Introduction Proximal humerus fractures are common, especially in the elderly, and often require surgical intervention to restore function. Aim The study aimed to evaluate the effectiveness of arthroplasty in the treatment of multifragment fractures of the proximal humerus by comparing clinical outcomes of reverse shoulder arthroplasty and osteosynthesis, including functional outcomes, complication rates, postoperative pain, and the need for revision surgery. Material and methods The results were assessed using the Constant-Murley, DASH and visual analogue pain scales. The study was conducted from November 2019 to December 2024 and included 68 patients with complex proximal humerus fractures. All patients had multifragmentary fractures of the Neer 3–4 type. Results and discussion The primary comparative analysis was based on the 12-month follow-up assessment. At this time point, the mean Constant-Murley score in the arthroplasty group was 72.8±6.3 points, compared with 58.4±7.2 points in the osteosynthesis group (p<0.05), while the mean DASH score was 22.3±4.1 and 34.7±5.6 points, respectively. The percentage of patients with good or excellent functional outcomes after arthroplasty reached 82%, while after osteosynthesis, it was only 54%. Pain levels according to the visual analogue scale at the 3-month follow-up were lower in the arthroplasty group (2.1±0.7 points vs. 4.5±1.1 points). The incidence of complications was 18% in the arthroplasty group and 36% in the osteosynthesis group, with repeat surgeries required in 10% and 24% of cases, respectively. Conclusions Arthroplasty was associated with better functional outcomes and lower pain intensity than osteosynthesis during the 12-month follow-up period and may represent a useful surgical option for selected patients with complex proximal humerus fractures.
Introduction During the COVID-19 pandemic, a marked increase in the incidence of Clostridioides Difficile Infection (CDI) was observed in Poland. This trend has been associated with widespread antibiotic use and healthcare burden during the SARS-CoV-2 pandemic. High disease severity, frequent recurrences, and limited therapeutic options continue to make CDI a significant clinical challenge. Aim To describe the clinical course and outcomes of Fecal Microbiota Transplantation (FMT) in patients with Clostridioides Difficile Infection following COVID-19. Material and methods This retrospective case series included four adult patients who developed CDI shortly after COVID-19. All patients underwent FMT between April and August 2021. Three patients experienced at least two severe recurrences before FMT, whereas one patient with fulminant CDI underwent FMT after the first episode. Clinical outcomes were assessed based on symptom resolution and absence of recurrence during follow-up. Results and Discussion All patients experienced resolution of diarrhea and gastrointestinal symptoms following FMT. No CDI recurrences were observed during follow-up. No procedure-related complications were reported. Although limited by the small sample size, heterogeneous study population, and retrospective design, the findings suggest that FMT may be a feasible therapeutic option in selected patients with severe or recurrent CDI following COVID-19. Conclusions In this small retrospective case series, Fecal Microbiota Transplantation was associated with favorable clinical outcomes and absence of CDI recurrence during follow-up in patients with severe or recurrent CDI following COVID-19.
Introduction The number of children in foster care has been continuously growing. The waiting time for a foster family varies from weeks to months. One of the main factors causing prolongation of the process is the inadequate number of foster families. Aim The aim of this study is to outline the problem of prolonged hospitalizations of newborns awaiting foster care placement Material and methods We performed a retrospective analysis of medical and social data of newborns hospitalized in the Department of Neonatal Diseases of the Independent Public Clinical Hospital No. 2 in Szczecin. No ethics committee approval was required due to the retrospective and anonymized nature of the data. Results and discussion Out of the 130 newborns requiring intervention, 61.5% were placed in foster care and 35.4% returned to their biological mothers. Nearly half were born preterm (46.2%), and over 60% of mothers did not receive adequate prenatal care. Substance use was noted during pregnancy in 51.5% of cases. In 2023, average hospital stay extended to 63,4 days. Legal delays, contributed to prolonged, non – medically indicated hospital stays. Conclusions The Polish system requires hospitals to take responsibility for newborns until placement in foster care is available. There is a lack of additional institutions that can adequately care for children. Hospitals cannot be places for newborns to await for their legal status to be regulated and are unable to provide children with proper development and care during the neonatal period. Introduction of systemic changes is necessary to give newborn children a chance for development in a functional family.
Introduction Anterior Cruciate Ligament (ACL) reconstruction in patients with a more than one-year rupture is associated with anteromedial rotator instability (AMRI). Additional procedures to correct developmental AMRI have demonstrated improved outcomes compared to isolated ACL reconstruction. Purpose: ACL reconstruction and Medial Collateral Ligament (MCL) augmentation will restore the AMRI. Aim In this study, we present a unique approach to treating chronic AMRI. We observed the development of chronic AMRI in patients who had neglected their ACL rupture. Material and methods In this prospective single-arm case series, 32 patients with chronic AMRI (more than 1 year since injury) were included. A Bone-Tendon-Bone BTB graft for ACL reconstruction and semitendinosus tendon augmentation of the MCL were performed, and a 2-year follow-up was conducted to assess knee stability and Range of Motion (ROM). Results and discussion At the end of the follow-up, most patients showed a significant improvement in their International Knee Documentation Committee (IKDC) scores, with knee stability restored to normal in 90.7% of cases. These findings demonstrate substantial post-operative improvement following the combined ACL reconstruction and MCL augmentation. Conclusions The BTB reconstruction of the ACL with an augmented MCL was associated with significant improvement in knee stability and functional scores in patients with chronic AMRI. This technique requires minimal additional action compared to a simple BTB technique, making it a feasible option for orthopedic surgeons.
Introduction Both BRAF V600E mutation and mismatch repair deficiency bear prognostic and predictive relevance in metastatic colorectal cancer, yet impact of simultaneous occurrence of both factors on prognosis is under-investigated. Aim Although retrospective studies support localised therapies for oligometastatic CRC in the general population, data for tumours harbouring both alterations are scarce. Case study In 2013, a 66-year-old female underwent radical resection for pT3 N0 distal sigmoid adenocarcinoma. Five months later she was diagnosed with oligometastatic recurrence in the right ovary. In 2014 the woman underwent hysterectomy and bilateral adnexectomy. Histopathology of the resected material confirmed adenocarcinoma metastasis in the right ovary. As the radicality of the resection was uncertain, the patient received 12 cycles of FOLFIRI chemotherapy after which the treatment was suspended due to no evidence of the disease. The follow-up imaging showed no signs of recurrence. A retrospective testing of tumor samples from metastasectomy revealed a BRAF V600E mutation and loss of MLH1, PMS2 expression indicating dMMR. Results and discussion Recently emerging data indicate at better prognosis in metastatic colorectal cancer with coexisting BRAF V600E mutation and dMMR as compared to cases with either of these biomarkers. The literature on the outcomes of metastatic resection in population with both alterations is scarce. The patient described here is an example of favourable outcome, with over 10-year survival after local treatment of colorectal metastases with aforementioned molecular profile. Conclusions Metastasis resection, should be further investigated in colorectal cancers harbouring high risk molecular alterations.
Introduction Solid pseudopapillary neoplasm (SPN) of the pancreas is an exceedingly rare tumor, accounting for 0.2% to 2.7% of all pancreatic neoplasms, predominantly affecting young females. Aim The aim of this study is to highlight a rare presentation of SPN as persistent fever of unknown origin (FUO) without other significant symptoms, emphasizing the need to include pancreatic neoplasms in FUO differential diagnosis. Case study An 18-year-old female presented with persistent FUO without other significant symptoms. Initial laboratory tests were largely unremarkable except for mild anemia. Imaging studies revealed a well-defined mass in the tail of the pancreas measuring 5 × 5 × 6 cm. An ultrasound-guided core needle biopsy suggested SPN, characterized by monomorphic cells with minimal atypia and a specific immunophenotype. The patient underwent a distal pancreatectomy with splenectomy. Histopathological examination confirmed the diagnosis of SPN (pT3 pN0 LVI− PNI+), with clear surgical margins and no lymph node involvement. The postoperative course was uneventful, and follow-up examinations showed no signs of recurrence. Results and discussion This case underscores the importance of considering pancreatic neoplasms in the differential diagnosis of FUO, even in young patients. Early detection and surgical intervention are crucial for favorable outcomes. Conclusions SPN is a rare low-grade malignant tumor with good prognosis following surgical resection. Increased clinical awareness of its atypical presentations is essential for timely diagnosis and treatment.
Introduction Introduction: The analysis of household expenditure on health in individual countries is of significant importance for public health. Aim The main goal of the study was to analyze household health expenditure in Poland against the background of 10 countries in Central and Eastern Europe. The second goal was to analyze absenteeism and calculate the costs of lost productivity due to COVID-19. Material and methods In this study covering 11 Central and Eastern European countries, we conducted an analysis of household health expenditure in 2020–2022 and analyzed absenteeism and indirect costs of COVID-19 in Poland in 2019–2023. The Human Capital Method was used to estimate economic losses in employee productivity resulting from COVID-19 in Poland. Results and discussion Median household expenditure on health (as % of total expenditure) for the analyzed countries (n = 11) in 2020 amounted to 5% (min. 2.4% in the Czech Republic, max. 7.2 in Bulgaria).The lowest value was observed in Slovakia (2.6%), the Czech Republic (2.7%), and Estonia (3.2%), and the highest in Romania (6.9%), Poland (6.5%), and Bulgaria (6.5%). Productivity losses in Poland due to COVID-19 in 2020 amounted to EUR 570.330 million; in 2021 - EUR 341 million, in 2022 - EUR 118.900 million, in 2023 - EUR 207.47 million. Conclusions In none of the analysed countries did the share of household health expenditure in 2020–2022 exceed 10% of total expenditure. The share of household expenditure on health in Poland was the third highest of the analysed countries, where the highest share of household expenditure on health was observed. Both the number of days of absence in total, the number of absences due to COVID-19, and indirect costs due to COVID-19 were the highest in 2020.
Introduction Infantile haemangiomas are the most common vascular tumours in children, with higher prevalence in females and low birth weight infants. Beard distribution haemangiomas, involving the lower face, chin, preauricular areas, and anterior neck, are often associated with airway involvement in the supraglottic or subglottic regions. Even isolated head and neck haemangiomas may carry a risk of airway complications. Diagnosis relies on clinical evaluation, with bronchoscopy reserved for complex cases. Aim To emphasise early recognition and treatment of airway involvement in focal head and neck haemangiomas. Case study A 4-month-old former 27-week preterm infant with birth weight of 1.07 kg, who required oxygen support since birth. He was referred for upper airway assessment due to stridor during crying. Examination revealed a stridor with subcostal and suprasternal recession and a 1.5x1.0 cm submental haemangioma. Direct laryngoscopy and bronchoscopy under anaesthesia identified an extensive airway haemangioma extending from the nasal cavity to the bronchi. The infant was treated with oral propranolol. At 11-month follow-up, the airway haemangioma had resolved, and the submental haemangioma had significantly reduced in size. Results and discussion Recognizing the association between head and neck haemangiomas and airway involvement is essential for prompt and effective management. Conclusions Head and neck haemangiomas, even if they appear isolated, may still pose a risk of airway involvement. Early recognition and a multidisciplinary approach are essential for managing these complex cases. Propranolol therapy plays a critical role in the treatment of these lesions, but close monitoring and ongoing follow-up are necessary to ensure successful outcomes and prevent airway complications.
Introduction The role of ultraviolet radiation (UVR) in processes occurring in ecosystem is significant, and the effects of its actions on human health are both positive and negative. UV radiation mainly affects the eyesight and skin. Prolonged exposure of the eyes to ultraviolet radiation, especially without protection can lead to serious diseases. On the other hand, insufficient exposure to UVR may seem as a serious public health issue. Aim The aim of this paper is to present health advantages that comes from preventive dose of solar radiation with an overview of their mechanisms of action. Material and methods This narrative review summarizes 36 peer-reviewed studies on vitamin D, sunlight exposure, and health outcomes, identified in PubMed, Scopus, and Google Scholar from 2002 to 2024 through screening of titles, abstracts, and full texts. Results and discussion Current sun protection guidelines often emphasize avoidance of exposure, which may contribute to vitamin D deficiency and related health problems. UV requirements vary with factors such as skin type, location, and season, underscoring the need for individualized recommendations that balance the risks and benefits of sunlight. Conclusions To reap the maximum benefits, it is important to find a balance between protecting oneself from its harmful effects and ensuring an adequate amount of exposure, which is necessary for vitamin D production and overall well-being.
Introduction Arnold–Chiari type I malformation (ACH I) is classically associated with neuro-otologic symptoms, including vertigo, imbalance, and characteristic oculomotor disturbances — particularly vertical oscillopsia and downbeat nystagmus. However, variability in oculomotor involvement is increasingly recognized. Among the clinical manifestations of Arnold–Chiari type I syndrome, oculomotor disturbances — especially in the sagittal plane — are commonly reported as characteristic findings. Aim This study aimed to analyze the presence and nature of oculomotor dysfunction in two patients diagnosed with Arnold–Chiari type I syndrome. Case study Two adult patients with MRI-confirmed ACH I underwent comprehensive neuro-otologic evaluation, including videonystagmography (VNG), optokinetic testing, saccadic and smooth-pursuit assessment, caloric stimulation, vestibular evoked myogenic potentials (VEMP), brainstem auditory evoked responses (BERA), audiometry, and complementary neurological and vascular studies. Oculomotor performance was analyzed in the sagittal, frontal, and horizontal planes. Results and discussion Neither patient demonstrated oculomotor abnormalities in the sagittal (vertical) or frontal planes. Expected features such as vertical gaze palsy, downbeat nystagmus or torsional deviations were absent. In contrast, both individuals exhibited isolated horizontal-plane dysfunction, including impaired smooth pursuit, asymmetrical optokinesis, horizontal nystagmus, and, in one case, canal paresis. The selective involvement of horizontal oculomotor pathways, with preservation of vertical and torsional mechanisms, suggests heterogeneous patterns of brainstem and cerebellar involvement in ACH I. Conclusions Arnold–Chiari type I malformation may present with isolated horizontal oculomotor abnormalities rather than the traditionally described vertical disturbances. Recognition of such atypical patterns is important for accurate diagnostic interpretation and underscores the need for larger studies to elucidate the full spectrum of oculomotor involvement in ACH I.
Introduction Artificial intelligence (AI) is increasingly used in medicine to support diagnosis, treatment and data management. However, its implementation raises significant ethical, legal and social concerns regarding the doctor–patient relationship. Aim This study examined the level of trust in medical AI among medical professionals and students. It focused on identifying factors influencing acceptance and concerns. Material and methods The survey targeted medical students, doctors, nurses, midwives, paramedics, dentists and academic teachers. The questionnaire contained 36 questions including 30 single choice and 6 multiple choice options. The survey was distributed in paper form at hospitals (20.0%), health centers (10.0%), universities (20.0%) and in electronic form (50.0%). All responses were collected anonymously. The results are presented descriptively and as pie charts. The survey was conducted from March to June 2025 among 682 individuals. Results and discussion Most respondents had only a theoretical knowledge of AI, which they had mainly acquired independently. Practical experience was rare, confirming the limited implementation of this technology. AI’s potential was assessed positively, especially in radiology, oncology and medical administration. There was a preference for collaborative models supervised by doctors. Key concerns included the risk of errors, lack of legal responsibility and the impact on patient relationships. Respondents emphasized the need for algorithm transparency, legal-ethical regulations and formal education at every training stage. Conclusions The medical community accepts AI primarily as a supportive tool, provided physician oversight is maintained. Findings highlight the need for physician education and clear legal-ethical regulations.
Introduction In older inpatients, SARS-CoV-2 positivity does not always indicate that COVID-19 is the cause of admission. Aim To compare clinical profiles and 180-day mortality between older adults admitted for typical COVID-19 and those with incidental SARS-CoV-2 infection. Material and methods This retrospective cohort study included 306 hospitalized patients aged ≥60 years with SARS-CoV-2 infection. Admission phenotype was manually adjudicated as typical COVID-19 respiratory disease or incidental SARS-CoV-2 infection. Baseline characteristics, multimorbidity, CRP, IL-6, D-dimer, SpO2, and 180-day mortality were analyzed. Mortality was assessed using Kaplan–Meier curves and multivariable logistic regression. Results and discussion The cohort included 266 typical and 40 incidental admissions. Multimorbidity was common in both groups (79.2% vs 89.7%; p = 0.122). Typical admissions had lower SpO2 and higher CRP at admission (75.2 vs 34.8 mg/L; p = 0.007), whereas incidental admissions had higher D-dimer concentrations (2.2 vs 1.1 ng/mL; p = 0.016). Crude 180-day mortality was higher in the typical COVID-19 group (42.9% vs 22.5%; p=0.014). After adjustment for age and multimorbidity, incidental phenotype was independently associated with lower mortality odds (OR = 0.40; 95% CI: 0.18–0.89; p = 0.027). Conclusions Typical COVID-19 and incidental SARS-CoV-2 infection are distinct geriatric admission phenotypes. Typical COVID-19 admissions are associated with higher 180-day mortality, independent of baseline multimorbidity.
Introduction Although many studies have already investigated breast carcinoma, they mainly focused on the most common types. Therefore, there is a lack of information about the rarer ones, such as mucinous breast carcinoma (MBC). Aim To summarize the knowledge gained so far about the epidemiology, etiology, prognostic factors, pathomorphological changes, and treatment of MBC and to present its characteristics based on original data. Material and methods A PubMed literature review was conducted. Tissue samples from 1122 patients with suspected or diagnosed breast carcinoma were analyzed. Tumor types were identified using hematoxylin and eosin staining, and immunohistochemistry was used to assess estrogen (ER), progesterone (PR), and HER2/neu receptor expression. Results and discussion The review identified pure MBC (PMC) and mixed MBC (MMC) as two subtypes of the tumor. Our results showed that PMC was dominant subtype. PMC patients were older at the time of the diagnosis than MMC. None of the females had distant metastases and only two presented with positive lymph node status. ER expression without PR expression was recognized in three cases, HER2 in four, and both ER and PR in fourteen Patients with PMC showed more frequent expression of ER and PR than those with MMC. Conclusions Overall, this study focused on the importance of subtype differentiation and the evaluation of clinical features in determining prognosis and selecting appropriate therapy for MBC. Additionally, we indicated factors that may influence patient prognosis such as hormonal status, lymph node involvement and age.
Introduction Refusal of hospitalisation and DAMA in paediatric patients are insufficiently studied, especially in Poland and Central and Eastern Europe. These decisions may affect safety and care continuity and are shaped by medical and non-medical factors. Aim To analyse the frequency, circumstances, and selected determinants of refusal of hospitalisation and DAMA among patients in the Pediatric Ward of the Independent Public Provincial Specialist Hospital in Chełm in 2013–2018. Material and methods This retrospective study analysed medical records of patients under 18 years of age presenting to the Emergency Department, Admission Rooms, and Pediatric Ward. Patients recorded during the first 10 days of each month in 2013–2018 were included. Variables were age, sex, ICD-10 diagnosis, mode of admission, length of stay, and discharge type. Analysis used Microsoft Excel and R 4.0.5, with α = 0.05. Results and discussion Among 6,525 analysed cases, refusal of hospitalisation occurred in 4.9% (n = 320). Among 2,315 hospitalised patients, discharge at the request of a legal guardian occurred in 11.4% (n = 263). DAMA patients were more often admitted by Emergency Medical Services than all cases (46.6% vs. 21.5%). Gastrointestinal disorders and infections were the most common diagnoses. Conclusions Refusal of admission and DAMA were not rare in this paediatric population. Further prospective studies are needed to identify causes and support interventions aimed at reducing these events.
Introduction Physiotherapy is a profession that requires both high physical fitness and psychological resilience, as practitioners are exposed to multiple occupational and educational stressors. Recent studies have shown increasing levels of stress, anxiety, and musculoskeletal complaints among physiotherapy students, which may affect their overall well-being and professional preparedness. Aim The aim of the study is to assess the impact of the duration of studies on the intensity of symptoms of reduced mental and physical health and selected correlates related to this impact. Material and methods The study was conducted using an online questionnaire from October 2024 to January 2025. The questionnaire included demographic questions and a standardized General Health Questionnaire – 28 (GHQ-28) and Oswestry Disability Index (ODI). The criteria for inclusion in the study required active status as a physiotherapy student and informed consent to participate in the study. Results and discussion Analysis showed a correlation between increased spinal pain (ODI) and the occurrence of chronic diseases among the respondents (p<0.05). Similarly, a correlation was found between deteriorated mental health (GHQ-28) and the occurrence of chronic diseases (p<0.05). The study also showed that a higher BMI was associated with lower spinal pain (p<0.05). Conclusions The duration of studies does not have a significant impact on the mental and physical health of students. The presence of chronic diseases has a negative impact on the mental and physical health of physiotherapy students, leading to more frequent pain and reduced mental well-being.
Introduction Evening exposure to blue light from digital devices has been associated with sleep disruption, reduced life satisfaction, and problematic internet use in adolescents, yet few studies have investigated these factors together in a single population. Aim To examine the relationships between pre-sleep screen exposure, sleep quality, life satisfaction, and internet use behaviors, and to explore factors associated with poor sleep quality among high school students. Material and methods A cross-sectional study was conducted in May 2025 with 364 students (grades preparatory to 11) from a private high school in Istanbul. Data were collected via an online survey including the Pittsburgh Sleep Quality Index (PSQI), Young Internet Addiction Test–Short Form (YIAT-SF), and the Satisfaction with Life Scale (SWLS). Descriptive statistics, Spearman correlations, and binary logistic regression were performed. Results and discussion Poor sleep quality was observed in 83.0% of participants, and 48.1% demonstrated borderline or risky internet use. PSQI was positively correlated with YIAT-SF (r = 0.401, p < 0.001) and negatively with SWLS (r = −0.254, p < 0.01). Logistic regression analysis indicated that higher YIAT-SF scores (OR = 1.067, p = 0.010) and screen exposure in the last hour before sleep (OR = 5.487, p < 0.001) were significantly associated with poor sleep quality. Conclusions Problematic internet use and evening screen exposure are significantly associated with poor sleep quality. School-based initiatives promoting digital hygiene and sleep education may contribute to mitigating the adverse effects of technology on adolescent well-being.
Introduction This study investigated the clinical and mechanical effectiveness of titanium nickelide structures in the treatment of mandibular condyle fractures. Aim The purpose of the study was to substantiate the use of metal structures made of titanium nickelide to increase the effectiveness of fixation methods and accelerate the recovery process in fractures of the mandibular condyle. Material and methods The study conducted clinical and X-ray observations, including computer topographical analysis and electromyography of the masticatory muscles, and investigated the use of titanium nickelide and titanium mini-plates in the surgical treatment of mandibular condyle fractures to assess their mechanical, biological, and functional properties. Results and discussion The findings confirmed that titanium nickelide exhibits high mechanical strength, shape memory under thermal exposure, and resistance to corrosion in physiological environments, ensuring accurate and durable fixation. Clinical trials demonstrated the material’s biocompatibility, contributing to accelerated bone healing and reduced postoperative complications. Conclusions Compared to traditional intermaxillary splints, titanium fixators and endoprostheses significantly reduced surgery time and recovery period, offering a safer, more efficient, and economically advantageous treatment option for mandibular condyle fractures.
Introduction Pen cap aspiration, though seemingly benign in origin, poses significant airway risks in children. Its smooth surface and cylindrical shape make removal technically demanding; delays in diagnosis and inappropriate manipulation may lead to complications. Aim To highlight the diverse retrieval strategies for pen cap aspiration in children, emphasizing individualized management and the importance of multidisciplinary collaboration. Case study Case 1, a 7-year-old boy, aspirated a mechanical pencil cap that lodged in the left main bronchus and was removed via rigid bronchoscopy using optical grasping forceps. In Case 2, a 7-year-old girl developed extensive subcutaneous emphysema after aspirating a pen cap. Rigid bronchoscopy failed to extract the object safely, and an emergency tracheal incision was performed for successful removal. In Case 3, an 8-year-old boy with concurrent COVID-19 infection aspirated a pen cap that was successfully retrieved using flexible bronchoscopy-guided cryotherapy, minimizing aerosol exposure and procedure time. Results and discussion The choice of removal technique depends on the foreign body’s characteristics, airway anatomy, and clinical stability. Rigid bronchoscopy remains the gold standard; however, open surgical or cryotherapy-assisted approaches may be warranted in select cases. Cryotherapy is effective for smooth or slippery objects, offering a safe, rapid, and minimally traumatic retrieval option. Conclusions Pen cap aspiration in children presents a diverse range of clinical scenarios that require tailored management. Awareness of various retrieval methods, including rigid bronchoscopy, tracheal access, and cryotherapy, improves safety and outcomes in paediatric airway foreign body cases.
Introduction Clostridioides difficile (CD) is a major healthcare-associated pathogen responsible for antibiotic-associated diarrhea and severe colitis. Probiotics have been proposed as a preventive strategy. However, data in critically ill patients remain limited. Aim To evaluate the effect of probiotic supplementation on CD stool concentration in patients hospitalized in coma. Material and methods This prospective, randomized preliminary study was conducted from May to August 2023 at the Department of Medical Rehabilitation “Budzik dla Dorosłych”. Fourteen patients in coma were randomized to receive either a new probiotic mixture (Labifid®, containing Bifidobacterium animalis AMT30 and Bifidobacterium breve AMT32) or standard hospital probiotics (Lactobacillus rhamnosus, Saccharomyces boulardii). Stool samples were collected at baseline, 1, 2, and 4 months afterwards. Results and Discussion Baseline CD levels were comparable between groups (2.1 × 10⁵ vs. 2.2 × 10⁶ CFU/g; p = 0.607). At 1, 2, and 4 months, patients receiving the new probiotics demonstrated significantly lower CD concentrations than controls (p = 0.032, p = 0.017, and p = 0.029, respectively). After 4 months, CD levels in the new-probiotic group fell below the detection limit. No serious adverse events were observed. Conclusions Supplementation with Bifidobacterium animalis and Bifidobacterium breve was associated with a significant reduction in CD stool concentration in comatose patients. However, due to the small sample size, it should be interpreted with caution.
Introduction The Nuss procedure is the gold standard for correcting pectus excavatum. Despite its effectiveness, the postoperative period is often associated with significant pain, which may persist for weeks and typically requires intravenous analgesia, often opioid-based. Cryoanalgesia, a reversible method that induces temporary intercostal nerve block, offers a safe alternative providing both early and long-lasting pain relief. Aim This study evaluates the impact of intraoperative intercostal nerve cryoanalgesia on postoperative pain intensity and hospitalisation duration in patients undergoing the Nuss procedure for pectus excavatum. Material and methods A retrospective analysis was performed on 57 patients treated over a 7-year period at a single centre. Patients were divided into two groups: those who received intraoperative cryoanalgesia (n = 41) and those without additional intraoperative analgesia (n = 16). Statistical analysis was performed using the Mann–Whitney test and Spearman rank correlation, with significance set at p < 0.05. Results and discussion Among the 57 patients, 53 (93%) were male, with a mean Haller Index of 3.98 and Correction Index of 33.78. Cryoanalgesia was applied in 71.9% of cases. Patients treated with cryoanalgesia demonstrated shorter hospital stays compared with the control group (3 ± 2 days vs. 5.5 ± 2 days; p < 0.001). Postoperative pain intensity measured by NRS was comparable between groups; however, opioid requirements were significantly lower in the cryogroup on day 3 (34% vs. 69%; p = 0.02) and day 4 (7% vs. 62.5%; p < 0.001). Conclusions Intraoperative cryoanalgesia reduces hospitalisation time and postoperative opioid use, offering an effective adjunct for pain management after the Nuss procedure.
