Uniwersytecki Szpital Dziecięcy

This study explores the evaluation of 2- or 4-methyl-9H-xanthen-9-one derivatives containing aminophenols or aromatic chiral/achiral aminoalkanols as potential blood vessel-sealing agents. A series of xanthone derivatives were synthesized and evaluated through multiple bioassays, including hyaluronidase inhibition assays, antiplatelet activity via collagen-induced platelet aggregation, antioxidant potential using DPPH and FRAP assays, and vasodilatory responses in isolated rat aortic rings precontracted with phenylephrine. Among the obtained derivatives, compound 2 (2-hydroxy-N-((9-oxo-9H-xanthen-2-yl)methyl)-2-phenylethan-1-aminium chloride) demonstrated the highest hyaluronidase inhibition (19.09% at 100 μM/L), comparable to the reference compound quercetin (26.17% at 100 μM/L). Furthermore, compound 2 exhibited significant antiplatelet activity, reducing collagen-induced aggregation by 40.42% at 200 μM (p < 0.0001), similar to quercetin (40.38% at 200 μM), though weaker than acetylsalicylic acid (ASA, 71% in-hibition at 50 μM). Antioxidant studies using DPPH and FRAP assays indicated that compound 1 (4-hydroxy-N-((9-oxo-9H-xanthen-2-yl)methyl)benzenaminium chloride) surpassed vitamin C's antioxidant effect by 35%, while showing high ferric-reducing activity (91%). Additionally, compound 2 demonstrated a vasodilatory effect on rat aortic rings precontracted with phenylephrine, in contrast to quercetin, which enhanced vasoconstriction. Quercetin and α-mangostin were selected as reference compounds due to their well-established vasorelaxant mechanisms and structural similarities to the synthesized xanthone derivatives, providing a basis for comparison in evaluating vascular sealing potential and endothelial protective activity. The study's findings suggest that 2-methylxanthone derivatives, particularly compound 2, hold potential as vascular sealing agents with additional antiplatelet and vasorelaxant properties. Compound 1, based on the present study, was chosen for further research due to its significant antioxidant properties. These results warrant further pharmacological evaluation for cardiovascular applications.

Background. Rett syndrome (RTT) is a rare, genetic neurological disease caused by a mutation of the methyl-CpG-binding protein 2 (MECP2) gene that mainly affects girls. There is no currently available causative treatment for this disease; trofinetide is the only drug dedicated to alleviating symptoms. Aim. The aim is to present potential medicines in clinical trials that have been observed to have a therapeutic benefit in the treatment of Rett syndrome. The article contains also descriptions of pathophysiology and symptoms of Rett syndrome, which can be affected by undermentioned pharmaceuticals. Material and methods. The study used Google Scholar, PubMed, and Scopus databases as its data sources. Other information was obtained from the Clinicaltrials.gov registry and database, and reports of companies conducting drug research. The literature was filtered by keywords: ‘Rett syndrome‘, ‘clinical trials’ and ‘gene therapies‘. Results. The treatment of Rett syndrome focuses on alleviating symptoms and improving the quality of life. Trofinetide is the only substance approved by the US Food and Drug Administration (FDA), which helps to reduce behavioral problems and improve social functioning. Currently, research is underway on genetic therapies, including gene replacement therapy, which may provide more effective treatment options in the future. Additionally, research is being conducted on other drugs that reduce symptoms in patients with RTT. Conclusions. Great hopes are associated with research on gene therapies, which are currently in clinical trial phases. In the future, this could bring significant benefits to patients; their implementation may not only improve aspects of the disease, such as respiratory issues, but also can result in better survival outcomes.

Survival outcomes for infants born at 22–23 weeks’ gestation vary widely across neonatal units. This national, prospective cohort study evaluated 919 infants born at 22–23 weeks’ gestation in South Korea between 2013 and 2022, using Korean Neonatal Network data. Infants were categorized based on the level of neonatal care: 785 in lower-level centers (Group A) and 134 in higher-level centers (Group B). Survival was significantly higher in Group B (64.9%) compared to Group A (29.3%) (P < 0.0001). Early deaths occurred more frequently and earlier in Group A. Proactive care—including antenatal corticosteroids, antenatal antibiotics, and immediate surfactant administration—was more common in Group B. Antenatal corticosteroid was significantly associated with reduced risk of death (hazard ratio 0.58; 95% confidence interval, 0.49–0.69; P < 0.0001). The timing of rapid decline in survival was delayed in higher-level centers. In addition, classifying institutions into higher- and lower-level groups according to the survival of infants born at 22–23 weeks’ gestation (≥50% vs. <50%) provides a good reflection of the quality of neonatal care. These findings highlight the importance of proactive care and timely in utero transfer to higher-level units in improving survival for peri-viable infants.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-28428-1.

Background:Hearing loss affects roughly 65% of adults aged 70 and older, vision impairment 20–30%, and dual sensory loss becomes more common with age. Meta-analyses show that these forms of sensory decline are associated with higher risks of hypertension, stroke, coronary heart disease, and cardiovascular mortality, even after adjustment for traditional cardiovascular risk factors. Shared vascular pathology explains part of these associations, but psychosocial and communication pathways may also contribute. Aim:To summarize evidence on psychosocial and communication-mediated mechanisms linking sensory decline to cardiovascular risk in older adults and to outline an integrated conceptual model. Material and Methods:A narrative review was conducted using targeted searches of PubMed and Google Scholar. Meta-analyses, cohort studies, and relevant qualitative and mechanistic literature were included. Findings were synthesized qualitatively. Results:Sensory impairment increases cognitive and communicative demands, which may heighten chronic stress and influence neuroendocrine and inflammatory pathways linked to cardiovascular disease. Reduced sensory input limits social participation and contributes to social isolation and loneliness, both established cardiovascular risk factors. In healthcare settings, communication barriers can impair symptom reporting, treatment adherence, and management of complex cardiovascular regimens. These pathways complement biological mechanisms and help explain persistent associations between sensory decline and cardiovascular outcomes. Conclusions:Psychosocial and communication mechanisms appear to be modifiable contributors to cardiovascular vulnerability in older adults with sensory impairment. Potential strategies include routine sensory screening, communication-accessible care, and interventions addressing isolation and stress. Randomized trials are needed to determine whether sensory interventions can reduce cardiovascular events.

Introduction: Cluster Headache (CH) is a rare but highly disabling primary headache disorder characterized by unilateral pain and cranial autonomic symptoms. It causes major personal and societal burden due to its impact on patients’ quality of life. Purpose of the study: The aim of this review is to provide a comprehensive analysis of CH, including its epidemiology, diagnostic criteria, risk factors, pathophysiology, and treatment. Recent advances in neurobiology and targeted therapies are highlighted. Description of the state of knowledge: Recognized as the most severe of the trigeminal autonomic cephalalgias, CH combines intense head pain with autonomic dysfunction and a distinct circadian pattern. Epidemiological studies report variability in prevalence across regions and demographic groups, with evidence of late-onset and pediatric cases contributing to diagnostic delays. Several risk factors have been identified, including smoking, alcohol consumption, and disturbances in circadian rhythms. Genetic studies reveal susceptibility loci associated with neurovascular regulation, inflammation, and circadian pathways, suggesting a complex genetic background. Functional and structural neuroimaging consistently implicate hypothalamic dysfunction, which interacts with trigeminovascular and parasympathetic systems. Standard treatment includes acute therapies such as subcutaneous triptans and high-flow oxygen, as well as preventive strategies with verapamil. Recent advances have introduced CGRP monoclonal antibodies and neuromodulation, providing new options for refractory patients. Conclusion: Advances in understanding the neurobiological basis and risk factors of CH have enabled more precise diagnostic and therapeutic approaches. However, further research is needed to optimize management and reduce disease burden.

Raman spectroscopy is a powerful method in the field of cancer diagnosis, for which various sample types and measurement modalities can be used. In this study, pleural effusion samples from twenty patients with suspected malignancies were analyzed. After fluid samples were fixed with ethanol and dried, high-quality spectra were taken at three different points using two laser lines. Principal Component Analysis showed clustering of spectra from malignant samples. The results show that despite a strong fluorescence signal from blood with the 532 nm laser line, spectra collected with both 532 nm and 785 nm laser lines are complementary, as they produce different high-intensity bands; e.g., breast cancer and adenocarcinoma signals are stronger with 785 nm. The main change in cancer specimens is an increase in amino acids. In addition, in small-cell carcinoma of the lung and mesothelioma, elevated nucleic acids and lipids were observed, respectively. Raman spectroscopy shows distinct profiles for control and malignant effusions. Further investigation of the utility of spectral markers in personalized treatment could improve survival.

The elimination of hepatitis C virus (HCV) infection as a public health threat is impossible to achieve without micro-elimination in children. Our study aimed to analyze the use of glecaprevir/pibrentasvir (GLE/PIB), one of the pangenotypic options recommended in children, which provides the shortest possible therapy duration. All consecutive children treated with an 8-week GLE/PIB regimen for chronic HCV infection between 2022 and 2024, whose data were collected retrospectively, were included in the analysis. The study population consisted of 42 patients with a median age of 10.5 years, mostly girls (61.9%), divided into age ranges of 3-5 years, 6-11 years and 12-18 years, comprising 6, 16 and 20 patients, respectively. Obesity was diagnosed only in the oldest group in as many as 25% of the children. Other comorbidities were present in 2 patients-kidney disease and bronchial asthma. All children were treatment-naive, and almost half of them (47.6%) were infected with genotype 1b. The advancement of liver disease by noninvasive elastography was assessed in 36 children, with half of them showing no fibrosis. Antiviral therapy was completed in all patients as planned, and the cure rate in the per-protocol population was 100% (39/39). Three girls were considered lost to follow-up. Adverse events were rare and mild, occurring only in the oldest group. Eight-week GLE/PIB therapy in children is well tolerated and highly effective in all age ranges regardless of gender. Its use in routine clinical practice will bring the ambitious goal of eliminating HCV worldwide a step closer.

Breaking bad news (BBN) of serious or life-threatening diagnoses is common in oncology and often induces significant patient anxiety and distress. The anticipation of such news can also cause considerable distress, prompting patients to adopt proactive coping strategies, such as information seeking, while waiting for the news. Although the use of traditional and emerging digital technologies to assist patients across diverse aspects of cancer care has grown considerably, their role in assisting patients while they await the possibility of receiving bad news (RBN) remains unclear. We conducted a scoping review, following PRISMA-ScR guidelines, to identify studies on digital interventions, at any stage of realization, that aim to aid patient preparation for potential bad news, to map characteristics of these interventions (e.g., target diagnoses, design features) and to assess reported outcomes from usability to implementation. Using broad search terms related to digital technology, patient support and RBN and/or BBN in oncology across many databases, we identified 1020 articles. Most of these targeted healthcare professionals and BBN training (delivered with digital technology) and some referenced digital technology in the context of patients and bad news. However, none of the 22 articles that reached full text screening addressed any form of digital support for patients in relation to RBN. These findings highlight a striking gap in the use of digital support for this personally significant aspect of the patient journey. We contextualize this gap by discussing the value of digital support for RBN from a patient perspective, addressing why the news waiting period has received no attention in the BBN literature and highlighting the conceptual and practical intersections between RBN and shared decision-making (SDM), including consideration of common and distinct design features of patients aids for RBN and for SDM. Finally, we outline future research directions to address this significant and unmet need.