Pomeranian Medical University

Background Functional gastrointestinal disorders (FGIDs), now known as disorders of gut-brain interaction (DGBIs), such as Irritable Bowel Syndrome (IBS) and Functional Dyspepsia (FD), significantly impact global health, reducing quality of life and burdening healthcare systems. This study addresses the epidemiological gap in Poland, focusing on the West Pomeranian Voivodeship. Methods We conducted a cross-sectional study of 2070 Caucasian patients (58.2% female, mean age 57.5 ± 15.1 years) undergoing gastrointestinal endoscopic examinations at Pomeranian Medical University from 2021 to 2023. Data were collected using Rome IV diagnostic questionnaires and correlated with gastroduodenoscopy and colonoscopy findings. Exclusion criteria were age under 18, pregnancy, Crohn’s disease, ulcerative colitis, severe comorbidities, cancer, immunosuppressive therapy, ileostomy/colostomy, incomplete questionnaires, or lack of consent. Results Using Rome IV criteria, IBS was diagnosed in 436 participants (21.1%) and FD in 248 participants (12.0%). Post-endoscopic evaluation revised FD diagnoses to 184 individuals (8.9%). Females had a higher prevalence of IBS and FD (OR 1.64 and 1.61, respectively). No significant association was found between higher BMI and increased risk of IBS and FD. Hypertension and diabetes prevalence were 35.1% and 13.0%, respectively. Individuals with a history of COVID-19 had a higher risk of developing IBS (OR 1.47, P = 0.050). Conclusions Our study provides crucial epidemiological data on IBS and FD in Poland, emphasizing the importance of endoscopic evaluations. Our findings highlight the need for regional studies to understand local DGBI prevalence, aiding targeted healthcare strategies. Graphical Abstract

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.

Background The problem of reduced physical activity in patients with stage 5 Chronic Kidney Disease (CKD) is becoming more and more interesting in the medical community. One of the innovative solutions that can significantly increase patients’ motivation to exercise is the integration of physical training with virtual reality (VR) technology during hemodialysis. The aim of this study was to comprehensively assess the impact of regular physical activity using virtual reality on the concentration of plasma PCSK9 protein and TNF-α in patients with stage 5 CKD treated with hemodialysis. Methods A prototype of the NefroVR system was used in the research project. The study group consisted of patients who were entrusted with the task of conducting training using the prototype of the NefroVR system. Results In the conducted research, a significant decrease in PCSK9 protein and TNF-α concentration was observed in the study group after 3 months of exercises using virtual reality in hemodialysis patients. Conclusion Regular physical activity using innovative physiotherapy methods, such as virtual reality, contributes to the improvement of inflammatory parameters and may improve lipid homeostasis. Clinical trial number not applicable.

Chronic diseases such as cancer, autoimmunity, and organ failure currently depend on conventional pharmaceutical treatment, which may cause detrimental side effects in the long term. In this regard, cell-based therapy has emerged as a suitable alternative for treating these chronic diseases. Transdif-ferentiation technologies have evolved as a suitable therapeutic alternative that converts one differentiated somatic cell into another phenotype by using transcription factors (TFs), small molecules, or small, single-stranded, non-coding RNA molecules (miRNA). The transdifferentiation techniques rely on simple, fast, standardized, and versatile protocols with minimal chance of tumorigenicity and genotoxicity. However, there are still challenges and limitations that need to be addressed to enhance their clinical translation percentage in the near future. Taking this into account, we have delineated the features and strategies used in the transdifferentiation techniques. Then, we delved into different intermediate states that were attained during transdifferentiation. Advancements in transdifferentiation techniques in the field of tissue engineering, autoimmunity, and cancer therapy were dissected. Furthermore, limitations , challenges, and future perspectives are outlined in this review to provide a whole new picture of the transdifferentiation techniques. Advancements in molecular biology, interdisciplinary research, bioinformatics, and artificial intelligence will push the frontiers of this technology further to establish new avenues for biomedical research.

There are many species of animals in the marine environment which are potentially dangerous to humans. Cnidarians that are responsible for burns are mainly found in tropical waters, but there are several species with cosmopolitan distribution. In some cases, contact with toxins from Cnidarians can cause symptoms of acute kidney damage. Because of an enormous diversity of the toxins produced by individual species of cnidaria, the mechanisms of renal damage are different in different cases. Currently, there is only one antitoxin available to treat burns by Cnidarians, this antitoxin can neutralize the toxin produced by Chironex fleckeri. However, recent studies on animal models give hope for the introduction of a universal biological agent that would be capable of inhibiting the activity of toxins produced by a variety of Cniadaria species. (Int Marit Health)

Fabricating complex hierarchical structures mimicking natural vessels and arteries is pivotal for addressing problems of cardiovascular diseases. Various fabrication strategies have been explored to achieve this goal, each contributing unique advantages and challenges to the development of functional vascular grafts. In this study, a three‐layered tubular structure resembling vascular grafts was fabricated using biocompatible and biodegradable copolymers of poly(butylene succinate) (PBS) using advanced manufacturing techniques. The outer layer was fabricated by template‐assisted electrospinning utilizing a 3D‐printed scaffold with a precise hexagonal pore design as the template, and the inner layer was coated with gelatin through perfusion. Cellulose nanocrystals (CNCs) were incorporated into electrospun fibers to enhance mechanical properties. The gelatin coating was applied to the lumen using perfusion coating, resembling the inner layer. Integration of 3D‐printed structures with electrospun fibers via template‐assisted electrospinning and gelatin coating resulted in a seamless multilayered scaffold. Mechanical testing demonstrated robustness, surpassing natural arteries in some aspects, while the gelatin coating significantly reduced liquid leakage, ensuring leak‐free functionality. Cytotoxicity assessment confirmed the biocompatibility of processed materials with fibroblast cells, supporting potential for medical applications.

Introduction Assess the clinical application of multifocal electroretinogram in the early detection of retinal dysfunction in patients treated with chloroquine (CQ) or hydroxychloroquine (HCQ). Material and methods In 13 female patients – 15 eyes (9 – CQ, 6 – HCQ) mean age: 51 years, range: 35–66 years, treatment mean time (CQ – 8.3, HCQ – 10.4 years) with normal results of routine ophthalmological examination, retinal sensitivity (AVF – 10-2, W-W), macular structure (spectral-domain optical coherent tomo- graphy – SD-OCT) multifocal electroretinogram – mfERG (ISCEV standard) was performed. MfERG results were compared with 13, mean age 51 years, range: 34–66 years, and refractive error matched healthy females (15 eyes). Results In the group taking CQ and HCQ, a statistically significant reduction in P1-wave response density was observed in rings 2, 3, 4, 5, and 6. This reduction was accompanied by abnormal ring ratios (R1/R2, R1/R3, R1/R5) compared to the control group (p ≤ 0.016). The most prominent dysfunction of the cone system was registered in the parafoveal region (R2) and perifoveal region (R3), as well as in the mid-peripheral retina (R5) (p < 0.000). In patients treated with CQ, a significantly higher retinal dysfunction in rings 3 and 6 was detected (p ≤ 0.039). The P1-wave response density in each ring was characterized by high sensitivity and specificity values, with the highest values found in ring 2 (sensitivity and specificity – 0.93, AUC = 0.98; p < 0.001). Conclusions In patients treated with chloroquine/hydroxychloroquine, bioelectrical dysfunction of the cone system was observed without typical retinal signs of drug toxicity. Multifocal ERG examination demonstrated significant utility as a screening test to detect premaculopathy stages of CQ/HCQ retinopathy.

Background The 313-variant polygenic risk score (PRS313) provides a promising tool for clinical breast cancer risk prediction. However, evaluation of the PRS313 across different European populations which could influence risk estimation has not been performed. Methods We explored the distribution of PRS313 across European populations using genotype data from 94,072 females without breast cancer diagnosis, of European-ancestry from 21 countries participating in the Breast Cancer Association Consortium (BCAC) and 223,316 females without breast cancer diagnosis from the UK Biobank. The mean PRS was calculated by country in the BCAC dataset and by country of birth in the UK Biobank. We explored different approaches to reduce the observed heterogeneity in the mean PRS across the countries, and investigated the implications of the distribution variability in risk prediction. Results The mean PRS313 differed markedly across European countries, being highest in individuals from Greece and Italy and lowest in individuals from Ireland. Using the overall European PRS313 distribution to define risk categories, leads to overestimation and underestimation of risk in some individuals from these countries. Adjustment for principal components explained most of the observed heterogeneity in the mean PRS. The mean estimates derived when using an empirical Bayes approach were similar to the predicted means after principal component adjustment. Conclusions Our results demonstrate that PRS distribution differs even within European ancestry populations leading to underestimation or overestimation of risk in specific European countries, which could potentially influence clinical management of some individuals if is not appropriately accounted for. Population-specific PRS distributions may be used in breast cancer risk estimation to ensure predicted risks are correctly calibrated across risk categories.

Background/Objectives: Crohn’s disease is known for being associated with an abnormal composition of the bacterial flora, dysbiosis and intestinal function disorders. Metabolites produced by gut microbiota play a pivotal role in the pathogenesis of CD, and the presence of unspecific extraintestinal manifestations. Methods: The aim of this study was a determination of the level of bacterial metabolites in blood plasma in patients with Crohn’s disease. CD patients (29) and healthy individuals (30) were recruited for this study. Bacterial metabolites (SCFAs and TMAO panel) were measured by a liquid chromatography–mass spectrometry system. Results: A significant correlation (p-value < 0.05) between CD and bacterial metabolites was obtained for three of eight tested SCFAs; acetic acid (reduced in CD; FC 1.7; AUC = 0.714), butyric acid (increased; FC 0.68; AUC = 0.717), 2MeBA (FC 1.168; AUC = 0.702), and indoxyl (FC 0.624). The concentration of CA (FC 0.82) and choline (FC 0.78) in plasma was significantly disturbed according to the biological treatment. Choline level (FC 1.28) was also significantly disturbed in the patients treated with glucocorticoids. In total, 68.97% of Crohn’s patients presented extraintestinal manifestations (EIMs) of Crohn’s disease, mainly osteoarticular complications. The level of BA was statistically significantly elevated in patients with extraintestinal (FC 0.602) manifestations, while in the group of patients with osteoarticular complications, a significant difference in the level of betaine (FC 1.647) was observed. Conclusions: The analyzed bacterial metabolites of plasma may significantly help in the diagnostic process, and in the monitoring of the disease course and treatment, in a lowly invasive way, as biomarkers after additional research on a larger group of patients.

Background/Objectives: Colon capsule endoscopy (CCE) is a non-invasive method for visualising the colon, but its clinical adoption has been slow. Although the COVID-19 pandemic reignited interest in CCE, its role in conventional gastrointestinal investigations remains unclear, leading to varied practices across Europe. This highlights the need for a comprehensive understanding of diverse approaches to CCE in clinical practice. Method: A web-based survey was conducted from January to July 2024, targeting European gastroenterologists and colorectal surgeons interested in capsule endoscopy through the International Capsule Endoscopy Research (iCARE) Group. The survey aimed to understand CCE application across Europe and investigate factors influencing its uptake. Results: Thirty-eight (n = 38) valid responses were received from 19 European countries. While 88% reported access to CCE, only 45% had local services readily available, and just 7% included CCE in national guidelines. The most common indication for CCE was for patients who declined or could not tolerate colonoscopy (30%), with 77% of CE specialists preferring its use in fit patients. Ease of access was significantly associated with service availability (p = 0.0358). Barriers to uptake included lack of reimbursement, insufficient knowledge, and limited use in research settings. Only 27% of specialists viewed CCE positively, while 57% had a negative perception. Conclusions: This study reveals the wide variation in CCE practices and critical factors influencing its uptake. Understanding common indications and patient groups is the key to guiding its future development, particularly as AI and telemedicine enhance its potential for rapid full digestive tract visualisation.

Malaria remains a major public health threat in Sub-Saharan Africa. According to the World Health Organization (WHO) estimates, Plasmodium falciparum species account for nearly 100% of the malaria cases occurring on the African continent. According to the Centers for Disease Control and Prevention (CDC), falciparum malaria predominates, but non-falciparum species are also present in Africa. The aim of the study was to assess the occurrence of asymptomatic malaria cases, as well as to identify Plasmodium species at two different settings with the lowest index of infections in Tanzania (according to the Tanzanian Ministry of Health < 1%), i.e., on the mainland (Arusha Region) and on the Pemba Island (Zanzibar Archipelago). The study was conducted in June 2023 and involved 722 individuals, including 449 residents of mainland Tanzania and 273 residents of the Zanzibar Archipelago. The screening consisted of two phases. In the first one, which was carried out at two different settings, i.e., in the Karatu Lutheran Hospital (Arusha Region, mainland Tanzania) and the Amal Hospital (Pemba, Zanzibar Archipelago), mRDTs (malaria rapid diagnostic tests) were performed, haemoglobin concentrations were measured, and blood samples for further molecular tests were collected onto Whatman micro cards from each of the individuals involved. In the second phase (conducted in Poland, Europe), RT-PCR tests for malaria were performed. The screening found asymptomatic Plasmodium infections in 4.2% of the study subjects from mainland Tanzania and in 4.8% from the Archipelago. The research confirmed cases of P. falciparum malaria but also found single cases of mixed infections with P. falciparum + P. malariae or P. ovale. The results demonstrated that the occurrence of malaria in northern mainland and Zanzibar Archipelago is higher than the official MoH reports present. The study findings are consistent with the reports by CDC, which suggest that non-falciparum species are also present in Sub-Saharan Africa.

Hops (Humulus lupulus L.) are widely recognized for their use in brewing, but they also possess significant pharmacological properties due to their rich bioactive compounds, with many varieties exhibiting diverse characteristics. This study investigates the chemical composition and biological activities of extracts from six hop varieties, focusing on quantifying xanthohumol and lupulone using High-Performance Liquid Chromatography (HPLC) and Total Phenolic Content (TPC) analysis. The hop varieties demonstrated significant variability in bioactive compound concentrations, with Aurora showing the highest xanthohumol (0.665 mg/g) and Zwiegniowski the highest lupulone (9.228 mg/g). TPC analysis revealed Aurora also had the highest phenolic content (22.47 mg GAE/g). Antioxidant activities were evaluated using DPPH, ABTS, CUPRAC, and FRAP assays, with Aurora and Oregon Fuggle displaying the most potent capacities. Aurora, in particular, showed the highest activity across multiple assays, including significant acetylcholinesterase (AChE), butyrylcholinesterase (BChE), and tyrosinase inhibition, with IC50 values of 24.39 mg/mL, 20.38 mg/mL, and 9.37 mg/mL, respectively. The chelating activity was also assessed, with Apolon demonstrating the strongest metal ion binding capacity (IC50 = 1.04 mg/mL). Additionally, Aurora exhibited the most effective hyaluronidase inhibition (IC50 = 10.27 mg/mL), highlighting its potential for anti-inflammatory applications. The results underscore the influence of genetic and environmental factors on the bioactive compound profiles of hop varieties and their biological activity offering promising avenues for pharmaceutical and nutraceutical applications. However, further studies are needed to fully understand the potential interactions between hop cones components.

Background: The accurate diagnosis of degenerative joint diseases (DJDs) of the temporomandibular joint (TMJ) presents a significant clinical challenge due to their progressive nature and the complexity of associated structural changes. These conditions, characterized by cartilage degradation, subchondral bone remodeling, and eventual joint dysfunction, necessitate reliable and efficient imaging techniques for early detection and effective management. Cone-beam computed tomography (CBCT) is widely regarded as the gold standard for evaluating osseous changes in the TMJ, offering detailed visualization of bony structures. However, ultrasonography (US) has emerged as a promising alternative, offering a non-invasive and radiation-free option for assessing TMJ disorders. This study aims to evaluate the diagnostic accuracy of US in identifying degenerative changes in the TMJ, with CBCT serving as the definitive diagnostic reference. By analyzing the sensitivity, specificity, and predictive values of US in detecting key degenerative markers—such as subchondral erosion, osteophytes, and joint space narrowing—this investigation seeks to assess its utility as a screening tool and its potential integration into clinical workflows. Methods: Forty adult patients presenting temporomandibular joint disorders were included in our cross-sectional study. Each patient underwent a clinical examination and was subjected to cone-beam computed tomography (CBCT) and ultrasonography (US). A statistical analysis was performed to compare the imaging results from CBCT and US. Results: The results are summarized in three tables. The first table presents a comparative analysis of radiological outcomes in patients with temporomandibular joint disorders using different imaging techniques. CBCT demonstrated higher sensitivity in detecting osteophytes in the right mandibular head (27.50% vs. 7.50%, p = 0.027) and higher detection rates for erosions, though without a significant advantage over US. The second table analyzes the consistency of diagnostic results between CBCT and US. A moderate agreement was observed for detecting normal bone structures, with AC1 values of 0.58 for the right and 0.68 for the left mandibular head (p < 0.001). The third table evaluates the diagnostic accuracy of US compared to CBCT. US demonstrated a positive predictive value (PPV) of 90% for detecting normal conditions, indicating its high reliability as a screening tool for normal findings. US demonstrates higher effectiveness in ruling out certain issues due to its high specificity and negative predictive value. However, its lower sensitivity in detecting abnormalities may lead to both false-positive and false-negative results. Conclusions: US holds significant promise as a screening modality for detecting normal anatomical features of the temporomandibular joint, its limitations in identifying more complex degenerative changes necessitate a cautious and integrated approach to TMJ diagnostics.