Background: Vasovagal syncope (VVS) is a common cause of transient loss of consciousness, particularly among young adults. Its diagnosis remains challenging because of overlapping manifestations with cardiac, neurological and functional disorders. This study aimed to evaluate diagnostic approaches, haemodynamic characteristics and preventive strategies in patients with suspected VVS. Materials and Methods: Clinical and instrumental findings were analysed in 78 patients with recurrent transient loss of consciousness, including 69 women (88.5%). Assessment comprised clinical history, neurological and cardiovascular examinations, electrocardiography, orthostatic testing and, where indicated, head-up tilt testing, ambulatory ECG monitoring, echocardiography and electroencephalography. Recurrence frequency, precipitating factors and preventive interventions were evaluated. Results: VVS was confirmed in 57 patients (73.1%), functional disorders in 8 (10.3%), epilepsy in 3 (3.8%) and cardiac causes in 7 (9.0%); the aetiology remained undetermined in 3 (3.8%). Annual syncope frequency was 3 [2; 5] episodes in VVS versus 2 [1; 4] in other diagnostic groups (p = 0.13). During active standing, heart rate increased by 18 [12; 25] versus 12 [8; 18] beats/min (p = 0.028), while systolic blood pressure decreased by 16 [10; 23] versus 8 [5; 14] mmHg (p = 0.005). Head-up tilt testing demonstrated greater hypotensive responses in VVS (p < 0.001). Coughing was identified as a potential situational trigger requiring separate diagnostic consideration. Conclusions: Accurate VVS diagnosis requires integrated clinical and haemodynamic assessment and exclusion of potentially serious alternative causes. Individualised trigger management, physical counter-pressure manoeuvres and appropriate preventive interventions are important components of patient care.
Basketball demands a complex mix of explosive power, endurance, and physical contact, putting significant mechanical and metabolic stress on players. During competition and intense training, repeated sprinting, jumping, and rapid decelerations trigger acute muscle damage, temporary inflammation, and an overproduction of reactive oxygen species affecting performance, muscle activity, and health. Muscle disruption is most commonly tracked via elevated serum levels of myoglobin, creatine kinase, and lactate dehydrogenase, each following a distinct recovery timeline. At the same time, players experience a brief inflammatory response—marked by transient leukocytosis and elevations of inflammatory cytokines (such as IL-6, TNF-α, and IL-10) and C-reactive protein—which generally settles within 24 to 48 hours. Acute exertion also causes a temporary shift in redox status, elevating oxidative stress markers (e.g., MDA, protein carbonyls) and depleting reduced glutathione. However, well-structured training and scheduled rest periods help athletes adapt, ultimately improving their resting antioxidant capacity and lowering basal cortisol levels. In this review, we examine the post-exercise response of muscle damage, inflammation, and oxidative stress markers in basketball. We also evaluate how practical recovery strategies—such as cold-water immersion, massage, active cool-downs, and targeted nutrition—can reduce fatigue and support faster physiological recovery.
Introduction: High-grade upper tract urothelial carcinoma (UTUC) is generally treated with radical nephroureterectomy. Kidney-sparing treatment may be considered in selected patients with imperative indications. Aim: To present the clinical course and 24-month outcome of percutaneous nephroscopic ablation of high-grade UTUC in a patient with a functionally solitary kidney and Lynch syndrome. Materials and Methods: We describe a case of high-grade non-invasive papillary UTUC in a woman in her late seventies who declined radical surgery because it would have resulted in permanent dialysis dependence. Following unsuccessful ureteroscopic management, percutaneous holmium:YAG laser ablation and adjuvant mitomycin C instillation were performed. Results and Discussion: The renal pelvic tumor was macroscopically ablated without major perioperative complications. During intensive surveillance with computed tomography urography, ureterorenoscopy, and selective urinary cytology, no recurrence or progression was detected over 24 months, and renal function remained stable. Conclusion: Percutaneous kidney-sparing treatment may be a feasible option in highly selected imperative cases of high-grade UTUC when radical surgery would result in dialysis dependence. This approach requires multidisciplinary decision-making, careful counseling, and strict long-term surveillance.
Introduction and purpose. Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a leading cause of ischaemic stroke, yet it frequently remains undiagnosed because of its paroxysmal and often asymptomatic nature. Artificial intelligence (AI), and in particular deep learning applied to the electrocardiogram (ECG), has emerged as a transformative approach both for detecting AF when the arrhythmia is present and for predicting future AF from an ECG recorded during sinus rhythm. The purpose of this narrative review is to summarise the current state of knowledge on AI-enabled ECG analysis for the detection and prediction of AF and to critically appraise its clinical readiness. Description of the state of knowledge. Convolutional neural networks can classify AF on single-lead and twelve-lead ECG with cardiologist-level accuracy (area under the curve, AUC, above 0.97 for rhythm classification) and can identify an "electrocardiographic signature" of AF on a normal sinus-rhythm tracing (AUC approximately 0.87). Consumer wearables using photoplethysmography and single-lead ECG achieve pooled sensitivity and specificity around 95%. Predictive models for incident AF reach AUC values of 0.78–0.85 and have been validated prospectively, enriching the diagnostic yield of screening. Nevertheless, false positives, unclassifiable tracings, limited external validity, and the absence of trials demonstrating a reduction in stroke temper enthusiasm. Summary. AI-ECG is a mature and accurate tool for AF detection and a promising instrument for AF prediction, but its translation into improved patient-relevant outcomes remains unproven. Rigorous external validation, outcome-driven randomised trials, and clear regulatory and implementation frameworks are required before routine clinical adoption. Keywords: Atrial Fibrillation; Artificial Intelligence; Deep Learning; Electrocardiography; Mass Screening; Stroke
A case of early intrafamilial reinfection with H. pylori in a patient with chronic non-atrophic gastritis—who had previously undergone successful eradication therapy—was analyzed, and its pathogenesis was explained. It was determined that a close relative—the patient’s father, who also suffered from chronic non-atrophic gastritis—lived in the same apartment and shared the same bathroom facilities with the patient. Over a six-month period, the father frequently (five times) took proton pump inhibitor (PPI) courses, each lasting 6–8 days, to manage exacerbations of his condition. Furthermore, it was noted that during the six months following his own treatment, the patient experienced severe stress related to the military conflict in Ukraine. Breath tests performed immediately after treatment and one month post-treatment were negative for H. pylori infection; however, a test conducted six months post-treatment returned a positive result. The patient’s early H. pylori reinfection was attributed to a fecal-oral transmission route, which occurred through contact between the patient’s palm and the father’s palm—the latter having been contaminated with an inactive form of H. pylori following defecation—as well as contact with surfaces in the bathroom that served as reservoirs for the bacteria. The father was an active shedder (donor) of inactive forms of H. pylori following his use of a PPI, while the patient (recipient) was under stress—a state that reduced both gastric acidity and immune defenses, thereby facilitating the rapid transition of the inactive H. pylori into its active form and allowing it to re-colonize the patient’s gastric mucosa.
