Lublin Oncology Center

To identify BKPyV, the VP1 protein sequence was analyzed and classified into genotypes in 246 RTRs before and after RTx from deceased donors during a one-year observation period. Quantitative assessment of BKPyV was conducted via qPCR. Prior to RTx, genotypes I and IV were identified in the urine (7.27 × 106; 1.20 × 105) and in serum (5.75 × 104; 1.12 × 104). After RTx, genotype I was predominant; identification of DNAuria-BKPyV (62.07%) and BKPyV-DNAemia (55.56%) peaked after three months, and the highest DNAuria-BKPyV titer was also observed after three months (6.48 × 109), whereas the BKPyV-DNAemia titer did not peak until after six months (2.21 × 107). The highest number of copies of genotype IV in the urine was observed after six months (9.54 × 109), while the highest titer in the serum was not observed until after 12 months (3.88 × 106). DNAuria-BKPyV precedes BKPyV-DNAemia, affects a larger group of patients, and has a greater and more easily detected viral load, which makes it not only an earlier marker, but the key predictive marker of greater clinical value than later detection of BKPyV-DNAemia alone. Early monitoring of DNAuria-BKPyV should be the basis of classical screening, and not merely an addition to it, and therapeutic interventions should be undertaken early to prevent nephropathy.

Systemic sclerosis is a rare, progressive, multisystem autoimmune disease that can affect the skin, digestive system, internal organs, joints, and hands. Pharmacological treatment remains the standard of care; however, it does not always adequately address all the distressing symptoms experienced by patients. This study aimed to review and summarise the available surgical options for systemic sclerosis. A comprehensive literature review was conducted using a broad search strategy to encompass the wide-ranging aspects of the disease. Systemic sclerosis is associated with a broad spectrum of clinical manifestations. Surgical interventions have been attempted for many of these, with the goals of improving patients' quality of life, reducing pain, and lowering disability. The most common procedures performed in patients with systemic sclerosis include anti-reflux operations and other gastrointestinal surgeries, various hand surgeries, organ transplantation, and selected orthopaedic or plastic procedures. Available evidence suggests that, although systemic sclerosis presents additional challenges in surgical management, it is not an absolute contraindication when surgery is indicated. Surgical management remains a valuable option in systemic sclerosis, particularly when conservative treatments are insufficient. Organ-specific procedures can improve quality of life and, in selected cases, be life-saving. By comprehensively reviewing the available surgical literature, this study may assist clinicians in considering operative approaches where appropriate. Further research is needed to standardise reporting and define clear surgical indications in patients with systemic sclerosis.

This systematic review investigates the impact of chronic stress on treatment outcomes among cancer patients with divergent survival rates, focusing on breast, prostate, pancreatic, and ovarian cancers. The analysis explores how chronic stress influences molecular pathways and tumor progression while comparing cancers with five-year survival rates above and below 50%. A comprehensive literature search was conducted in PubMed and Scopus for studies published between 2014 and 2025 using combinations of keywords related to “chronic stress,” “psychological stress,” “psychotherapy,” and selected cancer types. All studies met the inclusion criteria according to the PRISMA 2020 guidelines. Evidence suggests that chronic stress is associated with the activation of neuroendocrine and immune mechanisms, including β-adrenergic and glucocorticoid signaling. These multifactorial processes are associated with disease progression and survival, particularly in pancreatic and ovarian cancers; however, these links remain primarily associative rather than causative. Conversely, psychotherapeutic interventions alleviate stress-related biological responses, improve quality of life, and may indirectly enhance therapeutic efficacy. By structuring the evidence around cancers with higher versus lower five-year survival, our review provides a survival informed synthesis of cancer type specific stress biology and stress-mitigating interventions, highlighting potentially targetable pathways and clear evidence gaps for future trials. The findings underscore the need to integrate psychological care into oncological practice to improve overall outcomes.

Radiotherapy is an integral part of early breast cancer treatment, when breast-conserving surgery is performed. Heart disease caused by radiotherapy can include pericardial lesions, cardiac dysfunction, valvular defects, coronary artery damage, and cardiac arrhythmias. Risk factors primarily include those related to the mean heart dose of radiation, but with the development of modern radiotherapy techniques, this problem is optimistically decreasing. However, concurrent pharmacological anticancer therapies still significantly impact the vessels and heart. The key problem, however, is pre-existing heart disease, often based on atherosclerosis or arterial hypertension. Efforts should be made to ensure that radiotherapy produces at most permissive cardiotoxicity, which will not affect the quality of life or survival. Hence, effective pharmacotherapy for primary and secondary cardioprotection is searching.

Background: Ventricular septal defect (VSD) is the most prevalent congenital heart defect, characterized by an abnormal communication between the ventricles, leading to a left-to-right shunt. Its clinical spectrum ranges from asymptomatic small defects to large shunts causing heart failure, pulmonary hypertension, or Eisenmenger syndrome. Early diagnosis and appropriate management are critical to prevent long-term complications. Methods: This literature review synthesizes current evidence on the classification, pathophysiology, diagnostic modalities, treatment options, and long-term outcomes of VSD. A comprehensive analysis of peer-reviewed articles and clinical guidelines was conducted to present up-to-date insights into the multidisciplinary approach to VSD care. Results: Anatomical subtypes of VSD vary in clinical significance, risk of complications, and management strategies. Advances in imaging, particularly echocardiography and cardiac MRI, have improved diagnostic precision. While small defects often resolve spontaneously and are managed conservatively, large or symptomatic defects may require surgical or transcatheter closure. Surgical repair remains the standard for most cases, but selected muscular and perimembranous defects can be treated percutaneously. Long-term follow-up is essential due to risks of arrhythmias, conduction block, residual shunts, or valve dysfunction. Emerging technologies—including biodegradable devices, minimally invasive surgery, and experimental gene therapy—may reshape future management paradigms. Conclusions: VSD management requires individualized, anatomy-guided decision-making supported by multidisciplinary expertise. Technological progress has expanded therapeutic options, yet lifelong surveillance remains necessary to mitigate late complications and optimize outcomes.

Introduction and purpose: Smoking remains one of the leading preventable causes of premature mortality worldwide. A structured search of PubMed and Google Scholar databases was performed to identify clinical, epidemiological and experimental evidence, including original studies, systematic reviews and meta-analyses, on the impact of active and passive smoking. This narrative review summarises current evidence on the health effects of tobacco smoking and secondhand smoke exposure, with a particular focus on cardiovascular, respiratory and neoplastic diseases. Description of the state of knowledge: Tobacco smoke contains numerous toxic and carcinogenic compounds that promote endothelial dysfunction, oxidative stress and chronic inflammation, thereby accelerating atherosclerosis and increasing the risk of myocardial infarction, stroke and other vascular events. Long-term exposure damages the airways and lung parenchyma, leading to chronic obstructive pulmonary disease (COPD), worse asthma control and increased susceptibility to respiratory infections. Smoking is also a major driver of cancer, accounting for most lung cancer cases and contributing substantially to malignancies of the upper aerodigestive tract, pancreas and bladder. Secondhand smoke, although involving lower levels of exposure, is associated with higher risks of cardiovascular disease, respiratory illness, type 2 diabetes and adverse outcomes in children and older adults. Conclusion: The available evidence clearly shows that there is no safe level of exposure to tobacco smoke. Smoking cessation and effective protection from secondhand smoke are essential components of strategies to prevent cardiovascular, respiratory and neoplastic diseases and should remain central priorities in public health policy and clinical practice.

Introduction and objective: Periodontitis (PD) is caused by dysbiosis of the oral microbiome (OMB). The prevalence of PD is increased in RA patients. Both conditions have the ability to activate common inflammatory pathways. The OMB shift contributes to more severe course of PD and RA. This paper aims to summarize the impact of OMB on chronic inflammation in the pathogenesis of PD and RA. Description of the state of knowledge: The OMB can influence chronic inflammation and protein citrullination. The presence of antibodies against citrullinated peptides (ACPA) correlates with an increased incidence and severity of periodontitis. While numerous studies have reported a relationship between the OMB, PD and RA, the role of specific bacteria in RA remains unclear. Methodology: A literature review was conducted using two databases - PubMed and Google Scholar - with search terms such as "oral microbiome”, “rheumatoid arthritis", "periodontal health”, “oral microbiota”, “periodontal disease”. Articles published within the last eight years were prioritized. Conclusions: PD is more prevalent and severe particularly in ACPA-positive RA patients. Alterations in OMB are associated with systemic inflammation, contributing to RA progression. and worsening periodontal conditions. Periodontal treatment shows a potential to reduce RA activity, emphasizing the importance of dental care in RA. Anti-inflammatory treatments may restore oral homeostasis. Targeting the OMB offers a potential for managing RA and PD. Further research is needed to establish guidelines for personalized therapies and prophylaxis.

Today, it is well established that the tumor microenvironment (TME), the tumor niche, along with melanoma cells, plays a crucial role in cancer dissemination and influences the effectiveness of anticancer therapies. Therefore, it may serve as a potential therapeutic target in melanoma treatment. In our research, we focused on the effects exerted by cells within the melanoma microenvironment on cancer progression and the development of therapy resistance. Specifically, we examined stromal cells accompanying melanoma cells in the tumor - cancer-associated fibroblasts (CAFs), cancer-associated keratinocytes (CAKs), and cancer-associated adipocytes (CAAs). Particular attention was given to keratinocytes, as their role in the melanoma microenvironment remains the least understood.

To evaluate the effect of erenumab treatment beyond monthly migraine days in patients with high-frequency episodic migraine who did not respond to at least one previous migraine preventive treatment. Reduction in monthly migraine days has been the efficacy standard for migraine preventive treatments; however, it does not fully capture the holistic benefit of the therapy. Erenumab, a monoclonal antibody targeting the calcitonin gene-related peptide pathway, has demonstrated reduction in monthly migraine days and improvement in function in patients with episodic and chronic migraine. In this phase 4, interventional, double-blind, randomized, placebo-controlled, multicenter, global study, treatment with erenumab was assessed over 4 months in adults with high-frequency episodic migraine. The study was conducted at 61 sites located across North America and Europe between September 2020 and October 2023. Patients with ≥1 qualifying oral triptan-treated migraine attack at baseline were randomized to receive erenumab 140 mg or placebo subcutaneously once monthly. The primary endpoint was change from baseline in mean monthly hours of at least moderate headache pain intensity over months 1, 2, and 3; secondary endpoints included change from baseline in mean monthly function, mean monthly duration of at least moderate pain intensity in migraine attacks, and mean monthly peak migraine pain intensity. Safety outcomes were also assessed. Of 512 randomized patients, 510 received erenumab 140 mg (n = 254) or placebo (n = 256) once monthly. Demographics and baseline characteristics were balanced between the two treatment arms. Erenumab 140 mg was superior to placebo in reducing duration of moderate or severe headache pain intensity over months 1, 2, and 3 (least squares mean [95% confidence interval {CI}] difference, -7.95 [-11.45, -4.46]; p < 0.001). Compared with placebo, erenumab significantly reduced migraine functional impact as assessed by the four domains of the Migraine Functional Impact Questionnaire, with a least squares mean (95% CI) difference of -7.36 (-10.80, -3.92) for physical functioning, -7.10 (-10.34, -3.87) for usual activities, -6.82 (-10.37, -3.27) for social functioning, and - 7.05 (-10.76, -3.34) for emotional functioning (p < 0.001 for all domains). Significant reductions with erenumab compared with placebo were also observed in duration of at least moderate pain intensity in residual or break-through migraine attacks (least squares mean [95% CI] difference, -1.07 [-1.92, -0.22]; p = 0.013) and peak migraine pain intensity (-0.48 [-0.85, -0.11]; p = 0.011). Incidence of grade 3 adverse events was 1.6% with erenumab and 1.2% with placebo; no grade 4 or fatal adverse events were reported in either treatment arm. Findings from the EMBRACE study demonstrated that treatment with erenumab in patients with high-frequency episodic migraine can provide positive therapeutic effects on ictal burden and pain, with residual migraine attacks tending to be shorter and less painful, with less overall impact.