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Szypłowska Małgorzata, Gorecka Adrianna, Kuś Adrian, Zaremba Bartłomiej, Obel Michał. Diagnosis and management of lipoedema – a review paper. Journal of Education, Health and Sport. 2020;10(9):494‑499. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.09.059 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.09.059 https://zenodo.org/record/4042181 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2020. Revised: 21.09.2020. Accepted: 22.09.2020. Diagnosis and management of lipoedema – a review paper Małgorzata Szypłowska1, Adrianna Gorecka1, Adrian Kuś1, Bartłomiej Zaremba1, Michał Obel2 1Student Research Circle at the Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin 2Student Research Circle at the Department of Endocrinology, Medical University of Lublin Supervisor: PhD Halina Piecewicz-Szczęsna3 3Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin Corresponding author: malgorzata.szyplowska@gmail.com Abstract Lipoedema is a chronic progressive disorder of adipose tissue leading to an enlargement of lower extremities. It is considered to be rare; however, the prevalence of the disease is underestimated because it is commonly misdiagnosed as obesity or lymphedema and the general awareness is poor. The etiology of the disorder is considered to be multifarious, including genetic inheritance, hormonal imbalance and microcirculation alterations. Diagnosis is mainly based on medical history and physical examination. Management of lipoedema is focused on reducing the symptoms, improving the quality of life and preventing further progression of the disease. The aim of this paper is to raise the awareness of the disease and provide appropriate clinical guidance for the assessment of lipoedema. We searched through the PubMed/MEDLINE database and took into consideration all of the results available as of 6 September, 2020 and outlined the current evidence regarding lipoedema epidemiology, etiology, clinical presentation, differential diagnosis, and management. Better understanding of lipoedema is crucial for establishing an early diagnosis and a proper treatment, which in turn will reduce the psychological and physical implications associated with the disease. Key words: lipoedema, lymphoedema, lipolymphoedema

FilareckaAgnieszka, Biernacki Maciej, Jęchorek Michał, Dudzic Piotr,Wyląg Joanna, Lisiński Jarosław, Polakowska-Mierzwa Karolina, Nowak Beata, Jabłoński Wiktor, Hozakowski Mateusz. Physiotherapy in a patient with colorectal cancer - preoperative management. Journal of Education, Health and Sport. 2021;11(10):193-203. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.10.017 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.10.017 https://zenodo.org/record/5602405 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.10.2021. Revised: 10.10.2021. Accepted: 26.10.2021. Physiotherapy in a patient with colorectal cancer - preoperative management Agnieszka Filarecka1,4, Maciej Biernacki2,4, Michał Jęchorek3, Piotr Dudzic4, JoannaWyląg4, Jarosław Lisiński4, Karolina Polakowska-Mierzwa4, Beata Nowak4, Wiktor Jabłoński4, Mateusz Hozakowski4 Collegium Medicum, UMK Bydgoszcz, Chair of Oncological Surgery Collegium Medicum, UMK Bydgoszcz, Chair and Department of Anatomy TOTU Addiction Therapy Center in Karnice Saint Celestine Association in Mikoszów Corresponding author: mgr Agnieszka Filarecka Collegium Medicum, UMK Bydgoszcz, hair and Clinic of Oncological Surgery Ul. Izabeli Romanowskiej 2, 85-796 Bydgoszcz, Poland Tel. 503074346 e-mail: aga.filarecka@gmail.com Summary During the surgical treatment of colorectal cancer, whether by laparoscopic or classic open method, the tissues in the abdominal cavity are traumatized. The cuts of the muscle fibers are associated with the disturbance of the tone of the postural muscles. A scar within the abdominal cavity also causes movement limitations in the form of restrictions in the mobility of the spine. The implementation of patient rehabilitation in the form of targeted physiotherapy before the procedure should be an indispensable element of the treatment of colorectal cancer. The aim of the study is to propose a therapy that uses the spine mobility test to diagnose deficits. The proposed preoperative therapy focuses mainly on improving the parameters of the spine's mobility. The paper presents examples of activities that can be used in therapy before surgery. A review of the available literature and own experience were used for the work. It can be concluded from the analyzed literature that physiotherapy in oncological patients is not very widespread and is neglected in the treatment process. Patients, by In the literature, before colorectal cancer removal surgery, they are not subjected to physical rehabilitation, which is associated with complications resulting from the course of the procedure. The process of rehabilitating patients after surgical treatment of colorectal cancer should take place in the pre-operative period. Physiotherapy should take into account the weakening of the muscle strength in the trunk and limitations of mobility caused by age. Rehabilitation should be aimed at restoring functionality. Key words:cancer, rehabilitation, spine mobility ranges

FilareckaAgnieszka, Biernacki Maciej, Jęchorek Michał, Leksowski Łukasz, MałekMichał, Tysowski Robert, Molek Karolina, TysowskaMagdalena, Szymura Karolina. The process of physiotherapy in patients treated for colorectal cancer. Journal of Education, Health and Sport. 2021;11(9):735-741. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.088 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.088 https://zenodo.org/record/5534624 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 20.09.2021. Accepted: 27.09.2021. The process of physiotherapy in patients treated for colorectal cancer Agnieszka Filarecka1,2, Maciej Biernacki3, Michał Jęchorek4, Łukasz Leksowski5, Michał Małek6, Robert Tysowski6, Karolina Molek6,Magdalena Tysowska7, KarolinaSzymura7 Collegium Medicum, UMK Bydgoszcz, Chair of Oncological Surgery State School of Higher Education in Gniezno, Institute of Health Science Collegium Medicum, UMK Bydgoszcz, Chair and Department of Anatomy TOTU Addiction Therapy Center in Karnice Collegium Medicum, UMK Bydgoszcz, Chair and Clinic of Rehabilitation St. Celestine Society, Mikoszow R-med, Wroclaw Tarnów School of Higher Education, Faculty of Applied Sciences Corresponding author: mgr Agnieszka Filarecka Collegium Medicum, UMK Bydgoszcz, Chair of Oncological Surgery Ul. Izabeli Romanowskiej 2, 85-796 Bydgoszcz, Poland Tel. 503074346 e-mail: aga.filarecka@gmail.com Summary Cancer is the cause of almost 1/3 of premature deaths worldwide. The problem of cancer incidence is a global problem. Better and better medical care and modern methods of treatment make the effects of treatment high. The invasiveness of the procedures, introducing systemic methods, causes traumatization of tissues, which causes disability. The paper presents the proposed method of physiotherapeutic treatment in a patient treated for colorectal cancer. A review of the available literature and own experiences were used for the study It can be concluded from the available literature that in the case of cancer treatment, treatment should be interdisciplinary and the use of physiotherapy is necessary at every stage of treatment. Keywords: disability, oncology, rehabilitation

Prylińska Monika, Kożuchowski Marcin, Husejko Jakub. A child with vitiligo. Journal of Education, Health and Sport. 2021;11(9):565-570. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.073 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.073 https://zenodo.org/record/5530607 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 20.09.2021. Accepted: 27.09.2021. A CHILD WITH VITILIGO Monika Prylińska1, Marcin Kożuchowski1, Jakub Husejko2 Department of Physiology of Physical Effort and Functional Anatomy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland Abstract: Vitiligo is a chronic skin condition which affects 0,5-2% of the world’s population, without any sex or ethnical predilection. Clinically it is characterized by the development of well-defined depigmented macules. Although its etiopathogenesis is exquisitely compound and remains not fully anderstood, it is known that it results from the destruction of melanocytes present in the skin. The aim of this paper is to present vitiligo clinical picture in a children population, its etiopathogenesis and available therapeutical methods. There are many therapeutic options for vitiligo, none of which is fully effective, hence appropriate patients education concerning various medical and cosmetic therapies, as well as the psychological aspects of the disease, is extremely important. Key words: vitiligo, child, melanocytes, phototherapy, vitiligo treatment

SachajAnna,Szczypiór-PiaseckaKarina,MińkoAlicja,AntczakKrzysztof. The programme of comprehensive rehabilitation after lumic post-resection with the reconstruction of a proximal part of femur with mutars system resulting from the treatment of pelvis chondrosarcoma. Journal of Education, Health and Sport. 2021;11(9):614-629. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.078 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.078 https://zenodo.org/record/5532820 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 20.09.2021. Accepted: 27.09.2021. The programme of comprehensive rehabilitation after LUMIC post-resection with the reconstruction of a proximal part of femur with MUTARS system resulting from the treatment of pelvis chondrosarcoma Anna Sachaj SKN Rehabilitacji Ortopedycznej i Terapii Manulanej przy KOTiONR PUM, Poland Karina Szczypiór-Piasecka https://orcid.org/0000-0002-9562-9201Katedra Ortopedii. Klinika Ortopedii, Traumatologii i Onkologii Narządu Ruchu Pomorskiego Uniwersytetu Medycznego, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland Alicja Mińko https://orcid.org/0000-0003-2299-3958alicja.minko287@gmail.comSKN Rehabilitacji Ortopedycznej i Terapii Manulanej przy KOTiONR, Pomorski Uniwersytet Medyczny w Szczecinie, Poland Krzysztof Antczak https://orcid.org/0000-0001-8443-0611Studium doktoranckie, Pomorski Uniwersytet Medyczny w Szczecinie, Poland Abstract Introduction:Malignant neoplasms of bone originating from the supporting tissues of the body of mesinchymal origin are heterogeneous in clinical and histological terms. In most cases, the etiology of these tumors is unknown. Histologically, sarcomas are classified into three main types. Chondrosarcoma (31% of sarcomas), osteosarcoma - originating from bone tissue (also accounts for 31% of sarcomas), Ewing sarcoma - originating from neuroectodermal tissue (accounts for 14% of sarcomas). The aim of this study was to present a program of comprehensive rehabilitation after LUMIC resection arthroplasty with reconstruction of the proximal part of the femur using the Mutars system as a result of pelvic chondrosarcoma treatment. Materials and methods:The paper describes a case of a patient diagnosed with left pelvic chondrosarcoma with a pathological fracture and destruction of the left hip joint. Results: In the rehabilitation program, both inpatient and outpatient, many methods of therapy have been used in order to restore the patient to the highest possible fitness as quickly as possible. The therapy was based on such exercises and methods as: PNF method, methods of visceral therapy, active exercises and methods of osteopathy. Conclusion: Rehabilitation is an indispensable element of the treatment of cancer patients. The introduction of modern techniques, such as manual therapy and osteopathy to rehabilitation, has a positive effect on the effectiveness of therapy. Key words: therapy; alloplastic; chondrosarcoma

KlasJakub, Kluz Natalia,MakaryczewMikołaj, Piwowar Klaudia. Treatment of schizophrenia and bipolar disorder (ChAD) - a review of the literature. Journal of Education, Health and Sport. 2021;11(9):473-483. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.061 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.061 https://zenodo.org/record/5524184 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 20.09.2021. Accepted: 23.09.2021. Treatment of schizophrenia and bipolar disorder (ChAD) - a review of the literature Jakub Klas1, Natalia Kluz1, Mikołaj Makaryczew1, Klaudia Piwowar1 1Medical University of Lublin ORCID ID and E-mail: Jakub Klas https://orcid.org/0000-0002-4795-1909jakubklas99@gmail.com Natalia Kluz https://orcid.org/0000-0002-5801-5913nataliakluz99@gmail.com Mikołaj Makaryczew https://orcid.org/0000-0003-4735-8221mo7655010@gmail.com Klaudia Piwowar https://orcid.org/0000-0001-8232-003Xklaudiaklaudia66@gmail.com ABSTRACT Introduction and aims of the study: The aim of this study is to present recent reports on the treatment and therapy of schizophrenia and bipolar disorder (ChAD). The current treatment of patients affected by these diseases is difficult and unsatisfactory, therefore it is necessary to find new therapeutic options that will improve the effectiveness of treatment For the purpose of this study, scientific papers were reviewed using the Google Scholar search engine covering studies from 2016 to 2021. A dozen papers covering the scope of the publication were selected. Results: In the treatment of schizophrenia, the use of cannabinoids is of greatest interest due to the action of the preparations on the endocannabinoid system. In the treatment of ChaD, promising reports have been published on the therapy with aripiprazole and the need to improve its use in the treatment of both akathisia and agitation. Furthermore, from the fact that abnormalities of calcium signalling are considered a possible pathophysiological process in ChAD, it has been suggested that calcium channel L antagonists may be potential therapeutic agents in bipolar affective disorder. One study also demonstrated the potential use of vortioxetine in the treatment of patients with a depressive episode. Conclusions: The results of recent studies on the treatment of schizophrenia and ChAD cited in this paper offer the prospect of creating treatment regimens that are more effective and targeted in the aforementioned diseases. However, further randomised trials are needed to confirm the effective use of the cited drugs in the treatment of these diseases. Keywords: schizophrenia, ChAD, bipolar disorder

GiermasińskiAdrian, Próchnicka Magdalena, Nowak Dominika, Oszczędłowski Paweł,NowaczekJustyna. Sexual dysfunction in patients with MDD treated with SSRIs - causes, measurement and prevention. Journal of Education, Health and Sport. 2021;11(9):368-376. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.046 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.046 https://zenodo.org/record/5519698 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 13.09.2021. Revised: 20.09.2021. Accepted: 21.09.2021. Sexual dysfunction in patients with MDD treated with SSRIs - causes, measurement and prevention Adrian Giermasiński1, Magdalena Próchnicka1, Dominika Nowak1, Paweł Oszczędłowski2, Justyna Nowaczek2 1 Chair and Department of Psychology, Medical University of Lublin, Chodźki street 7, 20-093 Lublin, Poland 2Chair and Department of Histology and Embiology with Experimental Cytology Unit, Medical University of Lublin, Radziwiłłowska Street 11, 20-080 Lublin, Poland Adrian Giermasiński; giermasinski.a@gmail.com; ORCID: 0000-0003-4442-9119 Magdalena Próchnicka; maadiii1210@gmail.com; ORCID: 0000-0002-0641-2079 Dominika Nowak; mika1200@onet.pl; ORCID: 0000-0002-0195-1102 Paweł Oszczędłowski; pawelosz99@gmail.com; ORCID: 0000-0001-7406-550X Justyna Nowaczek; justynafaustynanowaczek@gmail.com; ORCID: 0000-0001-7622-2345 Abstract Major Depressive Disorder(MDD) is serious psychiatric condition and they affect one in five people during their lifetime, the annual prevalence rates for the US population are 7.1% among adults, slightly more common among women (8.7%) than men (5.3%). Selective serotonin reuptake inhibitors are among the pharmacological agents most commonly used in the treatment of MDD. The mechanism of action of antidepressants is not yet fully understood. Currently, it is believed that the mechanism of the so-called down-regulation, i.e. reducing the density of receptors in the postsynaptic membrane, in this case mainly 5HT2 receptors. All of the antidepressants in use today have some common side effects. The side effect that will be discussed in the broadest possible way in this paper are sexual dysfunctions appearing during the therapy. Measuring the degree to which a given substance affects the sexual function of a patient diagnosed with MDD encounters many difficulties on its way. There are currently several questionnaires enabling such an assessment, the most common are CSFQ, ASEX and SexFX. Also the major problem is Post SSRI Sexual Disfunction. A number of animal studies have proven that prolonged exposure to SSRIs leave permanent changes in the CNS, but unfortunately, similar studies have not yet been conducted in humans.The aim of this study is to present the problem of sexual dysfunction as a side effect of SSRI therapy, to present the causes and to propose a strategy to combat SSRI-induced sexual dysfunctions. Key words: Sexual dysfunction; Depression; MDD; SSRI

WokurkaWojciech, Węgrzyniak Agata, Dudek Iga, Piech Piotr. Pulmonary embolism as a complication of fracture of the proximal end of the humerus - literature review. Journal of Education, Health and Sport. 2021;11(9):388-395. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.049 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.049 https://zenodo.org/record/5519987 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 21.09.2021. Accepted: 21.09.2021. Pulmonary embolism as a complication of fracture of the proximal end of the humerus - literature review Wojciech Wokurka [1],Agata Węgrzyniak [1], Iga Dudek [2], Piotr Piech [3][4] [1] Human Anatomy Research Group, Department of Human Anatomy, Medical University of Lublin [2] Student Research Group at the Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin [3] Department of Human Anatomy, Medical University of Lublin [4] Department of Orthopedics and Traumatology, Medical University of Lublin Authors: Wojciech Wokurka: orcid.org/0000-0001-9936-5656; wojciechwokurka@gmail.com[main author] Agata Węgrzyniak: orcid.org/0000-0001-8638-0013; agataw97@gmail.com Iga Dudek: orcid.org/0000-0002-8101-074X; iga.dudek6@gmail.com Piotr Piech: orcid.org/ 0000-0001-8717-7957; ppiotr.md@gmail.com[corresponding author] Abstract Introduction and purpose: Pulmonary embolism (PE) is one of the leading causes of death worldwide. There are many factors that increase the risk of its occurence.High costs of treatment, non-specific symptoms and high mortality of the disease determine the further search for new methods of treatment and diagnostics. The aim of the study is to determine the incidence of PE in patients after fracture of the proximal end of the humerus. Materials and methods:A literature search was conducted in the PubMed MEDLINE database of medical publications using the following keywords: pulmonary embolism, deep vein thrombosis, proximal humerus fracture. Results: Among the found articles, 4 original papers describing the problems of pulmonary embolism after fractures of the proximal end of the humerus were qualified for further analysis. The incidence of PE after this type of fracture is rare and ranges from 1.3% to 5.1%. Moreover, PE was not the cause of death of any patient in the analyzed literature. Conclusion: The need for further randomized controlled trials on a large group of patients operated with the same technique was demonstrated, including subgroups with and without antithrombotic chemoprophylaxis. Key words:pulmonary embolism, deep vein thrombosis, proximal humerus fracture.

Kozioł Ilona, Budzyńska Julia, Leśniewska Magdalena, Milanowska Joanna. Epilepsy and cannabidiol - a new perspective for seizures treatment. Journal of Education, Health and Sport. 2021;11(8):226-235. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.08.023 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.08.023 https://zenodo.org/record/5224171 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.08.2021. Revised: 15.08.2021. Accepted: 19.08.2021. Epilepsy and cannabidiol - a new perspective for seizures treatment Ilona Kozioł1, Julia Budzyńska1, Magdalena Leśniewska1, Joanna Milanowska2 Student Scientific Circle on Chair and Department of Applied Psychology, Medical University of Lublin Chair and Department of Applied Psychology, Medical University of Lublin Abstract BACKGROUND: Despite the fact that the number of antiepileptic drugs is constantly increasing, epilepsy can still be a therapeutic challenge. Approximately one-third of patients with epilepsy have persistent seizures refractory to treatment. The limited number of effective alternatives motivates researchers to seek new solutions. There is some hope for cannabidiol (CBD) preparations. AIM OF THE STUDY: The purpose of this study was to review the most recent available literature on the use of cannabidiol in the treatment of refractory epilepsy in children and adults. For this purpose, the PubMed and Google Scholar databases were reviewed. The phrase "cannabidiol and epilepsy" was used to search the database. After Screening titles and abstracts a total of 19 papers and articles cited in them were received and analyzed in detail. RESULTS: Nowadays there are many CBD related products available in the market, Cannabis sativa and Cannabis indica are the plants used due to their strong therapeutic effects and also seizure control. Regulations regarding the use of raw marijuana, cannabis extracts, and cannabinoid-based drugs vary from place to place. Many studies have been generated on the efficacy of cannabinoid therapy in the treatment of epilepsy. This therapy in patients with Dravet syndrome and Lennox-Gaust syndrome results in a reduction in the frequency of motor and total seizures. The most commonly reported side effects of CBD are drowsiness, seizures and diarrhea, but the therapy is generally well tolerated. SUMMARY AND CONCLUSIONS: Many available studies support the efficacy of CBD as a treatment option to reduce seizure frequency in children with drug-resistant epilepsy, particularly in patients with Dravet and Lennox-Gastaut syndrome. However, there is a lack of reports on the use of CBD in the adult population, which may be an area for further research. Keywords: cannabidiol; epilepsy; children

Mroczek Joanna, Krzewski Szymon, Baranowski Mateusz. Andersen Tawil syndrome – a case study. Journal of Education, Health and Sport.2021;11(04):45-50. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.04.005 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.04.005 https://zenodo.org/record/4711077 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.04.2021. Revised: 07.04.2021. Accepted: 22.04.2021. Andersen Tawil syndrome – a case study Joanna Mroczek, Szymon Krzewski, Mateusz Baranowski Joanna Mroczek* 1, https://orcid.org/0000-0002-7765-2176, joannamroczekw@gmail.com Szymon Krzewski 2, https://orcid.org/0000-0003-2339-6741, smn.krzak@gmail.com MateuszBaranowski 3, https://orcid.org/0000-0001-7266-738Xmateusz.gromek.baranowski@gmail.com 1. lek. Joanna Mroczek, Department of Pediatric Endocrinology and Diabetology, Medical University of Lublin, Lublin, Poland 2. lek. dent. Szymon Krzewski, Chair and Department of Pedodontics, Medical University of Lublin, Lublin,Poland 3. lek. dent Mateusz Baranowski, Chair and Department of Periodontology, Medical University of Lublin, Lublin, Poland *Corresponding author Joanna Mroczek – PhD student, M.D. in pediatric endocrinology diabetology speciality training, MAIL, joannamroczekw@gmail.com, Depratment of Pediatric Endocrinology and Diabetology, Medical University of Lublin, Lublin, Poland Key words: Andersen Tawil Syndrome; Andersen; Tawil; ATS; protein KIR 2.1; dilated cardiomyopathy Abstract Introduction: The first case of a patient with periodic paralysis of muscles accompanied by ventricular arrhythmias was described in 1963 by Klein and colleagues [1]. In 1971, the team led by E.D. Andersen published a paper on the familial coexistence of neurological disorders and arrhythmias accompanied by dysmorphic features, suggesting a new, unclassified disease syndrome [2]. Another report, this time by the Tawil team, analyzed 10 cases described up to the time and 4 new diagnosed by him, giving the genetic basis for understanding the mechanisms of the disease inheritance [3]. In 2003, the syndrome described by Tawilla was named after Andersen and Tawill (Andersen Tawil Syndrome- ATS). ATS (syn. long QTc syndrome, type 7, LQTS 7,) is a rare genetic disorder inherited in an autosomal dominant manner. So far around 200 diagnoses of ATS have been made in the world. Mutations in the KCNJ2 gene located on the long arm of chromosome 17, encoding the Kir 2.1 protein, are responsible for the disease subtype 1, which accounts for 60% of the described cases. This protein is a component of the potassium ion channel, and its abnormal structure and function is the cause of repolarization disorders in the cells of the heart and skeletal muscles. However, in 6-20% of patients from families with confirmed presence of KCNJ2 mutations, no clinical symptoms of the syndrome were reported. It proves its differentiated penetration, and the genetic mechanism in the remaining patients remains unknown. Despite the fact that patients with ATS are a very heterogeneous group in terms of the observed symptoms, this syndrome has a classic triad: 1. changes in the ECG trace of the T wave and the presence of the U wave (extended duration of the descending arm of the T wave, a characteristic wide U wave and a wide combination of T and U waves - these features distinguish ATS from other long QTc syndromes) and arrhythmias in the form of single multifocal premature ventricular beats, polymorphic, bidirectional ventricular tachycardia, which may be asymptomatic or, more often, cause palpitations. Less common manifestations of arrhythmias are fainting, cardiac arrest and sudden cardiac death[4]. 2. periodic muscle strength impairment (periodic paralysis) occurring most often after a prolonged period of rest or during rest after intense exercise, accompanied by a decrease in the concentration of potassium in the blood serum; in some cases, there is a constant, albeit slight, weakening of muscle strength 3. typical malformations (dysmorphia), most often including short stature, hypertelorism, small mandible, low-set auricles and abnormalities of curvature within the spine. In patients with an unconfirmed genetic mutation, the diagnosis of ATS requires at least two of the above-mentioned symptoms. However, in some genetically confirmed cases their expression may be very low[5] Due to the described dysfunctions in the cognitive sphere, mainly in the field of reading skills and mathematical skills, patients should also be covered by psychological care, and due to behavioral changes, in some cases also psychiatric.

Kosz Katarzyna, Zarankiewicz Natalia, Zielińska Martyna, Kuchnicka Aleksandra. Changes in management of patients with cancer during COVID-19 pandemic. Journal of Education, Health and Sport. 2020;10(9):577-590. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.09.070 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.09.070 https://zenodo.org/record/4046094 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 17.09.2020. Revised: 23.09.2020. Accepted: 23.09.2020. Changes in management of patients with cancer during COVID-19 pandemic Katarzyna Kosz, Natalia Zarankiewicz, Martyna Zielińska, Aleksandra Kuchnicka Katarzyna Kosz ORCID iD: https://orcid.org/0000-0001-6848-0598 Affiliation: Student Scientific Group of Oncological Surgery, Radziwiłłowska 13 (SPSK Nr 1) 20-080 Lublin Medical University of Lublin Natalia Zarankiewicz ORCID iD: https://orcid.org/0000-0001-9203-3376 Affiliation: Student Scientific Group of Oncological Surgery, Radziwiłłowska 13 (SPSK Nr 1) 20-080 Lublin Medical University of Lublin Aleksandra Kuchnicka ORCID iD: https://orcid.org/0000-0001-8481-7592 Affiliation: Student Scientific Group of Oncological Surgery, Radziwiłłowska 13 (SPSK Nr 1) 20-080 Lublin Medical University of Lublin Martyna Zielińska ORCID iD: https://orcid.org/0000-0001-8886-8274 Affiliation: Student Scientific Group of Oncological Surgery, Radziwiłłowska 13 (SPSK Nr 1) 20-080 Lublin Medical University of Lublin ABSTRACT Introduction: As of March 11, 2020, COVID-19 has been declared as a global pandemic. It has spread rapidly and profoundly impact the function of health care system all around the world. As a result, management and organisation of oncology units had to be altered in order to provide security measures and safe care for patients. Purpose: The aim of this paper is to review current knowledge involving management of patients with malignancies during COVID-19 pandemic. Particular attention has been paid to changes in diagnosis, treatment and follow-up of patients with cancer. Material and methods: The review includes publications released in 2019 and 2020. The data has been collected by the use of PubMed, WHO website and other online published guidance. Results: As a lot of clinical trials has been suspended, current therapy options for patients with cancer has been also limited. Moreover, patients became fearful of becoming infected by SARS-CoV-2 and accordingly they were less likely to attend screening programmes. Additionally, as the amount of surgeries has been reduced, the need for radiotherapy service has increased. Chemotherapy has been found to be risky for patients with cancer as it may favour them to SARS-CoV-2 infection. Conclusions: Appropriate security measures need to be implemented in order to protect against SARS-CoV-2 infection but optimal health care access should be provided as well. There is a high necessity to share knowledge and experience on the impact of pandemic on patients with malignancies. However, a lot of patients are fearful of COVID-19, adverse effects of delayed diagnosis, treatment and follow-up should not be diminished. Key words: cancer; covid-19; malignancy

Jankowska Paula, Jankowski Krzysztof, Rudnicka-Drożak Ewa, Kamiński Piotr. Lipid disorders in blue-collar workers in Lubelskie region. Journal of Education, Health and Sport. 2020;10(9):357‑363. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.09.041 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.09.041 https://zenodo.org/record/4033634 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 12.09.2020. Revised: 12.09.2020. Accepted: 17.09.2020. Lipid disorders in blue-collar workers in Lubelskie region Paula Jankowska1, Krzysztof Jankowski1, Ewa Rudnicka-Drożak1, Piotr Kamiński2 1. Chair and Department of Family Medicine, Medical University of Lublin 2. Department of Traumatology and Emergency Medicine, Medical University of Lublin ABSTRACT Introduction Lipid disorders are the most important risk factor of cardiovascular disease (CVD). For clinical practice and assessment of patient`s cardiovascular risk the most relevant is to determine plasma concentration of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C). Blue-collar workers are a group of patients with higher estimated cardiovascular risk than other workers groups. The aim of the study The aim of the study was to asses prevalence of lipid disorders in blue-collar workers from Lubelskie region. Material and methods The method of this paper was to perform a retrospective analysis of data provided by the National Health Fund. The study population enclosed patients aged 35, 40, 45, 50, 55 included in the Cardiovascular Disease Prevention Program held in Primary Healthcare (PH) setting on the area of Lubelskie region in years 2008-2018. Patients analyzed were blue-collar workers. The chi-square test was used to test the relationship between the two qualitative features and the Pearson linear correlation between the quantitative features. The analyzes were performed using the IBM SPSS Statistics for Windows, version 25 program (IBM Corp., Armonk, N.Y., USA). The significance level was assumed to be α = 0,05. Results In 26226 patients hyperlipidemia was observed in 65,6% and LDL cholesterol levels higher than 115 mg/dl in 52,8% of patients. The mean total cholesterol serum concentration was 203,8 mg/dl, LDL cholesterol - 120,1 mg/dl and median triglycerides concentration – 101,0 mg/dl. Conclusions Hyperlipidemia was a common problem in blue-collar workers in Lubelskie region in years 2008-2018. Intense prophylactic actions are needed to reduce cardiovascular risk of this group of population. Key words: Dyslipidemias; Cardiovascular Diseases

Chałupnik Aleksandra, Chilimoniuk Zuzanna, Sobstyl Anna, Dobosz Maciej, Borkowska Aleksandra, Wieteska Małgorzata. Role of the gut microbiota in human health. Journal of Education, Health and Sport. 2020;10(8):458‑469. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.08.056 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.08.056 https://zenodo.org/record/4009501 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 10.08.2020. Revised: 15.08.2020. Accepted: 31.08.2020. Role of the gut microbiota in human health Aleksandra Chałupnik1, Zuzanna Chilimoniuk1, Anna Sobstyl1, Maciej Dobosz1, Aleksandra Borkowska1, Małgorzata Wieteska2 1. Student Research Circle at the Department of Family Medicine, Medical University of Lublin Supervisor: PhD Grzegorz Mizerski 2. Student Research Circle at the Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin Corresponding author: Aleksandra Chałupnik, olachalupnik@op.pl ORICID ID: Aleksandra Chałupnik: https://orcid.org/0000-0003-4249-470X Zuzanna Chilimoniuk: https://orcid.org/0000-0001-8261-0192 Anna Sobstyl: https://orcid.org/0000-0003-0330-5742 Maciej Dobosz: https://orcid.org/0000-0002-4413-3310 Aleksandra Borkowska: https://orcid.org/0000-0002-0950-2176 Małgorzata Wieteska: https://orcid.org/0000-0002-1566-7559 ABSTRACT Introduction: The human gut microbiota has become the subject of extensive research in recent years and the knowledge of the species inhabiting the gut is growing rapidly. Microbiota plays an important role in human health and diseases. It takes part in obtaining and storing energy, as well as in metabolic functions. The aim of the study: The purpose of the study is to collect and review scientific publications about the impact of gut microbiota on human health. Material and method: The paper uses standard criteria as the research method. The articles used to create the reviews were published on the PubMed and Google Scholar platforms. Description of the state of knowledge: Numerous studies suggest that composition of intestinal microbiota has impact on the long-term functioning of the human organism. Depressive disorders appear to be associated with changes in the microbiota. In depressed patients, fewer bacteria of the type Bacteroidetes and higher level of Alistipes are found. A few studies have demonstrated a link between gut microbial signatures and hypertension. Studies have shown that T2DM patients may have an altered composition of gut microbiota, mainly a decreased Bacteroidetes/ Firmicutes ratio and decrease in some functional bacteria when compared to healthy people. Intestinal microorganisms are also a key element in the proper functioning of the immune system by influencing the maturation process of the immune system's cells. Summary: To sum up, numerous studies indicate that abnormal composition of the intestinal microflora is the cause of not only faster development of metabolic syndrome, but also other diseases. It influences the development of circulatory, nervous or immune system diseases. Its abnormal composition is influenced by many factors such as diet, lifestyle or antibiotic therapy. Keywords: gut microbiota, health, probiotics, microorganisms

FilareckaAgnieszka,Jęchorek Michał. Proprioceptive Neuromuscular Facilitation method in physiotherapy in patients after mastectomy.Journal of Education, Health and Sport. 2020;10(8):570-583. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.08.061 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.08.061 https://zenodo.org/record/4057163 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 03.08.2020. Revised: 31.08.2020. Accepted: 31.08.2020. Proprioceptive Neuromuscular Facilitation method in physiotherapy in patients after mastectomy Agnieszka Filarecka1, Michał Jęchorek2 Collegium Medicum, UMK Bydgoszcz, Chair and Clinic of Oncological Surgery ToTu addiction therapy and treatment center in Karnice Corresponding author: mgr Agnieszka Filarecka Collegium Medicum, UMK Bydgoszcz, hair and Clinic of Oncological Surgery Ul. Izabeli Romanowskiej 2, 85-796 Bydgoszcz, Poland Tel. 503074346 e-mail: aga.filarecka@gmail.com Summary: Rehabilitation in the course of breast cancer is an indispensable part of the treatment. The implementation of rehabilitation in the form of kinesitherapy should also take place in the pre-treatment period, so as to compensate for the possibility of complications associated with immobilisation of the patient after mastectomy. In most studies on post-mastectomy rehabilitation, emphasis is placed on anti-anginal prophylaxis and lymphedema therapy. The article aims to present treatment proposals that use the concept of PNF in improved postmastectomy patients. This method, known since the 90's, is often reserved for patients with neurological damage, but can also be successfully used in other patient groups using its main principles and philosophy of therapeutic goals. The article presents examples of activities that can be used in therapy in various phases. The paper presents the method of using the method associated with the upper limb dysfunction after mastectomy, which can be freely modified for the purposes of superior therapy. A review of available literature and own experience was used. Keywords: cancer; disability; shoulder pain

Bator Damian, Jańczyk Magdalena, Samek Ilona, Wójcik Magdalena, Dąbrowska Justyna, Łopuszańska Urszula. Effectiveness of Equine Assisted Activities or Therapies in relation to mental illness and mental disorders - a review. Journal of Education, Health and Sport. 2020;10(6):309-320. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.06.033 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.06.033 https://zenodo.org/record/3923186 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.06.2020. Revised: 15.06.2020. Accepted: 30.06.2020. Effectiveness of Equine Assisted Activities or Therapies in relation to mental illness and mental disorders - a review Damian Bator, Magdalena Jańczyk, Ilona Samek, Magdalena Wójcik, JustynaDąbrowska, Urszula Łopuszańska Damian Bator1 , 0000-0002-8464-932X, bat199979@gmail.com Magdalena Jańczyk1, 0000-0002-4948-9463, magdajanczyk7@gmail.com Ilona Samek1, 0000-0002-5538-5396, samekilona@gmail.com Magdalena Wójcik1, 0000-0002-0999-6284, magdalena.wojcik967@gmail.com Justyna Dąbrowska1 , 0000-0002-1356-6965, jdabrowska00@gmail.com dr n. med. Urszula Łopuszańska2 , 0000-0001-6517-7577, urszula.lopuszanska@umlub.pl 1) Student Scientific Circle at the Department of Applied Psychology of the Medical University in Lublin 2) Department of Applied Psychology, Medical University of Lublin Summary Introduction and purpose: the Terminology Guidelines of the American Hippotherapy Association defines Equine Assisted Activities or Therapies (EAA/T) as a collection of different forms of contact between man and horse. EAA/T have become increasingly common interventions in the last decade, demonstrating therapeutic benefits in various areas of mental health. The aim of this report is to identify the forms and programmes of EAA/T that are used and to summarise and assess the latest available evidences of their clinical effectiveness in the treatment of symptoms of mental illness and disorders such as autism spectrum disorders, post-traumatic stress syndrome or schizophrenia. In order to achieve the above mentioned objectives, a literature review has been conducted to summarise existing evidence relating to the subject matter of the study in a descriptive manner. Description of the state of knowledge: 13 findings were found in autism spectrum disorders (1 review paper and 5 research papers), post-traumatic stress syndrome (1 review paper and 4 research papers), schizophrenia (1 review paper), and children whose parents were addicted (1 research paper). Summary: the results of the research indicate that Equine Assisted Activities and Therapies (EAA/T), including horse riding, may be beneficial for people with mental illnesses and disorders, such as autism spectrum disorders, post-traumatic stress syndrome, schizophrenia, and for people whose parents were addicted. The promising results so far support further research projects. Key words: hippotherapy; equine assisted; mental illness

Rybin A. I. Current ideas about molecular genetic subtypes of ovarian cancer: a personalized approach and a new platform for further research. Journal of Education, Health and Sport. 2021;11(11):157-168. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.11.014 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.11.014 https://zenodo.org/record/5732877 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 10.10.2021. Revised: 22.10.2021. Accepted: 26.11.2021. Current ideas about molecular genetic subtypes of ovarian cancer: a personalized approach and a new platform for further research A. I. Rybin Odessa National Medical University Abstract Highly malignant ovarian cancers are a histopathological diagnosis, but can be multiple diseases at the molecular level. Research aimed at identifying molecular genetic subtypes of ovarian cancer is being conducted to find an answer to the question: can different molecular subgroups influence the choice of treatment? One of the achievements of this direction is the recognition of the dualistic theory of the origin of ovarian carcinomas with their division into High-grade and Low-grade subtypes. However, the data of sequencing of the tumor genome suggest the existence of 6 subtypes of carcinoma, including two LG and four HG subtypes. Patients of subtype C1 are characterized by a high stromal response and have the lowest survival, tumors of C2 and C4 subtypes have a higher rate of intratumoral CD3 + cells, lower stroma gene expression and better survival than C1. The mesenchymal subtype C5 is widely represented by mesenchymal cells, characterized by overexpression of N-cadherins and P-cadherins, low expression of differentiation markers and lower survival than C2 and C4. The use of a consensus algorithm to determine the subtype allows the identification of only a minority of ovarian cancers (approximately 25%). In this regard, the practical significance of this classification still requires additional research, and today it is permissible to talk about the existence of only 2-3 reproducible subtypes. It is thought that it makes sense to randomize tumors into groups with altered expression of angiogenic genes and with overexpression of immune response genes, as in the angiogenic group there is a comparison of the advantage in survival (prescribing bevacizumab improves it, and in the immune group even increases bevacizumab). Molecular subtypes with poorer survival rates (proliferative and mesenchymal) also benefit most from bevacizumab treatment. The review focuses on some advances in understanding molecular, cellular, and genetic changes related to ovarian cancers with the results achieved so far in describing molecular subtypes of ovarian cancer. The available information is the basis for planning further research. Key words: ovarian cancer; molecular genetic heterogeneity; molecular subtypes; prognosis; reproducibility.

Kechedzhyiev V. V. The relationship between quality of life in sarcopenia and skeletal muscle index in patients with advanced lung cancer. Journal of Education, Health and Sport. 2021;11(11):100-107. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.11.009 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.11.009 https://zenodo.org/record/5717323 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 10.10.2021. Revised: 22.10.2021. Accepted: 19.11.2021. THE RELATIONSHIP BETWEEN QUALITY OF LIFE IN SARCOPENIA AND SKELETAL MUSCLE INDEX IN PATIENTS WITH ADVANCED LUNG CANCER V. V. Kechedzhyiev Zaporizhzhia State Medical University, Ukraine ORCID ID: 0000-0003-0800-3209 Abstract Introduction. Today the relevance of sarcopenia is increasing in various types of malignant neoplasms.This syndrome is most common in patients with advanced forms of cancer and can adversely affect survival, treatment outcomes, and functional status. The prevalence of sarcopenia in patients with lung cancer is higher than in other types of malignant tumors. To understand the relationship between sarcopenia and quality of life is especially important for patients with advanced cancer. Aim. To assess the relationship between skeletal muscle index (SMI) and quality of life in sarcopenia in patients with advanced lung cancer. Materials and methods. A prospective analysis was carried out of 28 patients with advanced lung cancer who have applied to the “ONCOLIFE” Medical Center since the beginning of 2021. All patients had sarcopenia on CT scan. Skeletal muscle cross-sectional area analyzed using software ImageJ (National Institutes of Health, Bethesda, MD, USA). To determine the quality of life in sarcopenia a questionnaire SarQoL was used. Pearson's correlation analysis was used to assess the correlation between quality of life and SMI. Results. Pearson's correlation analysis showed a statistically significant positive correlation between quality of life and SMI (r = 0,451, р = 0,016, N=28). Body mass index (BMI) positively correlated with quality of life (r = 0,398, р = 0,036, N=28), and age negatively correlated with SMI (r = -0,391, р = 0,040, N=28). There was no statistically significant correlation between indicators such as BMI and SMI, as well as age and quality of life. Conclusions. Quality of life in sarcopenia statistically significantly correlates with SMI in patients with metastatic lung cancer. Early diagnosis of sarcopenia is essential for timely prescription of treatment aimed at maintaining and better muscle mass, which can improve cancer patients quality of life. Key words: lung cancer patient; quality of life; skeletal muscle index.

Teshchuk Viktor, Teshchuk Nazarii, Ruskykh Oleksandr. Anomalies of the cerebral arteries in military servants - participants of ato-oos, who suffered ischemic strokes. Journal of Education, Health and Sport. 2021;11(10):187-192. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.10.016 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.10.016 https://zenodo.org/record/5593235 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 30.09.2021. Revised: 12.10.2021. Accepted: 22.10.2021. ANOMALIES OF THE CEREBRAL ARTERIES IN MILITARY SERVANTS - PARTICIPANTS OF ATO-OOS, WHO SUFFERED ISCHEMIC STROKES Viktor Teshchuk, Nazarii Teshchuk, Oleksandr Ruskykh Military-medical clinical centre of South region of Ukraine, Odesa, Ukraine Teshchuk Viktor, Honored Doctor of Ukraine, MD, PhD, Associate Professor, Head of angioneurology Department of neurosurgery and neurology clinic of the Military-medical clinical centre of South region of Ukraine, Odesa, Ukraine Teshchuk Nazarii, neurologist of the Military-medical clinical centre of South region of Ukraine, Odesa, Ukraine Ruskykh Oleksandr, neurologist of the Military-medical clinical centre of South region of Ukraine, Odesa, Ukraine Abstract The analysis of medical histories of 129 patients aged 20 to 59 years, who suffered acute cerebrovascular disorders (AСVD) of the ischemic type (IT), and participated in ATO-JFO was carried out. Anomalies of cerebral arteries were found in all of them. A significant role of hypoplasia of the right posterior cerebral artery, aplasia of the posterior connective, left anterior cerebral and anterior connective, as well as pathological S-shaped tortuosity of the internal carotid artery, hypoplasia of the vertebral arteries and their combinations in the development of acute cerebrovascular disorders in ATO members was established. Key words: acute cerebrovascular disorders; ischemic stroke; magnetic resonance angiography; intracerebral and extracerebral artery abnormalities

Tuchkina I. O., Tuchkina M. Yu., Kiebashvili S. V. Abdominal pain syndrome in girls, adolescents and young women with tumor-like formations of the uterine adnexa. Journal of Education, Health and Sport. 2021;11(10):135-142. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.10.012 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.10.012 https://zenodo.org/record/5586045 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 30.09.2021. Revised: 12.10.2021. Accepted: 20.10.2021. ABDOMINAL PAIN SYNDROME IN GIRLS, ADOLESCENTS AND YOUNG WOMEN WITH TUMOR-LIKE FORMATIONS OF THE UTERINE ADNEXA I. O. Tuchkina, M. Yu. Tuchkina, S. V. Kiebashvili Kharkiv National Medical University Tuchkina Iryna - ORCID: https://orcid.org/0000-0003-4280-1474 Tuchkina Maryna - ORCID: https://orcid.org/0000-0002-9903-1784 Kiebashvili Salome - ORCID: https://orcid.org/0000-0003-0787-5996 Abstract The article presents the clinical features of the complicated course of tumor-like formations of the uterine adnexa in girls, adolescents and young women. The characteristic symptoms of adnexal torsion are described. Topographic and anatomic features leading to torsion of ovarian cysts and uterine appendages, features of the surgical treatment of patients with complicated adnexal torsion are presented. The aim was to study the frequency of occurrence of ovarian tumor-like formations and their complicated course in girls, adolescents and young women, improve early diagnosis and develop optimal methods of conserving surgical treatment of this pathology. Material and methods. The study included 90 girls, adolescents and young women. Patients were divided into three groups. 1 group included 30 young women; the 2nd group consisted of 35 adolescents 13-17 years; 3 group consisted of 25 girls from 2 to 12 years. Diagnostic complex included clinical, special gynecological, comprehensive laboratory, ultrasound (including doppler ultrasound) research, computer and magnetic resonance imaging (if indicated). Results and discussion. The final diagnosis of “Ovarian cyst” was verified in 46 of 90 patients (51,1 %): group 1 – 26 of 30 (86,6 %), in 2 – 18 of 35 (51,4 %), in 3 - 2 of 25 (8 %). It is established that the torsion of the uterine adnexa was detected in 44 of 90 patients: in 1 group – 13,3% of cases (4 of 30 young women), in 2 group – 48,5 % (17 of 35 adolescents), in 3 group – 92 % (23 of 25 girls). 76 surgeries were performed by laparoscopy with preservation of the ovarian reserve, 12 patients were treated conservatively with final diagnosis “Ovulatory syndrome” and “Retention cyst of the ovary”. Conclusions. Ovarian cyst as the cause of abdominal pain is significantly more often diagnosed in young reproductive age than in patients of prepubertal and pubertal age. In girls and adolescent girls with symptoms of acute abdomen the torsion of intact uterine adnexa was significantly more common than in adult patients, due to anatomical features of the internal reproductive organs and more a mobile lifestyle inherent in this age group. Optimal treatment of functional ovarian cyst is complex conservative therapy, surgical treatment of ovarian cysts at a young age is conducted under strict indications, treatment of choice is laparoscopy. Key words: ovarian cyst; uterine adnexаl torsion; girls; adolescents; young reproductive age; laparoscopy.

SzydełkoJoanna,DąbrowskaIzabela. Single nucleotide polymorphisms in adiponectin and its receptors’ genes as potential risk factors for coronary artery disease in type 2 diabetes mellitus – an up-to-date overview. Journal of Education, Health and Sport. 2021;11(9):722-734. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.087 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.087 https://zenodo.org/record/5534087 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 20.09.2021. Accepted: 27.09.2021. Single nucleotide polymorphisms in adiponectin and its receptors’ genes as potential risk factors for coronary artery disease in type 2 diabetes mellitus – an up-to-date overview Joanna Szydełko1a, Izabela Dąbrowska2b 1Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Poland 2Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Poland a jszydelko@interia.pl, ORCID ID: https://orcid.org/0000-0003-3744-9058 b nematoda@gmail.com, ORCID: https://orcid.org/0000-0003-1593-2284 Corresponding author: Joanna Szydełko Department of Endocrinology, Diabetology and Metabolic Diseases Jaczewskiego 8 Street 20-954 Lublin, Poland phone: +48 81 72 44 668 e-mail: jszydelko@interia.pl Abstract Introduction: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease with still growing incidence among adults and young people worldwide. Patients with T2DM are more susceptible to develop coronary artery disease (CAD) than non-diabetic individuals. Several pre-clinical and clinical studies suggested that adiponectin, a pleiotropic hormone with anti-atherogenic, anti-inflammatory, and insulin-sensitizing properties, may be a molecular link between metabolic and cardiovascular diseases. Aim of the study: This article summarizes the current knowledge on single nucleotide polymorphisms (SNPs) within the adiponectin and its receptors’ genes on the risk of CAD in patients with T2DM. Description of knowledge: Adiponectin, the most abundant circulating adipocytokine, is encoded by the Acrp30/adiponectin gene on chromosome 3q27, which constitutes a region specific for obesity-related metabolic syndrome. A genetic deficit of this adipokine may be responsible for the increased risk of CAD both in the general population and T2DM subjects. The results of recent years’ studies highlight that SNPs at the adiponectin locus, +45 T>G and +276 G>T as well within its two receptors, are determinants of early onset atherosclerosis in individuals with T2DM. Conclusions: SNPs in ADIPOQ, ADIPOR1 and ADIPOR2 may modify the risk of CAD in the group of patients with T2DM. SNP +45 and SNP +276 seem to be attractive, molecular markers for identification of diabetic individuals at especially high risk of CAD. The discovering of their exact mechanisms may result in novel screening options as well as diagnostic process and treatment scheme. Therefore, further research is required to determine the effects of adiponectin and its receptors’ polymorphisms and their roles in the pathogenesis of obesity-related metabolic diseases. Key words: adiponectin; AdipoR1; AdipoR2; type 2 diabetes mellitus; coronary artery disease; single nucleotide polymorphisms

GóralczykWanesa, Borowiecka Monika, Mikos Eryk, Kanon Karol. Risk of prostate cancer in patients with Parkinson’s disease. Journal of Education, Health and Sport. 2021;11(9):691-696. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.084 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.084 https://zenodo.org/record/5533822 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 20.09.2021. Accepted: 27.09.2021. Risk of prostate cancer in patients with Parkinson’s disease Wanesa Góralczyk1*, Monika Borowiecka1, Eryk Mikos1, Karol Kanon1 1Medical University of Lublin *Corresponding author e-mail: wanesagoralczyk@gmail.com Wanesa Góralczyk; ORCID: 0000-0001-5804-2869 Monika Borowiecka; ORCID:0000-0003-2612-7838 Eryk Mikos; ORCID:0000-0003-0507-2882 Karol Kanon; ORCID: 0000-0001-6705-1302 Abstract Introduction: In recent years, an association between Parkinson’s disease and cancer has been reported with many clinical and epidemiological studies, encouraging the investigation of a potential common pathogenic pathway connected with both diseases. However, association between neurogenesis, medical treatment of Parkinson’s disease and occurence of prostate cancer (PCA) is still being discussed. Brief description of the state of knowledge: There were carried out population-based case-control researches that checked the connection between Parkinson’s disease and the risk of prostate cancer in Western (Canada, USA, UK, Denmark, Sweden, Israel) and Asian (Taiwan) populations. Studies revealed that Parkinson’s disease had significant association with reduced risk of prostate cancer in most of studied populations (Western) and increased in Asian population. Conclusions: Most of researches proved thatParkinson’s disease was associated with reduction of risk of prostate cancer, which decreased with increasing duration of Parkinson’s disease. The relationship between those conditions in Asian population needs to be checked in the future. Key words: Parkinson’s disease, prostate cancer

FilareckaAgnieszka,BiernackiMaciej,JęchorekMichał,LeksowskiŁukasz. Physiotherapy of patients with CNS damage as a result of a brain tumor. Journal of Education, Health and Sport. 2021;11(9):630-638. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.079 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.079 https://zenodo.org/record/5532870 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 20.09.2021. Accepted: 27.09.2021. Physiotherapy of patients with CNS damage as a result of a brain tumor Agnieszka Filarecka1,2, Maciej Biernacki3, Michał Jęchorek4, Łukasz Leksowski5 1 Collegium Medicum, UMK Bydgoszcz, Chair of Oncological Surgery 2 State School of Higher Education in Gniezno, Institute of Health Science 3 Collegium Medicum, UMK Bydgoszcz, Chair and Department of Anatomy 4 TOTU Addiction Therapy Center in Karnice 5 Collegium Medicum, UMK Bydgoszcz, Chair and Clinic of Rehabilitation Corresponding author: mgr Agnieszka Filarecka Collegium Medicum, UMK Bydgoszcz, Chair of Oncological Surgery Ul. Izabeli Romanowskiej 2, 85-796 Bydgoszcz, Poland Tel. 503074346 e-mail: aga.filarecka@gmail.com Abstract Rehabilitation as a process of return to fitness should take place at every stage of the disease. Stimulation to restore lost motor function should take place all day, including when lying in bed or transferring from one position to another. Placement items are an indispensable component of restoring floatation, as well as the element of nursing the patient. By correct arrangement of the patient we affect the stimulatory nervous system. Thanks to the correct arrangement we prevent bone-joint changes, lymphedema and also stimulate the cerebral cortex. This articule aims to propose the positioning of the patient and his transfers as a passive way of rehabilitation. Key words: positioning, patient positioning, rehabilitation, care, patient transfer.

BaranowskaAnna, Szczypiór-PiaseckaKarina,MińkoAlicja,AntczakKrzysztof. Comprehensive rehabilitation program after knee arthroplasty of GMRS as a result of treatment of a chondrosarcoma of distal part of femur with pathological fracture of the lateral femoral condyle. Journal of Education, Health and Sport. 2021;11(9):594-605. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.076 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.076 https://zenodo.org/record/5532618 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 20.09.2021. Accepted: 27.09.2021. Comprehensive rehabilitation program after knee arthroplasty of GMRS as a result of treatment of a chondrosarcoma of distal part of femur with pathological fracture of the lateral femoral condyle Anna Baranowska annabaranowska@interia.pl Country* ORCID iD SKN Rehabilitacji Ortopedycznej i Terapii Manulanej przy KOTiONR, Pomorski Uniwersytet Medyczny w Szczecinie, Poland KarinaSzczypiór-Piasecka karinaszczypior@interia.pl ORCID iDhttps://orcid.org/0000-0002-9562-9201 Katedra Ortopedii. Klinika Ortopedii, Traumatologii i Onkologii Narządu Ruchu Pomorskiego Uniwersytetu Medycznego, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland Alicja Mińko alicja.minko287@gmail.com ORCID iDhttps://orcid.org/0000-0003-2299-3958 SKN Rehabilitacji Ortopedycznej i Terapii Manulanej przy KOTiONR, Pomorski Uniwersytet Medyczny w Szczecinie, Poland Krzysztof Antczak antczak.krzysztof.01@gmail.com ORCID iDhttps://orcid.org/0000-0001-8443-0611 Studium doktoranckie, Pomorski Uniwersytet Medyczny w Szczecinie, Poland Abstract Introduction:Malignant neoplasms of bones and articular cartilage resulting from the operation of the mesenchymal sales cell valuation bank. Cells can differentiate in many countries. in. chondrocytes, osteoblasts or adipocytes The bone cancer that occurs is osteosarcoma. In second place is chondrosarcoma (chondrosarcoma). Materials and methods:The work was written based on the development of a patient who had the further development of the femur part of the former cartilage sarcoma radio station. The entire treatment procedure at the Department of Orthopedics, Traumatology and Oncology of the Musculoskeletal System, located at Unii Lubelskiej 1 street in Szczecin. Results: At the main point of treatment of the hospital clinic, the patient, the patient who returns as good working point, points to restore lost functions, as well as self-service learning. Conclusion: Rehabilitation is an indispensable carrier of services for cancer patients. Introducing modern techniques such as therapy and osteopathy to rehabilitation, ensuring the economy of therapy. Keywords: therapy; alloplastic; chondrosarcoma

ŻurawDaria, Oleksa Paulina, Sobczyk Mateusz. Obesity as an "infectious" disease. Journal of Education, Health and Sport. 2021;11(9):534-537. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.069 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.069 https://zenodo.org/record/5527843 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 20.09.2021. Accepted: 24.09.2021. Obesity as an "infectious" disease Daria Żuraw1, Paulina Oleksa1, Mateusz Sobczyk1 Daria Żuraw, ORCID:0000-0003-0815-4322, dariazuraw19@gmail.com Paulina Oleksa, ORCID:0000-0002-3474-6156, gp.oleksa@gmail.com Mateusz Sobczyk, ORCID:0000-0001-8690-2387, m.sobczyk1777@gmail.com 1Student Research Circle at the Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin, Poland Abstract Introduction: Obesity has been recognized as a global epidemic by the WHO, followed by a wealth of empirical evidence supporting its contagiousness. However, the dynamics of the spread of obesity between individuals are rarely studied. A distinguishing feature of the obesity epidemic is that it is driven by a process of social contagion that cannot be perfectly described by the infectious disease model. There is also social discrimination in the obesity epidemic. Social discrimination against obese people plays quite different roles in two cases: on the one hand, when obesity cannot be eliminated, social discrimination can reduce the number of obese people; on the other hand, when obesity is eradicable, social discrimination can cause it to explode.(1) Materiał and methods: A literature analysis on obesity epidemic was carried out within the Pubmed, Google scholar and Research Gate platform. The following keywords were used in serach: obesity, epidemy, children, body max index. Purpose of the work: The aim of the following analysis is to present an obesity as an infectious disease. The steadily increasing percentage of obese people, including children, shows that there is an obesity epidemic. This is the phenomenon of social contagion, which partially explains the concept of homophily, which involves the grouping of people with similar characteristics. Potential explanations are also provided by sharing a living environment with similar access to certain foods and similar opportunities for physical activity, which defines the occurrence of analogous health habits Key words: obesity; epidemy; children; body max index

Pytka Michalina, Oszczędłowski Paweł, Nowaczek Justyna, Żywicka Aleksandra. Situation of oncological patients during COVID-19 pandemic with particular emphasis on lung cancer patients. Journal of Education, Health and Sport. 2021;11(9):512-519. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.066 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.066 https://zenodo.org/record/5526689 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 20.09.2021. Accepted: 24.09.2021. Situation of oncological patients during COVID-19 pandemic with particular emphasis on lung cancer patients Michalina Pytka [1], Paweł Oszczędłowski [1], Justyna Nowaczek [1], Aleksandra Żywicka [1] Chair and Department of Histology and Embryology with Experimental Cytology Unit, Medical University of Lublin, Radziwiłłowska Street 11, 20-080 Lublin, Poland Michalina Pytka; michalinapytka@gmail.com ; ORCID 0000-0002-4813-9357 Paweł Oszczędłowski; pawelosz99@gmail.com; ORCID: 0000-0001-7406-550X Justyna Nowaczek; justynafaustynanowaczek@gmail.com; ORCID: 0000-0001-7622-2345 Aleksandra Żywicka; azywicka810@gmail.com; ORCID: 0000-0003-2015-830X SUMMARY Introduction and purpose: The purpose of this study is to review literature about alterations to treatment regimens to lung cancer during COVID-19 pandemic accessible on PubMed platform. In pulmonary neoplasms, early diagnosis and treatment is a key to ensure patient safety. Burdening of healthcare systems during pandemic has resulted in many obstacles in oncologic treatment. A brief description of the state of knowledge: The lung cancer is the most frequent and the most deadly cancer in men and women. COVID-19 is a pulmonary infectious disease whose spread around the world has resulted in a pandemic. At the onset of the worldwide pandemic, many institutions, including healthcare facilities were closed, making it more difficult to provide oncological patients the treatment compliant with the standards. The anxiety of patients caused by the pandemic has caused delays in treatment that can cause progression of the disease. In patients with lung cancer mortality of COVID-19 was around 50%, which made their visits at hospital hazardous. Before the accessibility of anti-COVID-19 vaccines telemedical healthcare was one of the ways to provide healthcare to oncological patients. Conclusions: Patients with lung cancer are one of the risk groups of COVID-19. Delays in their treatment caused by the pandemic are potentially dangerous and negatively affect the therapy. Telemedicine is a useful too provide medical care, but has its own limitations. Key words: COVID-19; Telemedicine; Lung cancer; pandemic

NiedobylskiSylwiusz,LaszczakKatarzyna,WarchołKonrad,MoqbilSara,KalickaKarolina. Bipolar Androgen Therapy in the management of prostate cancer. Journal of Education, Health and Sport. 2021;11(9):484-490. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.062 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.062 https://zenodo.org/record/5524190 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 20.09.2021. Accepted: 23.09.2021. Bipolar Androgen Therapy in the management of prostate cancer Sylwiusz Niedobylski(1); https://orcid.org/0000-0001-7266-623X; sniedobylski@gmail.com Katarzyna Laszczak(1); https://orcid.org/0000-0002-5084-0273; kasia.laszczak19@gmail.com Konrad Warchoł(1); https://orcid.org/0000-0001-9467-680X; konrad.wrh@gmail.com Sara Moqbil(1); https://orcid.org/0000-0003-1230-1444; saramoqbil1@gmail.com Karolina Kalicka(1); https://orcid.org/ 0000-0002-7474-4737; kalicka.karolina@gmail.com (1) Faculty of Medicine, Medical University of Lublin, Aleje Racławickie 1, 20-059 Lublin, Poland Abstract Introduction and purpose: Prostate cancer (PCa) as one of the most frequent neoplasms in men remains a challenge for oncologists. The main strategy of its treatment is the Androgen Deprivation Therapy (ADT) the principle of which is an inducement of hypogonadism. The lack of testosterone is not only a factor greatly contributing to a decrease of quality of life overall, but additionally it increases the odds of the complications, including low libido and erectile disfunction, metabolic abnormalities, high cardiovascular risk, osteoporosis, anaemia, or depression. ADT also has the potential of inducement of castration resistance (CRPC), which significantly worsen patients prognosis. The main purpose of this review is to explore the Bipolar Androgen Therapy (BAT), which has the potential to solve the aforementioned problems. State of knowledge: The mechanism of BAT action has been described. BAT is effective not only against CRPC, but androgen-dependant PCa as well. BAT reverses the hormone resistance in CRPC, thus allowing the rechallenging of the ADT. It has the direct cytotoxic effect on cancer cells. Additionally BTA increases the exponents of the general quality of life of the patients. There is a number of active clinical trials regarding BAT. Conclusions: BAT is a safe therapeutic strategy with the high efficacy in reversing hormone resistance in CRPC patients, thus significantly increasing their health prognoses and it allows to alleviate or avoid the adverse effects of ADT. Key words: Bipolar Androgen Therapy, prostate cancer

KlasJakub, Kluz Natalia, Piwowar Klaudia. NSAIDs and PPIs - review of new reports. Journal of Education, Health and Sport. 2021;11(9):462-472. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.060 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.060 https://zenodo.org/record/5524096 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 20.09.2021. Accepted: 23.09.2021. NSAIDs and PPIs - REVIEW OF NEW REPORTS Jakub Klas1, Natalia Kluz1, Klaudia Piwowar1 1Medical University of Lublin ORCID ID and E-mail: Jakub Klas https://orcid.org/0000-0002-4795-1909jakubklas99@gmail.com Natalia Kluz https://orcid.org/0000-0002-5801-5913nataliakluz99@gmail.com Klaudia Piwowar https://orcid.org/0000-0001-8232-003Xklaudiaklaudia66@gmail.com Abstract The aim of this study is to systematise knowledge on non-steroidal anti-inflammatory drugs (NSAIDs) - cyclooxygenase (COX) enzyme inhibitors and proton pump inhibitors (PPIs) inhibiting potassium hydrogen ATPase. A review of recent reports on possible side effects and new therapeutic options will be presented. Results: Over the last few years, reports of PPI side effects have been published: drug-induced thrombocytopenia, severe hypomagnesemia, hyponatremia or rhabdomyolysis. In the case of NSAIDs, ancillary therapeutic effects in the supportive therapy of multiple myeloma or in the reduction of adenoma formation in the colon stand out, but also cases of acute kidney injury in children. On the basis of meta-analyses, attempts were made to demonstrate the effect of individual NSAIDs on the occurrence of cardiovascular complications, stroke or myocardial infarction Conclusions: Despite the fact that the indicated preparations were admitted to the list of drugs several decades ago, still their pharmacological potential (on the example of NSAIDs, which can be successfully used even in complementary therapy) has not been fully exploited. The aforementioned reports on side effects must not be forgotten. It is possible that the examples presented in the review will raise awareness in order to use these drugs with greater respect, in accordance with the recommendations in the leaflet. Key words: Non-steroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (PPIs)

Samek Ilona, Jańczyk Magdalena, Wójcik Anna, Białek Justyna, Krawiec Paulina, Milanowska Joanna. Public awareness of tropical diseases. Journal of Education, Health and Sport. 2021;11(9):409-416. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.052 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.052 https://zenodo.org/record/5520098 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 21.09.2021. Accepted: 22.09.2021. Public awareness of tropical diseases Ilona Samek (1)*, Magdalena Jańczyk (1), Anna Wójcik (2), Justyna Białek (2), PaulinaKrawiec (2), dr n. o zdr. Joanna Milanowska (3) 1) Student Research Group of Applied Psychology, Medical University of Lublin 2) Student Scientific Association at Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin 3) Department of Applied Psychology, Medical University of Lublin * E-mail address: samekilona@gmail.com ORCID ID: Ilona Samek: https://orcid.org/0000-0002-5538-5396 Magdalena Jańczyk: https://orcid.org/0000-0002-4948-9463 Anna Wójcik, https://orcid.org/0000-0002-2697-8600 Justyna Białek, https://orcid.org/0000-0002-8447-3395 Paulina Krawiec, https://orcid.org/0000-0002-9527-5837 Joanna Milanowska: https://orcid.org/0000-0001-9741-1583 Abstract Introduction: Despite medical advances, the prevention and treatment of tropical diseases continue to be a current problem for communities. Purpose: To present the public awareness of tropical diseases. Material and method: The study was conducted by using an author's questionnaire. 158 questionnaires were collected and analysed. Results: The study included women (55.7%) and men (44.3%) of varying ages, nearly half of whom were studying or are studying a medical profession. The analysis showed that 92.4% of the respondents were aware of the factors causing contagious and parasitic diseases. Only 5.0% of respondents expressed opposition to prevention when travelling to tropical countries. Every fourth person planning a trip would not go to a specialist on this issue. Nearly 90% of respondents wanted to be vaccinated before travelling. On the other hand, only 15.2% of respondents knew that malaria is not currently prevented by a vaccine, but by chemoprophylaxis. One in five respondents said there was no need for hygienic food consumption, while more than half (53.8%) had not heard of the rule "cook, steam, peel or forget". Among the most important preventive measures, respondents most often selected hand washing (50.6%), taking care of hygiene (20.2%) and immunization (17.8%). Conclusions: Most of the respondents, especially those with medical education, demonstrated basic knowledge of tropical diseases. However, there is a great need for education, especially about visiting a doctor before travelling, types of prevention and methods of hygienic food consumption. The possibility of implementing programmes to supplement knowledge should be kept in mind. Keywords: tropical diseases; contagious diseases; awareness; society.

MielniczekKatarzyna.The influence of the Mediterranean diet on glucose metabolism. Journal of Education, Health and Sport. 2021;11(9):430-433. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.055 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.055 https://zenodo.org/record/5520371 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 21.09.2021. Accepted: 22.09.2021. The influence of the Mediterranean diet on glucose metabolism Katarzyna Mielniczek; kasiamielniczek@gmail.com Medical University of Lublin, Faculty of Medicine, Lublin, Poland Abstract Introduction:Insulin resistance is the first stage of diabetes development. It has been defined as a dysmetabolic state in which the biological response of target tissues (particularly liver, muscle and adipose tissue) to circulating insulin is impaired. This leads to hyperinsulinemia, which in turn leads to obesity and type 2 diabetes (T2D). The basic ingredients of the Mediterranean diet, such as fruit, vegetables, fish rich in fat, extra virgin olive oil, tree nuts, red wine, have been defined in the functional food model by the natural content of nutraceuticals such as polyphenols, terpenoids, flavonoids, alkaloids, sterols and unsaturated fatty acids. Purpose of the work : Demonstrate the beneficial effects of implementing the Mediterranean diet in patients with insulin resistance or type 2 diabetes. The appropriate samples were accessed using a search engine in the PubMed database. The reviews and meta-analyzes published over the last 10 years were used. Results:After changing the diet to a diet rich in these nutrients, a greater improvement in IR was shown in obese people compared to other diets. In addition, dietary polyphenols demonstrated clinically significant benefits in metabolic and microvascular functions leading to lowering of fasting cholesterol and glucose, and anti-inflammatory and antioxidant properties in high-risk and T2DM patients. Conclusions:Mediterranean diets with the addition of extra virgin olive oil or nuts reduced total body weight and improved glucose metabolism. Key words:insulin resistance; Mediterranean diet; type 2 diabetes; unsaturated fatty acids

Żak Klaudia, Piwoński Michał, Stanicki Paweł, Kalicka Karolina, Nowaczek Justyna. Mechanisms of drug resistance in ovarian cancer. Journal of Education, Health and Sport. 2021;11(9):362-367. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.045 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.045 https://zenodo.org/record/5518243 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 13.09.2021. Revised: 20.09.2021. Accepted: 21.09.2021. Mechanisms of drug resistance in ovarian cancer Klaudia Żak1, Michał Piwoński1, Paweł Stanicki1, Karolina Kalicka1, JustynaNowaczek1 1 - Medical University of Lublin Klaudia Żak: e-mail: zakklaudia3@gmail.com, ORCID:0000-0003-2421-2553 Michał Piwoński: e-mail: michalpiwonski2@gmail.com, ORCID:0000-0001-6510-8993 Paweł Stanicki: e-mail: stanicki99@gmail.com, ORCID:0000-0002-4942-9030 Karolina Kalicka: kalicka.karolina@gmail.com, ORCID: 0000-0002-7474-4737 Justyna Nowaczek: justynafaustynanowaczek@gmail.com, ORCID: 0000-0001-7622-2345 Abstract Ovarian cancer is the fifth most common cancer affecting women and the most lethal cancer among the gynecological cancers. Because of the lack of specific symptoms and no special screening tools, it is recognised in an advanced stage. In addition, drug resistance in ovarian cancer is so frequent, that genes and cross-talks between some important pathways are still analysed. In this review, the major and recently identified molecular mechanisms of drug resistance, including platinum, taxane, bevacizumab and PARPi resistance mechanisms in ovarian cancer from relevant literature have been investigated. Key words: platinum resistance; PARPi resistance; ovarian cancer; drug resistance

NowaczekJustyna, Oszczędłowski Paweł,Pytka Michalina,Giermasiński Adrian. Epidemiology of fractures during COVID-19 pandemic: a short review. Journal of Education, Health and Sport. 2021;11(9):383-387. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.048 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.048 https://zenodo.org/record/5519736 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 21.09.2021. Accepted: 21.09.2021. Epidemiology of fractures during COVID-19 pandemic: a short review Justyna Nowaczek [1], Paweł Oszczędłowski [1], Michalina Pytka [1], AdrianGiermasiński [2] Chair and Department of Histology and Embryology with Experimental Cytology Unit, Medical University of Lublin, Radziwiłłowska Street 11, 20-080 Lublin, Poland Chair and Department of Psychology, Medical University of Lublin, Chodźki Street 7, 20-093 Lublin, Poland Justyna Nowaczek; justynafaustynanowaczek@gmail.com; ORCID: 0000-0001-7622-2345 Paweł Oszczędłowski; pawelosz99@gmail.com; ORCID: 0000-0001-7406-550X Michalina Pytka; michalinapytka@gmail.com ; ORCID 0000-0002-4813-9357 Adrian Giermasiński; giermasinski.a@gmail.com; ORCID 0000-0003-4442-9119 Summary Introduction and purpose:The purpose od this study is to describe changes in epidemiological trends of fractures, especially osteoporotic fractures, during COVID-19 pandemic. Before the pandemic, fractures in the young population were more frequent than in elderly population, because of more active lifestyle. A brief description of the state of knowledge: COVID-19 pandemic and lockdown has effectively reduced people’s mobility and ability to travel. This has resulted in lowered rate of traumatogenic incidents that cause fractures, including traffic accidents and accidents during performing sport. When people spend more time at their homes, incidence of household fractures is growing, especially in elderly population. Osteoporosis makes bones of elderly people more suspectible to fracture. Majority of drugs used in treatmen for osteoporosis are said not to interact with risk or severity of COVID-19 infection. Conclusions: During the COVID-19 pandemic, geriatric fractures have become one of the severe problems for healthcare systems. Isolation at people’s homes has resulted in increased rate of fractures occuring at home, especially in elderly population. Difficulties caused by pandemic made rates of properly performed osteoporotic treatment lower, increasing risk of fractures even more. Mortality after fractures has risen even in patients with negative result of testing for COVID-19. Key words: Osteoporosis; Fracture; Low-energetic fracture; COVID-19

WęgrzyniakAgata,WokurkaWojciech,DudekIga,PiechPiotr. What are the newest outcomes about Legg-Calve-Perthes disease etiology after 110 years over its discovering? – literature review. Journal of Education, Health and Sport. 2021;11(9):396-400. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.050 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.050 https://zenodo.org/record/5519997 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 15.09.2021. Revised: 21.09.2021. Accepted: 21.09.2021. What are the newest outcomes about Legg-Calve-Perthes disease etiology after 110 years over its discovering? – literature review Agata Węgrzyniak1,Wojciech Wokurka1, Iga Dudek2 Supervisor: PhD Piotr Piech3,4 Afiliacja: 1 Human Anatomy Research Group, Department of Human Anatomy, Medical University of Lublin 2Student Research Group at the Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin 3Department of Human Anatomy, Medical University of Lublin 4Department of Orthopedics and Traumatology, Medical University of Lublin ORCID ID: Agata Węgrzyniak: https://orcid.org/0000-0001-8638-0013; agataw97@gmail.com Wojciech Wokurka: https://orcid.org/0000-0001-9936-5656; wojciechwokurka@gmail.com Iga Dudek: https://orcid.org/0000-0002-8101-074X; iga.dudek6@gmail.com Piotr Piech: https://orcid.org/0000-0001-8717-7957; ppiotr.md@gmail.com Abstract Idiopathic avascular necrosis of the femoral head, known as Legg-Calve-Perthes disease (LCPD), is one of the most common necrosis among paediatric patients. Although it was described over 110 years ago its aetiology is still not established. Neither have effective treatment methods, which main aim is to maintain the joint with a full range of motion and to reduce the risk of developing degenerative changes. According to the literature, the exact aetiology of LCPD has still not been established. Increasingly, immunological and genetic disorders are highlighted in the literature, which may be an important cause of disease development. However, the number of reliable studies on this subject is very limited. Once again, the influence of various risk factors present in fetal life has been analysed, but in a study with a significantly larger group of subjects. It has been repeatedly stressed that age, stage and radiological classification have a very important influence on the choice of treatment method and its effectiveness. Another important aspect is the need for reliable clinical trials to determine the effectiveness of bisphosphonate drugs and BMPs (bone morphogenetic proteins). In all studies, the need to perform more studies, on quantitatively larger groups of subjects, is significantly emphasized. Key words: Legg-Calve-Perthes disease, Idiopathic avascular necrosis of the femoral head, etiology

MielniczekKatarzyna. Botulinum toxin in the treatment of neuralgia and neuropathic pain.Journal of Education, Health and Sport. 2021;11(9):310-314. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.038 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.038 https://zenodo.org/record/5515785 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.09.2021. Revised: 18.09.2021. Accepted: 18.09.2021. Botulinum toxin in the treatment of neuralgia and neuropathic pain Katarzyna Mielniczek; ORCID Id: https://orcid.org/0000-0003-2575-3642; kasiamielniczek@gmail.com Medical University of Lublin, Faculty of Medicine, Lublin, Poland Abstract Introduction:Botulinum toxin is one of the most powerful neurotoxins currently known, with high affinity to the cholinergic synapse, which sufficiently inhibits the release of acetylcholine. Its use has proved to be effective in the treatment of many diseases of the musculoskeletal system. Although most of the therapeutic effects of botulinum toxin are due to the temporary relaxation of skeletal muscles (caused by inhibition of acetylcholine release), research is ongoing into its effects on the nervous system. Purpose of the work:The aim of the study is to analyze the effectiveness of botulinum toxin in the treatment of neuralgia and neuropathic pain. Method: The relevant samples were accessed by means of an electronic search in the PubMed database. The analysis used reviews and meta-analyzes posted on the platform over the last 10 years. Conclusions:Botulinum toxin has great potential in the treatment of pain. It is multitasking due to its favorable safety profile and long-lasting relief from a single injection compared to other pain medications. The side effects caused by it were assessed to be mild to moderate and included a local skin reaction (swelling), injection site pain, muscle weakness, flu symptoms, nausea and vomiting. Keywords:botulinum toxin; neuropathic pain; pain treatment; neuralgia; BoNT / A

MielniczekKatarzyna. Safety and Side Effects of COVID-19 Vaccines.Journal of Education, Health and Sport. 2021;11(9):315-320. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.039 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.039 https://zenodo.org/record/5515797 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 10.09.2021. Revised: 19.09.2021. Accepted: 19.09.2021. Safety and Side Effects of COVID-19 Vaccines Katarzyna Mielniczek; ORCID Id: https://orcid.org/0000-0003-2575-3642; kasiamielniczek@gmail.com Medical University of Lublin, Faculty of Medicine, Lublin, Poland Abstract Introduction:COVID-19 is a respiratory disease caused by the SARS-CoV-2 virus. The types of COVID-19 vaccines have been distinguished, ie vector viral vaccines, mRNA, subunit vaccines. These include traditional approaches - inactivated, live-attenuated and protein / adjuvant-based, as well as novel, as yet unlicensed - viral vectors and nucleic acids. There are scientific publications showing the safety and possible side effects of vaccines from various companies. Purpose of the work :Analysis of the safety of COVID-19 vaccines on the basis of scientific publications published on the PubMed scientific platform. Publications have been published in the last 12 months. The safety and adverse effects of vaccines were assessed in the course of clinical trials. Results:Among the main side effects so far were mild / moderate pain at the injection site, redness, hives and rash. Allergic reactions to vaccines are - apart from pronounced local reactions (> 10 cm) at the injection site - very rare and are usually caused by the vaccine's allergy to the components of the vaccine. In addition, there may be swelling or tenderness of the lymph nodes in the armpit, headache, pain in the muscles and joints, nausea and vomiting. Conclusions:Regardless of the concern, these vaccines are characterized by similar mild, systemic side effects, which indicates the similarity in the safety of these vaccines. Severe adverse reactions occur in extreme cases. More patients only experienced side effects after the second dose. Keywords:vaccines; coronavirus; COVID-19; safety of COVID-19 vaccines; side effects

KlasJakub, Kluz Natalia, Piwowar Klaudia. Xylometazoline and oxymetazoline - unusual effects of everyday drugs (literature review).Journal of Education, Health and Sport. 2021;11(9):272-281. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.033 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.033 https://zenodo.org/record/5515163 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.09.2021. Revised: 12.09.2021. Accepted: 18.09.2021. Xylometazoline and oxymetazoline - unusual effects of everyday drugs (literature review) Jakub Klas1, Natalia Kluz1, Klaudia Piwowar1 1Medical University of Lublin ORCID ID and E-mail: Jakub Klashttps://orcid.org/0000-0002-4795-1909jakubklas99@gmail.com Natalia Kluzhttps://orcid.org/0000-0002-5801-5913nataliakluz99@gmail.com Klaudia Piwowarhttps://orcid.org/0000-0001-8232-003Xklaudiaklaudia66@gmail.com Abstract The aim of the study is to systematize the knowledge about xylometazoline and oxymetazoline - commonly used nasal sprays with sympathicomimetic effect, mainly directly on α-adrenergic receptors [1]. A review of recent reports on possible side effects and new therapeutic options will be presented. Results: Over several years, reports have been published regarding descriptions of unusual cases of side effects, such as angina attack [4], a case of respiratory failure in a newborn [5], ischemic stroke [6], or anaphylactic reaction during routine surgery. In experiments using rats, on the other hand, it has been shown that these substances can also cause increased inflammation of the lower respiratory tract [7], as well as numerous ophthalmic problems [8]. Recent reports also suggest new uses for xylometazoline and oxymetazoline. In combination with lidocaine, an intranasal solution of xylometazoline has shown efficacy in the anesthesia of maxillary teeth in patients with minor carious lesions [9], and a beneficial therapeutic combination of oxymetazoline and dye laser (PDL) has also been reported for the treatment of rosacea, among others [10]. Conclusions: Although imidazoline derivatives were admitted to the drug list decades ago, still their pharmacological potential has not been fully exploited. Finding applications of these drugs in dermatology and dentistry may not only improve the efficacy and comfort of treatment, but also significantly reduce the costs of the whole therapy. The aforementioned reports on the side effects of xylometazoline and oxymetazoline should not be forgotten. It is possible that the presented examples will increase awareness to use these drugs with more respect, according to the recommendations on the leaflet. Key words : xylometazoline, oxymetazoline, rosacea, anesthesia dental

LicznerGrzegorz, Wiciński Michał, Cadelski Karol, Malinowski Bartosz. Is the determination of bone turnover markers and vitamin D useful in the diagnosis of degeneration spine disease?Journal of Education, Health and Sport. 2021;11(9):259-271. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.032 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.032 https://zenodo.org/record/5515131 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.09.2021. Revised: 12.09.2021. Accepted: 18.09.2021. Is the determination of bone turnover markers and vitamin D useful in the diagnosis of degeneration spine disease? Grzegorz Liczner, Michał Wiciński, Karol Cadelski, Bartosz Malinowski Department of Pharmacology and Therapeutics, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie 9, 85-090 Bydgoszcz, Poland Abstract: Degenerative disease of the lumbar spine is one of the most common diseases of the human musculoskeletal system and a significant public health problem. The main manifestation of degenerative spine disease is back pain, which in most cases is treated symptomatically rather than causally. The diagnosis of degenerative spine disease has been previously based on medical history and diagnostic imaging. Recently, much attention has been devoted to the biochemical indicators of bone and cartilage metabolism, which are well understood among patients with osteoporosis. Bone turnover markers indicate the metabolic activity of bone and cartilage. They occur in blood serum, urine, and synovial fluid in the form of collagen-derived proteins or enzymes, involved in the formation or resorption of bone and cartilage tissue. The study below was aimed at assessing the usefulness of determining the markers of bone turnover and cartilage damage in the blood serum of people with degenerative disease of the lumbar spine diagnosed by MRI. The biochemical diagnostics included the measurement of inflammatory parameters. The results show that the degenerative disease of the spine is local, accompanied by inflammation, and vitamin D deficiency is among the factors leading to its development. Key words:degenerative spine disease, back pain, markers of bone turnover, markers of cartilage damage, vitamin D.

DrożakMartyna,DrożakPaulina,DziekońskaJustyna,NowińskaMartyna,GrabowyPaulina. Xerostomia among elderly patients – systematic review.Journal of Education, Health and Sport. 2021;11(9):289-297. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.035 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.09.035 https://zenodo.org/record/5515203 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.09.2021. Revised: 18.09.2021. Accepted: 18.09.2021. Xerostomia among elderly patients – systematic review Martyna Drożak1, Paulina Drożak1, Justyna Dziekońska2, Martyna Nowińska2, PaulinaGrabowy2 Students’ Scientific Association of Chair and Department of Family Medicine, Medical University of Lublin Students’ Research Group of Applied Psychology, Medical University of Lublin Abstract Introduction and purpose:Xerostomia is a salivary secretion malfunction that affects from 1 to 29% of the population. It is a common problem among elderly patients, however undeniably it still remains an underdiagnosed issue. Searching among available literature in the PubMed database with the following phrases: xerostomia; elderly, the aim of this article was to provide a broad review on the underdiagnosed problem which is xerostomia among elderly patients. Description:A group at risk of developing xerostomia are people over 65 years old and women in the perimenopausal period. Although dry mouth varies in etiology, geriatric patients mostly develop xerostomia as a result of head and neck radiotherapy, Sjögren syndrome or medication treatment. Untreated symptoms can lead to severe issues which heavily impact not only oral health of the patient, but also their everyday life quality, since xerostomia may lead into difficulty of speaking, swallowing and tasting. The plan of treatment is influenced by the etiology of the case, however it is aimed to stimulate salivary flow and eradicate the use of unnecessary medication which may cause dry mouth. Prevention of dry mouth is based on maintenance of good oral hygiene. Conclusions:Diagnosing the problem early can prevent patients from suffering the consequences of chronic xerostomia, therefore awareness should be brought to this issue. Dentist could also highly improve the quality of xerostomic patient’s life, if the chosen treatment significantly improved patient’s symptoms. Key words:xerostomia; elderly

KłosińskaMartyna, Kaczyńska Agnieszka. Polycystic ovarian syndrome - management and treatment.Journal of Education, Healthand Sport. 2021;11(9):123-130. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.017 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.09.017 https://zenodo.org/record/5484900 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 25.08.2021. Revised: 26.08.2021. Accepted: 07.09.2021. POLYCYSTIC OVARIAN SYNDROME - MANAGEMENT AND TREATMENT Martyna Kłosińska1, Agnieszka Kaczyńska1 Martyna Kłosińska, martynaklosinska69@gmail.com, https://orcid.org/0000-0001-7649-085X Agnieszka Kaczyńska, agaagnieszkakk@gmail.com, https://orcid.org/0000-0002-8943-9401 (1) Faculty of Medicine, Medical University of Lublin, Aleje Racławickie 1, 20-059 Lublin, Poland SUMMARY The polycystic ovarian syndrome is an endocrine disorder with a high prevalence affecting reproductive-aged women and adolescent girls. The most common symptoms are infertility, numerous ovarian cysts, hyperandrogenism, menstrual cycle abnormalities. The disease has a great impact on patients, impairing their quality of life. Bearing that in mind, innovative therapeutic approaches are needed. We aim to describe current management and treatment concepts adopted in PCOS therapy. The analysis of previously published studies was conducted by using the PubMed, Google Scholar, and Scopus databases. Mentioned studies show that lifestyle changes may benefit PCOS therapy in multiple ways. Dietary and exercise interventions have a notable influence on women’s body composition as well as biochemical parameters. The reduction of body weight or BMI is a therapeutic achievement likewise patients’ contribution to managing PCOS. Pharmacotherapy provides plentiful treatment choices to adopt. Studies show that hormonal contraceptive has a significant impact on both hyperandrogenism and menstrual abnormalities. Metformin is proven to reduce BMI, improve LDL levels, and lower the risk of OHSS in women undergoing IVF/ICSI-ET. A meta-analysis proved metformin’s monotherapy superiority over clomifene citrate or their combination in treating infertility. However, both substances are not recommended as the first-line choice. Regrettably, many studies mention short of evidence, lack of larger sample sizes, or insufficient duration preventing further research. The conclusion we draw is that approaches of managing and treating PCOS are constantly advancing and updating. However, there is a necessity for future studies to expand their research by gathering more data and considering diverse cases. Key words: polycystic ovarian syndrome; endocrine productive disorder; infertility; hyperandrogenism; hormonal contraceptive; metformin; clomifene citrate

CyboranKatarzyna,KucMonika,KalickaMaria,KorzecTomasz,KaniaKonrad. Awareness of young people from different countries about risk factors influences on cardiovascular diseases.Journal of Education, Healthand Sport. 2021;11(9):108-112. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.015 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.09.015 https://zenodo.org/record/5475450 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 21.08.2021. Revised: 26.08.2021. Accepted: 06.09.2021. Awareness of young people from different countries about risk factors influences on cardiovascular diseases Katarzyna Cyboran - katarzyna_cyboran@o2.pl; Medical Faculty, Institute of Medical Sciences, Collegium Medicum, Oleska Street 48, 45-052 Opole Poland Monika Kuc - kuc.monika96@gmail.com; Medical Faculty, Institute of Medical Sciences, Collegium Medicum, Oleska Street 48, 45-052 Opole Poland Maria Kalicka – maria.kalicka96@gmail.com; Faculty of Medicine, Medical University of Lublin, Aleje Racławickie 1 Street, 20-059 Lublin Poland Tomasz Korzec – tkorzec@poczta.fm; Faculty of Medicine, Medical University of Lublin, Aleje Racławickie 1 Street, 20-059 Lublin Poland Konrad Kania – 1konradkania@gmail.com; Faculty of Medicine, Medical University of Lublin, Aleje Racławickie 1 Street, 20-059 Lublin Poland ABSTRACT One of the main reasons of deaths in the entire world is cardiovascular disease (CVD). Because of this, 17.9 million people died in 2019, which is 32% of deaths worldwide. Among these deaths, 85% were due to heart attack and stroke. More than 75% of deaths occur in low- and middle-income countries. Among the 17 million people under the age of 70 who died prematurely in 2019 due to non-contagious diseases, as many as 38% were caused by CVD. The most important risk factors for CVD include smoking, an unhealthy diet, obesity, inactivity, and alcohol consumption. These factors reflect the ongoing economic, social, and cultural changes. The development of this disease is also influenced by stress and genetic factors. Thanks to early diagnosis, it is possible to initiate treatment early and increase the patient's chance of survival. [1] KEY WORDS: cardiovascular diseases, risk factors, young people

RaczkiewiczPrzemysław,KalickaMaria,KorzecTomasz,KaniaKonrad,CyboranKatarzyna. Diagnosis of the pancreatic cancer.Journal of Education, Healthand Sport. 2021;11(9):67-73. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.009 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.09.009 https://zenodo.org/record/5457575 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 21.08.2021. Revised: 26.08.2021. Accepted: 05.09.2021. Diagnosis of the pancreatic cancer 1Przemysław Raczkiewicz, 1Maria Kalicka, 1Tomasz Korzec, 1Konrad Kania, 2Katarzyna Cyboran 1Medical University of Lublin, Faculty of Medicine, Lublin, Poland 2Medical Faculty, Institute of Medical Sciences, Collegium Medicum, Opole, Poland Abstract Introduction:The pancreatic cancer arises from non-invasive precursor lesions and develops through the accumulation of characteristic gene mutations. The recent scientific reports based on genetic tests state that the approximate time between cancerous initiation and the development of cancer with metastasisis15 years. We candistinguish three main precancerous lesions leading to the pancreatic cancer: pancreatic intraepithelial neoplasia (PanIN), mucinous cystic neoplasms (MCN), and intraductal papillary mucinous neoplasms (IPMN). The imaging tests used for the diagnostics and observation of precancerous pancreas lesions are MR, MRC, CT and EUS. Method:review of the recent literature based on PubMEd, Google scholar research based onthe following key words: pancreatic cancer, precancer of the pancreas, pancreatic cyst, tuber of the pancreas, medical imaging of the pancreas Purpose of the work: systematizing information about precancers of the pancreatic cancer based on the latest research and findings Key words: precancer of the pancreas, pancreatic cyst, pancreatic cancer, pancreatic ductal adenocarcinoma

KluzNatalia, Klas Jakub. Treatment of malignant melanoma - a review of the literature.Journal of Education, Healthand Sport. 2021;11(9):55-66. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.09.008 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.09.008 https://zenodo.org/record/5457352 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 21.08.2021. Revised: 26.08.2021. Accepted: 05.09.2021. Treatment of malignant melanoma - a review of the literature Natalia Kluz, Jakub Klas Studenckie Koło Naukowe przy Zakładzie Onkologii Klinicznej i Chemioterapii, Uniwersytet Medyczny w Lublinie Abstract Melanoma is caused by genetic mutations in melanocytes, pigment-producing cells found in the skin, eye, inner ear, and soft meninges. Sun exposure, atypical nevi, previous history of melanoma, and the presence of multiple (≥40) common nevi were found to be associated with an increased risk of melanoma detection (OR: 1. 3; 95% CI: 1. 1-1. 6). Its prevalence is highest among light-skinned populations and in regions of lower latitudes. Significance of family history of melanoma and presence of congenital nevi were excluded. For localized primary melanoma, the dominant prognostic factors for survival are lesion thickness, ulceration, and lymph node involvement Understanding the pathogenesis of melanoma has been crucial in developing new therapeutic approaches. The characterization of oncogenic signaling pathways and interactions has made it possible to identify new targets for clinically effective therapies, such as pathway inhibitors and antibodies to immune checkpoints or the use of phototherapy. In this article we describe the main signaling pathways which are deregulated in melanoma. We also mention how it has become a viable and crucial strategy for melanoma therapy and then thoroughly review the safety, clinical efficacy and progress regarding PDT- promising alternative therapy and the immunotherapies of melanoma in especially advanced metastatic stage basing on published clinical data and registered clinical trials, most of which are in phase III. Keywords: malignant melanoma; immunotherapy; photodynamic therapy

Pankiv M. V., Paltov Ye. V., Masna Z. Z., Chelpanova I. V., Kovalska M. Ye. Dynamics of pathomorphological changes in the structural organization of the intervertebral disc at the end of the seventh and fourteenth day of experimental opioid exposure at the ultrastructural level. Journal of Education, Health and Sport. 2021;11(08):427-437. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.08.048 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.08.048 https://zenodo.org/record/5495940 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.08.2021. Revised: 16.08.2021. Accepted: 31.08.2021. UDK:714.616.711-018.3⁄.4:615.212.7]-076.4 Dynamics of pathomorphological changes in the structural organization of the intervertebral disc at the end of the seventh and fourteenth day of experimental opioid exposure at the ultrastructural level M. V. Pankiv, Ye. V. Paltov, Z. Z. Masna, I. V. Chelpanova, M. Ye. Kovalska Danylo Halytsky Lviv National Medical University Pankiv M.V. Danylo Halytsky Lviv National Medical University, Department of Normal Anatomy, Lviv, Ukraine; https: //orcid.org/0000-0002-3714-2577 Paltov Ye.V. Danylo Halytsky Lviv National Medical University, Department of Normal Anatomy, Lviv, Ukraine; https://orcid.org/0000-0002-2622-4753 Masna Z.Z. Danylo Halytsky Lviv National Medical University, Department of Operative Surgery with Topographic Anatomy, Lviv, Ukraine; https://orcid.org/0000-0003-2057-7061 Chelpanova I.V. Danylo Halytsky Lviv National Medical University, Department of Histology, Cytology and Embryology, Lviv, Ukraine; https://orcid.org/ 0000-0001-5215-814X Kovalska M. Ye. Danylo Halytsky Lviv National Medical University, Department of pathological physiology, Lviv, Ukraine; https://orcid.org/0000-0002-6232-3951 Abstract In general, the modern literature pays attention to the issues of spine pathology and intervertebral discs. A significant percentage of vertebral disorders - scoliosis, osteochondrosis, spinal disc herniation, etc., occur as a result of exposure to various factors and manifest in changes of the intervertebral discs. The aim of our work was to study at the ultrastructural level the features of pathomorphological manifestations in the structural components of the intervertebral disc at the end of the seventh and fourteenth days of experimental opioid exposure. Materials and methods of research. The objects of the study were 32 sexually mature, white, male rats, weighing 92 - 103 g, aged 4.5 months. Animals were injected with nalbupine intramuscularly once daily (at 10-11 a.m.) for 14 days. The initial dose of nalbuphine was 8 mg/kg during the first week, 15 mg/kg during the second week. It created the conditions of chronic opioid exposure. Before sampling, the animals were withdrawn from the experiment using dibutyl ether. Intervertebral discs of rats were used as a material for ultrastructural study. Ultrastructural specimens were prepared according to the accepted methods. The results of the study. As a result of the sampling after 7 days of opioid exposure we found inhomogeneous osmiophilicity and compaction of the nucleus pulposus matrix in which intensively accumulated osmiophilic grains of glycogen proteoglycans, increased the number of collagen fibers, some of them were heterogeneous. It was also noted the development of moderate degenerative changes in some notochondral cells, which was accompanied by increased vacuolization of the cytoplasm by inhomogeneous compaction of the nucleus and an increase of heterochromatin there. After 14 days necrotic changes in the cells of the nucleus pulposus, as well as the destruction of collagen fibers of the annulus fibrosus were found. In particular, an increase in the amount of heterochromatin in the nucleui of notochondral cells, which was accompanied by a decrease in the volume of the nucleui and inhomogeneous swelling of the cytoplasm. Active fibroblasts were often visualized in the annulus fibrosus. Intense osmiophilicity and thickening of collagen fibers of the annulus fibrosus were observed in some areas of the fibrous ring. Focal destruction of collagen fibers was also noted. In the areas of destruction the fibrils of collagen fibers disintegrated into an inhomogeneous fine-grained stratified mass and were located loosely. Conclusions. At the end of the first week we found that the cytoplasmic processes of chondrocytes decreased in volume, shortened, underwent fragmentation and destruction, some of them detached from the surface of the plasmolemma. At the end of the second week signs of opioid exposure progressed and manifested by an increase in the destruction of cytoplasmic processes in chondrocytes. Also focal destruction of collagen fibers was noted. Keywords: opioid; intervertebral disc; rat; seventh and fourteenth day.

Medvedeva M. O., Tertyshnyk D. Y., Safonova I. M., Lazurenko V. V., Borzenko I. B. Ultrasound investigation in pregnant women with diabetes mellitus. Journal of Education, Health and Sport. 2021;11(08):480-490. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.08.054 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.08.054 https://zenodo.org/record/5565210 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.08.2021. Revised: 16.08.2021. Accepted: 31.08.2021. ULTRASOUND INVESTIGATION IN PREGNANT WOMEN WITH DIABETES MELLITUS M. O. Medvedeva1, D. Y. Tertyshnyk2, I. M. Safonova1, V. V. Lazurenko2, I. B. Borzenko2 ¹, Department of Radiation Diagnostics ²Kharkiv National Medical University, Department of Obstetrics and Gynecology №2 Mariia Medviedieva orcid: 0000-0002-5146-6471 Denis Tertyshnik orcid: 0000-0003-3942-1016 Inessa Safonova orcid: 0000-0002-7300-4868 Viktoriya Lazurenko orcid: 0000-0002-7300-4868 Iryna Borzenko orcid: 0000-0002-0390-7068 Abstract Introduction. Ultrasound (US) has been used in obstetrics for more than 30 years and is considered to be reliable, simple, quick in results, painless and cheap method. The aim: to optimize the use of US in childbirth in pregnant women with diabetes and determine the outcome of childbirth, taking into account the condition of the fetus and newborn. Materials and methods. 52 pregnant women, among them 32 with diabetes mellitus (pre-gestational diabetes was in 20 persons and 12 persons had gestational diabetes) have been examined. The average age of pregnant women in the main group was 29.8 ± 5.4 years, in the control group - 25.7 ± 4.3 years. All women in the main and control groups were primiparous. The gestation period in the main group was 39.1 ± 0.5 weeks [38.0; 39.6], in the control group - 39.5 ± 0.7 [38.4; 40.5] weeks. Clinical-laboratory and instrumental examinations were made. Control group consisted of 20 physiologically pregnant women. To determine the condition and size of the fetus and its progress in labor, immediately at the end of the first and during the second staage of labor, transabdominal and transperineal US and Doppler examination were performed with device HD 11 XE Phillips (USA). Results. Pregnant women with diabetes are more likely to have a pathological second stage of labors due to macrosomia and problems with the birth of the fetus, as evidenced by the lack of increased angle of progress and decreased head-perineal distance. The data obtained indicate the prospects of using ultrasound in childbirth as an objective non-invasive method for predicting the likelihood of vaginal birth, which will reduce operative delivery and perinatal pathology. Conclusions. The use of ultrasound in childbirth in women with diabetes and diabetic fetopathy can determine the possibility of complications in the promotion of the fetus, including clinical narrow pelvis, shoulder dystocia, the occurrence of distress, as evidenced by the Apgar scale and CLS. Intraparietal ultrasound helps to guide the plan of childbirth, reduce the frequency of cesarean delivery, perinatal morbidity and mortality, and birth trauma. Key words: pregnant women with diabetes; diabetic fetopathy; intraparietal ultrasound.

Olekshij P. V. Characteristics of cytokine status in the pathogenesis of experimental periodontitis and immobilization stress. Journal of Education, Health and Sport. 2021;11(08):504-509. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.08.056 https://apcz.umk.pl/JEHS/article/view/JEHS.2021.11.08.056 https://zenodo.org/record/5579592 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.08.2021. Revised: 16.08.2021. Accepted: 31.08.2021. UDC: 616.314.18-002.4-092:612.176:616.155.3-097.37]-092.9 Characteristics of cytokine status in the pathogenesis of experimental periodontitis and immobilization stress P. V. Olekshij Lviv Medical Institute Abstract The aim of our study is to elucidate changes in the content of pro-inflammatory interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and anti-inflammatory cytokines interleukin-10 (IL-10) in the blood serum of guinea pigs in the dynamics of experimental periodontitis and immobilization stress. The dynamics of the combined pathology (experimental periodontitis and immobilization stress) is accompanied by a pronounced progression of the proinflammatory group of cytokines - TNF-α and IL-6 against the background of declining functional activity of IL-10 at all stages of their formation (3 rd , 5 th and 15 th days) with an advantage on the 15 th day of the experiment. The data obtained indicate an imbalance of pro- and anti-inflammatory cytokines and impaired cytokinogenesis, which is important for the pathogenesis in this combined pathology. Key words: periodontitis; stress; cytokines.

KrasaAleksandra,KoziołMagdalena,Piecewicz-SzczęsnaHalina,ŁopuszyńskaAnna,PiekarskaEwa,WięsykPiotr,PawlickiMateusz. Neurological manifestations and complications of COVID-19. A literature review. Journal of Education, Healthand Sport. 2021;11(8):349-360. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.08.039 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.08.039 https://zenodo.org/record/5300055 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.08.2021. Revised: 15.08.2021. Accepted: 28.08.2021. Neurological manifestations and complications of COVID-19. A literature review Aleksandra Krasaa, Magdalena Kozioła, Halina Piecewicz-Szczęsnab, Anna Łopuszyńskaa,Ewa Piekarskaa, Piotr Więsyka, Mateusz Pawlickia aStudent Scientific Association at Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin, ul. Radziwiłłowska 11, Lublin 20-080, Poland bDepartment of Epidemiology and Clinical Research Methodology of the Medical University of Lublin, ul. Radziwiłłowska 11, Lublin 20-080, Poland Corresponding author: Aleksandra Krasa, aleksandra.krasa97@gmail.com ORCID ID: Aleksandra Krasa, 0000-0002-0733-202X, aleksandra.krasa97@gmail.com Magdalena Kozioł, 0000-0002-8671-5968, magdalena.koziol@icloud.com dr n. med. Halina Piecewicz-Szczęsna, 0000-0002-0573-7226, halpiec@gmail.com Anna Łopuszyńska, 0000-0001-5133-4180, lopuszynskaania@gmail.com Ewa Piekarska, 0000-0002-4954-379X, piekarskaewaa@gmail.com Piotr Więsyk, 0000-0001-6785-6741, piotrwiesyk@gmail.com Mateusz Pawlicki, 0000-0001-8318-6573, pawlak32@gmail.com ABSTRACT Introduction. The first case of SARS-CoV-2 infection was identified in December 2019 in Wuhan, China. The disease spread rapidly worldwide and the WHO declared a pandemic on March 11, 2020. Although coronavirus disease 2019 (COVID-19) has been associated primarily with respiratory disorders, more and more research is focusing on neurological manifestations and complications. Objective. The aim of the review is to systematize and update the knowledge and available research on neurological complications among COVID-19 patients. Review methods. A systematic search of PubMed and Google Scholar databases was conducted for studies. The following keywords combinations were used: COVID-19, SARS-CoV-2 infection, neurological complications, neurological manifestations, neuroinvasion, neurovirulence. Results. The disease in most patients is characterized by mild to medium fever, fatigue, dry cough, dyspnea, muscle pain and headache. ACE2, which is the receptor for SARS-COV-2, is ubiquitously expressed in a variety of human organs, including the brain. Following previous reports, these receptors are expressed in both glial cells and neurons. Many studies have reported neurological symptoms and complications among COVID-19 patients. The reported manifestations include: smell and taste disturbance, non-specific symptoms such as myalgia, headache and dizziness, acute cerebrovascular complications, encephalopathy, meningoencephalitis/encephalitis, seizure and complications of the peripheral nervous system. Conclusion.Healthcare professionals dealing with COVID-19, neuroscientists, and the general public should be aware of the neurological complications of COVID-19. Further studies are needed to assess the incidence of COVID-19 neurological complications in different populations and more analyzes are also required to understand the detailed mechanism of how the virus affects the nervous system. Keywords:COVID-19, SARS-CoV-2 infection, neurological complications, neurological manifestations, neuroinvasion, neurovirulence.

Piekarska Ewa, Pawlicki Mateusz, Łopuszyńska Anna, Kozioł Magdalena, Krasa Aleksandra, Piecewicz-Szczęsna Halina. Caffeine in Pain Perception and Management. Journal of Education, Health and Sport. 2021;11(8):328-333. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.08.036 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.08.036 https://zenodo.org/record/5274050 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.08.2021. Revised: 15.08.2021. Accepted: 26.08.2021. Caffeine in Pain Perception and Management Ewa Piekarska1, Mateusz Pawlicki1, Anna Łopuszyńska1, Magdalena Kozioł1, Aleksandra Krasa1, Halina Piecewicz-Szczęsna2 1Student Scientific Association at Department of Epidemiology and Clinical Research Methodology Medical University of Lublin, ul. Radziwiłłowska 11, Lublin 20-080, Poland 2Department of Epidemiology and Clinical Research Methodology of the Medical University of Lublin, ul. Radziwiłłowska 11, Lublin 20-080, Poland Corresponding author: Ewa Piekarska, piekarskaewaa@gmail.com ORCID ID: Ewa Piekarska https://orcid.org/0000-0002-4954-379X; piekarskaewaa@gmail.com Mateusz Pawlicki https//orcid.org/0000-0001-8318-6573, pawlak32@gmail.com Anna Łopuszyńska https://orcid.org/0000-0001-5133-4180, lopuszynskaania@gmail.com Magdalena Kozioł https://orcid.org/0000-0002-8671-5968, magdalena.koziol@icloud.com Aleksandra Krasa https://orcid.org/0000-0002-0733-202X, ola.AK62@gmail.com Abstract: Introduction: Caffeine is considered to be one of the most frequently used pharmacologically active substances in the world. Caffeine is a psychoactive and central nervous system stimuli that has the ability to increase energy, decrease fatigue, promote alertness and wakefulness. Potential role of caffeine's nociceptive properties shows that it may play a relevant role in pain modulation. Although caffeine at dietary levels is not a sufficient analgesic in its own, it has been included in many over-the-counter and prescription drugs. This review addresses caffeine's analgesic properties in pain management. Results: Caffeine shows relevant role in pain modulation through blocking adenosine receptors which are involved in nociception. Studies show that habitual dietary caffeine consumption results in decreased pain sensitivity. As an adjuvant to commonly used analgesics, caffeine provides an important increase in pain relief in various types of pain such as postoperative dental pain, headaches, or fibromyalgia. Conclusions: In conclusion, caffeine is associated with decreased pain sensitivity. Addition of caffeine to analgesics has resulted in their enhanced analgesic efficacy in pain treatment. Key words: caffeine; pain; analgesia

WięsykPiotr, Krasa Aleksandra, Słaboń Małgorzata, Piecewicz-Szczęsna Halina. A quality of life for patients with diabetes.Journal of Education, Health and Sport. 2021;11(8):276-282. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.08.029 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.08.029 https://zenodo.org/record/5229162 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.08.2021. Revised: 15.08.2021. Accepted: 20.08.2021. A quality of life for patients with diabetes Piotr Więsyk1, Aleksandra Krasa1, Małgorzata Słaboń1, Halina Piecewicz-Szczęsna2 1 Students’ Scientific Association at Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin, ul. Radziwiłłowska 11, Lublin 20-080, Poland; 2 Department of Epidemiology and Clinical Research Methodology of the Medical University of Lublin, ul. Radziwiłłowska 11, Lublin 20-080, Poland Corresponding author: Piotr Więsyk, piotrwiesyk@gmail.com Piotr Więsyk Orcid ID: https://orcid.org/0000-0001-6785-6741 E-mail: piotrwiesyk@gmail.com Aleksandra Krasa: Orcid ID: https://orcid.org/0000-0002-0733-202X E-mail: aleksandra.krasa97@gmail.com Małgorzata Słaboń: Orcid ID: https://orcid.org/0000-0003-1627-8878 E-mail: malgorzata.slabon@wp.pl Dr n. med. Halina Piecewicz-Szczęsna Orcid ID: https://orcid.org/0000-0002-0573-7226 E-mail: halpiec@gmail.com Department of Epidemiology and Clinical Research Methodology of the Medical University of Lublin, ul. Radziwiłłowska 11, Lublin 20-080, Poland Abstract Introduction and purpose: Diabetes mellitus (DM) is a metabolic disease caused by a chronic state of hyperglycemia, which results from a defect in the function or secretion of endogenous insulin. It is a disease that leads to serious complications such as blindness, lower limb amputation, ischemic heart disease or ischemic strokes. Description of the state of knowledge: The World Health Organization has identified diabetes mellitus as a global epidemic. Between 1980 and 2014, the number of people with diabetes increased from 108 million to over 422. Between 2000 and 2016, more than 7 million deaths from diabetes were reported in 108 countries, but this is an under-number due to the fact that many patients are not diagnosed with diabetes. The prevalence of diabetes in recent years is also higher in low and middle income (LMIC) countries than in high income (HIC) countries. DM also places a significant financial burden on the healthcare budget. Despite relatively large investments in medical care, clinical trials and public health interventions do not reduce the rate of increase in incidence. In the United States, annual healthcare expenditure for people with diabetes is 2.3 times greater than for people without diabetes. Summary: It is well known that diabetes significantly reduces patients' quality of life. It is influenced by both severe complications related to DM and adherence to strict medical recommendations. The low quality of life of diabetic patients contributes to depression, which is associated with not compliance with medical recommendations and increased mortality. Key words:Diabetes; Mortality; Quality of life

WróblewskiHubert, ZimnaAleksandra. Use of Rifaximin in Irritable Bowel Syndrome Treatment.Journal of Education, Health and Sport. 2021;11(8):247-254. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.08.025 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.08.025 https://zenodo.org/record/5226929 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.08.2021. Revised: 15.08.2021. Accepted: 19.08.2021. Use of Rifaximin in Irritable Bowel Syndrome Treatment Hubert Wróblewski, Aleksandra Zimna Faculty of Medicine, Medical University of Lublin Abstract Introduction and purpose of the work: Irritable Bowel Syndrome (IBS) affects up to 10% of the population. The deterioration in health-related quality of life in IBS patients has been shown to be comparable to, and perhaps even more severe than, other serious chronic organic diseases such as inflammatory bowel disease, diabetes, hypertension, and end-stage renal disease. The aim of the study is to present a new method of IBS treatment. State of knowledge: There are four main types of IBS: Constipation-predominant IBS (IBS-C), Diarrhea-predominant IBS (IBS-D), Fluctuating IBS (IBS-M), and the unclassified form of IBS (IBS-U). Disturbances in entero-brain interactions play a key role in its multifactorial etiopathogenesis. In patients with IBS, quantitative and qualitative disturbances in the composition of the intestinal microbiota can be found. So far, it has not been possible to clearly establish the cause of the disease, so there is no possibility of causal therapy and effective cure. Both non-pharmacological methods and drugs, including rifaximin α, have been used in IBS therapy. Summary: Rifaximin has a positive effect on the symptoms of IBS. In clinical trials conducted in patients with IBS, the use of rifaximin for 2 weeks was associated with a reduction in the severity of joint symptoms, bloating, abdominal pain and discomfort, and an improvement in stool consistency within 4 and 12 weeks, and did not increase the risk of side effects. In the forms: with predominant diarrhea, mixed and unclassified, in order to reduce the overall symptoms as well as reduce the severity of flatulence and / or diarrhea, a 14-day therapy with rifaximin αis recommended. Key words: rifaximin; irritable bowel syndrome; treatment Abstrakt Wprowadzenie i cel pracy: Zespół jelita drażliwego (Irritable Bowel Syndrome-IBS) dotyka nawet 10% społeczeństwa. Wykazano, że pogorszenie jakości życia związanej ze zdrowiem u pacjentów z IBS jest porównywalne, a może nawet bardziej dotkliwe, niż inne poważne przewlekłe choroby organiczne, takie jak nieswoiste zapalenie jelit, cukrzyca, nadciśnienie i schyłkowa niewydolność nerek. Celem pracy jest przedstawienie nowej metody leczenia IBS. Stan wiedzy:Wyróżnia się cztery główne podtypy IBS: IBS zdominującym zaparciem (IBS-C), IBS zdominującą biegunką (IBS-D), IBS ze zmiennym rytmem wypróżnień (IBS-M) iniesklasyfikowaną postać IBS (IBS-U). W jej wieloczynnikowej etiopatogenezie kluczową rolę odgrywają zaburzenia interakcji jelitowo-mózgowych. U chorych z IBS można stwierdzić ilościowe i jakościowe zaburzenia składu mikrobioty jelitowej. Dotychczas nie udało się jednoznacznie ustalić przyczyny choroby, zatem nie istnieje możliwość terapii przyczynowej oraz skutecznego wyleczenia. W terapii IBS zastosowanie znalazły zarówno metody niefarmakologiczne oraz leki, do których zaliczyć można ryfaksyminę α. Podsumowanie: Ryfaksymina korzystnie wpływa na objawy IBS. W przeprowadzonych badaniach klinicznych u chorych z IBS stosowanie ryfaksyminy przez 2 tygodnie wiązało się ze zmniejszeniem nasilenia łącznych dolegliwości, wzdęcia, bólu brzucha i dyskomfortu oraz poprawą konsystencji stolca w ciągu 4 i 12 tygodni oraz nie zwiększyło ryzyka objawów niepożądanych. Wpostaciach: zdominującą biegunką, mieszanej iniesklasyfikowanej, wcelu zmniejszenia objawów ogółem, jak również zmniejszenia nasilenia wzdęcia i/lub biegunki rekomenduje się 14-dniową terapię ryfaksyminą α. Słowa kluczowe: ryfaksymina; zespół jelita nadwrażliwego; leczenie

ZimnaAleksandra, Wróblewski Hubert. Eating habits in patients with inflammatory bowel disease.Journal of Education, Health and Sport. 2021;11(8):255-260. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.08.026 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.08.026 https://zenodo.org/record/5226959 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.08.2021. Revised: 15.08.2021. Accepted: 19.08.2021. Eating habits in patients with inflammatory bowel disease Aleksandra Zimna, Hubert Wróblewski Faculty of Medicine, Medical University of Lublin Abstract Introduction: Ulcerative colitis and Crohn's disease are the most common inflammatory bowel diseases. Pharmacotherapy plays a major role in the treatment of both exacerbations and remissions, however, diet is also important, which should be selected individually to the patient's needs, especially taking into account the patient's needs. reaction to the food and the symptoms you are currently experiencing. The purpose of introducing the diet is, inter alia, facilitating intestinal regeneration, accelerating and extending the period of disease remission, and preventing malnutrition in patients. Aim:The aim of the study is to analyze the eating habits and diet of IBD patients in remission. Materials and methods: The results were obtained on the basis of a questionnaire survey. Results: 95 people took part in the survey, 56.4% of them suffer from UC and 43.6% from CDI, 48.5% of respondents admit that they smoke more than 10 cigarettes a day. As many as 43.6% do not do any sports More than half of respondents eat white bread and exclude blue cheese from the diet. 24.5% of respondents are mostly meat products and 13.8% - vegetables. Only 27% of respondents use probiotics, only 40% consume pickled products regularly. Almost 6% do not eat fish and 35 people do it sporadically, unlike poultry, which is eaten several times a week by less than half of the respondents, 27 of the respondents excluded smoked meats from their diets. Only 25% of the respondents do not consume NSAIDs, while for 6% their consumption is everyday life. Conclusions:The study shows that there is a constant need to educate patients about a healthy lifestyle, including promoting physical activity and obeying the harmful effects of smoking on their health, life and the course of diseases by emphasizing CDD, because smoking tobacco aggravates this disease, similar to the consumption of NSAIDs. When analyzing the obtained results, attention should be paid to the low interest in consuming probiotics, which have a positive effect on the intestinal microflora, and to emphasize the benefits of consuming pickled products. It seems that the selection of food products and the diet used by the respondents is an expression of individual needs, subjective beliefs and preferences. Key words:diet; inflammatory bowel diseases; education Abstrakt Wstęp: Wrzodziejące zapalenie jelita grubego i choroba Leśniowskiego-Crohna to najczęstsze choroby zapalne jelit. Farmakoterapia odgrywa dużą rolę w leczeniu zarówno zaostrzeń, jak i remisji, jednak ważna jest również dieta, którą należy dobierać indywidualnie do potrzeb pacjenta, szczególnie biorąc pod uwagę potrzeby pacjenta. reakcja na pokarm i objawy, których obecnie doświadczasz. Celem wprowadzenia diety jest m.in. ułatwienie regeneracji jelit, przyspieszenie i wydłużenie okresu remisji choroby oraz zapobieganie niedożywieniu u pacjentów. Cel: Celem pracy jest analiza nawyków żywieniowych i diety pacjentów z IBD w okresie remisji. Materiał i metody: Wyniki uzyskano na podstawie badania ankietowego. Wyniki: W ankiecie wzięło udział 95 osób, 56,4% z nich cierpi na WZJG, a 43,6% na ZCD, 48,5% respondentów przyznaje, że pali więcej niż 10 papierosów dziennie. Aż 43,6% nie uprawia sportu. Ponad połowa badanych je białe pieczywo i wyklucza z diety sery pleśniowe. 24,5% respondentów to głównie produkty mięsne, a 13,8% - warzywa. Tylko 27% badanych stosuje probiotyki, tylko 40% regularnie spożywa produkty marynowane. Prawie 6% nie je ryb, a 35 osób robi to sporadycznie, w przeciwieństwie do drobiu, który zjada kilka razy w tygodniu mniej niż połowa badanych, 27 respondentów wykluczyło ze swojej diety wędliny. Tylko 25% badanych nie zażywa NLPZ, a dla 6% ich spożycie to codzienność. Wnioski: Z przeprowadzonych badań wynika, że istnieje ciągła potrzeba edukowania pacjentów w zakresie zdrowego stylu życia, w tym promowania aktywności fizycznej oraz przestrzegania szkodliwego wpływu palenia na ich zdrowie, życie i przebieg chorób poprzez podkreślanie CDD, ponieważ palenie tytoniu pogłębia tę chorobę , podobnie jak zażywanie NLPZ. Analizując uzyskane wyniki należy zwrócić uwagę na małe zainteresowanie spożywaniem probiotyków, które mają pozytywny wpływ na mikroflorę jelitową oraz podkreślić korzyści płynące ze spożywania produktów marynowanych. Wydaje się, że dobór produktów spożywczych i stosowanej przez respondentów diety jest wyrazem indywidualnych potrzeb, subiektywnych przekonań i preferencji. Słowa kluczowe:dieta; nieswoiste choroby zapalne jelit; edukacja

BrylińskiŁukasz, Drożak Paulina, Drożak Martyna, Augustowska Katarzyna,Duda Piotr, Bura Agata, Rudnicka-Drożak Ewa. Chronic traumatic encephalopathy – current state of knowledge.Journal of Education, Health and Sport. 2021;11(8):86-100. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.08.010 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.08.010 https://zenodo.org/record/5201470 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.08.2021. Revised: 10.08.2021. Accepted: 14.08.2021. Chronic traumatic encephalopathy – current state of knowledge Łukasz Bryliński1, Paulina Drożak1, Martyna Drożak1, Katarzyna Augustowska1, PiotrDuda1, Agata Bura1, Ewa Rudnicka-Drożak2 Students’ Scientific Association of Chair and Department of Family Medicine, Medical University of Lublin. Chair and Department of Family Medicine, Medical University of Lublin. Abstract Introduction and purpose.Chronic traumatic encephalopathy (CTE) is a tauopathy caused by repetitive, mild head injuries. It is characterized by perivascular accumulation of hyperphosphorylated tau protein in the neurons and astrocytes. CTE leads to changes in central nervous system, both on microscopic and macroscopic level. The aim of the study was to present the current knowledge on chronic traumatic encephalopathy among athletes, its predisposing factors, symptoms and consequences, as well as diagnostic methods and treatment. Description.CTE occurs among contact sport players, such as American football, ice hockey, soccer, baseball, box and MMA (mixed martial arts), as well as among soldiers and victims of domestic violence. Repetitive head injuries and long career duration increase the risk of CTE. Symptoms of chronic traumatic encephalopathy include a commonly occurring triad: cognitive disturbances, behavioral problems and mood disturbances. Other symptoms include memory loss, parkinsonism, headaches, speech and walking problems. Currently, the only diagnostic method of CTE is a posthumous detection of neuropathological markers. Methods such as detection of exosomal tau protein in plasma and imaging techniques give hope to diagnose CTE in alive patients. Treatment methods of CTE, such as LIPUS (low intensity pulsed ultrasound) therapy are currently being developed. Conclusions.Chronic traumatic encephalopathy among athletes is a serious problem that affects multiple people due to the popularity of contact sports. Thus, an emphasis should be put on prevention, raising awareness and appropriate protection of athletes through changes in regulations and improvement of protective equipment. Key words: chronic traumatic encephalopathy; athletes