Background: Previous methods used to estimate the pelvis were based on visual and palpation assessment, which are characterized by low reliability. Research using a Duometer, which is an appropriate diagnostic tool to carry out pelvic measurements, allows a more accurate assessment of the pelvic girdle. The aim of the study: The aim of the work was to assess the pelvic position at students using the Duometer in the sagittal plane. Material and methods: The research covered 30 students, including 15 women and 15 men between the ages of 20 and 24. The test method included assessing the pelvic position in the sagittal plane with the help of the Duometer, which was subject to assessment of the pelvis in the free position, maximum anteversion, maximum retroversion and measurement of mass and height of the body. The position of the pelvis in the sagittal plane was assessed on the basis of the angular size according to the Bibrowicz classification. Results: Among the subcjets women had correct pelvic position in all the cases studied, they were in standards proposed by Bibrowicz, while men only the maximum retroversion result was in the standards, and the other two were below the proposed standards.Conclusion: Pelvic alignment in the neutral position obtains greater angular values in the female group. Higher angular values, both in maximum anterior tilt and posterior tilt, were also characterised by women. Pelvic alignment in individual positions in the study group, assessed on the basis of angular values, tended to be within the lower normative ranges determined by Bibrowicz. The exceptions were pelvic positioning in neutral and maximum anterior tilt in the male group.

Atypical hemolytic uremic syndrome (aHUS) is a rare disease stemming from complement system dysregulation, manifesting as thrombotic microangiopathy (TMA). It is also described as a heritable, life-threatening disorder characterized by uncontrolled complement activation, leading to systemic TMA and damage to vital organs. aHUS is frequently considered a prototypical form of complement-mediated TMA (CM-TMA), resulting from the dysregulation and overactivation of the alternative complement pathway, culminating in excessive terminal complement activation. The classical clinical triad of aHUS encompasses thrombocytopenia, microangiopathic hemolytic anemia and acute kidney injury.This review paper aims to provide a comprehensive overview of atypical hemolytic uremic syndrome (aHUS). Specifically, this work intends to define aHUS, encompassing its pathomechanism, clinical presentation, and diagnostic criteria. Attention is also directed towards secondary aHUS, which can occur in association with various underlying conditions. Furthermore, this review covers current, available treatment modalities utilizing eculizumab and ravulizumab, providing a comparative analysis of these two agents and highlighting their significance as terminal complement pathway inhibitors. The fundamental mechanism underlying aHUS is the uncontrolled activation of the complement system, particularly its alternative pathway, leading to systemic TMA and life-threatening organ damage. The management of aHUS has been transformed with the introduction of terminal complement inhibitors, such as eculizumab and ravulizumab, which have demonstrated efficacy in improving hematological and renal parameters. Ravulizumab, a long-acting C5 inhibitor, allows for less frequent dosing compared to eculizumab. This paper underscores the importance of early recognition and the implementation of complement inhibitor therapy in aHUS and indicates the necessity for future comparative studies of eculizumab and ravulizumab to optimize treatment strategies.

<ns3:p>Background: Allergies represent aberrant immune reactions to otherwise harmless substances, leading to various clinical symptoms, with atopic dermatitis (AD) being one of the most prevalent forms. AD is a chronic, recurrent inflammatory skin condition characterized by the typical distribution and distinctive morphology of lesions, as well as intense pruritus. Its development is influenced by genetic predispositions, environmental factors, and immune dysregulation, particularly the overproduction of immunoglobulin E (IgE) and a disrupted Th1/Th2 balance skewed toward the Th2 immune response.Aim of the study: This paper explores the multifactorial nature of AD, emphasizing the role of environmental tobacco smoke as a modifiable risk factor.Material and methods: PubMed and Medline databases were searched, and relevant literature was selected.Discussion: We did not find a significant correlation between either active smoking (OR 0.97, 95% CI [0.80; 1.18]) or passive smoking (OR 1.04, 95% CI [0.96; 1.13]) and the incidence of AD, due to the high heterogeneity of studies—some showing a negative effect and others a positive one. The mechanisms linking environmental tobacco smoke exposure to AD include alterations in epidermal barrier function, modulation of the immune response, and epigenetic changes affecting gene expression. Although a consensus is emerging that smoking exposure is associated with an increased risk of AD, many studies suggest a potential protective effect of smoking on AD pathogenesis.Conclusions: Continued research is necessary to address methodological limitations in existing studies and to elucidate the complex interplay between smoking and the pathogenesis of AD. Such understanding could inform public health initiatives aimed at reducing smoking exposure, particularly in vulnerable populations such as children and pregnant women.</ns3:p>

Background: Breast cancer (BC) remains a leading cause of cancer-related mortality among women worldwide. Metastasis to lymph nodes is a critical determinant of prognosis and treatment decisions. MicroRNAs (miRNAs), small non-coding RNA molecules, have emerged as promising biomarkers due to their regulatory roles in gene expression.Aim of the study: This review evaluates the current understanding and potential applications of miRNAs as biomarkers for lymph node metastasis in BC patients.Material and methods: A comprehensive literature search was conducted using the PubMed and Google Scholar databases. Studies published between 2005 and 2023 were included, focusing on research articles, clinical trials, and reviews addressing miRNAs in the context of lymph node metastasis in BC. Keywords included "miRNA," "breast cancer," and "lymph node metastasis." Relevant articles were selected based on relevance, methodological rigor, and their contribution to the field.Results: Current research highlights the pivotal role of miRNAs in the metastatic process of breast cancer. Key miRNAs, such as miR-124, miR-10b, and miR-155, contribute to either promoting or inhibiting metastasis by influencing pathways involved in cell proliferation, migration, and invasion. For instance, miR-124 suppresses multiple steps of metastasis by targeting pro-metastatic genes, while miR-10b regulates genes associated with cell motility. Clinical studies indicate that the expression profiles of multiple miRNAs can serve as predictive biomarkers for lymph node metastasis, offering insights into tumor aggressiveness and potential therapeutic targets in BC.Conclusions: The identification of miRNAs as biomarkers for lymph node metastasis in BC holds significant promise for improving diagnostic accuracy and advancing personalized treatment strategies. Despite these advancements, further research is needed to validate current findings in larger and more diverse patient populations, and to standardize detection methods. A deeper understanding of the molecular mechanisms underlying miRNA regulation will enhance their clinical applicability. Ultimately, integrating miRNA profiling into clinical practice could revolutionize BC management, leading to improved prognostic tools for early detection and more effective targeted therapies.

Background: There are significant differences in the anatomy and physiology of children compared to adults, which have important implications for anesthesia. The incidence of anesthetic complications is higher in children than in adults. Newborns, infants, and children undergoing emergency procedures or those with severe comorbidities are particularly at increased risk for potential complications.Aim of the study: The aim of this work is to identify anesthetic complications associated with the cardiovascular system, along with their management.Material and methods: This work is based on both available literature and the authors' experience. The search process identified relevant articles using valid keywords across electronic databases, including Embase, PubMed, Scopus, Web of Science, and the Cochrane Library. In total, 29 articles published between 1994 and 2022 were deemed eligible for inclusion in our review.Results: Common cardiovascular complications in pediatric anesthesia include sudden cardiac arrest (SCA), hypotension, bradycardia, and arrhythmias. Neonates and infants under 12 months of age have the highest rate of adverse events, both intraoperatively and in the postanesthesia recovery room. Conclusions: The foundation of safe pediatric anesthetic practice consists of careful preoperative assessment, adherence to strict pediatric anesthesia protocols, and the presence of an experienced team. Moreover, only anesthesiologists well-trained in pediatric care should be entrusted with the management of pediatric patients.

Background: Epilepsy is the most common chronic neurological disorder in children and often affects mental health, quality of life, and various social aspects of daily living. It is essential to focus not only on seizure control but also on providing psychological and psychiatric support.Aim of the Study: This review aims to characterize the mental health challenges faced by children with epilepsy and the difficulties experienced by their families. It is crucial to draw the attention of healthcare professionals and society to the complex issues these patients and their families encounter.Material and Methods: We conducted electronic searches on PubMed, Google Scholar, and the National Institute for Health and Care Excellence (NICE) databases, which served as the primary sources of literature for this review.Results: Pediatric patients with epilepsy are at increased risk of developing mental health disorders and behavioral issues. Conditions such as depression, anxiety, autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) occur more frequently in this group compared to the general population. These children are also at higher risk for suicidal ideation and attempts. Most children do not receive adequate mental health support, and when it is available, it is often insufficient. The condition affects not only the patient's mental health but also the well-being of the entire family, contributing to stress and stigma.Discussion: Research highlights a strong association between epilepsy and mental health disorders such as depression and ADHD, yet access to appropriate psychological and psychiatric care remains limited. This complex issue requires a multidisciplinary approach that includes medical treatment as well as social support. Future research should focus on interventions that enhance mental health and improve the quality of life for both patients and their families.Conclusions: Mental health disorders are common among pediatric epilepsy patients, emphasizing the need for comprehensive care. Early diagnosis, effective treatment, and support for both patients and their families are crucial.

Background: The effectiveness of dry needling (DN) is still under scrutiny within the medical community. Consequently, ongoing efforts are being made to enhance objectivity. Aim of the study: The goal was to demonstrate the distinct bioelectrical activity in the thigh muscles resulting from the dry needling of trigger points in the gluteus minimus muscle. Material and methods: Four healthy asymptomat-ic subjects were examined, with two of them presenting latent trigger points (LTrPs) accompanied by referred pain (RP), while the other two did not exhibit LTrPs. All participants underwent 2 x 5 minutes of fast-in-fast-out dry needling (DN) of the gluteus minimus muscle, monitored by super-ficial electromyography (sEMG). Results: The analyzed sEMG reveals the bioelectrical activity of the specific muscles where patients experienced referred pain (RP). In the RP-affected area, there was a notable rise in mean bioelectrical activity, ranging from 117% to 338%, accompanied by an increase in mean amplitude from 3.6 V to 26 V. Conversely, in patients without RP, the mean amplitude only ranged from 0.2 V to 2.2 V, despite the presence of severe pain associated with dry needling (DN).Conclusions: For the first time, heightened bioelectrical activity in a specific muscle group of the thigh, resulting from dry needling of the gluteus minimus latent trigger point (LTrP) that induced referred pain, has been documented.

Background: Obesity causes organ dysfunction through several pathophysiological mechanisms, such as the physical impact of increased fat mass, the presence of ectopic fat in tissues and organs, metabolic effects, and inflammatory mechanisms [1]. Prospective studies have shown that fat deposits are associated with cardiovascular outcomes independently of other traditional risk factors. It has been proposed that the prothrombotic and proinflammatory environment of fat deposits has a significant role in the pathogenesis of cardiovascular disease (CVD) [2]. The weight loss induced by anti-obesity drugs may improve cardiovascular risk, and glucagon-like peptide-1 analogs - may promote these benefits independently of weight loss [3]. Glucagon-like peptide-1 receptor agonists (GLP-1Ras), such as semaglutide, have direct effects at multiple sites, including glucose-dependent stimulation of insulin secretion, the suppression of glucagon secretion, appetite reduction, and delayed gastric emptying [2]. Aim of the study: This paper aims to summarize and analyze current knowledge regarding the effects of semaglutide on cardiovascular outcomes in individuals who are overweight or obese but do not have diabetes. Material and methods: This literature review was performed according to PICO guidelines. The MEDLINE database was searched. The following search query was used: “semaglutide and cardiovascular disease”. The “Free full text” filter was applied. Results: Analysis of the SELECT trial showed that in patients with atherosclerotic CVD and who were overweight or obese, treatment with semaglutide 2–4 mg reduced major adverse cardiovascular events and composite heart failure endpoints compared to placebo [4]. In the analysis of the STEP-HFpEF trial, semaglutide was better than placebo in improving heart failure-related symptoms and reducing body weight in obese participants with heart failure-related obesity with preserved ejection fraction [5]. According to the STEP 1 and 4 studies, semaglutide may reduce the use of antihypertensive or lipid-lowering drugs compared with placebo [6]. Conclusions: Semaglutide improves symptoms and physical limitations and reduces inflammation and body weight [7]. Despite the promising results, further research is necessary to assess the long-term effects of semaglutide.

Background: Sleep has both immediate and long-term impacts on health. Aim of the study: This study aimed to evaluate the relationship between the quality of biological night-time regeneration, socio-economic status, health behaviors, nutritional status, and fat tissue distribution among adult women (n=46, aged 45-65 years). Material and methods: Socio-economic and lifestyle data were collected through a questionnaire, while anthropometric measurements were obtained using standard instruments. Statistical analyses were performed using the STATISTICA software package. Results: The study found no significant associations between socio-economic status, and the frequency of well-slept (participants satisfied with night-time regeneration) or sleep-deprived (respondents dissatisfied with night-time regeneration) individuals. However, an increased frequency of beer consumption was associated with dissatisfaction with night-time regeneration. There was no significant relationship between BMI categories and fat distribution types in relation to self-reported sleep sufficiency. Nonetheless, the analysis indicated that both BMI and WHR were higher in women who reported dissatisfaction with night-time regeneration compared to those who reported satisfaction. The trends suggest that women with higher education, white-collar occupations, residing in large cities, and consuming weak alcoholic beverages reported poorer sleep quality more frequently. This pattern is associated with a higher risk of excessive weight and central fat distribution, potentially due to increased psychosocial stress. Conclusions: Further research is necessary to verify these trends and elucidate the underlying mechanisms.

Background: Healthcare professionals of emergency department (ED) is particularly vulnerable to incidents of aggression from patients.Aim of the study: To determine the opinions of medical staff regarding the aggressive behavior of patients admitted to an ED and to assess the impact of incidents of aggression on the professional burnout level.Material and methods: A diagnostic survey was conducted among 102 medical employees of the ED from September 2023 to February 2024. Maslach Burnout Inventory (MBI) and self-developed questionnaire were used.Results: A group of 100% (n=102) of the respondents experienced aggressive behavior from a patient hospitalized in ED. The respondents most often experienced aggression several times a week" (38.24%; 39) or several times a month" (29.41%; 30). The main forms of aggressive behavior presented by patients were: raised voice (93.14%; 95), use of profanity (86.27%; 88), and insults (76.47%; 78). When faced with aggressive behavior, staff most commonly experienced the following emotions: stress 63.73% (n=65), anger 63.73% (n=65), and helplessness 45.10% (n=46). 47 (46.08%) members of the medical staff had a high level of emotional exhaustion, 31 (30.39%) had a high level of depersonalization, and 48 (47.06%) presented a high level of lack of personal achievement. A significant correlation was observed between negative emotions aroused in ED medical staff by patients presenting aggressive behavior and domains of professional burnout.Conclusions: There is a need to train ED medical staff how to effectively deal with anger and feelings of humiliation caused by patients' aggressive behavior.