Background:Surgery remains the most effective treatment for patients with non-small cell lung cancer (NSCLC). However, pneumonectomy is usually associated with high mortality and morbidity rates. Defining post-operative death after such extensive procedures remains controversial. This study aimed to assess the 30- and 90-day post-pneumonectomy mortality rates. The secondary aim was to identify the most critical factors determining early post-pneumonectomy mortality. Methods:This retrospective, single-institution cohort study was conducted at a high-volume center and included a large group of 514 patients who underwent pneumonectomy for NSCLC from 2006 to 2020. Our analysis considered patient comorbidities, staging, surgical techniques, neoadjuvant chemotherapy, and major complications, and examined their associations with 30- and 90-day mortality rates. We initially performed a univariable Cox regression analysis, followed by multivariable analyses, including variables with P<0.1. Results:The 30- and 90-day mortality was equal to 4.3% and 9.1%, respectively. For 30-day mortality, statistically significant factors included the occurrence of a bronchopleural fistula (BPF) [hazard ratio (HR) =5.128; 95% confidence interval (CI): 2.009-13.087; P<0.001], positive bronchial resection margin (HR =7.917; 95% CI: 2.61-24.01; P<0.001) and the prolonged intubation (>48 hours) (HR =3.822; 95% CI: 1.06-13.785; P=0.041). For the 90-day mortality, the presence of the BPF (HR =5.284; 95% CI: 2.706-10.318; P<0.001), positive bronchial resection margin (HR =3.528; 95% CI: 1.370-9.083; P=0.009), chest wall infiltration (HR =3.770; 95% CI: 1.121-12.676; P=0.03), and prolonged intubation (>48 hours) (HR =2.912; 95% CI: 1.102-7.649; P=0.03) were the statistically significant risk factors. Conclusions:A 90-day follow-up period should be considered when assessing short-term mortality rates after major pulmonary resections. Monitoring long-term mortality is important, as the mortality rate in our group doubled after 3 months. BPF, prolonged intubation, chest wall infiltration, and positive bronchial resection margin significantly increase the risk of 30- and 90-day mortality rates.

Breast cancer poses a significant public health challenge in Poland, with incidence rates exceeding the EU average and a concerning disparity between incidence and mortality. This review analyzes the key steps of breast cancer diagnosis and treatment in Poland, examining factors influencing therapeutic outcomes. We explore the complex interplay of epidemiological trends, prevention strategies, the impact of the National Oncology Strategy (NSO) and the National Cancer Network (KSO), access to care challenges, treatment protocols, and drug programs. While Poland has made strides in implementing comprehensive care pathways, including the DiLO card system and dedicated drug programs, significant gaps remain. Low screening participation, delays in diagnosis, limited access to innovative therapies, and reimbursement restrictions hinder optimal patient outcomes. This review highlights the urgent need for targeted interventions to address these challenges, improve early detection, enhance access to care, and ultimately reduce the burden of breast cancer for Polish patients.

Background:Pain management in children with Molar-Incisor Hypomineralization (MIH) poses challenges for pediatric dentists. MIH affects the enamel of the first permanent molars and incisors, increasing the risk of cavities, hypersensitivity, and making anesthesia and dental treatments more difficult. Children with MIH often experience dental fear, necessitating effective pain management techniques. Photobiomodulation (PBM) has potential analgesic benefits in dentistry but requires further evaluation for its effectiveness in MIH cases. Aim:This study aimed to assess the impact of photobiomodulation on pain control in maxillary permanent molars affected by MIH. Methods:In our randomized split-mouth clinical study, 45 participants (25 males, 20 females) aged 7 to 15 years, with both maxillary molars affected by MIH, were assigned to either the intervention group (PBM plus standard anesthesia, n = 45 teeth) or the control group (standard anesthesia alone, n = 45 teeth). PBM parameters included a power of 100 mW, a wavelength of 635 nm, energy of 6 J, fluence of 12 J/cm2, and a duration of 60 s. Pain perception, anesthesia commencement, and its extension time were measured and analyzed using SPSS version 23.0 (p < 0.05). Results:The PBM group reported significantly lower subjective pain (mean VAS 2 [1-5]) compared to the control group (6 [2-8]), p < 0.001. FLACC scale scores were also lower in the intervention group (3 [1-5]) compared to the control group (7 [5-8]), p < 0.001. The PBM group showed a lower heart rate (84.6 bpm ± 6.1) compared to the control (113.2 bpm ± 6.1), p < 0.001. Additionally, the anesthesia developed faster in the PBM group (mean: 3.6 ± 0.9 min) compared to the control (6.1 ± 0.8 min, p < 0.001), and the anesthetic effect persisted longer (70.2 ± 3.9 min vs. 50.7 ± 8.9 min, p < 0.001). Conclusion:Photobiomodulation improves pain management and the effectiveness of local anesthesia in maxillary molars affected by MIH by diminishing pain experience and enhancing anesthesia effects, providing a promising approach for pain control in children.

Background: Breast cancer is a major health concern in Poland, with significant incidence and mortality rates despite national screening programs. This retrospective study aimed to evaluate critical aspects of breast cancer management, focusing on waiting times, treatment coordination, cancer characteristics, diagnostic testing, and staging. Methods: We retrospectively analyzed 587 medical records of breast cancer patients (585 female, 2 male) collected between March 2023 and June 2024 through a data donation model. Data included tumor characteristics (histological type, grade, stage, biological subtype, receptor status, Ki-67), diagnostic and genetic tests, and timelines of key events in the diagnostic and therapeutic pathways. Results: Although referral to first oncology consult (18 days) and MDT referral/admission to treatment (10 days) met NFZ guidelines, diagnosis to surgery (94 days) and diagnosis to drug treatment (109 days) were significantly delayed. No records showed oncology coordinator assignment or educational material provision. Clinically, invasive carcinoma NST (77%) and early-stage (IA/IIA, 61%) were prevalent, with Luminal B (HER2-negative) being the most common biological subtype. BRCA1/2 testing was common, but Oncotype DX was not. For 314 HR+ HER2- patients, stage IA (44%) was most common, with no BRCA1/2 mutations found. Conclusion: Breast cancer care in the Łódź voivodeship falls short of national guidelines due to long waiting times and poor care coordination, a problem worsened by incomplete data. Improving record-keeping and speeding up diagnostic and treatment pathways are crucial for better breast cancer management in Poland. While patient data donation can help analyze real clinical pathways, data completeness, and consistency remain challenges.

Introduction: The outcomes of lung cancer surgery depend on the patients' nutritional status. Body fat percentage (BF%) is one of the indicators of body composition and nutritional status. Direct measurement of BF% is complicated, requires significant resources and is rarely performed. The CUN-BAE (Cl & iacute;nica Universidad de Navarra - Body Adiposity Estimator) index has been shown to accurately predict BF% is several clinical settings, but its relation to the outcomes of lung surgery has not been reported so far. Aim: To determine the relation of the BF% to the outcomes of thoracoscopic lobectomy. Material and methods: This retrospective study included 1,183 patients who underwent thoracoscopic lobectomy for non -small cell lung cancer between June 1999, and September 2019 at one department. BF% was calculated according to the Cl & iacute;nica Universidad de Navarra - Body Adiposity Estimator equation. The primary endpoints were postoperative complications and long-term survival. Results: Univariate analysis showed that higher BF% was related to lower incidence of complications (p = 0.001), including prolonged air leak (p < 0.001), atelectasis (p < 0.05), psychosis (p < 0.001), reoperations (p < 0.05), and shorter chest drainage (p = 0.001) and hospitalization duration (p < 0.001). Multivariate analysis showed that higher BF% was correlated with lower risk of complications (p = 0.005; OR = 0.964; 95% CI: 0.940 to 0.989), including prolonged air leak (p < 0.001; OR = 0.923; 95% CI: 0.886 to 0.962), and shorter duration of chest drainage (p < 0.001; B = -0.046; 95% CI: -0.069 to -0.023) and hospitalization (p < 0.001; B = -0.112; 95% CI: -0.176 to -0.048). Cox proportional hazards regression analysis showed that BF% was not related to long-term survival. Conclusions: Body fat percentage is a valuable tool that can help predict the short-term outcomes of minimally lobectomy for lung cancer.

BACKGROUND:Minimally invasive endodontics is recommended for young, immature teeth to preserve healthy pulp and dentin tissue. OBJECTIVES:The aim of the study was to examine the cold sensitivity of immature teeth that received photobiomodulation (PBM) after vital pulp therapy (VPT). MATERIAL AND METHODS:The study followed the STROBE guidelines and included 123 healthy patients aged 8-13. The immature teeth (incisors, premolars and molars) that qualified for VPT received the bioceramic material - Biodentine. In this experiment, teeth were treated immediately and at 24 h post-VPT with a 635-nm diode laser using a power of 100 mW, a power density of 200 mW/cm2 and a total energy of 4 J (PBM group, n = 43), while those not treated were the control group (n = 43). The tooth sensitivity to cold was measured using a visual analogue scale (VAS) before and at 6 h, 1 day, 7, 30, and 90 days after treatment. The predictor variable was PBM skills regarding the ability to decrease cold sensitivity after VPT. The primary endpoint was the time to reverse hypersensitivity to cold, and the secondary endpoint was the occurrence of possible side effects. The Mann-Whitney U test, Friedman test along with Dunn's post hoc test, and the χ2 test were used to investigate tooth sensitivity. RESULTS:Eighty-six immature permanent teeth of 86 children were included in the study. It was shown that the difference was significant for sensitivity to a cold stimulus between the groups at 6 h, 24 h, 7 days, and 30 days, but no difference was found preoperatively and at 90 days (6 h, 24 h, 7 days, and 30 days, p < 0.001, and 90 days, p = 0.079). However, patients in both groups reported a decrease in discomfort provoked by cold stimuli throughout the follow-up period. CONCLUSIONS:Photobiomodulation decreased postoperative sensitivity and was more acceptable for patients. Further randomized clinical studies with placebo-controlled groups are needed.

Background/Objectives: DDX3X syndrome is often misdiagnosed as autism spectrum disorder (ASD, Rett Syndrome, and Dandy-Walker Syndrome). Precise phenotyping is needed with reference to neurodevelopmental diagnosis. Observation of behavior and communication in parents with DDX3X syndrome in the USA, France, and Poland; conversations with the parents of patients; and rudimentary information in evidence-based medical articles prompted us to identify differences in communication, play, and social interaction between children with ASD only, those with both ASD and DDX3X, and those with DDX3X only. Methods: As diagnostic tool for DDX3X patients, we created a questionnaire divided into four sections: medical, social, play, and communication. Results: The results showed inconsistent diagnoses in different countries where children could have been diagnosed with DDX3X. In a comparative analysis, individuals with DDX3X exhibited greater social skills than individuals with ASD. Furthermore, those with DDX3X demonstrated higher levels of social functioning compared to children with ASD. Therefore, parents of children recently diagnosed with ASD or similar conditions are encouraged to complete a survey to determine if their child is likely to have features of DDX3X syndrome. Conclusion: Identification of early behavioral markers that differentiate children with ASD and those with DDX3X could lead to the earliest opportunity for identification and intervention, and can significantly impact developmental trajectories, leading to better long-term outcomes.

Lymphadenectomy is an essential part of complete surgical operation for non-small cell lung cancer (NSCLC). This retrospective, multicenter cohort study aimed to identify factors that influence the lymphadenectomy quality. Data were obtained from the Polish Lung Cancer Study Group Database. The primary endpoint was lobe-specific mediastinal lymph node dissection (L-SMLND). The study included 4271 patients who underwent VATS lobectomy for stage IA NSCLC, operated between 2007 and 2022. L-SMLND was performed in 1190 patients (27.9%). The remaining 3081 patients (72.1%) did not meet the L-SMLND criteria. Multivariate logistic regression analysis showed that patients with PET-CT (OR 3.238, 95% CI: 2.315 to 4.529; p < 0.001), with larger tumors (pT1a vs. pT1b vs. pT1c) (OR 1.292; 95% CI: 1.009 to 1.653; p = 0.042), and those operated on by experienced surgeons (OR 1.959, 95% CI: 1.432 to 2.679; p < 0.001) had a higher probability of undergoing L-SMLND. The quality of lymphadenectomy decreased over time (OR 0.647, 95% CI: 0.474 to 0.884; p = 0.006). An analysis of propensity-matched groups showed that more extensive lymph node dissection was not related to in-hospital mortality, complication rates, and hospitalization duration. Actions are needed to improve the quality of lymphadenectomy for NSCLC.

People differ in their preferred time for intellectual activities. Morningness-eveningness preferences describe the preferred time for performing daily activities and are determined by chronotype. Chronotype reflects circadian preference in humans and is divided into morning, intermediate, and evening types. Learning motivation is a key predictor of student success and may influence learning and study, academic performance, intention to continue medical research, and well-being. Helping students develop learning motivation may improve their educational achievement and health. There are opposing studies regarding chronotype and academic achievement. We hypothesized that chronotype affects the learning motivation of medical school students. We used the reduced Morningness-Eveningness Questionnaire (rMEQ), and the Motivated Strategies for Learning Questionnaire (MSLQ) for Russian, Polish, Japanese, and Australian students in the first and second years of medical university. A total of 540 medical students answered the questionnaires. The MSLQ contains six subscales: intrinsic goal orientation, extrinsic goal orientation, self-efficacy for learning and performance, control of learning beliefs, task value, and test anxiety. The rMEQ was used to classify the students into three types, which were morning (26.7

The Nuss procedure is the most common corrective surgery for pectus excavatum. We analyzed treatment outcomes and complication rates in 1238 patients treated with the Nuss procedure from 2002 to 2021, focusing on the number of corrective bars used. Using Propensity Score Matching based on age, sex, BMI, pre-operative FEV1, and the Haller index, we created two groups: 546 patients with a single bar and 546 with two bars. Both groups achieved similar correction effects (Haller index: single bar = 2.58 vs. two bars = 2.56; p = 0.65). In the univariate analysis, in the two-bar group, the postoperative complications were observed more often (28.6% vs. 15.4%, p < 0.001), including pneumothorax (11.2% vs. 6.2%, p < 0.001), hemothorax (3.7% vs. 0.7%, p < 0.001), additional drainage (13.7% vs. 5.3%, p < 0.001), the need for thoracentesis (8.6% vs. 2.9%, p < 0.001), bar displacement (3.8% vs. 0.7%, p < 0.001), pleural effusion (10.6% vs. 3.1%, p < 0.001), and fever (6.6% vs. 3.8%, p < 0.041). In the logistic regression, two bars significantly increased the risk of postoperative complications (p = 0.019), including hematoma (p = 0.036), pleural effusion (p = 0.002), and the need for thoracentesis (p = 0.013). Using two corrective bars during the Nuss procedure is associated with a higher rate of postoperative complications but similar corrective results.

INTRODUCTION: In the education of medical professionals, thorough theoretical and practical preparation of future healthcare professionals is highly important. Current developments and technological advances offer considerable opportunities for the design and construction of educational e-resources, including various types of multimedia and interactive materials. As their production is relatively expensive and time consuming, both in terms of content and technology, it is worth developing them for a wider, nationwide audience. MATERIALS AND METHODS: E-materials, such as decision-based games, educational videos, multimedia atlases, and infographics, were designed and produced for the Integrated Educational Platform of the Ministry of Education and Science in Poland as part of a national EU project for post-secondary education of medical caregivers, medical electronics technicians, and information technology technicians. The materials included topics from anatomy, physiology, lifethreatening conditions, first aid, health promotion and prevention, and psychophysical development. The research group consisted of fourth-year medical students who, as part of the subject of scientific research, performed an analysis of ematerials in terms of their educational value and evaluation of their technological aspects. Methods such as interviews, reviews, analysis, and discussion were used. RESULTS: After the analysis carried out, the main characteristics (advantages) and recommendations considered important by the knowledge recipients in terms of a) content and methodology, and b) technology, were identified. These include: a) the way the information is conveyed, visualisation of the content presented, highlighting, concise delivery of the content, motivation for learning, and b) the way the content is presented, visualization of the message, visual and auditory impact, changing the speed of content playback, ability to work on different devices. Recommendations for the creation of e-resources are: a) accuracy of the presented content, detail of the content, b) navigation, the ability to go back to earlier stages of the game, additional videos, sounds that convey the realism of the situation. CONCLUSIONS: Feedback from future users of educational multimedia materials is necessary. Their analysis should be taken into account when creating e-resources. 1) Content: content should be appropriately matched to the recipient's knowledge level, and presented in a concise manner. 2) Methodology: Multimedia should enable independent decisionmaking at different stages of learning, as well as include patterns of behaviour, especially in life-threatening conditions. It is important to highlight and visualise the content, combining visual and auditory cues 3) Technology: the content presented should reflect reality (high production quality), enable proper navigation, and be accessible on various devices.

Introduction Management of patients with anorexia nervosa (AN) desires psychiatric/medical care. In average AN disease onset they represent a younger generation than 18 y.o. In this age typically children and adolescents are under regular dental care. Whether young AN patients should be included to intensive oral supervision may be still questionable. In literature little information on changes in oral cavity caused by AN were reported. Objectives Therefore, the aim of the study was to evaluate caries incidence, tooth wear, gingival inflammation, and oral hygiene level among adolescent AN inpatients, highlighting the aspect of oral health manifestations in case-control study. Methods Based on clinically confirmed 130 AN restrictive subtype hospitalized female subjects (BMI <15 kg/m2, age 14.8±1.8), dental status has been examined regarding the occurrence of caries lesions using Decay Missing Filling Teeth (DMFT), erosive wear as Basic Erosive Wear Examination (BEWE), gingival condition as Bleeding on Probing (BOP) and plaque deposition as Plaque Control Record (PCR). The results were compared with age-matched 110 female controls (BMI 19.8±2.3 kg/m2, age 15.5±1.8, p=0.744) dentally caried in public University dental clinic (p<0.05) in the same time period. Results AN patients compared with healthy adolescents were found to present higher incidence of oral-related complications according to dental status (DMFT 3.9±4.5 vs. 2.0±1.8, p=0.005), erosive tooth wear (BEWE 18.9% vs. 2.9%, p<0.001), less efficient in controlling plaque (PCR 43.8% vs. 13.7%, p<0.001) and gingival inflammation (20.0% vs. 3.9%, p<0.001). AN group, a significant correlation between BOP, BEWE, and duration of AN symptoms (p<0.05), similarly to the number of decayed teeth D, filled teeth F and PCR were detected (p<0.05). Conclusions Although the obtained results did not reveal any severe oral complications, AN diagnosis in adolescence may influence to numerous oral-related symptoms from dental caries, the onset of erosive tooth wear, failure in dental hygiene to be continuated as gingival inflammation. After AN diagnosis a regular preventive intervention should be performed during dental recall sessions. There is a need for professional oral hygiene/diet instructions combined with regular oral check up visits to avoid oral complications and disease progress. For clinical revelance an active collaboration between psychiatric and dental specialists is needed. Disclosure of Interest None Declared

Background: The internet is a primary source of health information for patients, supplementing physician care. Google Trends (GT), a popular tool, allows the exploration of public interest in health-related phenomena. Despite the growing volume of GT studies, none have focused explicitly on oncology, creating a need for a systematic review to bridge this gap. Objective: We aimed to systematically characterize studies related to oncology using GT to describe its utilities and biases. Methods: We included all studies that used GT to analyze Google searches related to malignancies. We excluded studies written in languages other than English. The search was performed using the PubMed engine on August 1, 2022. We used the following search input: "Google trends" AND ("oncology" OR "cancer" or "malignancy" OR "tumor" OR "lymphoma" OR "multiple myeloma" OR "leukemia"). We analyzed sources of bias that included using search terms instead of topics, lack of confrontation of GT statistics with real-world data, and absence of sensitivity analysis. We performed descriptive statistics. Results: A total of 85 articles were included. The first study using GT for oncology research was published in 2013, and since then, the number of publications has increased annually. The studies were categorized as follows: 22% (19/85) were related to prophylaxis, 20% (17/85) pertained to awareness events, 11% (9/85) were celebrity-related, 13% (11/85) were related to COVID-19, and 47% (40/85) fell into other categories. The most frequently analyzed cancers were breast (n=28), prostate (n=26), lung (n=18), and colorectal cancers (n=18). We discovered that of the 85 studies, 17 (20%) acknowledged using GT topics instead of search terms, 79 (93%) disclosed all search input details necessary for replicating their results, and 34 (40%) compared GT statistics with real-world data. The most prevalent methods for analyzing the GT data were correlation analysis (55/85, 65%) and peak analysis (43/85, 51%). The authors of only 11% (9/85) of the studies performed a sensitivity analysis. Conclusions: The number of studies related to oncology using GT data has increased annually. The studies included in this systematic review demonstrate a variety of concerning topics, search strategies, and statistical methodologies. The most frequently analyzed cancers were breast, prostate, lung, colorectal, skin, and cervical cancers, potentially reflecting their prevalence in the population or public interest. Although most researchers provided reproducible search inputs, only one-fifth used GT topics instead of search terms, and many studies lacked a sensitivity analysis. Scientists using GT for medical research should ensure the quality of studies by providing a transparent search strategy to reproduce results, preferring to use topics over search terms, and performing robust statistical calculations coupled with sensitivity analysis.

The standard of care for patients with early-stage non-small cell lung cancer (NSCLC) is anatomical lung resection with lymphadenectomy. This multicenter, retrospective, cohort study aimed to identify predictors of 5-year survival in patients after thoracoscopic lobectomy for stage IA NSCLC. The study included 1249 patients who underwent thoracoscopic lobectomy for stage IA NSCLC between 17 April 2007, and December 28, 2016. The 5-year survival rate equaled 77.7%. In the multivariate analysis, higher age (OR, 1.025, 95% CI: 1.002 to 1.048; p = 0.032), male sex (OR, 1.410, 95% CI: 1.109 to 1.793; p = 0.005), chronic obstructive pulmonary disease (OR, 1.346, 95% CI: 1.005 to 1.803; p = 0.046), prolonged postoperative air leak (OR, 2.060, 95% CI: 1.424 to 2.980; p < 0.001) and higher pathological stage (OR, 1.271, 95% CI: 1.048 to 1.541; p = 0.015) were related to the increased risk of death within 5 years after surgery. Lobe-specific mediastinal lymph node dissection (OR, 0.725, 95% CI: 0.548 to 0.959; p = 0.024) was related to the decreased risk of death within 5 years after surgery. These findings provide valuable insights for clinical practice and may contribute to improving the quality of treatment of early-stage NSCLC.

A thorough theoretical and practical preparation is crucial in the education of medical professionals. Present-day knowledge recipients expect a broad range of multimedia and interactive resources in the consumed media. The article discusses examples of such implementations for the nationwide education of a pharmacy technician, massage technician, medical sterilization technician, and occupational therapy technician. These examples were created for the Integrated Education Platform of the Ministry of Education and Science in Poland, as part of an EU-funded project. This study delineates the characteristics of e-materials, such as instructional and educational videos, film sequences, scenario-based learning games, interactive documentation, 3D animations, simulators and virtual tours. We prepared a learner benefit analysis based on the e-materials discussed. We aimed to formulate recommendations and guidelines for designing and developing multimedia and interactive resources, paying special attention to educational values and content for the medical industry. Regardless of the type of multimedia, profession and content, materials should prioritize realism, interactivity and detailed presentation of the situations/cases. The same multimedia rarely achieve different learning objectives and learning outcomes. To design and produce high-quality multimedia, it is necessary to know their characteristics and to work with a team of subject matter experts experienced in e-learning development.

Background The management of oral health during severe symptoms of Covid-19 is still a challenge, especially in intensive care units under invasive/noninvasive ventilation in hospital. Understanding the cause-and-effect relationships may allow for individual adjustment of oral care recommendations during Covid-19 disease. The study’s objective was to assess Covid-19 patients’ oral health status under hospital treatment due to pulmonary adverse Covid-19 outcomes. Material and methods Covid-19 patients (mean age 74.4 ± 15.4; n = 120, male n = 50/female n = 70) were admitted to hospital in the acute phase of Covid-19 between January and March 2022 who required oxygen therapy due to pneumonia, rapid respiratory failure, low saturation. Blood and radiological tests were taken according to National Health Fund guidelines. The condition of teeth (Decayed, Missing, Filled teeth as DMFT index), dental hygiene (Plaque Control Record as PCR index), periodontal status (probing depth PD, clinical attachment CAL, bleeding on probing BOP) and oral mucosa (BRUSHED and Beck scores) were examined. Results Charateristics of the teeth (dental caries 35.2%, DMFT Median 22), plaque retention (83.4%), advanced periodontitis (48.3%), xerostomia (74.2%), oral mucosa inflammation (80.8%), angular cheilitis (53.3%), hemorrhagic (21.7%) showed a high incidence of harmful oral conditions. BRUSHED model and Beck score indicated moderate oral dysfunction and need for oral care every 8 h. Spearman’s analysis revealed a significant positive correlation between pneumonia and neutrophile, interleukin-6 IL-6, C-reactive protein CRP ( p = 0.01, p < 0.001, p < 0.001), negative to lymphocyte count ( p < 0.001). Multiple and logistic regressions selected the following risk predictors for pneumonia as IL-6, CRP, obesity and for severe COVID-19 symptoms D-dimer level and a lack of targeted vaccination ( p < 0.001). Among oral predictors, the PCR index and Beck score were significant for both outcomes (respectively p < 0.001, p < 0.012). Patients who received oxygen therapy with face masks had more often angular heilitis and debris ( p = 0.025, p = 0.035). Conclusions COVID-19 hospitalised patients with severe symptoms crossing with poor oral health-related conditions. This may exacerbate a response for COVID infection, and play a role in cytokine storm. For Covid-19 management, to inhibit extraoral/intraoral complications, it is recommended to adjust oral hygiene procedures, including antibacterial, protective, moisturising agents after individual oral health assessment.

BACKGROUND Studies have demonstrated a lower incidence of complications after video-assisted thoracoscopic surgery (VATS) lobectomy compared with thoracotomy, but the data on in-hospital and 90-day mortality are inconclusive. This study analyzed whether surgical approach, VATS or thoracotomy, was related to early mortality of lobectomy in lung cancer and determined the differences between in-hospital and 90-day mortality. METHODS Data of all patients with non-small cell lung cancer who underwent lobectomy between January 1, 2007, and July 30, 2018, were retrieved from Polish National Lung Cancer Registry. Included were 31 433 patients who met all study criteria. After propensity score matching, 4946 patients in the VATS group were compared with 4946 patients in the thoracotomy group. RESULTS Compared with thoracotomy, VATS lobectomy was related to lower in-hospital (1.5% vs 0.9%, P [ .004) and 90-day mortality (3.4% vs 1.8%, P < .001). Mortality at 90 days was twice as high as in-hospital mortality in both the VATS (1.8% vs 0.9%, P < .001) and thoracotomy groups (3.4% vs 1.5%, P < .001). Postoperative complications were less common after VATS compared with thoracotomy (23.6% vs 31.8%, P < .001). CONCLUSIONS VATS lobectomy is associated with lower in-hospital and 90-day mortality compared with thoracotomy and should be recommended for lung cancer treatment, if feasible. Patients should also be closely monitored after discharge from the hospital, because 90-day mortality is significant higher than in-hospital mortality.

Universities can offer their master’s students who want to improve their language skills different learning environments. They can range from traditional classes to online programmes equivalent to an on-campus experience or reaching beyond it. Learning technical English through a curriculum that is inspiring and stimulating due to authentic materials used in a gamified setting can result in positive learning outcomes and increased satisfaction levels among lecturers and students. The former can find new challenges helping prevent burnout, the latter have the chance to develop hard and soft skills, including analytical, reflective and critical thinking, through context-specific language. Interactions structured around online activities which involve searching for information in authentic resources and completing activities that allow for progress to the next level can effectively prepare students for challenges they will encounter in their professional life. They can also capture imagination and unlock the creative potential of the educators involved in their development and of participants bored with school routine and textbooks. Thus, a gamified language course for specific purposes can become a highly motivating environment, in which young people develop their creativity, language proficiency and knowledge of technological advances not only in the fields of their interest; they are also exposed to new learning practices due to the application of game-design elements. The ideas presented above will be supported by students’ opinions and attitudes expressed during a pilot Moodle course in a gamified format conducted at Gdansk University of Technology in the summer semester of 2021/2022.

Background High-energy devices allow better vessel sealing compared with monopolar electrocautery and could improve the outcomes of surgical operations. The objective of the study was to compare tissue dissection by the LigaSure™ device with that by monopolar electrocoagulation for thoracoscopic lobectomy and lymphadenectomy. Methods This pragmatic, parallel group, prospective randomized controlled trial was funded by the Medtronic External Research Program (ISR-2016–10,756) and registered at www.clinicaltrials.gov (NCT03125798). The study included patients aged 18 years or older, who had undergone thoracoscopic lobectomy with lymphadenectomy at the Department of Thoracic Surgery of Poznan University of Medical Sciences between May 3, 2018, and November 4, 2021. Using simple randomization, the patients were assigned to undergo tissue dissection with either the LigaSure device (study group) or monopolar electrocautery (control group). Participants and care givers, except operating surgeons, were blinded to group assignment. The primary outcome was postoperative chest drainage volume. Secondary outcomes were change of the esophageal temperature during subcarinal lymphadenectomy and C-reactive protein level 72 h after surgery. Results Study outcomes were analyzed in 107 patients in each group. We found no differences between the study and control groups in terms of chest drainage volume (550 vs. 600 mL, respectively; p = 0.315), changes in esophageal temperature (− 0.1 °C vs. − 0.1 °C, respectively; p = 0.784), and C-reactive protein levels (72.8 vs. 70.8 mg/L, respectively; p = 0.503). The mean numbers of lymph nodes removed were 12.9 (SD: 3.1; 95% CI, 12.4 to 13.5) in the study group and 11.6 (SD: 3.2; 95% CI, 11.0 to 12.2) in the control group ( p < 0.001). Conclusions The use of the LigaSure device did not allow to decrease the chest drainage volume, local thermal spread, and systemic inflammatory response. The number of lymph nodes removed was higher in patients operated with the LigaSure device, which indicated better quality of lymphadenectomy.

The COVID-19 pandemic disrupted cancer screening programs and care for individuals with malignancies. We aimed to analyze the effects of the COVID-19 pandemic on the interest of Google users in cancers and their screenings. We collected data from Google Trends (GT) from 1 January 2015 to 31 December 2021 worldwide for nine topics representing cancer screening and the HPV vaccine and for 33 topics representing malignancies. We performed a secular analysis comparing the prepandemic (2015–2019) and pandemic (2020–2021) period. We performed forecasting analysis on the prepandemic timeline to assess interest in the analyzed topics if the pandemic hadnot occurred.The actual interest in most of the analyzed topics was significantly lower than in the forecasted trend. Interest in 6 of the 9 topics representing cancer screening and 3 of the 33 topics representing cancer was higher during the pandemic than in the prepandemic period. The interest of Google users in cancer screenings increased in 2020–2021 compared to 2015–2019, but the growth was less dynamic than expected. The interest in many cancers during the pandemic was significantly lower than in the prepandemic period, especially during March and April 2020. The lower interest in cancers and their screenings may delay the diagnosis and worsen the long-term outcomes.