Folia Medica Cracoviensia[JOURNAL]
Sun
200 papers
The role of the dentist in the diagnosis and early detection of neoplastic lesions based on the example of Proliferative verrucous leukoplakia, classified as an OPMD.
Stawarz-Janeczek M, Łazarz-Bartyzel K, Kiencało A … +1 more , Pytko-Polończyk J
Folia Med Cracov · 2026 Mar · PMID 42295076
Proliferative verrucous leukoplakia (PVL) was first described by Hansen, Olson, and Silverman in 1985 as a form of hyperkeratosis, remained resistant to treatment and was further distinguished by the aggressive nature of...
Proliferative verrucous leukoplakia (PVL) was first described by Hansen, Olson, and Silverman in 1985 as a form of hyperkeratosis, remained resistant to treatment and was further distinguished by the aggressive nature of the lesions and a high rate of malignant transformation (MT). The OPMDs classification developed in 2020 recognized PVL as a distinct form of multifocal oral leukoplakia, characterized by a progressive clinical course and with changing clinical and histopathological features. According to WHO, the risk of malignant transformation of PVL among OPMDs is approximately 50%. This frequent MT of PVL involves transformation into VC or OSCC, which, according to various sources in the literature, occurs in between 43.87% and 65.8% of cases, and according to some in up to 70% of cases. Some reports even suggest a possible malignant transformation rate of around 100%. PVL usually occurs in multiple areas of the oral cavity simultaneously and is characterized by slow but continuous progression. The aetiology of PVL and the factors influencing its progression to cancer are unknown. Close monitoring of patients is recommended and, if necessary, biopsies should be performed to assess changes in the appearance, colour, and size of observed lesions, as well as the appearance of subsequent lesions. Early diagnosis, surgical removal, and patient observation are crucial in the treatment of PVL.
Current evidence of gut microbiota dysbiosis and its role in atrial fibrillation and cardiovascular diseases.
Szwarkowska M, Sobieszek KA, Bartus K … +1 more , Sadowski J
Folia Med Cracov · 2026 Mar · PMID 42295075
The human gut microbiota has emerged recently as an important regulator of cardiovascular physiology through its effects on metabolism, immune signaling, and systemic inflammation. Increasing evidence suggests that alter...
The human gut microbiota has emerged recently as an important regulator of cardiovascular physiology through its effects on metabolism, immune signaling, and systemic inflammation. Increasing evidence suggests that alterations in intestinal microbial composition (dysbiosis) may contribute to the development and progression of atrial fibrillation (AF). This review summarizes current evidence on gut microbiota alterations, microbiota-derived metabolites, and their mechanistic links to atrial fibrillation pathogenesis and potential therapeutic strategies. Patients with AF demonstrate reduced microbial diversity and characteristic shifts in bacterial taxa, including depletion of short-chain fatty acid-producing bacteria and enrichment of potentially pro-inflammatory microorganisms. Gut microbiota-derived metabolites appear to play a key role in mediating these effects. Trimethylamine N-oxide (TMAO), lipopolysaccharide (LPS), and phenylacetylglutamine (PAGln) promote oxidative stress, endothelial dysfunction, and activation of inflammatory pathways such as NF-κB and the NLRP3 inflammasome, leading to atrial fibrosis, electrical remodeling, and increased arrhythmogenic susceptibility. In contrast, short-chain fatty acids exert anti-inflammatory and cardioprotective effects that may stabilize cardiac electrophysiology. Importantly, the relationship between gut microbiota and atrial fibrillation appears to be bidirectional, as cardiovascular disease itself may influence intestinal barrier integrity and microbial composition. Understanding the gut-heart axis may open new perspectives for risk stratification and therapeutic strategies, including dietary interventions and microbiome-targeted therapies. Further clinical studies are required to determine whether modulation of the gut microbiota can effectively prevent or modify the course of atrial fibrillation.
Preliminary clinical association between the Nerve-Sparing Quality (NSQ) Score and early functional outcomes after robot-assisted radical prostatectomy.
Kempisty J, Balawander K, Dąbrowski O … +1 more , Burdziak K
Folia Med Cracov · 2026 Mar · PMID 42295074
INTRODUCTION: Nerve-sparing during robot-assisted radical prostatectomy (RARP) plays a critical role in postoperative functional recovery, particularly urinary continence and erectile function. Although several tools exi...
INTRODUCTION: Nerve-sparing during robot-assisted radical prostatectomy (RARP) plays a critical role in postoperative functional recovery, particularly urinary continence and erectile function. Although several tools exist for assessing surgical performance in robotic surgery, objective intraoperative evaluation of nerve-sparing quality remains limited. The Nerve-Sparing Quality (NSQ) Score was recently introduced as a structured intraoperative scoring system designed to evaluate the technical quality of neurovascular bundle preservation. The aim of the present study was to explore the preliminary clinical correlation between NSQ Score and early functional outcomes following RARP. METHODS: This retrospective observational study included 20 patients who underwent RARP and had available intraoperative NSQ Score assessment together with 6-month postoperative functional follow-up. The NSQ Score is a 10-point intraoperative scoring system based on five domains: dissection plane, bleeding control, bundle manipulation, continuity of dissection, and symmetry. Functional outcomes were assessed at 6 months using data obtained from routine postoperative follow-up records, using pad use (pads per day) and the International Index of Erectile Function-5 (IIEF-5). Associations between NSQ Score and functional outcomes were evaluated using Spearman correlation analysis. Exploratory subgroup comparisons were performed using an NSQ Score threshold of ≥8. RESULTS: The mean NSQ Score was 7.95 ± 1.61. Mean pad use at 6 months was 0.75 ± 0.91 pads/day, and mean IIEF-5 score was 18.05 ± 6.60. Higher NSQ Score correlated with lower pad use (Spearman ρ = -0.56, p = 0.011) and higher IIEF-5 (ρ = 0.87, p < 0.001). Patients with NSQ Score ≥8 demonstrated significantly better erectile function compared with those with lower scores (21.38 ± 4.46 vs 11.86 ± 5.40, p = 0.001) and lower pad use (0.38 ± 0.51 vs 1.43 ± 1.13 pads/day, p = 0.035). CONCLUSIONS: Higher NSQ Score was associated with improved early functional outcomes after RARP, particularly regarding erectile function and postoperative pad use. These findings provide preliminary clinical support for the construct validity of the NSQ Score as a structured intraoperative measure of nerve-sparing quality. Larger prospective studies incorporating baseline functional parameters are required to determine the independent predictive value of the NSQ Score.
Positive effects of probiotics in people living with HIV: a narrative review.
Sobocińska W, Kubicka G, Kołodyński Ł
Folia Med Cracov · 2026 Mar · PMID 42295073
Despite effective antiretroviral therapy (ART), no clear guidelines exist on microbiome-targetednadjuncts for people living with HIV (PLWH). Human immunodeficiency virus (HIV-1) infection damages the gastrointestinal tra...
Despite effective antiretroviral therapy (ART), no clear guidelines exist on microbiome-targetednadjuncts for people living with HIV (PLWH). Human immunodeficiency virus (HIV-1) infection damages the gastrointestinal tract by altering the mucosal surface and prompting dysbiosis. Gut microbial imbalance, characterized by the predominance of opportunistic bacteria, leads to increased microbial translocation, which, in turn, results in chronic inflammation, digestive tract symptoms, and reduced quality of life. PLWH have substantial dysbiosis compared to healthy controls. In addition, gastrointestinal complications occur as a side effect of ART treatment. Gut-associated lymphoid tissue (GALT) harbors the majority of CD4+ lymphocytes, and this population is significantly depleted during HIV-1 infection. Antiretroviral therapy does not facilitate CD4+ lymphocyte restoration in GALT tissue. Even if the general CD4+ lymphocyte count increases, the GALT CD4+ count, despite therapy, remains stable and low due to unknown causes. Research assessing probiotics in PLWH on ART has yielded mixed results. Some studies report that probiotics may increase CD4+ T cell counts, improve gut barrier integrity, and reduce the incidence of diarrhea in HIV-positive patients. These benefits may be linked to specific probiotic strains that possibly enhance immune function by promoting regulatory T cell populations, thus decreasing microbial translocation. On the other hand, multiple studies did not show any consistent or significant benefits from probiotic supplementation for PLWH. This article assesses critical clinical trials and systematic reviews on this topic, based on limited existing research data. More data from large clinical trials on this topic is needed to assess whether this is or is not a justified new clinical approach for HIV-1-positive patients.
Elevated mycophenolic acid levels after kidney transplantation: avoiding unnecessary dose reduction through team-based TDM interpretation.
Śmiertka A, Cios A, Hońdo Ł … +5 more , Supernak A, Grzywa A, Sobczyńska K, Krzanowska K, Wesołowska A
Folia Med Cracov · 2026 Mar · PMID 42295072
Mycophenolate mofetil (MMF) is a cornerstone immunosuppressive agent used in combination with calcineurin inhibitors and corticosteroids to prevent acute allograft rejection in solid organ transplant recipients. Long-ter...
Mycophenolate mofetil (MMF) is a cornerstone immunosuppressive agent used in combination with calcineurin inhibitors and corticosteroids to prevent acute allograft rejection in solid organ transplant recipients. Long-term transplant outcomes depend not only on the pharmacological efficacy of immunosuppressive regimens but also on individualized dosing strategies and sustained medication adherence. Owing to the complex and highly variable pharmacokinetics of MMF's active metabolite, mycophenolic acid (MPA), therapeutic drug monitoring (TDM) has become an important tool for optimizing treatment safety and efficacy. We report a case of a kidney transplant recipient with unexpectedly elevated MPA exposure in the absence of clinical toxicity. A detailed pharmacokinetic assessment combined with a comprehensive clinical pharmacist-led medication review indicated that the increased MPA concentrations and elevated AUC0-12h were most likely related to impaired renal elimination of mycophenolic acid glucuronide (MPAG). Reduced MPAG clearance may enhance enterohepatic recirculation (EHR) of MPA, resulting in increased systemic exposure. This case highlights the importance of interpreting elevated MPA concentrations within a broader clinical context and underscores the critical role of clinical pharmacists, as members of an interdisciplinary team, in integrating TDM with comprehensive pharmacokinetic assessment to ensure safe and effective long-term immunosuppressive therapy.
Infectious screening and vaccination coverage in patients with inflammatory bowel disease: a single-center observational study.
Banasik E, Dobrowolska A, Roszak M … +1 more , Eder P
Folia Med Cracov · 2026 Mar · PMID 42295071 · Publisher ↗
INTRODUCTION: Patients with inflammatory bowel disease (IBD) are at increased risk of infections due to immune dysfunction and use of immunosuppressive and biologic therapies. Therefore, proper screening for latent infec...
INTRODUCTION: Patients with inflammatory bowel disease (IBD) are at increased risk of infections due to immune dysfunction and use of immunosuppressive and biologic therapies. Therefore, proper screening for latent infections and vaccinations are important to improve treatment safety. The aim of the study was to assess serological screening for hepatitis B and C virus (HBV, HCV) infections and to evaluate vaccination coverage in patients with IBD in routine clinical practice in a tertiary center. MATERIALS AND METHODS: A total of 105 patients with IBD were included (Crohn's disease, n = 56; ulcerative colitis, n = 48; IBD unclassified, n = 1). Data were collected using an original questionnaire and laboratory assessment of HBV and HCV markers. A subgroup analysis evaluated COVID-19 vaccination and adverse events. RESULTS: All patients reported a negative history of HBV and HCV infection. Anti-HBc total antibodies were detected in 5 patients, while none were HBsAg-positive and none tested positive for anti-HCV antibodies. Among 82 patients vaccinated against HBV, 31 (38%) had nonprotective anti-HBs titers. Current IBD treatment was not associated with impaired vaccine response. Vaccination rates for influenza, pneumococci, and meningococci were low. Only 15% of patients reported receiving information about vaccination from the physicians. In the COVID-19 subgroup, 74.7% of patients were vaccinated, with mostly mild adverse events. CONCLUSIONS: Despite existing recommendations, screening and vaccination coverage in patients with IBD remain insufficient, indicating the need for implementation of immunoprophylaxis in routine clinical practice.
Haddad Syndrome - more than don't forget to breathe.
Kubińska K, Kwiatkowski S, Milczarek O
Folia Med Cracov · 2026 Mar · PMID 42295070 · Publisher ↗
Congenital central hypoventilation syndrome (CCHS) and Hirschsprung's disease (HD) belong to neurocristopathies - autonomic nervous system defects caused by abnormal neural crest cells migration. Their co-occurrence defi...
Congenital central hypoventilation syndrome (CCHS) and Hirschsprung's disease (HD) belong to neurocristopathies - autonomic nervous system defects caused by abnormal neural crest cells migration. Their co-occurrence defines Haddad Syndrome (HS) associated also with increased risk of neural crest origin tumors, mainly neuroblastoma (NBL), and PHOX2B gene mutation. This case concerns a male newborn presenting respiratory failure minutes after birth. Due to sleep apnea and increasing hypercapnia, he required intubation. Genetic testing revealed an anomaly in PHOX2B gene. In subsequent days, the patient did not pass the meconium, which, based on the imaging tests and biopsy, raised a suspicion of HD. The boy was diagnosed with HS and additional diagnostic measures, including cancer screening, were ordered, owing to the syndrome's characteristics. Awareness of such conditions enables clinicians to implement targeted management that may significantly improve long-term outcomes and quality of life for affected children.
Arrhythmogenic right ventricular cardiomyopathy - a disease that ends athletic careers.
Skrzypek A, Perera I, Szeliga M
Folia Med Cracov · 2026 Mar · PMID 42295069 · Publisher ↗
Arrhythmogenic right ventricular cardiomyopathy, commonly detected between the second and fifth decades of life, is caused by mutations that result in the dysfunction of the junctions between cardiomyocytes. However, in...
Arrhythmogenic right ventricular cardiomyopathy, commonly detected between the second and fifth decades of life, is caused by mutations that result in the dysfunction of the junctions between cardiomyocytes. However, in 40% of patients, the causative mutation cannot be identified. The detection of arrhythmogenic right ventricular cardiomyopathy is particularly important in endurance athletes, as dangerous ventricular arrhythmias and symptoms of heart failure occur at a younger age in this patient group. The course of arrhythmogenic right ventricular cardiomyopathy involves four stages: no macroscopic changes in the myocardium, clinically overt ARVC, progressive dysfunction of the right ventricle and subsequently the left ventricle and end-stage. Transthoracic echocardiography is a widely available cardiac imaging study. This examination allows for the visualization of segmental or global wall motion abnormalities of the right ventricle. Cardiac magnetic resonance imaging, supplemented by late gadolinium enhancement, is the preferred examination for patients with suspected arrhythmogenic right ventricular cardiomyopathy. An alternative diagnostic study in cases of contraindications is multidetector-row computed tomography. Once a diagnosis of arrhythmogenic right ventricular cardiomyopathy is established, it is recommended to cease sports participation. Only moderate recreational physical activity is permissible.
Monitoring manual dexterity in dental students - a quasi-longitudinal studyand insights from a natural pandemic experiment.
Zarzecka-Francica E, Gala A, Myciński P … +1 more , Pihut M
Folia Med Cracov · 2026 Mar · PMID 42295068 · Publisher ↗
Clinical classes for dental students in Poland start at the beginning of the third year and continue until the end of the fifth year. The implementation of theoretical knowledge tests and trains their manual skills and m...
Clinical classes for dental students in Poland start at the beginning of the third year and continue until the end of the fifth year. The implementation of theoretical knowledge tests and trains their manual skills and makes visible the complexity and variability of clinical cases. The COVID-19 pandemic forced a clinical lockdown, interrupting students' ability to train for six months. The aim of the study was to compare manual dexterity scores measured by the Purdue Pegboard Test (PPT) before and after clinical lockdown among third- and fifth-year dental students and to assess the role of clinical placement. We investigated whether the initial female manual dexterity advantage has changed and whether the subjective assessment of dexterity correlates with objective measurement. The study consisted of students performing PPT subtests, tallying the score and answering additional questions. The cross-sectional (quasi-longitudinal) study included 175 students; 96 before the outbreak of the pandemic and 79 who took a six-month break from full-time classes. Measurements were taken each time for Year III at the very beginning of the start of practical classes, and for Year V at the end. Analysis comparing cohorts studied before and after the clinical lockdown revealed no significant differences in PPT scores within the same year of study. However, fifth-year students achieved higher scores than third-year students on selected PPT subtest. The t-Welch test showed that year V scores significantly higher on most subtests compared to year III. In a two-factor ANOVA analysis, women scored higher than men on all subtests. Spearman's correlation analysis revealed a lack of correlation between self-esteem and objective PPT scores among third- and fifth-year students. The findings may suggest a relative stability of the assessed aspects of manual dexterity during a break lasting up to six months, and clinical seniority was associated with higher PPT score. The gender effect persisted, while self-assessment did not coincide with objective measurement supporting the need for objective monitoring of teaching needs.
High-fat diet-induced obesity affects sulfurtransferases activity in mice hearts.
Szlęzak D, Misterka-Kozaka A, Majewska-Szczepanik M … +1 more , Bronowicka-Adamska P
Folia Med Cracov · 2026 Mar · PMID 42295067 · Publisher ↗
INTRODUCTION: Obesity is a chronic disease with complex etiology, characterized by excessive accumulation of fat tissue, which poses a health hazard and increases, among others, risk of cardiovascular diseases. Hydrogen...
INTRODUCTION: Obesity is a chronic disease with complex etiology, characterized by excessive accumulation of fat tissue, which poses a health hazard and increases, among others, risk of cardiovascular diseases. Hydrogen sulfide (H2S), an endogenous gaseous transmitter, plays an important role in the cardio- vascular system, affecting blood pressure and heart function. AIM: The aim of this study was to determine the effect of high-fat diet-induced (HFD-induced) obesity to hydrogen sulfide metabolism in mice hearts. MATERIALS AND METHODS: The research material consisted of hearts collected from male wild-type C57BL/6 mice fed for 8 weeks with a normal diet (ND) or high-fat diet. Ex vivo analyses included testing the activity of selected sulfur enzymes (cystathionine gamma-lyase - CGL, 3-mercaptopyruvate sulfurtransferase - MPST, and thiosulfate sulfurtransferase - TST), determining the sulfane sulfur level, and examining the ability of tissues to produce hydrogen sulfide. RESULTS: Tissues collected from HFD-fed mice were characterized by a lack of CGL activity, increased TST activity, and higher levels of sulfane sulfur compared to group of ND mice. Additionally, the capacity to produce H2S was higher in the hearts of HFD mice. CONCLUSIONS: Our study shows that HFD-induced obesity affects hydrogen sulfide levels and sulfur enzyme activity in mice hearts. It can be speculated that the increased ability of HFD mice tissues to produce H2S is a compensatory mechanism for obesity-induced changes. The conducted research indicates the key importance of sulfurtransferases, MPST and TST, in sulfur metabolism in the heart and indicates a new area for further analysis.
Does newest immunomodulative treatment in patients with psoriasis impact growth and transformation of melanocytic nevi in patients with psoriasis? Preliminary results from a prospective cohort study.
Kacprzyk M, Masajda M, Kulbat A … +3 more , Richter K, Brzewski P, Wysocki WM
Folia Med Cracov · 2026 Mar · PMID 42295066 · Publisher ↗
INTRODUCTION: Patients with psoriasis treated with biologic therapy are considered to have increased risk of developing skin neoplasms. The impact of novel therapies on the development and biology of melanocytic lesions...
INTRODUCTION: Patients with psoriasis treated with biologic therapy are considered to have increased risk of developing skin neoplasms. The impact of novel therapies on the development and biology of melanocytic lesions is not completely known. The aim of the study was assess if the treatment with biologics exerts effects on the melanocytic nevi. MATERIAL AND METHODS: Dermoscopy and videodermoscopic imaging of 276 melanocytic lesions were performed at the initial visit and after one year in 13 patients with psoriasis treated with IL-12/23 inhibitors, IL-23 inhibitors or IL-17 inhibitors. RESULTS: The nevi size significantly increased at the one-year follow-up in the whole study group and in patients treated either with IL-23 inhibitors or IL-12/23 inhibitor. 2% of melanocytic nevi showed an increase in any of the scores (ABCD score, 7-Point Checklist score, CASH score) or at least 1-mm change in the diameter at the one-year follow-up; however, these changes were not statistically significant between the different therapy groups. CONCLUSIONS: Although treatment with novel groups of biologics leads to an increase in nevi size, it does not contribute to significant structural or color changes in melanocytic nevi or to the development of dysplastic nevi or melanoma at the one-year follow-up.
CAR-Tography of modeling approaches and opportunities in cellular therapy of cancer.
Jesionek M
Folia Med Cracov · 2026 Mar · PMID 42295065 · Publisher ↗
Chimeric Antigen Receptor CAR-T therapy represents a potent adoptive cell immunotherapy for cancer, yet its clinical application remains constrained by pronounced interindividual variability, severe adverse events, and r...
Chimeric Antigen Receptor CAR-T therapy represents a potent adoptive cell immunotherapy for cancer, yet its clinical application remains constrained by pronounced interindividual variability, severe adverse events, and restricted efficacy in solid tumors. Computational modeling has emerged as a critical framework for analyzing and characterizing CAR-T cell behavior to mitigate these clinical limitations. This systematic review synthesizes 20 computational models identified through targeted bibliographic search that were developed using human clinical datasets. The reviewed studies employ a range of mathematical frameworks, including cellular kinetics and population pharmacometrics models, tumor-immune interaction models, quantitative systems pharmacology approaches, and multiscale mechanistic models. Across these frameworks, CAR-T cells are represented as dynamic populations undergoing expansion, contraction, persistence, and functional exhaustion. Many models further incorporate phenotypic stratification into functional subsets, most commonly effector and memory cells, to capture the multiphasic kinetics observed in clinical settings. Additional variables frequently include tumor burden, antigen expression, host immune cells, cytokines, and CAR-target complexes, reflecting different levels of biological detail and modeling objectives. Based on this analysis, I propose a unified set of core variables that captures the key biological processes represented across existing models while providing a consistent structure for future modeling efforts. Together, these studies demonstrate that the choice and structure of variables used to describe CAR-T cell populations and their interactions are key determinants of model interpretability and translational relevance. Improved access to longitudinal clinical datasets and phenotype-resolved measurements will be essential for developing more predictive and clinically applicable computational models of CAR-T therapy.
Management of two osteomas in the frontoethmoidal region using an osteoplastic flap, endoscopic approach and 3D CT imaging.
Hypnar J, Rudziński M, Magdziarz M … +7 more , Pośpiech J, Możdżeń K, Błażejowski M, Przeklasa M, Hartwich P, Konior M, Tomik J
Folia Med Cracov · 2026 Mar · PMID 42295064 · Publisher ↗
The aim of this study was to demonstrate the application of preoperative three-dimensional (3D) computed tomography (CT) reconstruction in the surgical management of paranasal sinus (PNS) osteomas.Osteomas are the most c...
The aim of this study was to demonstrate the application of preoperative three-dimensional (3D) computed tomography (CT) reconstruction in the surgical management of paranasal sinus (PNS) osteomas.Osteomas are the most common benign PNS tumors and can lead to significant symptoms, including chronic rhinosinusitis, frontal pressure, and orbital or intracranial complications. Surgical excision is recommended for symptomatic cases or those with potential complications, with endoscopic and external approaches being the primary techniques. A 74-year-old patient presented with symptoms of chronic rhinosinusitis, including nasal obstruction and anosmia. CT revealed osteomas in the left ethmoid and frontal sinuses, measuring 27 × 21 × 28 mm and 15 × 17 mm, respectively. The patient was qualified for surgical excision of lesions. Preoperative planning included 3D CT reconstruction to assess the osteomas' size, location, and surgical access, particularly for a planned osteoplastic flap (OPF). During surgery, an endoscopic approach was initially utilized, resulting in frontosphenoethmoidectomy and removal of ethmoid osteoma. The other osteoma extended from the anterior to the posterior wall of the frontal sinus and required conversion to an external approach using the preplanned OPF. The surgery was successfully completed, with intraoperative findings being consistent with imaging. Postoperative complications were limited to frontal sinus outflow stenosis, managed endoscopically during follow-up. PNS osteomas may require complex surgical planning, especially when endoscopic and external approaches are combined. Preoperative 3D CT reconstruction provides valuable insights into tumor characteristics and aids in precise surgical planning. This case highlights the utility of 3D imaging in safe and effective management of challenging PNS osteomas.
Pregnancy and postpartum period as risk factors for cervical artery dissection.
Skrzat J, Yevstifeieva A, Goncerz G
Folia Med Cracov · 2026 Mar · PMID 42295063 · Publisher ↗
Pregnancy and the postpartum period are associated with physiological, hormonal, and hemodynamic changes that may increase susceptibility to cervical artery dissection. Structural alterations of the arterial wall can res...
Pregnancy and the postpartum period are associated with physiological, hormonal, and hemodynamic changes that may increase susceptibility to cervical artery dissection. Structural alterations of the arterial wall can result from a variety of factors, predisposing vessels to injury and subsequent neurovascular events. In the present study, we analysed the contribution of multiple factors to the development of cervical artery dissection in pregnant women, including advanced maternal age, hormonal status, hypertension, hyperlipidaemia, connective tissue disorders, arterial malformations, migraine, adverse or rapidly changing head and neck positions, neck trauma, chiropractic manipulation, the presence of an elongated styloid process, pressure-inducing activities, and physical exercise.
Total Ferric Reducing Ability of Plasma as an independent caries risk marker in pregnant women with diabetes.
Waligóra J, Kuśnierz-Cabala B, Pawlica-Gosiewska D … +2 more , Gawlik K, Pytko-Polończyk J
Folia Med Cracov · 2026 Mar · PMID 42295062 · Publisher ↗
Pregnancy and diabetes increase the risk of developing pathologies in the oral cavity. Saliva biomarkers can be used as diagnostic markers in the monitoring of dental diseases. The study aimed to evaluate hard dental tis...
Pregnancy and diabetes increase the risk of developing pathologies in the oral cavity. Saliva biomarkers can be used as diagnostic markers in the monitoring of dental diseases. The study aimed to evaluate hard dental tissue health in pregnant women with two forms of diabetes and salivary antioxidant activity to identify optimal non-invasive caries risk factors. The study involved 104 pregnant women: 35 patients with gestational diabetes mellitus (GDM), 30 patients with type 1 diabetes (T1D), and 39 pregnant patients without diabetes mellitus (control group). Physical examination included caries assessment using the dental DMFT index, caries frequency, SiC index, and dental treatment index. Oral hygiene was also assessed using the Approximal Plaque Index (API). The study of unstimulated saliva measured the total Ferric Reducing Ability of Plasma (FRAP), as well as the activity of superoxide dismutase (SOD), glutathione reductase (GR), and glutathione peroxidase (GPX). In the analyzed patient population, caries frequency totalled 100%, with active tooth decay observed in 72.12% of patients, whereas caries intensity was similar in the studied groups. In all groups, oral hygiene (API) was average. In T1D group, higher values of the API index (p = 0.001) were observed vs. the control group. Antioxidant activity was similar in the study groups. The independent determinants of caries occurrence included API (p = 0.002) and FRAP concentration (p = 0.02). The health of dental hard tissues in the examined patients was unsatisfactory and similar in the studied groups. FRAP concentration and oral hygiene (API) functioned as determinants of caries.
Population developmental hazard of over-the-counter NSAIDs.
Burdan F, Burdan M, Potępa M … +1 more , Kucharski P
Folia Med Cracov · 2025 Dec · PMID 41607171 · Publisher ↗
INTRODUCTION: Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs, i.e., aspirin, diclofenac, dipyrone, ibuprofen, naproxen) and paracetamol are commonly ingested medications during pregnancy that for a l...
INTRODUCTION: Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs, i.e., aspirin, diclofenac, dipyrone, ibuprofen, naproxen) and paracetamol are commonly ingested medications during pregnancy that for a long time were classified as relatively safe for mothers and fetuses. AREAS COVERED: The review focuses on developmental toxicity of OTC NSAIDs. EXPERT OPINION: Same epidemiological studies show that OTC antipyretics and painkillers may increase risk of spontaneous abortion, intrauterine growth retardation, preterm constriction of ductus arteriosus with secondary persistent pulmonary hypertension, reduced fetal renal perfusion that leads to oligohydramion, prolonged pregnancy, as well as selected congenital anomalies, including orofacial cleft, cardiovascular (i.e. ventricular septal defect, pulmonary valve stenosis) and neural tube defects (i.e., anophthalmia/microphthalmia, encephalocele, spina bifida), amniotic bands/limb body wall defects, and transverse limb deficiencies. However, other reports prove high prenatal tolerability or even beneficial effect in case of selected maternal sicknesses, especially influenza or disease with fever and thrombotic complications. The best advice for pregnant women is to avoid any xenobiotic, especially multidrug therapy, but in case OTC NSAIDs are needed they should be ingested in lowest effective dose under physician consultation. After gestational week 20, NSAIDs could be ingested with caution and withdrawn at gestational week 32, since they may induce constriction of the ductus arteriosus and affect renal function. The only exception is low-dose of aspirin, ingestion of which should be stopped one week before delivery with epidural anesthesia or could be prolonged until the end of pregnancy in patients with antiphospholipid syndrome.
Urogynaecological physiotherapy as a support of surgical treatment in Poland - assessment of participation, awareness and satisfaction.
Mazur-Biały A, Duszka-Seternus K, Tim S … +1 more , Sówka J
Folia Med Cracov · 2025 Dec · PMID 41607170 · Publisher ↗
INTRODUCTION: Urinary incontinence (UI) and pelvic organ prolapse (POP) are prevalent conditions that significantly impair women's quality of life, yet awareness of conservative treatment options remains limited. AIM: To...
INTRODUCTION: Urinary incontinence (UI) and pelvic organ prolapse (POP) are prevalent conditions that significantly impair women's quality of life, yet awareness of conservative treatment options remains limited. AIM: To assess women's knowledge and awareness regarding urogynaecological physiotherapy, as well as to evaluate quality of life and satisfaction after gynaecological and urogynaecological surgeries. MATERIAL AND METHODS: The study included 438 women undergoing surgery for pelvic floor dysfunction or other gynaecological conditions. Participants completed self-designed and validated questionnaires regarding physiotherapy knowledge, pre- and postoperative engagement, preventive behaviours and treatment satisfaction. RESULTS: Nearly half of the participants (48.1%) had never heard of pelvic floor physiotherapy, with POP patients being the least informed (53.6%). Only 24.3% received a physiotherapy referral before surgery, and 16.7% underwent preoperative therapy, most often limited to one or two sessions. After surgery, 30.5% were referred to physiotherapy, while 18.0% participated. Women who attended physiotherapy - especially pre- operatively - were significantly more likely to perform pelvic floor muscle training (PFMT) correctly (78.6% vs. 18.9%, p <0.001) and to engage in preventive behaviours (92.9% vs. 54.1%, p <0.001). Subjective outcomes were also better: patients with physiotherapy both before and after surgery most frequently rated their health as "much better" and expressed greater willingness to repeat surgery (p = 0.003). CONCLUSION: Awareness of urogynaecological physiotherapy remains insufficient. Physiotherapy, particularly when integrated both pre- and postoperatively, enhances PFMT performance, preventive behaviours, subjective treatment outcomes and satisfaction with surgery. Expanding access to physiotherapy and improving patient education could optimise long-term management of UI and POP.
Bilateral extra hilar branching pattern of renal artery: Its embryological basis and clinical elucidation.
Singh A, Singh S, Hanusun N HH … +2 more , Poddar P, Ansari A
Folia Med Cracov · 2025 Dec · PMID 41607169 · Publisher ↗
Extra-hilar branching refers to the main renal artery dividing before reaching the hilum of the kidney into an anterior and posterior branch. Embryologically, initial segmentation of renal artery may occur due to ablatio...
Extra-hilar branching refers to the main renal artery dividing before reaching the hilum of the kidney into an anterior and posterior branch. Embryologically, initial segmentation of renal artery may occur due to ablation of renin cell precursors and mutations of the renin-angiotensin system or due to delayin communication between the constituents located within the mesenchyme of the vascular structures and those found in the mesenchyme of the metanephros, such as hepatocyte growth factor and glial-derived neurotrophic factor. The variations in renal vascular anatomy is of clinical relevance to surgeons and radiologists in cases of renal transplantation, vascular reconstruction and assessment of renovascular hypertension. The present case report involves the extra hilar branching of bilateral renal arteries with its embryological basis and clinical elucidation.
General principles of the diagnosis and treatment of patients with emporomandibular disorders.
Pihut M, Orczykowska M, Gala A … +2 more , Osmenda G, Kulesa-Mrowiecka M
Folia Med Cracov · 2025 Dec · PMID 41607168 · Publisher ↗
Temporomandibular disorder (TMD) is a condition affecting a growing population of people worldwide. It is an etiologically, diagnostically and therapeutically challenging condition. The aim of this article was to present...
Temporomandibular disorder (TMD) is a condition affecting a growing population of people worldwide. It is an etiologically, diagnostically and therapeutically challenging condition. The aim of this article was to present difficult and important subjects for doctors, who are less experienced yet but who are treating patients with TMD. This article presents modern general methods for treating patients with temporomandibular disorders. The principles of treatment are described on the basis of the author's more than 30 years of clinical experience and taking into account the contemporary literature describing this issue. The therapeutic management of the use of appliances called occlusal splints is characterized, and the importance of stopping the pathological habits of clenching or grinding teeth is described. In addition, procedures such as intramuscular injections of botulinum toxin type A and intraarticular injections of hyaluronic acid have been described. Additionally, the physiotherapeutic procedures used, such as laser biostimulation, sonophoresis, postisometric muscle relaxation, or manual therapy, and the need for psychotherapeutic support are described. The description of the procedures includes valuable tips for each of the sections of primary and supportive treatment of TMD. This article highlights all the necessary steps in the treatment of this group of patients and offers an overview of the methods. This paper highlights the most innovative methods that are currently used in the treatment of TMD. The use of the described methods guarantees therapeutic progress and pain relief. In addition, the article explains the importance of psychological support due to the predominant etiological factors of TMD.
Health behaviors and quality of life among young adults during the COVID-19 pandemic.
Kawalec-Kajstura E, Kuźmicz I, Śmierciak I … +3 more , Padykuła M, Ostrogórska-Gonszewska P, Sułkowska J
Folia Med Cracov · 2025 Dec · PMID 41607167 · Publisher ↗
INTRODUCTION: The COVID-19 pandemic has affected the life quality and young adults' health behaviors. Aim Assessment of health behaviors and life quality in young adults during the COVID-19 pandemic. MATERIAL AND METHODS...
INTRODUCTION: The COVID-19 pandemic has affected the life quality and young adults' health behaviors. Aim Assessment of health behaviors and life quality in young adults during the COVID-19 pandemic. MATERIAL AND METHODS: The study was conducted in a group of 161 people aged 18-25 years. The study employed a diagnostic survey method using the World Health Organization Quality of Life Questionnaire in the Polish version and the Health Behavior Inventory, as well as a self-designed questionnaire. RESULTS: The average value of the total health behavior intensity index in the examined group was 75.83 ± 13.9. The average scores obtained in each domain were similar, with the highest score referring to under-taking health practices (3.31 ± 0.68) and the lowest referring to proper eating habits (2.95 ± 0.81). Only 11.80% of respondents presented a high level of health behaviors. The average score for overall quality of life was 3.87 ± 0.81 points, with the physical domain scoring most favorably (15.18 ± 2.65 points) and the psychological domain scoring the lowest (13.45 ± 3.48 points). There was a significant positive correlation between respondents' health behaviors and their quality of life (r =0.288; p <0.001). Respondents indicated that the pandemic negatively affected their quality of life in the psychological (63.98%), social (60.25%) and environmental (45.34%) domains. CONCLUSIONS: Nearly half of the respondents reported low intensity of health behaviors. Their quality of life was good. The physical domain scored highest and the mental domain scored lowest, which was also reflected in the highest score for the adverse impact of the pandemic on the quality of life in the same domain.
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