Medical University of Lublin

Intravenous leiomyomatosis (IVL) is a rare condition characterized by the proliferation of uterine smooth muscle cells within the lumen of vascular vessels. Despite its histologically benign nature, IVL can invade cardiac vessels, leading to severe complications such as circulatory failure and heart blockade. This underscores the critical need for accurate diagnosis and comprehensive preoperative management to prevent fatal outcomes. A previously healthy 41-year-old woman was admitted to Gynecology Department following abnormal findings on a routine abdominal ultrasound (USG). The USG revealed a pelvic tumor accompanied by extensive thrombosis of the ovarian veins and inferior vena cava (IVC). Abdominal magnetic resonance imaging (MRI) showed an enlarged myomatous uterus measuring 85 x 70 x 60 mm with two oval-shaped focal lesions near the left ovary, measuring 50 x 50 x 45 mm and 80 x 50 x 60 mm. Additionally, vascular CT revealed a free-floating thrombus extending from the ovarian veins, right common iliac vein (CIV), IVC, and into the right atrium. The patient was scheduled for a single-step surgery. She underwent a total abdominal hysterectomy (TAH) with bilateral salpingo-oophorectomy (BSO), followed by sternotomy with extracorporeal circulation (ECC) to remove the tumor from the circulatory tract. Postoperative histopathological examination confirmed the diagnosis of IVL. Patients with IVL extending into the circulatory system should be managed by multidisciplinary teams comprising oncological gynecologists, as well as vascular and cardiothoracic surgeons. This collaborative approach ensures radical surgical resection, which is essential in preventing future recurrences of IVL.

Background. Athletes frequently experience gastrointestinal (GI) disturbances overlapping with Irritable Bowel Syndrome (IBS). Performance supplements—including carbohydrate gels and beverages, protein powders, creatine, caffeine-based pre-workouts, probiotics, prebiotics, and buffering agents—can mechanistically exacerbate or attenuate these symptoms. Aim. To summarize human data (2021–2026) regarding the effects of performance and recovery supplements on IBS-like symptoms in athletes, identifying mechanistic themes and research gaps. Material and methods. This narrative review synthesized evidence from PubMed and Scopus, including observational studies and clinical trials. Results. No identified trials recruited athletes with Rome-defined IBS, though a high prevalence of IBS-like symptoms was documented. Multi-strain Lactobacillus or Bifidobacterium probiotics showed small-to-moderate reductions in symptom severity in several randomized trials. Conversely, prebiotics and high-FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) sports products were linked to increased lower-GI burden. Experimental data indicated higher symptom rates with solid carbohydrates compared to gels or beverages at equivalent dosages. Sodium bicarbonate remains strongly associated with GI discomfort, despite novel hydrogel delivery systems. Emerging "gut-supportive" supplements (e.g., collagen peptides, multi-ingredient fermented whey) showed neutral acute effects or preliminary, uncontrolled chronic improvements. Conclusions. Supplement effects are highly dependent on FODMAP content, osmolality, and underlying GI vulnerability. Multi-strain probiotics and low-FODMAP carbohydrate strategies demonstrate the most consistent potential for symptom reduction. High-priority research should focus on rigorously phenotyped athletes with confirmed IBS and head-to-head trials of low- vs. high-FODMAP formulations.

Nursing students face high academic and emotional demands that may adversely affect their mental well-being and psychological resources. Understanding the relationships between stress, life orientation, and sense of coherence is essential for developing effective support strategies. This study aimed to examine the mediating role of perceived stress in the relationship between life orientation and sense of coherence among nursing students, with the year of study as a moderator. A multicentre cross-sectional study was conducted between October and December 2023 among 2,689 undergraduate nursing students in Poland aged 18–30 years. Data were collected using a sociodemographic questionnaire and standardized instruments: LOT-R, SOC-29, and PSS-10. Moderated mediation analyses were performed. Most participants reported high levels of perceived stress and high dispositional optimism, while sense of coherence scores were moderate. Optimism showed a negative direct association with meaningfulness, which strengthened in the second year of study and became partially mediated by stress in the third year. In the first two years, higher optimism was associated with lower manageability; this relationship weakened in the third year, suggesting adaptive changes. The third year emerged as a critical period, during which stress significantly reduced comprehensibility and meaningfulness and played a stronger mediating role between optimism and sense of coherence. Perceived stress mediates the relationship between life orientation and sense of coherence in nursing students, with patterns differing across years of study. These findings highlight the need for targeted educational and psychological interventions to enhance stress management, emotional resilience, and psychological resources, particularly in later stages of nursing education. Not applicable.

ObjectiveTo evaluate associations between culture-detected vaginal microbial colonization, body composition parameters, and lifestyle factors in women with gestational diabetes (GD).DesignCross-sectional observational study.SettingTertiary university hospital, Department of Obstetrics and Perinatology, Lublin, Poland.PopulationOne hundred pregnant women, including 47 with GD and 53 healthy controls.MethodsAnthropometric measurements, bioelectrical impedance analysis (BIA), and vaginal culture-based microbiological assessment were performed. Dietary habits, lifestyle behaviours, and supplement use were evaluated using a validated questionnaire. BIA assessed hydration status and body composition, including total body water, extracellular and intracellular water, lean tissue mass, and body cell mass.Main outcome measuresPrevalence of selected vaginal microorganisms (Candida albicans, Streptococcus agalactiae), body composition indices, and lifestyle factors.ResultsWomen with GD had significantly higher BMI during pregnancy, greater lean tissue mass and body cell mass, and increased total and extracellular water compared with controls (all p < 0.05). Vaginal swabs showed a higher prevalence of Candida albicans (27.7% vs. 5.7%) and Streptococcus agalactiae (23.4% vs. 0%) in the GD group. Women with GD more frequently reported alcohol and coffee consumption before pregnancy and were less likely to use folic acid or probiotic supplements. Due to multiple comparisons, some findings may reflect type I error and should be interpreted cautiously.ConclusionsGD was associated with a higher prevalence of selected culture-detected vaginal microorganisms, as well as differences in body composition and health-related behaviours. These findings highlight potential interactions between metabolic status, microbial colonization, and lifestyle factors in pregnancy. Given the cross-sectional design, causality cannot be inferred, and comprehensive microbiome studies are needed to confirm broader ecological changes.

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.

Triple-negative breast cancer (TNBC) remains one of the most aggressive breast cancer subtypes and is associated with limited therapeutic options, underscoring the urgent need for novel treatment strategies. In this study, a library of seventeen 1,3,5-triazine derivatives potentially targeting TNBC was developed using an activity-based approach. Compounds were synthesized via an ultrasound-assisted protocol, providing an efficient and environmentally friendly methodology. The synthesized library was evaluated in vitro against the human TNBC cell lines MDA-MB-468, MDA-MB-231, and Hs578T, as well as the non-tumorigenic epithelial cell line MCF10A. Compounds 9 and 17 exhibited the most promising antiproliferative activity against TNBC cell lines (MDA-MB-468: IC50 = 36.62 µM for 9 and 38.29 µM for 17; MDA-MB-231: IC50 = 37.32 µM for 9 and 32.86 µM for 17; Hs578T: IC50 = 57.26 µM for 9 and 34.87 µM for 17), while maintaining acceptable selectivity toward non-cancerous cells. The lead compounds were further assessed in vivo using a Danio rerio model to evaluate general toxicity and cardiotoxicity. In addition, ADME parameters were predicted for all compounds using biomimetic chromatography. Overall, compounds 9 and 17 emerged as promising small-molecule candidates for TNBC treatment, requiring further toxicological evaluation in more human-relevant in vivo models.

Malnutrition is common among patients with heart failure (HF), yet accurate assessment of nutritional status in this population remains challenging. The phase angle (PhA) derived from bioelectrical impedance analysis (BIA) has been proposed as a marker of nutritional status at the cellular level; however, concerns persist regarding its dependence on hydration status. This study aimed to assess the association between HF and nutritional status, with particular emphasis on phase angle (PhA) measured at 50 kHz, and to evaluate its diagnostic value in comparison with other indices, including the Nutritional Risk Screening 2002 (NRS 2002), body mass index (BMI), and selected laboratory parameters. In this cross-sectional study, 270 patients with chronic coronary syndrome were evaluated using laboratory tests, anthropometric measurements, the NRS 2002, and BIA. Patients were stratified according to HF status. Statistical analyses included parametric and non-parametric tests, correlation analyses, multivariable logistic regression models, and receiver operating characteristic (ROC) curve analysis. Adjustments were made for age, sex, BMI, estimated glomerular filtration rate (eGFR), hemoglobin, and extracellular fluid percentage (ECF%). Heart failure was present in 91 of 270 patients (33.7%). Patients with HF had significantly lower PhA (median 4.79 vs 5.22; p < 0.001), higher NRS 2002 scores (p = 0.010), and lower eGFR and hemoglobin levels. In multivariable logistic regression analysis, PhA remained independently associated with HF (odds ratio (OR) = 0.62; p = 0.016), whereas NRS 2002 and ECF% were not significant. Inclusion of ECF% did not improve model performance. In ROC analysis, PhA showed modestly higher discriminative ability for HF (area under the curve (AUC) = 0.636) compared with NRS 2002 (AUC = 0.594) and BMI (AUC = 0.598). Heart failure is associated with impaired nutritional status. Phase angle appears to be a clinically relevant marker that remains independently associated with HF after adjustment for hydration status and may be considered as a complementary tool for routine nutritional screening in this high-risk population.

Background: Vascular injury after total knee arthroplasty (TKA) is rare but may be limb-threatening. Popliteal artery branch pseudoaneurysm is an uncommon complication that can present with nonspecific symptoms, potentially mimicking postoperative hematoma, infection, or deep venous thrombosis (DVT). Case presentation: A 79-year-old man underwent primary left TKA for advanced osteoarthritis (OA). Seven months later, he sustained a low-energy fall closed reduction and bracing were implemented. Due to recurrent episodes of instability with spontaneous self-reduction, a constrained revision TKA (R-TKA) was performed. Eighteen days after revision, the patient was readmitted because of persistent pain-related functional impairment. Duplex Doppler ultrasonography revealed a partially thrombosed pseudoaneurysm measuring 33 × 37 mm arising from a popliteal/genicular branch. Computed tomography angiography (CTA) confirmed a partially thrombosed pseudoaneurysm with a contrast-filled component within a larger periarticular fluid collection. This suggested a second, smaller pseudoaneurysm along the feeding vessel; hemarthrosis and soft-tissue edema were also present. After multidisciplinary evaluation, selective catheter angiography via left common femoral access was performed, and the injured branch was occluded using coil embolization combined with n-butyl cyanoacrylate tissue adhesive. Completion angiography demonstrated successful exclusion of the pseudoaneurysm without complications. Conclusions: Delayed pseudoaneurysm of a popliteal artery branch should be considered after revision TKA in patients with atypical swelling, hemarthrosis, or disproportionate pain. Duplex ultrasound and CTA are complementary diagnostic tools, and endovascular embolization provides a minimally invasive, effective, and low-morbidity treatment option when the lesion involves a branch vessel.

Background: Existing evidence suggests an association between temporomandibular disorders (TMDs) and alterations in body posture and balance; however, the mechanism underlying this relationship remains unknown. The present study aimed to investigate the associations between specific TMD subtypes, indices of bioelectrical activity of the masticatory muscles, and parameters of body posture and balance. Methods: The study followed a case-control study design. A total of 81 participants were enrolled, including 33 controls and 48 individuals with TMD, classified into myofascial (n = 14), articular (n = 17), and mixed (n = 17) subtypes. Diagnosis of temporomandibular disorders was carried out by prosthodontic specialists using the Polish adaptation of the Diagnostic Criteria for Temporomandibular Disorders. Masticatory muscle bioelectrical activity was assessed by surface electromyography. For statistical analysis, the Asymmetry Index and Functional Clenching Activity Indices were used. Static balance was evaluated with a pedobarographic platform. The sway area, velocity, and length of the Center of Pressure, as well as the foot contact area, were recorded and automatically calculated by the system. Measurements were performed under different mandibular conditions, with both eyes open and eyes closed. Correlation analyses were performed using Spearman Rank Order Correlation. Pearson's Chi-squared test was used for the analysis of categorical variables. Results: Weak to moderate negative correlations were primarily observed, indicating that higher indices of masticatory muscle bioelectrical activity were associated with better postural balance, with distinct correlation patterns identified across different TMD subtypes. Conclusions: This exploratory study identified multiple correlations between masticatory muscle activity and postural or balance parameters, suggesting possible subtype-specific patterns in TMDs. However, the evidence remains preliminary and should be interpreted with caution, warranting further confirmatory and longitudinal research.