatki piersiowej. Przypadek ukazuje, jak ważne jest wczesne postawienie właściwej diagnozy oraz wprowadzenie odpowiedniej terapii w aktywnej fazie choroby, aby uniknąć tak poważnych powikłań.

Celem badania była analiza roli kortyzolu zarówno w leczeniu, jak i etiologii bruksizmu. Przeprowadzono przegląd piśmiennictwa dostępnego w bazach danych PubMed oraz Embase, opublikowanego w okresie od listopada 2013 r. do listopada 2023 r. bez ograniczeń językowych. W pierwszej kolejności przeprowadzono ocenę tytułów oraz abstraktów, a następnie dokonano selekcji na podstawie całych artykułów. Do analizy włączono badania obserwacyjne oraz randomizowane kontrolowane badania kliniczne, które oceniały związek między zdiagnozowanym bruksizmem a poziomem kortyzolu w ślinie. Przeprowadzono ocenę jakości metodologicznej badań i ekstrakcję danych. Finalnie do przeglądu włączono osiem artykułów. Analiza wykazała znaczącą korelację między wyższymi stężeniami kortyzolu a występowaniem bruksizmu. Ponadto u osób z bruksizmem stężenie kortyzolu przed rozpoczęciem leczenia było wyższe niż po jego zakończeniu.

Lipid disorders are the most common risk factor for atherosclerotic cardiovascular disease (ASCVD) in Poland, where it is responsible for up to 200,000 deaths per year, with the number of myocardial infarctions and strokes reaching 80,000 annually and 25% of people dying within 3 years after a myocardial infarction. Despite the availability of effective drugs, the level of control of low-density lipoprotein cholesterol (LDL-C) is low, at only about 20% among high- and very high-risk patients who often require combination lipid-lowering therapy (LLT) with a potent statin (e.g. rosuvastatin) and ezetimibe. Moreover, in Poland, even as many as several million patients require concomitant lipid-lowering and antiplatelet (acetylsalicylic acid) therapy in view of their risks and indications. Single pill combinations (SPCs) improve adherence to treatment as well as the achievement of therapeutic goals and allow a greater reduction in cardiovascular incidents and mortality. This Expert Opinion Paper endorsed by the Polish Lipid Association (PoLA), is a practical recommendation on how to more effectively treat patients with indications for LLT and antiplatelet therapy using available rosuvastatin-based combination therapies (with ezetimibe or acetylsalicylic acid).

Introduction Older individuals are at risk of malnutrition resulting from chronic diseases-related body and muscle mass reduction. In turn, nutritional deficiencies may enhance catabolic processes, leading to accelerated aging and comorbidity, thus creating a vicious cycle. Our study aimed to assess the prevalence of malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria and to determine the health correlates of malnutrition in a representative sample of community-dwelling older adults. Methods We used the GLIM criteria to diagnose malnutrition in 5,614 participants of the PolSenior2 study. The PolSenior2 study was a population-based survey designed to assess the medical, psychological, social, and economic characteristics of community-dwelling older adults. Results Malnutrition was diagnosed in 13.4% of the participants using the GLIM criteria. Results of multiple logistic regression showed that the risk of depression [OR 4.18, p<0.001], peptic ulcer disease [OR 2.73, p<0.001], past stroke [OR 1.71, p<0.001], cognitive impairment [OR 1.34, p = 0.015], and chronic pain [OR 1.23, p = 0.046] were independent correlates of malnutrition. Conclusion Due to the high risk of malnutrition, special attention should be paid to individuals in late old age. Suspected malnutrition should also be considered in people at risk of depression, with peptic ulcer disease, past stroke, and cognitive impairment. Chronic pain should also prompt the diagnosis for malnutrition.

Purpose This study aimed to summarize the existing English-language literature on central nervous system (CNS) meningeal melanocytomas in children, and additionally describe our institutional case report. Methods PubMed database was screened on September 2, 2024, for English-language papers reporting on pediatric patients with CNS meningeal melanocytoma. Results A total of 17 papers reporting on 18 patients with 19 CNS meningeal melanocytomas were found in the literature. Additionally, we reported on a 15-year-old male patient with C2-C6 meningeal melanocytoma. Pediatric cohort analysis showed nearly equal sex distribution and a mean age at diagnosis of 11.9 years. There were fifteen intracranial (75%) and five spinal tumors (25%). Four lesions (20%) were diagnosed as intermediate-grade melanocytomas, while the remaining sixteen (80%) were benign meningeal melanocytomas. Most tumors were hyperintense on T1-weighted imaging (85%) and hypointense on T2-weighted imaging (73%). All tumors showed positivity for S100 and Melan-A. Most tumors were characterized by a lack of CNS invasion (91%). Gross-total resection (GTR) was performed in 61% of tumors. Adjuvant radiotherapy (RT) was applied in 50% of patients with incomplete tumor resection. Postoperatively, 62% of patients achieved a favorable outcome. We found 1, 2, 3, and 4-year overall survival of 80%, 71%, 71%, and 50%, respectively. The recurrence rate was 15% after a mean time of 10 months. Conclusions Meningeal melanocytomas constitute a rare subgroup of CNS tumors. Surgical tumor removal aiming at maximally safe GTR remains a standard approach, resulting in favorable postoperative outcomes. Considering high recurrence rate, long-term follow-up is needed.

Background: Physicians use transesophageal echocardiography (TEE) as part of the workup for acute ischemic stroke; however, its importance is controversial. While its clinical utility in this patient population may seem logical, based on current data and guideline recommendations, there is no empirical recommendation for using TEE over transthoracic echocardiogram (TTE). This study aimed to provide an update on the TEE's impact on the clinical outcomes of patients with acute stroke. Methods: We conducted a retrospective single-institution cohort study at a tertiary care hospital from June 2021 to August 2022 for patients admitted with new-onset ischemic stroke with or without hemorrhagic conversion who subsequently had a TEE completed at the same admission or after discharge. The primary outcome was the detection of management changes based on TEE results, while secondary outcomes included positive findings leading to embolic stroke, the feasibility of performing TEE as an inpatient versus outpatient procedure, and the TTE yield compared to TEE. Results: A total of 176 patients underwent TEE to investigate the cause of stroke. The mean age of those with positive TEE findings was 65.5 years versus 66 years for those with negative or irrelevant findings. Positive TEE patients were 47.7% female versus 45% in the negative findings group. Both age and sex comparisons did not yield statistically significant differences (P values 0.81 and 0.73, respectively). Patients with positive TEE findings accounted for 66 (37.5%), with the most common cardiac pathology being patent foramen ovale (PFO), followed by aortic atherosclerotic plaque. The transthoracic echocardiography (TTE) yield was much lower than that of TEE. Conclusion: In patients with newly diagnosed stroke, TEE provided high diagnostic value and impacted the management of 23.9 % of all patients who underwent the test. These findings support its continued use in diagnostic workups, with a higher diagnostic yield than the transthoracic approach. Conflict of Interest: The authors declare that they have no affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.

Background: Removal of spontaneously fractured leads with their proximal ends migrated into the vascular space has not been analysed in detail thus far. The study aimed to compare the effectiveness of different approaches and auxiliary tools for removing fractured leads with migrated proximal ends. Methods: Retrospective analysis of 72 cases from a database containing 3847 TLEs (transvenous lead extraction). Results: Most of the leads were passive, especially unipolar. Procedure complexity in such cases was high but with satisfying effectiveness (procedural success rate 93.06%) and independent of the position of the proximal end. The rate of major complications was 2.78%, which may be attributed to long implant duration (152.2 months). Extraction of such leads did not influence long-term survival. The femoral approach was most often used (62.50%). In 79.16% of leads, mechanical dissection was required. In 66.7%, proximal ends were strongly attached to the wall, and a loop had to be applied. In 15.28% of procedures, the lead was wrapped around a pig-tail catheter (“spaghetti twisting technique”). Conclusions: (1) Spontaneous lead fracture with the proximal ends migrated into the vascular space is a rare finding (1.87% of the TLE). (2) Removal of such leads requires the use of different approaches as well as dedicated and non-dedicated tools. (3) Despite a high level of procedure complexity, its effectiveness is high, with an acceptable rate of major complications.