Andrzej Frycz Modrzewski Krakow University

Wstp: Neuroborelioza jest jedn z najczstszych pozamzgowych manifestacji zakaenia Borrelia burgdorferi i moe prowadzi do uszkodzenia nerwu twarzowego.Poraenie nerwu VII skutkuje asymetri twarzy, ograniczeniem funkcji mini mimicznych, trudnociami w artykulacji, poykaniu i mimice emocjonalnej.Rehabilitacja w przebiegu neuroboreliozy obejmuje zarwno kinezyterapi, jak i metody fizykalne, w tym elektrostymulacj mini twarzy, ktrej celem jest pobudzenie osabionych wkien miniowych,

Wstp: Neuroborelioza jest jedn z najczstszych pozamzgowych manifestacji zakaenia Borrelia burgdorferi i moe prowadzi do uszkodzenia nerwu twarzowego.Poraenie nerwu VII skutkuje asymetri twarzy, ograniczeniem funkcji mini mimicznych, trudnociami w artykulacji, poykaniu i mimice emocjonalnej.Rehabilitacja w przebiegu neuroboreliozy obejmuje zarwno kinezyterapi, jak i metody fizykalne, w tym elektrostymulacj mini twarzy, ktrej celem jest pobudzenie osabionych wkien miniowych,

Introduction & Aim: Sudden cardiac arrest remains a leading cause of mortality, with global survival rates remaining low. High-quality CPR characterized by adequate depth and minimal interruptions, is the cornerstone of survival. Manual CPR quality often declines due to rescuer fatigue and challenging environments. Mechanical chest compression devices (MCCDs) offer a potential solution to ensure consistent quality. This study aims to provide an overview of MCCDs available in the Polish Emergency Medical System, highlighting their advantages, limitations and applications, while evaluating their clinical effectiveness compared to manual CPR. Material and methods: The study consisted of a descriptive and comparative literature review, focusing on the technical data and clinical evidence (up to 2025) for the AutoPulse, LUCAS, and Corpuls CPR systems used in Poland. Data analysis included RCTS, cohort studies, systematic reviews, and meta-analyses evaluating MCCDs, utilizing PubMed, Scopus, and Google Scholar. Results: MCCDs ensure high-quality, uninterrupted compressions, particularly in challenging transport or specific scenarios, freeing up personnel for other tasks. Large-scale randomized controlled trials (RCTs) and recent meta-analyses demonstrate that MCCDs provide comparable survival outcomes to high-quality manual CPR, with survival rates ranging from 6.0% to 9.4%. However, MCCDs show a significant advantage in specialized scenarios - prolonged transport, catheterization labs, or as a bridge to advanced therapies like eCPR and extracorporeal life support. Conclusions: MCCDs are reliable alternatives for specific clinical situations. Although they involve higher costs and different injury patterns, the benefits of maintaining consistent CPR quality in conditions where manual compressions fail are measurable. Current guidelines recommend their use as a viable alternative in specific, difficult circumstances, rather than as a routine replacement for manual CPR.

Addison’s disease (AD) is a relatively uncommon illness presented by decreased adrenal production of adrenocortical hormones - mainly glucocorticoids. We present a case of a patient who had symptoms of chronic fatigue, depression that made it difficult for her to carry out everyday household activities. In basic laboratory tests, they mainly noted low sodium (Na), increased potassium (K) and low fasting glucose concentration. The patient’s informed consent was obtained for the presentation of anonymised laboratory, clinical and imaging data. On the basis of the clinical picture and hormonal tests, Addison’s disease was confirmed. Significant clinical improvement was observed following the addition of hydrocortisone to the treatment regimen. Advances in optimizing treatment for patients with Addison’s disease have enabled them to lead normal lives. However, it is important to continuously educate patients and healthcare professionals about the ever-present threat of adrenal crisis.

The pes anserinus (PA) is a tendinous complex located on the anteromedial surface of the proximal tibia, formed by the conjoined insertions of the sartorius, gracilis, and semitendinosus muscles. It contributes to internal rotation and flexion of the tibia, providing stability to the medial knee compartment. During the routine dissection of a 75-year-old female cadaver, an unusual PA variant was found. On the right limb, four accessory tendons were identified: one accessory sartorius tendon (aSART), one accessory gracilis tendon (aGRT), and two accessory semitendinosus tendons (aSTT1 and aSTT2). Distally, the aSTT1 fused with the aGRT and subsequently joined the aSART, forming a single fascial band that inserted slightly inferior to the typical PA footprint. No corresponding variations were present on the contralateral side. The coexistence of accessory slips from all three PA muscles appears exceedingly rare. This case report presents a unique variant of PA, emphasizing the extent of its anatomic variability. Awareness and recognizing such variants of PA is crucial for surgeons, as this knowledge may help prevent the misidentification of tendons during medial knee procedures and tendon graft harvesting.

Understanding oocyte and ovarian aging has become critically important, as trends in family planning evolve, with many women choosing to have children later in life. The ovary, a crucial organ in female reproduction, is particularly susceptible to age-related changes and is one of the organs that exhibit functional deterioration most distinctly with age. The aging of female reproductive systems also affects longevity and various health outcomes. A better understanding of both oocyte and ovarian aging will lay the cornerstone to elucidate the phenomenon of longevity in women. Here, clinical data from 400 women of various ages undergoing intracytoplasmic sperm injection (ICSI) have been analyzed, including Anti-Müllerian Hormone (AMH) and Follicle-Stimulating Hormone (FSH) levels, the number of recovered oocytes, blastocyst rates, pregnancy rates, and live birth rates. Our analyses revealed significant differences in the aforementioned rates between patients of young and advanced age. For the biomarker analysis, we further utilised a novel predictive performance of age-associated gene expression signatures for oocyte aging, demonstrating its potential to provide molecular-level insights into oocyte quality over time. By analyzing RNA sequencing data generated from human oocytes of different ages, a genome-wide landscape of age-associated gene expression has been described. Additionally, metabolome profiling has been performed on young and reproductively aged mice, serving as a model for human ovaries. Changes in metabolites of the murine ovaries during aging have been recorded. In conjunction with traditional biomarkers, multiomics data represent a transformative approach in reproductive health, and they may offer personalised risk assessments and interventions to mitigate age-related fertility decline in women. Our metabolome profiling provides a valuable resource for elucidating the metabolomic basis of ovarian aging. Our findings offer novel insights into systemic shifts associated with oocyte and ovarian aging. This integrated approach may unlock new avenues for fertility preservation, ovarian rejuvenation, and assisted reproduction.

Background: Miniaturized percutaneous nephrolithotomy techniques have been developed to reduce the morbidity associated with standard percutaneous nephrolithotomy (PCNL) while maintaining high stone clearance. Among these approaches, mini-PCNL and ultra-mini PCNL (UMP) are increasingly used; however, their optimal indications remain incompletely defined. Aims: To review and synthesize current evidence regarding the efficacy, safety, and clinical indications of mini-PCNL and UMP in the management of kidney stone disease. Methods: A narrative review of the literature was performed using PubMed/MEDLINE, Scopus, and Web of Science databases. Clinical studies, comparative analyses, meta-analyses, reviews, and international guideline documents addressing mini-PCNL and UMP were included. Evidence was synthesized descriptively with emphasis on stone- and patient-related factors influencing technique selection. Results: Both mini-PCNL and UMP demonstrated high stone-free rates when applied in appropriately selected patients. Mini-PCNL achieved superior stone clearance for larger (15–30 mm), multiple, or high-density renal stones, owing to efficient fragment extraction. UMP was associated with lower perioperative morbidity, reduced bleeding risk, and shorter hospital stay, with optimal outcomes observed in smaller stone burdens. Differences in efficacy between techniques were minimal for stones <15 mm but became more pronounced with increasing stone size and complexity. Conclusions: Mini-PCNL and UMP are complementary techniques in contemporary percutaneous stone surgery. Mini-PCNL is best suited for larger or more complex stones requiring active fragment removal, whereas UMP offers advantages in minimizing invasiveness and accelerating recovery in selected patients. Individualized treatment selection based on stone characteristics, patient factors, and surgical expertise is essential to optimize outcomes.

Background: Obesity is a global health problem due to its increasing prevalence over the past several decades. It is strongly associated with an elevated risk of cardiovascular diseases, both directly through metabolic mechanisms affecting the circulatory system and indirectly through traditional risk factors such as hypertension, dyslipidemia, and type 2 diabetes. Aim: This review discusses the pathological changes occurring in the cardiovascular system under the influence of obesity. It presents the mechanisms linking obesity with selected cardiovascular diseases and outlines the role of physical activity in obesity. Methods: The review was conducted using the PubMed, Web of Science and Google Scholar databases, limited to full-text, open-access publications from the years 2013–2025. Results: As body weight increases, the risk of cardiovascular diseases such as heart failure, hypertension, and arrhythmias also rises. Weight reduction helps lower the risk of developing these disorders. Combined aerobic and resistance training (CART), as well as High-Intensity Interval Training (HIIT), has a beneficial effect on well-being and the condition of the cardiovascular system. Conclusion: Obesity and the metabolic disturbances it causes are strongly associated with an increased risk of cardiovascular diseases. Obesity is not only a co-existing factor but also an independent risk factor for cardiovascular conditions. Effective intervention requires an individual approach.

Background: iron deficiency anemia (IDA) is a widespread, preventable condition that diminishes work capacity, cognition, and overall health. Dysregulation of iron homeostasis — principally via hepcidin‑mediated sequestration — distinguishes absolute deficiency from functional deficiency, guides diagnostic interpretation and helps to choose the type therapy. Aim: The aim of this article is to compare the available oral iron supplements with respect to efficacy, tolerability and practical use. It summarizes current evidence regarding optimal dosing and frequency of administration in individuals with iron deficiency and iron-deficiency anemia. Methods: narrative review of literature up to 2025, prioritizing recent meta‑analyses, systematic reviews, randomized controlled trials, phase III randomized studies and other high‑quality studies. Searches were conducted in PubMed/MEDLINE, Embase, Web of Science and Google Scholar. Key search terms included oral iron, ferrous sulfate, liposomal iron, sucrosomial iron, ferric maltol and ferrous bisglycinate. This review compares their efficacy and tolerability. Study selection, data extraction, and quality evaluation followed standard review procedures; findings were synthesized and summarized in tables. Results: new supplements generally achieve comparable or faster hematologic responses at lower elemental iron doses and are associated with fewer gastrointestinal side effects, which may improve adherence, particularly in patients intolerant of ferrous salts or with inflammatory conditions. Dosing approaches that account for hepcidin dynamics (alternate-day or single morning dosing) enhance absorption. Heterogeneity in study populations, dosing regimens and outcome measures limits direct comparisons. Conclusion: oral iron formulations show broadly similar efficacy; selection should prioritize tolerability, comorbidity context, and dosing strategies that optimize absorption. Individualized therapy with routine monitoring of hemoglobin and ferritin improves outcomes and adherence.