University of Computer Sciences and Economics in Olsztyn

Intense physical exercise, especially when performed frequently or for prolonged durations, can disturb iron balance through a combination of increased demand, increased loss, and impaired absorption. The strongest evidence comes from endurance sport, military training, and periods of intensified loading, where iron deficiency without anemia and overt iron-deficiency anemia are both common clinical problems. Mechanisms include exercise-induced inflammation and hepcidin upregulation, intravascular hemolysis, gastrointestinal microischemia with occult blood loss, hematuria, sweat losses, menstrual blood loss, low energy availability, and the amplified iron demand of altitude-related erythropoiesis. Importantly, the hematologic response to training also includes plasma volume expansion, which can mimic anemia without true iron deficiency and complicate interpretation. In athletes, clinically meaningful iron deficiency may present before hemoglobin falls, with fatigue, impaired recovery, lower maximal oxygen uptake, diminished training quality, and reduced work efficiency. Diagnosis therefore requires more than hemoglobin alone and should integrate ferritin, transferrin saturation, inflammatory context, and where indicated soluble transferrin receptor or reticulocyte indices. Management begins with confirmation of true deficiency and identification of the mechanism, followed by dietary optimization, oral iron when indicated, and selective use of parenteral iron in carefully chosen cases. This review summarizes the physiology linking exercise to iron homeostasis, identifies athlete groups at highest risk, distinguishes pseudoanemia from true deficiency, and provides a practical framework for diagnosis, prevention, and treatment.

Background: Conservative treatment for adolescent idiopathic scoliosis (AIS) includes physiotherapeutic scoliosis-specific exercises (PSSE) and bracing. One PSSE-based approach is the Rigo Concept, which emphasizes three-dimensional (3D) postural correction, expansion techniques, muscle activation, and postural integration. Recently, increasing interest has been directed toward incorporating whole-body vibration (WBV) into physiotherapy. WBV is a reflex-based neuromuscular training method shown to improve muscle strength and power and enhance proprioception, which may be beneficial in the treatment of AIS. Objectives: This study aimed to assess the effects of physiotherapy based on the Rigo Concept combined with WBV on sagittal spinal curvatures, trunk symmetry, and the angle of trunk rotation (ATR) in girls with AIS. Methods: This prospective controlled experimental study included 45 girls (12.8 ± 1.7 years) with AIS who participated in a 5-day physiotherapy session based on the Rigo Concept. Of these, 22 participants additionally received WBV using a Galileo Med 35 platform (3 × 3 min/day, frequency 25 Hz, peak-to-peak displacement 2 mm), forming the Rigo-WBV group. The remaining participants received the Rigo Concept alone (Rigo-ONLY). Participants were allocated to the study groups using a quasi-random method based on the order of enrollment. ATR was defined as the primary endpoint, while thoracic kyphosis, lumbar lordosis, sacral slope, coronal balance, and scapular position were considered secondary outcomes. All outcomes were assessed before and after the intervention. Results: Neither the Rigo-WBV nor the Rigo-ONLY intervention affected sagittal spinal curvatures (p > 0.05). Coronal balance improved in both the Rigo-WBV (Δ 0.5 cm, p < 0.001) and Rigo-ONLY groups (Δ 0.4 cm, p = 0.005). In the Rigo-ONLY group, an improvement in scapular height asymmetry was observed (Δ 1.1°, p = 0.010). Following the Rigo-WBV intervention, ATR decreased in the main thoracic (Δ 1.9°, p < 0.001), thoracolumbar (Δ 1.9°, p < 0.001), lumbar curve (Δ 2.1°, p < 0.001), and pelvis (Δ 1.0°, p < 0.001). In the Rigo-ONLY group, a reduction in ATR was observed only in the thoracolumbar curve (Δ 1.9°, p < 0.001). Conclusions: In terms of clinical and postural changes, five-day physiotherapy based on the Rigo Concept, with or without WBV, does not influence sagittal spinal curvatures in girls with AIS. Both interventions may improve coronal balance. Moreover, the Rigo Concept combined with WBV may reduce ATR.

Background: Aortic dissection (AoD) is a life-threatening medical emergency characterized by the separation of the layers of the aortic wall. The typical clinical presentation of AoD includes intense thoracic pain in the anterior chest or interscapular region, often described as migratory and tearing in nature. However, in rare cases, AoD can present without classic signs but with neurological symptoms, including seizures. Case Presentation: A 60-year-old patient experienced a sudden loss of consciousness followed by a tonic-clonic seizure and subsequently developed right-sided weakness. He had a medical history of hypertension and smoking. Although the symptoms quickly resolved, the brain imaging revealed signs of an acute ischemic stroke located in the left hemisphere. The seizures resumed, blood D-dimer levels were found to be highly elevated, and subsequent thoracic and abdominal computed tomography angiography revealed the presence of AoD, which originated at the proximal part of the ascending aorta. The patient received symptomatic treatment to alleviate his symptoms and prevent complications and was quickly transferred for surgical intervention, resulting in a favorable outcome. Conclusions: This case demonstrates that a tonic-clonic seizure can be the first clinical manifestation of AoD. Such atypical symptoms highlight the diverse and misleading nature of AoD presentations, underscoring the challenges in the diagnostic process. This emphasizes the need for increased clinical vigilance when treating a patient experiencing their first seizure episode.

Background/Objectives: Optimizing routine neurointerventional workflow and minimizing exposure to ionizing radiation during coil-only endovascular treatment of intracranial aneurysms depend on operator experience, reduced frame rates during both fluoroscopy and digital subtraction angiography (DSA), and the use of advanced angiographic systems. The low-dose protocol implemented in this study used the lowest available fluoroscopy frame rate (3.125 frames per second [fps]) and a nominal acquisition rate of 2 fps (actual = 2.45 fps) for DSA, three-dimensional (3D) rotational angiography, two-dimensional (2D)/3D mapping, and roadmapping. Methods: This retrospective analysis encompassed 245 coil-only procedures performed at a single tertiary center from 2018 to 2024. Data collected for each procedure included dose-area product (DAP), reference air kerma (Ka,r), fluoroscopy time (FT), and the total number of DSA frames. Local diagnostic reference levels (DRLs; 75th percentile [P75]) and typical values (50th percentile [P50]) were determined and descriptively compared with values reported in the literature. Results: The P75 values, representing DRLs, were 22.4 Gy·cm2 for DAP (literature range, 123-272.8 Gy·cm2), 268 mGy for Ka,r (1171-4240 mGy), 18 min 56 s for FT, and 285 DSA frames. The P50 values were 13.8 Gy·cm2 for DAP (78.7-179.0 Gy·cm2), 196 mGy for Ka,r (801-2804 mGy), 13 min 25 s for FT, and 208 DSA frames. Conclusions: In this single-center cohort, dose metrics for coil-only intracranial aneurysm treatment were within the lower range of published values. Cross-study comparisons are descriptive and require cautious interpretation. The proposed local DRLs may support quality assurance, dose optimization, and patient safety in comparable clinical settings. Further multi-center and multi-operator studies are warranted to evaluate transferability and applicability beyond coil-only procedures.

This case report describes mandibular distraction osteogenesis (DO) in a six-year-old patient with first and second branchial arch syndrome and obstructive sleep apnea, in whom 3D surgical planning was combined with ultrasonography (US) for postoperative monitoring. The aim was to illustrate how patient-specific 3D modeling and a structured ultrasonography protocol can support safe mandibular advancement while limiting radiation exposure in a pediatric patient with complex craniofacial deformity. Preoperatively, a 3D-printed model of the mandible, generated from a cone beam computed tomography (CBCT) scan, was used to guide precise osteotomy planning and vector orientation. The surgical procedure was conducted using a Risdon approach and piezoelectric tools to ensure minimal trauma. Postoperative monitoring incorporated serial panoramic radiography and US at predefined time points to assess gap size, callus formation, and vascularity during distraction and consolidation. US identified early callus formation, progressive cortical bridging, and preserved callus vascularity, and, together with radiographic findings, guided the timing of distraction termination and distractor removal at 16 weeks. This case adds to the limited literature on pediatric mandibular DO by demonstrating the feasibility of integrating patient-specific 3D virtual planning with US-based follow-up to improve the safety, precision, and radiation-conscious management of DO in pediatric patients with complex craniofacial deformities.

Background. Nitric oxide has emerged as a key physiological signalling molecule that has a significant impact on vessels, skeletal muscle function and exercise performance. With this in mind, increasing its production is of great interest to clinicians and athletes, making citrulline malate a potential medication and one of the most popular ergogenic supplements. Aim. This article aims to review current knowledge on citrulline malate supplementation, with emphasis on its pharmacokinetics, proposed medical application and ergogenic benefits. Material and Methods. Literature search in PubMed and Google Scholar for clinical trials, meta-analyses, and reviews on citrulline malate using keywords: citrulline malate, nitric oxide, muscle endurance, medical applications, supplementation”. Results. Citrulline malate exhibit its positive impact on many medical conditions. In pulmonary hypertension by improving exercise tolerance and modestly reducing arterial pressure. In metabolic conditions, leading to better glycaemic control, improved lipid profiles, and reduced inflammation in diabetes. Men with mild erectile dysfunction report subjective improvements when using citrulline malate alone or alongside other therapies. In atherosclerosis, it increases the elasticity of the arteries, which becomes weaker in advanced disease. Beyond medical applications, citrulline malate supplementation is primarily known for supporting short-term, high-intensity exercise by delaying fatigue, improving endurance, lowering perceived exertion during resistance training and reducing post-workout muscle soreness. Conclusion: Citrulline malate could be used as medical application and can enhance exercise performance by delaying fatigue and reducing muscle soreness. Larger, rigorously controlled trials are required to establish optimal dosing, target activities and long-term safety.

The COVID-19 pandemic has had a profound global impact since its emergence in late 2019. Characterized by a wide spectrum of clinical manifestations, COVID-19 has necessitated extensive research into the host-pathogen interactions that drive disease progression. Understanding the molecular mechanisms underlying the host response to SARS-CoV-2 infection is crucial for the development of effective therapeutic interventions and preventative strategies. This study employed a multi-omic approach that combined direct RNA sequencing (DRS) and Illumina cDNA sequencing to investigate whole blood transcriptomic profiles in COVID-19 patients. By leveraging the unique capabilities of Nanopore DRS, which provides long-read sequencing data, we were able to capture not only gene expression levels but also crucial poly(A) tail length fluctuations and non-adenine residue (non-A) modifications. This comprehensive analysis allowed us to identify differentially expressed genes and explore the impact of these poly(A) modifications on function within the context of COVID-19. Findings reveal significant alterations in gene expression patterns, poly(A) tail lengths and non-A modifications in COVID-19 patients compared to healthy controls. Results provide valuable insights into the complex interplay between viral infection, host immune response, and RNA processing, contributing to a deeper understanding of COVID-19 pathogenesis.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-21969-5.

Życie społeczne toczy się w różnych przestrzeniach życia codziennego. Jedną z przestrzeni społeczno-kulturowych jest Kościół, w którym były i są obecne osoby z niepełnosprawnością. Szeroki zakres poruszanego tematu sięga do czasu przeszłego, gdzie uwaga jest skierowana na wątkach życia codziennego wybranych postaci z niepełnosprawnością, którzy kierując się chrześcijańską wiarą swoim postępowaniem byli czytelnym znakiem zmiany społecznej. Analizy jakościowe życiorysów prowadzono w świetle aktualnych obszarów badawczych poszukiwań w pedagogice specjalnej, a w szczególności analiz podmiotowego bycia w świecie osób z niepełnosprawnością. Analiza życiorysów skłania do refleksji nad możliwością zaczerpnięcia z żywotów świętych, wzorów postępowania dla współczesnych pokoleń. Artykuł jest rozszerzeniem badań nad codziennością osób z niepełnosprawnością o przestrzeń Kościoła rzymskokatolickiego.

Introduction: Primary immune thrombocytopenia (ITP) is the most common thrombocytopenic disorder in children. The aim of this study was to assess the epidemiology and current therapeutic practices in children with ITP in Poland. Material and methods: A survey was conducted in 19 pediatric hematology centers. The analysis covered the period of 2022–2023. The survey included 14 questions regarding the number of patients diagnosed and treated for ITP. The centers provided separate data for each year. Results: In the years 2022–2023, a new diagnosis of primary immune thrombocytopenia (nITP) was made in 814 patients. A subgroup of 130 children with persistent ITP (16%) and a total of 452 with chronic ITP were treated. nITP was treated with IVIG (627; 77%) or steroids (154; 19%). TPO agonist drugs were administered as follows: eltrombopag in 215 (26%) patients, romiplostim in 115 (14%) patients, and avatrombopag in 6 (0.7%) patients. Other conservative therapies were administered to 38 (4.6%) patients, including: mycophenolate mofetil (n = 16), rituximab (n = 9), azathioprine (n = 3), sirolimus (n = 2), vincristine (n = 1), vinblastine (n = 1), cyclophosphamide (n = 1), mercaptopurine (n = 1), chronic steroid therapy (n = 2), and dexamethasone + eltrombopag (n = 1). Surgical treatment was performed in 4 patients, including splenectomy (n = 3) and splenic artery embolization (n = 1). Discussion: A low level of adherence to the ASH 2019 recommendations regarding the use of steroids in nITP was noted. Oral TPO agonists were used twice as frequently compared to the subcutaneous form. Conclusions: In the years 2022–2023, ITP was diagnosed in an average of 407 children annually. Immunosuppressive treatment was applied in 4.6% and surgical treatment in 0.5% of children with ITP.

Background: Spinal muscular atrophy type 1 (SMA1) is a severe neuromuscular disorder characterized by progressive muscle weakness and atrophy, including the muscles of the oral cavity and esophagus. Eosinophilic esophagitis (EoE), a chronic, allergic disease, presents with eosinophilic infiltration of the esophagus, leading to esophageal dysmotility. Feeding difficulties may occur in both conditions. So far, the coexistence of EoE and SMA1 has not been described; we present the first such case. Case presentation: The patient was a girl with SMA1 diagnosed shortly after birth, treated with nusinersen and onasemnogene abeparvovec, and fed a standard industrial diet through a gastrostomy. In her second year of life, she developed increasing symptoms: distress during feeding, regurgitation, vomiting, and weight loss. She was treated with proton pump inhibitors without clinical improvement. Gastroscopy was performed, revealing superficial epithelial damage with bleeding in the proximal esophagus. Histopathology showed chronic inflammation with up to 150 eosinophils per high-power field, microabscesses, spongiosis, and basal layer hypertrophy. The girl was diagnosed with EoE. Her diet was switched from a standard industrial formula to an amino acid-based formula, which led to marked clinical improvement, the resolution of symptoms, and appropriate weight gain. Conclusions: This case report highlights the challenges of diagnosing EoE in SMA1 patients and emphasizes the need for multidisciplinary approaches and further investigation of allergic manifestations in SMA1 patients.