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ABSTRACT Coronary artery calcification is probably the main determinant of the poor outcome of percutaneous coronary interventions and is associated with higher rates of adverse events. There are currently different balloon or specific device-based plaque modification techniques available. Knowing their characteristics and proper use is key for the optimal treatment of calcified lesions. This position paper—promoted by the Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC)—describes existing plaque modification techniques currently available and proposes an algorithm for the management of calcified lesions.

Introduction: The National Scientific Congress (NSC) is an annual event held in Peru in which medical students from all over the country present their research work. Objectives: To determine the publication rate in indexed scientific journals of research papers submitted to the NSCs held between 2010 and 2014, as well as the factors associated with their publication, and to describe the characteristics of the published papers. Materials and methods: Retrospective study in which 407 abstracts of research papers were reviewed. A publication time window of 6 years (from submission) was considered. A bivariate analysis was performed to assess differences between categorical and numerical variables using the chi-square and Mann-Whitney U tests, respectively. In addition, a multivariate analysis was performed using Poisson regression models (a crude and an adjusted model), calculating relative risk (RR) values with their respective 95% confidence intervals (95%CI) to determine the factors associated with the publication of papers. A significance level of p

Introduction: Herbal medicine has been growing in popularity over the last few years. One of the most often used herbal remedy is Withania somnifera, more widely known as Ashwagandha Now known for its anti-stress, anti-inflammatory, antioxidant, anti-cancer, anti-anxiety properties it ranks as a cure-all. However, there is a rising amount of alarming reports regarding its safety. It has been observed that its effects are not always beneficial, and for some patients the risks of taking it may be greater than the promoted benefits. Aim of study: The aim of this paper is to evaluate possible risks connected to Withania Somnifera consumption based on available research articles and case reports. Materials and methods: This article is based on the literature found in the PubMed Database from the period of 2004-2024 with the use of keywords such as “Ashwagandha”; “Withania Somnifera”, “herbal medicine”;”complementary medicine”;“liver injury”; “thyrotoxicosis”; “adrenal insufficiency”;”autoimmune diseases”. Results: The outcomes of all the reviewed studies in this paper indicate that Withania Somnifera might cause a wide range of side effects. They include herb induced liver injury, endocrine complications such as thyrotoxicosis and adrenal insufficiency, acute graft rejection in a kidney transplant recipient and possible contribution to the onset of new autoimmune disease in patient with the history of autoimmune disorders. Conclusion: Further long-term research is needed on the Ashwaghanda’s benefits but particularly on its safety and potential side effects. The common education on the risks of taking herbal supplements should be carried out among health professionals and the rest of the society. Ashwagandha should not be used by patients with liver, endocrine and autoimmune disorders as well as transplant recipients.

Introduction and purpose Acne is one of the most common dermatological conditions, especially in adolescents. The etiology of acne is complex, and many factors influence the formation of lesions. Local inflammation, a proliferation of Propionibacterium acnes, hormonal influences with particular importance of androgens, hyperkeratinization, and excessive sebum production are essential in the pathogenesis. The factors stimulating these processes are complex and not always clear. Therefore, in our work, we focused on investigating the connection between a high-glycemic diet and the formation of acne lesions. The state of knowledge The link between diet and acne has been only mentioned in the literature for many years. However, the development of science has made it possible to understand the exact pathogenesis of acne and the relationship of acne lesions to specific dietary components. Of all the diet products, a high glycemic index diet stands out as the one with the most significant impact. Foods with a high glycemic index, i.e. those with a high amount of simple sugars, through an increase in the expression of factors such as insulin, IGF-1 cause excessive sebum production in the sebaceous glands and even an increase in inflammatory infiltration, which further exacerbates acne lesions. In the following review paper, we have looked at the metabolic pathways and hormonal changes that link the consumption of high glycemic index foods to the formation of acne lesions and described several original papers that unequivocally demonstrate the critical role of this diet on acne formation. Summary Based on the literature, we emphasize that in acne treatment, it is necessary not only to focus on medications but, above all, to look at the patient holistically, modifying the lifestyle with particular importance on modifying the patient's diet by lowering its glycemic index.

Introduction: Psoriatic arthritis is a chronic disease involving peripheral arthritis, spondylitis, dactylitis (inflammation of the whole digit) and enthesitis. It is a disease equally prevalent in both genders. Psoriatic arthritis coexists with several conditions, including metabolic syndrome, obesity, cardiovascular disease, inflammatory bowel disease, and liver disease. The reciprocal effects of comorbidities with psoriatic arthritis are demonstrated by recent research. There are several risk factors associated with the condition that might hasten or worsen its symptoms. Aim of the Study: The purpose of this paper is to present a thorough analysis of the research that has been done on comorbidities and risk factors for psoriatic arthritis. With an emphasis on changeable elements that might impact the disease's progression, the goal is to illustrate the multifaceted nature of psoriatic arthritis. The intention is also to highlight comorbidities that need to be considered while treating a patient with the illness. Materials and methods: An analysis of papers available in PubMed and Google Scholar was performed using the following key words: psoriatic arthritis, psoriatic arthritis and lifestyle, psoriatic arthritis and comorbidities, psoriatic arthritis and cardiovascular risk, psoriatic arthritis and gastrointestinal diseases, psoriatic arthritis and physical activity, psoriatic arthritis and diet, psoriatic arthritis and alcohol, psoriatic arthritis and smoking. Conclusions: Psoriatic arthritis is a chronic disease that affects many areas of patients' lives. It is critical to consider the connections that exist between this illness and other comorbidities. In order to provide a patient with this ailment with the best care possible, variables that might exacerbate the illness's progression must also be taken into consideration. Patients' mental health should get particular attention, and lifestyle modifications should be promoted.

Introduction The rising prevalence of electronic cigarette (e-cigarette) use has prompted concerns regarding its potential health implications. While much attention has focused on respiratory and cardiovascular effects, injuries, oral trauma, and bone fractures linked to e-cigarette use have received less scrutiny. This paper aims to comprehensively review the landscape of injuries, oral trauma, and bone fractures induced by e-cigarettes, shedding light on this underexplored facet of e-cigarette-related harm. Material and Methods This literature review has analyzed 16 papers. Inclusion criteria: researches and case reports published after 2015. PubMed and Google Scholar has been searched to identify the papers. Analysis of the Literature Existing literature suggests a growing incidence of injuries, oral trauma, and bone fractures associated with e-cigarette use, albeit with limited systematic investigation. Mechanisms underlying these injuries range from device malfunctions to inadvertent impacts during use. Case reports highlight a spectrum of injuries, including oral burns, dental trauma, and skeletal fractures, often involving the face and mouth regions. Conclusions Despite the lack of comprehensive epidemiological data emerging evidence underscores the need for heightened awareness and preventive measures to mitigate e-cigarette-related injuries. Enhanced education, regulation of e-cigarette devices, and promotion of safer usage practices are crucial steps towards reducing the burden of e-cigarette-related harm on oral and skeletal health.

Introduction and purpose Non-specific and specific lower back pain syndrome is one of the leading causes of musculoskeletal disability and affects more than half of the population worldwide. The aim of this paper is to confront the problem of lumbar pain, possible diagnostic options, conservative and surgical opportunities with long term satisfactory rate. State of knowledge The paper reviews literature on lower back pain syndrome, sciatica, radiculopathy and lumbar disc herniation in regards to detection of the problem, classifying it and possible methods of resolvement. The WHO defines lower back pain as one of the leading causes of musculoskeletal dysfunction and it focuses on reducing the occurrence by programs like WHO Rehabilitation 2030 Initiative, UN Decade of Healthy Ageing and others. The paper also focuses on non surgical options of treatment. Material and method A review of the literature available in the “PubMed” and Google Schoolar was conducted. We focused on differential diagnosis depending on clinical presentation and possible treatment methods depending on symptoms, pathogenesis of the disorder and available procedures. Summary Our review managed to present the current state of development, possible differential diagnosis, prevalence of neural compressions, sciatica and radiculopathy in different diagnostic options. By receiving multiple studies we confront varied opinions of specialists regarding the approach to lower back pain syndrome and favorable forms of care. Additionally we came to the conclusion that the difference of patients' long term satisfactory rate in regards to nonoperative and operative treatment is not significant, and flattens over the years.

Gilbert’s syndrome is the most common inherited jaundice worldwide. It affects 5-10% of the population. It is caused by a mutation of the UGT1A1 gene, which results in impaired bilirubin metabolism. It is a benign disease and does not affect the life expectancy of patients. Patients with Gilbert’s syndrome should be alert to factors that exacerbate the course of the disease, interactions with medications taken and possible comorbidities such as hemolytic anemia, cholelithiasis or schizophrenia. However, it is the responsibility of physicians with such patients under their care to properly educate patients. Gilbert’s syndrome carries not only the consequences associated with the mutation, but also has many benefits that patients may not be fully aware of. Mildly elevated bilirubin levels have an antioxidant and anti-inflammatory effect, which prevents the development of lifestyle diseases and cancer. Ongoing clinical trials suggest that this could be a great step toward new treatments for diseases affecting the entire human population. PURPOSE OF THE WORK: This review paper aims to show Gilbert’s syndrome as a multifaceted disease and to sensitize doctors' attention to patients with the described mutation. MATERIALS AND METHODS: An analysis of papers available in PubMed and Google Scholar was performed using the following key words: Gilbert’s syndrome, bilirubin, UDP-glucuronosyltransferase, Gilbert’s syndrome harmful and protective aspects, iatrogenic Gilbert’s syndrome RESULTS: The result of the work is to present Gilbert’s syndrome as a disease that carries medical problems directly related to the mutation, but also, in some cases, has a protective effect on affected individuals. The work highlights the complexity of the problem.

Introduction and purpose: Diabetes has emerged as a global lifestyle disease, with an alarming rise in cases, particularly of type 2 diabetes. In Poland, over 3 million people are diagnosed, and an estimated 4 million cases are expected by 2030. Effective treatment involves a multifaceted approach, including dietary intervention, physical activity, and pharmacological options. Incretins, such as glucagon-like peptide-1 (GLP-1), play a pivotal role in carbohydrate metabolism regulation, and GLP-1 analogs have become essential in managing type 2 diabetes. This paper explores the development and mechanisms of GLP-1 analogs, detailing their impact on insulin secretion, gastric emptying, and weight reduction. Description of the state knowledge: Various GLP-1 receptor agonists, including exenatide, liraglutide, dulaglutide, semaglutide, and the novel tirzepatide, are discussed. These drugs exhibit diverse pharmacokinetics, modes of administration, and effects on glucose metabolism and weight. Despite their efficacy, there is a concerning trend of off-label use, particularly for obesity treatment, leading to shortages for patients with valid prescriptions. This misuse is fueled by para-advertising on social media platforms, contributing to a surge in prescriptions and reimbursement costs. To address this, guidelines for GLP-1 analog use in obesity treatment are proposed, emphasizing the need for a stable drug supply and normalizing drug availability. Summary: In 2023, concerns intensified with reports of counterfeit GLP-1 analogs, prompting regulatory interventions. The paper concludes by underscoring the critical role GLP-1 analogs play in diabetes and obesity treatment, while emphasizing the importance of responsible prescription practices, guidelines adherence, and regulatory vigilance to ensure patient safety and mitigate the risks associated with misuse and counterfeit drugs.

Effective body posture entails the correct alignment of body parts in relation to each other and is crucial for preserving balance, stability, and the efficient operation of muscles and joints. The major types of posture abnormalities such as lordosis, kyphosis and scoliosis can lead to alterations in various areas of the body, such as stomatognatic system. The potential correlation between malocclusion and body posture remains a subject of controversy. The aim of this review is to investigate and evaluate the association between posture defects and malocclusion on the basis of literature. This literature review has analyzed 18 studies. Inclusion criteria: clinical researches published after 2010, regarding children and adults. PubMed and Google Scholar has been searched to identify the papers. In 18 analyzed studies, 2133 patients were enrolled (including 979 children aged 4-18). A positive correlation between scoliosis and different types of malocclusion has been proven by six papers. There are also other noteworthy dependencies, such as overjet and pelvic torsion, kyphosis and sagittal position of mandible, skeletal Class III and torticollis, cross bite and scapula plane. Adolescent Idiopathic Scoliosis significantly affects the stomatognathic system, leading to issues like crossbite, crowding, increased overjet, overbite, partial open bite, and midline deviation. Orthopedists should collaborate with orthodontists for comprehensive treatment, particularly during developmental stages.

This scientific paper focuses on the treatment of breast cancer, one of the most common cancers among women. Despite increased awareness and the popularity of screening tests, statistics indicate a significant rise in incidence. The paper presents breast-conserving treatment methods, including brachytherapy, as a modern technique with promising outcomes. It describes the physical properties of ionizing radiation used in brachytherapy, discussing the photoelectric effect, Compton effect, and the phenomenon of pair production. The paper then delves into the biological effects of ionizing radiation, emphasizing the dependence on the cell cycle phase. It highlights lethal, sublethal, and potentially lethal cellular damage, categorizing the effects of radiation interaction into early and late responses. The discussion transitions to the application of brachytherapy in breast cancer treatment, focusing on various techniques such as LDR, PDR, and HDR. The paper provides a detailed description of brachytherapy's use in breast-conserving treatment, considering contraindications, treatment planning, and Accelerated Partial Breast Irradiation (APBI) techniques. The radioisotopes used in brachytherapy are also presented, with special attention to Iridium-192. The physical and practical aspects related to this isotope are discussed, along with other commonly used radioisotopes such as Cesium-137, Cobalt-60, and Strontium-90. The paper concludes with a summary, emphasizing the significance of brachytherapy in breast cancer treatment and outlining its prospects for development. The authors highlight precision and shortened therapy duration.

Introduction and purpose: In our work, we focused on presenting the role of collagen supplementation and its impact on skin and joint health. We considered studies discussing the differences in the effects of collagen from various plant and animal sources. We also examined the influence of the degree of hydrolysis on the absorbability of the supplement. The aim of the paper is to comprehensively summarize knowledge on collagen supplementation, differentiating between its sources and forms. Material and methods: In our paper, we endeavored to address the subject of oral collagen supplementation comprehensively. We explored studies about various forms and sources of collagen. We also delved into the collagen supplementation impact on skin and joints health and impact of additives in enhancing the positive effect of collagen . State of knowledge: Oral collagen supplementation can be beneficial for skin and joints health. It promote collagen synthesis in human body increasing strength of skin and joints. The higher the degree of collagen hydrolysis, the more easily it is absorbed by the body. Additives in the form of vitamin C and A can enhance collagen synthesis. Results and conclusions: This review article indicates a growing interest in oral collagen supplementation and its impact on health. Although there are encouraging findings regarding positive effects, further research is necessary to better understand and determine the optimal conditions for achieving maximum supplementation benefits. This information may be crucial for clinical decisions made by physicians regarding joint reinforcement and anti-aging effects on the skin.

Introduction and purpose The term "probiotic" rooted in Latin, signifies 'for life,' reflecting the historical use of fermented products for therapeutic purposes. While browsing many websites devoted to healthy eating or popular science topics, we often came across the topic of probiotic food without any confirmation by scientific research. The aim of this paper is to confirm or exclude the presence of probiotics in popular foods. State of knowledge The paper reviews literature on the health benefits of various food that is traditionally considered probiotic, focusing on how they impact on varied health conditions. Defined by the WHO as living microorganisms conferring health benefits when consumed adequately, probiotics, mainly bacteria from Lactobacillus and Bifidobacterium genera, play a vital role in maintaining gut microbiota balance, regulating digestion, supporting the immune system and influencing mental and cardiovascular health. In addition, the paper also searches for scientific basis for their action. Material and methods A review of the literature available in the “PubMed” and Google Schoolar was conducted. We focused on checking whether the microorganisms contained in pickled food meet the WHO criteria for probiotics. Summary Our review managed to prove the probiotic effect of almost all presented food, except for miso. By reviewing many articles, we shed a lot of uncertainty on the repeated myth about the lack of probiotic effect of cucumbers preserved in vinegar and what is more, we found scientific assumptions about the probiotic effect of vinegar itself. Fermented food contains numerous strains of bacteria that are resistant to acid, bile and temperature in the human digestive tract and can be effectively used as a source of probiotics. Additionally, compared to probiotics from the pharmacy, fermented products provide not only probiotics, but also nutritional value, valuable fiber and vitamins, benefiting to our health.

Introduction and purpose: The purpose of this scientific paper is to review the current knowledge of the effects of red wine on human health, particularly with regard to cardiovascular disease. State of Knowledge: Since the 1990s, red wine has gained its status as a health-promoting alcohol through the French Paradox - when drunk in moderate amounts, it protects against cardiovascular disease. The authors have collected scientific papers on the health effects of alcohol, red wine and resveratrol-a polyphenol that is the main component with health-promoting effects of wine. On their basis, they analyzed the assumptions of the positive effects of wine reaching inconclusive conclusions. Summary: Despite the fact that both ethanol and resveratrol have a positive effect in in vitro studies, in population studies their effect is much less significant, either because the negative behavioral-health effects in the case of ethanol are omitted or the actual effective doses of resveratrol are omitted.

Context: Angular gyrus is an anatomical structure of the brain located in the parietal lobe, taking part in writing and reading, language-use, memory and attention and spatial recognition. It is supplied by the angular gyrus artery, which is one of the caudal branches of the middle cerebral artery. One of the clinical pathologies of the angular gyrus artery is the ischemic stroke of the angular gyrus in the dominant hemisphere, responsible for the presence of Gerstmann Syndrome: left-right disorientation, agraphia, alexia, acalculia and finger agnosia. This systematic review aims to present the variety of anomalies of the main cerebral artery and the angular gyrus artery. Objective: Preparing a systematic review of papers describing the course anomalies of the angular gyrus artery. Materials and methods: PubMed and Google Scholar electronic databases was searched for phrases: ‘Angular gyrus artery’, ‘Artery of angular gyrus’, ‘Middle cerebral artery branches’, ‘Branches of middle cerebral artery’, ‘Gerstmann Syndrome’ published between years 2015 and 2023. Also 3 papers published before 2000 were used. From the selected 30 papers, 6 were used to prepare this analysis. Results: The middle cerebral artery, from which arises the angular gyrus artery, is marked by a significant variety of its division, mainly the number of the dividing trunks of the artery. Depending on the type of the division, the angular gyrus artery can arise from the upper, middle or lower trunk and vary in sizes. It can also appear as a singular or two separate branches. Instances of the anomaly of both the angular gyrus artery and posterior parietal artery are rare, but reported. Conclusions: The angular gyrus artery is characterised by a number of anomalies in its course, separation from the middle cerebral artery, diameter and branching.

Introduction and purpose: Currently, the role of the gut microbiota in the pathogenesis of different diseases is being widely researched, the understanding of whether the dysbiosis of the gut flora demonstrates the significant role in Alzheimer disease (AD) is accentuated. The aim of this paper is to summarize the existing paper about the role of the gut microbiota - its diversity, stability and composition in this condition. The search was conducted using PubMed and Google Scholarship databases. Brief description of the state of knowledge: It is still uncertain if alteration in gut microbiome is a consequence of AD or its risk factor, but some findings suggest that the intestinal flora is able to influence the activity of the brain and lead to its dysfunctions. There is also the association between composition of the gut microbiome and AD. Results indicate that affected patients had less heterogeneity in their microbiome and the progression of AD led to alterations in the bacterial flora. Introducing modifications of the gut microbiota is considered as a therapeutic option for AD. Following personalized diet, probiotics, prebiotics and synbiotics administration or fecal microbiota transplantation (FMT) may be beneficial for affected patients. Conclusions: The subject of the role of the gut microbiota merits further research as foregoing results of conducted studies are pointing to its possibly meaningful role. Presently, still more data is needed as most of the research was collected on animal models and the analysis conducted on humans remains insufficient. We conclude that further studies are warranted in order to fully understand the pathophysiology of the disease and the possible usefulness of microbiome therapy.

Introduction and purpose: Apples are a widely consumed fruit globally and are known to be a great source of nutrition. Studies have shown that apples contain high levels of antioxidants, dietary fiber, and vitamins that contribute to numerous health benefits. This paper aims to provide a comprehensive review of the impact of apples on human health. State of knowledge: The paper reviews the current literature on the health benefits of apples, focusing on their impact on various health conditions such as cancer, cardiovascular diseases, diabetes, and obesity. Additionally, it examines the role of apples in improving intestinal, immune, and cognitive function. The paper also discusses the potential mechanisms by which apples exert their health benefits, such as high levels of flavonoids, polyphenols, and dietary fiber. Summary: In conclusion, the vast body of evidence reviewed in this paper supports the notion that consuming apples regularly can contribute to better health outcomes. They may help reduce the risk of chronic diseases, such as cancer, cardiovascular diseases, and diabetes, as well as promote healthy gut microbiota and immune function. Despite the controversy surrounding the use of pesticides in apple cultivation, the benefits of consuming apples outweigh the risks. Therefore, it is highly recommended to include apples as part of a balanced and nutritious diet to promote optimal health and wellbeing. As the saying goes, "An apple a day keeps the doctor away".

Introduction and aim Diabetic foot ulcer (DFU) is a chronic condition that affects an increasing number of people each year[1]. Healing the ulceration requires cooperation between patients, specialists and scientists in order to achieve satisfactory results. Treating this type of wound is not only a therapeutic challenge[1,2,3,4,5,6], but also an economic one, which is why so much scientific research has already been made on this phenomenon[2,3]. Still scientists continue their quest for new cost-effective alternatives to current therapeutic options that would be consistent with contemporary knowledge and available engineering capabilities in pursuance of creating techniques and new dressings that will accelerate the healing of DFUs[2,3,7,8]. Factors such as stress, obesity, certain medications, and chronic diseases appear to negatively affect the process of repair [1,9,10,4,6,11]. Studies prove that aloe vera gel due to its healing properties, can be considered as a potential dressing that will expedite the mending process of diabetic foot ulceration[12,13,14]. In this paper, we performed a literature review of the applicability of aloe vera in the healing process of DFUs. Materials and methods Searching the available literature, including randomized clinical trials and systematic reviews, we drew on databases focusing on the effects of treatment for diabetic foot ulceration using Aloe vera. Conclusion: The current scientific research on the use of Aloe vera gel in diabetic foot ulcer treatment indicates that this method is safe, effective and inexpensive[2,3]. However the difficulty of treatment and the increasing prevalence of this type of wound pose a challenge to finding new solutions and exploring mechanisms in which aloe vera can have a possible role in the wound healing process. Nevertheless, this paper presents a promising impact of Aloe vera gel applicability in the healing process of diabetic foot ulcer.

Introduction and purpose: Currently, as the frequency of obesity is alarming, the role of many factors that could contribute in preventing and treating this condition are being researched, among them the certain food with beneficial health profiles - one of them is soybeans, specifically the isoflavones it contains. Populations that consume soy are known for lower risk of various disorders - among them obesity. The aim of this paper is to summarize the existing paper about the role of these bioactive components in the treatment of this condition. The search was conducted using PubMed and Google Scholarship databases. Brief description of the state of knowledge: Obesity is one of the leading challenges in today’s healthcare as it leads to various chronic diseases that are fraught in consequences. Current knowledge is pointing into the association between composition of the soy isoflavones and the lower risk of obesity. Results of the studies indicate that patients affected with obesity could benefit from introducing soy isoflavones into their diet along with other necessary modifications. Conclusions: Soy isoflavones are potential agents in the holistic obesity treatment. Consumption of isoflavones merits further recognition as foregoing results of conducted studies are pointing to its possibly meaningful role. It is worth mentioning that consumption of soy isoflavones is not only an anti-obese factor, but also presents various other health benefits and when consumed rationally poses no risk to human’s well being. We conclude that further studies would enable us to fully reveal the potential of those polyphenols.

Introduction and purpose of the work. Aesthetic medicine currently has many methods to keep our skin in the best possible condition, and one of these methods is the use of tissue stimulators. The purpose of the following paper is to analyze, present and apply tissue stimulators in anti-aging prevention. Review methods. The paper is based on a review of literature about tissue stimulators, aesthetic medicine and anti-aging therapy. Most of the publications used were from Pubmed and Google Scholar electronic databases. State of the art description. Aesthetic medicine is a department that over the past few years has been closely associated with the slowing down of skin aging processes. In humans, over the years, proliferative processes slow down, the rate of collagen and elastin degradation increases, and the intercellular matrix is reduced. Substances known as tissue stimulators used in anti-aging therapies mean that the above processes can be delayed. Conclusion. The expectations of patients visiting aesthetic medicine clinics regarding activities that improve their appearance are increasing. They are unable to accept their own aesthetic defects, which is why they often strive for unnatural effects. Tissue simulator treatments can be a valuable way for patients to maintain healthy and rejuvenated skin.

Introduction: Xenotransplantology, the field of transplantation involving organs or tissues between different species, holds great promise for addressing the global organ shortage crisis. However, the development of new technologies without proper legislative preparation raises significant moral and ethical considerations. This paper provides an overview of the current state of xenotransplantology, highlighting its revolutionary potential alongside the moral dilemmas it entails. Aim of the study: The aim of this study is to assess current social, ethical, religious, and legal trends regarding the issue of xenotransplantation. Materials and methods: To obtain up-to-date information concerning trends in xenotransplantation, a review of the PubMed and Google Scholar databases, along with the latest legislative reports in both Europe and Poland, was performed. Conclusions: Firstly, the authors briefly report on the current situation concerning transplantology and the widely spread organ donor crisis. Next, the issue of species boundaries and the moral status of non-human animals is addressed. The assessment of ethical implications of utilizing animals as organ donors is examined, along with the legal acts regulating this issue. Moreover, the authors attempt to evaluate the cultural and religious differences related to this concern. Furthermore, this study discusses the allocation and distribution of xenotransplants, considering issues of justice, fairness, and access to this innovative medical technology. Lastly, the paper delves into the risks and uncertainties associated with xenotransplantation, including the possibility of cross-species disease transmission and intensified course of organ rejection disease.

Introduction and Purpose: Coeliac disease is an increasingly prevalent disorder worldwide. It is estimated to affect about 1% of the population and its symptoms heavily impact people's lives. The aim of this paper is to delve into the topic of coeliac disease and present basic information about its origins, current diagnostic methods, and the challenges associated with its treatment. This article includes all the necessary information from up-to-date sources. State of Knowledge: Coeliac disease was discovered a long time ago, but it is still not completely understood. Every year, new research is published regarding different populations in various countries. While we know more about the disease, its symptoms, and causes, we are still far from fully understanding all the inflammatory processes occurring in the human body. There is solid evidence that this enteropathy is caused by gluten, and the only way to reduce the clinical manifestation of coeliac disease is to adhere to a gluten-free diet. However, some patients do not benefit from this type of diet and still suffer from coeliac disease. New drugs currently being developed offer hope for these individuals, as they attempt to target the immunological reaction and mitigate the immune response in the small intestine. Conclusion: As approximately 1% of the population suffers from this disease, it is crucial to diagnose patients in the early stages of its development. Early diagnosis can prevent the development of other disorders that coexist with coeliac disease, which can be particularly dangerous, especially for children. This paper provides up-to-date information about the clinical manifestations of the disease, as well as methods of diagnosis.

The Caribbean is experiencing a worsening epidemic of obesity and noncommunicable diseases (NCDs) and it has the worst rates of premature mortality from cardiovascular diseases in the region of the Americas. Creating enabling environments to improve dietary diversity would help reduce obesity and diet-related NCDs. The Improving Household Nutrition Security and Public Health in the CARICOM project aimed to increase dietary diversity in the Caribbean, and to determine and implement effective, gender-sensitive interventions to improve food sovereignty, household food security, and nutrition in CARICOM states. Primary quantitative and qualitative research, scoping reviews, stakeholder engagement, implementation of interventions and dissemination activities were undertaken. This paper describes the overall project design and implementation, discusses challenges and limitations, and presents core achievements to inform further work in Small Island Developing States throughout CARICOM to advance the nutrition agenda in the Caribbean. The results of the project’s research activities are presented in other papers published in this special issue on nutrition security in CARICOM states.

This article focuses on the promotional aspects related to the tourist attractiveness of the neighboring countries-Poland and Slovakia. The purpose of the article is to analyze the issue in question and point out the importance of the search for ways to increase the effectiveness of management of the area of tourism promotion in both countries. The authors used an empirical research method with quantitative-statistical and qualitative studies on specific promotional campaigns. The Olympic Games have the greatest marketing potential among sporting events, as the most important sporting event in the world. The possibility of organizing such an event in Poland and Slovakia would certainly serve to improve the recognition rates of both countries. The authors will try to demonstrate this potential as part of the considerations in this article. Acknowledgement: This paper was supported by the project NP-KSV-ET-01-2023-12/ST - International cooperation in the field of development, management and law in tourism and sports between the Republic of Poland and Slovak Republic. The views expressed in this paper are those of the authors and should not be taken as reflecting the position of any authority, entity or institution. This article presents the legal status as of 25 March 2023.

Oral mucosa is an inner lining of oral cavity, which maintains different functions including protection of epithelial integrity. Pathology of oral mucosa can develop in response to the action of pathogenic microorganisms, viruses, and various traumatic factors; it can be a result of systemic pathology of a patient as well. Pain and discomfort usually accompanies such conditions leading to decrease of patient wellbeing. The basis of the pharmacological regulation of the regeneration process is the stimulation of wound healing. The aim is to summarize and discuss the spectrum of remedy options that are used to stimulate epithelization of oral mucosa. The overall goal of the paper is to provide full and comprehensive information for dentists and their patients about medicament variety, ways of theirs application and dosage. Methods. Relevant literature from MEDLINE (PubMed), Google Scholar, and in open access journals which are published by Elsevier was selected using the following key words «oral mucosa», «epithelization», and «remedy» were used in various combinations by the year of 2023. In total there were found 48 papers. To the selected scientific papers we applied the inclusion and exclusion criteria to choose the relevant ones. Conclusions. A significant number of drugs for the treatment of inflammatory processes in the oral cavity are available nowadays on dental market. Numerous studies substantiates the effectiveness of their use in dentistry. Therefore, when choosing pharmacological drugs, preference is given to drugs with a complex effect, which locally affect various links of the pathogenetic mechanism of the occurrence of diseases and do not disturb human wellbeing.

Endometriosis is a chronic gynaecological disease characterized by the presence of the uterine mucosa that functions in accordance with the menstrual cycle outside of its usual location. This disease significantly reduces the quality of life of women facing numerous ailments, most often pain, and may lead to reduced fertility. The prevalence of endometriosis is difficult to determine due to the complexity and lengthy diagnosis. It is estimated that this disease occurs in 3-8% of women of reproductive age, and symptoms may also appear after menopause. It is worth noting that the relationship between the disease's severity and endometriosis symptoms is often not proportional. The aim of the paper is to present a case report of a 23-year-old female patient with endometriosis, to differentiate the disease from irritable bowel syndrome and to draw attention to the problematic and lengthy diagnostic process due to the multitude of symptoms from various organs. Material and method: Study of an individual case of a patient and a review of scientific articles available in Google Scholar and a review of publicly available textbooks in the field of medicine. The paper emphasizes the need to broaden the knowledge about endometriosis by specialists in many fields of medicine and points to the lack of quick, minimally invasive tests enabling efficient diagnosis of the disease. Increasing the awareness of doctors including other specializations than gynaecology, organizing campaigns to increase awareness of the disease among women, which may contribute to earlier diagnosis of patients, earlier application of an effective treatment, and improvement of patients' quality of life.

Introduction:Lipid disorders are one of the most common modifiable risk factors for cardiovascular disease. Until now, the mainstay of dyslipidemia treatment was the use of widely available statins. These drugs, despite significantly lowering cholesterol and bringing its concentration to desired values were associated with a number of side effects. In addition, the need for daily use of statins is inconvenient for patients and leads to their irregular use and, consequently, failure to achieve the desired effect. The new drug, inclisiran, which is a PCSK9 inhibitor, represents the future in the treatment of lipid disorders. Studies conducted to date have explored the drug's mechanism of action, frequency of administration to achieve the desired effect, and side effects. The results of these studies have confirmed the significant efficacy of inclisiran,which may become a major form of treatment for dyslipidemia in the future. Purpose of the work: This article reviews the state of knowledge based on available studies on inclisiran. The aim of the review is to present the most important information about this drug related to the mechanism of action, effects on the body or assessment of efficacy. Materials and methods: The authors, based on databases such as PubMed, Scopus and Google Scholar, created a paper summarizing a review of currently available publications, concerning a new drug in the treatment of dyslipidemia- inclisiran. The authors searched for available information , using terms under the heading "key words" contained in other scientific papers. Summary Inclisiran is a novel drug that represents the future in the treatment of dyslipidemia. Due to the lack of systemic effect, it has insignificant side effects, and the need for such rare administration will allow to obtain the desired lipid concentrations even in patients who do not cooperate.

The primary purpose of this paper is to determine and prove the impact of loads with different intensities on the treadmill on the heart frequency, as well as to prove the relationship and impact of some anthropometric and motor parameters on the physiological one in the manifest space. In harmony with the purpose of the research, three basic hypotheses have been presented that cover the anthropological research fields. In this paper, 19-year-old students of the Faculty of Sports Sciences are included. To achieve the purpose of the paper, a sample of 80 students who were regular students during the year 2022/2023 was included. Four anthropometric variables, three motor tests (running tests) and four physiological tests (pulse at rest and during loads) are included in this paper. For the three groups of the system of variables, the basic statistical and distribution parameters for each variable, as well as the measures of asymmetry and normal distribution, were calculated. Then the correlations between the variables in the manifest space, as well as the correlations between the system of variables. In order to determine the relationship between predictor variables (anthropometric and motor characteristics) and criterion variables (results of functional skills), regression analysis was applied in the manifest space. The processing of the results shows that the obtained values do not deviate from the normal distribution, which completes their metric characteristics. The impact of morphological and motor factors on heart rate results has not been proven.

Background: C-reactive protein (CRP) is a commonly determined biomarker of inflammation and may reflect the progression of a vascular disease. CRP values within 12 to 24 hours of stroke symptom onset are an independent predictor of adverse functional outcome in terms of the level of motor recovery in the first year of follow-up. Objective: This study aims to provide a complementary analysis of the scientific literature and critically review studies on the use of CRP as a potential biomarker associated with stroke and affecting the achievement of neurorehabilitation progress in post-stroke patients. Methods: This critical review of the literature was prepared based on the following inclusion criteria: (1) original research, (2) studies indexed in PubMed, Scopus and PEDro databases, (3) full-text articles in English, (4) papers published in 2012 – 2022, and (5) papers addressing the use of PCR assay as a biomarker of rehabilitation effectiveness. Results: Based on a review of PubMed, Scopus and PEDro databases, 47, 56 and 9 papers, respectively, were selected based on precisely selected keywords and included in full for further full text review. In this review, the most important scientific rationale was included in response to the aim of this paper. Summary: Recognition of the role of inflammatory and immunological factors in the development of atherosclerosis and the occurrence of ischaemic stroke provides scope for the search for new methods of stroke risk assessment and the development of new methods to prevent stroke. Further empirical validation and unequivocal demonstration of the levels of CRP as a potential marker that affects the health status of a post-stroke patient are needed to ensure the greatest possible level of motor recovery and ability to function independently in terms of all activities of daily living.

INTRODUCTION: Retinoids are a broad group of natural and synthetic compounds derived from vitamin A. Many studies have shown strong anti-aging effects, and they have also been shown to have therapeutic effects on acne vulgaris or psoriasis. Vitamin A and its derivatives make the skin more elastic and smooth, cause a decrease in fine wrinkles and cause an increase in fibroblast activity and collagen fiber production. Retinoid compounds regulate biological processes of the skin such as immune processes, angiogenesis, proliferation and differentiation. THE AIM OF STUDY: The purpose of this paper is to discuss the effects of retinoids and the use of the substances in skin diseases. MATERIALS AND METHOD: Literature review of PubMed, Google Scholar and Science Direct and evaluation of available randomized controlled trials using retinoids in terms of treatment effectiveness in terms of skin quality, anti-aging benefits use in dermatology. CONCLUSIONS: Vitamin A and its derivatives plays an important role in anty-aging prevention and treatment of skin diseases, such as acne vulgaris, psoriasis and photo-aging. There are still many ongoing studies and not known opportunities of its use to treat other skin diseases that we should be aware of and keep track of new papers that indicate such.

HEARTS in the Americas is the regional adaptation of the World Health Organizations Global Hearts Initiative, which will be the model for risk management for cardiovascular disease (CVD) in primary health care in the Region of the Americas by 2025. It has already been implemented in 21 countries and 1045 primary health care centers throughout Latin America and the Caribbean. It takes a public health and health systems approach to systematically introduce simplified interventions at the primary health care level and focuses on hypertension as a clinical entry point. This paper introduces a new, improved application (app), the main component of which is the calculator for CVD risk and hypertension management. The paper summarizes the risk assessment approach and the methodology used by the World Health Organization to update its cardiovascular risk charts in 2019; describes the app, its use, functionality and validation process; and provides a set of practical recommendations for optimizing CVD risk and hypertension management by using the app in clinical practice. The HEARTS app is a powerful tool to improve the quality of care provided in primary health settings. The creation and dissemination of the HEARTS app is an essential step in the journey towards eliminating preventable CVD in the Americas.

Introduction and purpose: The aim of artificial sweeteners is to replace the sweetness of sugar without contributing to the higher energy consumption or unfavorable metabolic effects conventional sugar causes. Synthetic sweeteners - one of the most popular groups - are labeled as safe for use in foods and represented by acesulfame K, aspartame, neotame, saccharin, sucralose, cyclamate and advantame. Although they underwent safety procedures, their possible unbeneficial effects are still being evaluated. In this paper we focus on their impact on the gut microbiome. Brief description of the state of knowledge: For now, the advantage of search conducted on animals is observed. Those papers show the possibility of a relationship between artificial sweeteners and composition of the gut microbiota. Changes that were observed affected the gut microbiota in a negative way as they may be responsible for causing disbalance in the conglomerate of microorganisms. Studies on humans are limited. Long term consumption of acesulfame K and sucralose is linked with modulation of the composition of the microbiota. It has also been shown that synthetic sweeteners are able to increase the ability of bacteria to form a biofilm. Conclusions: Heretofore published paperworks about the impact of synthetic sweeteners on the gut microbiota are not sufficient to conduct valuable and unambiguous conclusions. Evidence collected until now is leading to a deduction that gut microbiota can be affected by the consumption of the sugar surrogates although more data is needed to clearly determine their possible role.

During the autumn season, it is common for mushroom pickers to eat poisonous mushrooms. This is due to many reasons, including the ignorance of pickers. The most common is the misidentification of inedible species as edible mushrooms. The result is poisoning, which in many cases requires hospitalization. This paper presents a case report of toadstool poisoning by a 62-year-old female patient. In addition, other relevant publications on intoxication, diagnostic methods and treatment are reviewed. The purpose of this paper is to present the management and treatment of a case of toadstool poisoning. The effects of mushroom poisoning can range from mild disorders, mainly gastrointestinal to organ failure and even death. Significant elevations of liver enzymes and prothrombin time are important in laboratory tests in cases of intoxication. Treatment most often involves specific antidotes, such as Sylimarin, Acetylcysteine. The diagnosis in most cases is made on the basis of the clinical picture and a thorough interview with the patient, and the diagnosis is established by detecting toxins in a urine test. The prognosis is better if patients with toadstool poisoning are admitted to the hospital early. It is worth noting that gastrointestinal syndromes can also result from eating raw or inadequately cooked mushrooms, and by eating them excessively or too often. Proper diagnosis and treatment of mushroom poisoning can save lives. It is very important to raise public awareness of mushroom poisoning, as well as early detection of potential signs of intoxication. Cooperation with the poison center and mycologists is very important, especially in high-risk cases.

This paper studies the effect of Mandarin proficiency on poverty reduction and its mechanism. The China General Social Survey (CGSS) is taken as the data source. From the perspective of social integration, the poverty reduction effect of Putonghua and its mechanism are empirically studied from the perspective of social interaction, social fairness, and social trust. The findings showed that improving the ability to listen and speak Mandarin positively affects social interaction, social trust, and social fairness. It showed that Putonghua proficiency positively correlates with the suppression of economic poverty. After the occurrence of poverty, whether a sample of absolute poverty or relative poverty, the ability to listen and speak in Mandarin has a specific inhibitory effect on social interaction, social trust, and social fairness. After the occurrence of poverty, the frequency of social interaction, social trust, and social public since have been reduced to a certain extent. Specifically, the ability to express Mandarin has shown remarkable results in improving social interaction, and the ability to listen among ordinary people has shown remarkable results in enhancing social fairness. The results of this paper provide empirical evidence of poverty alleviation in China via Improving Mandarin Proficiency. This research is also of great significance for optimizing poverty alleviation paths through language in the post-poverty alleviation era.

Se estudia la disponibilidad en acceso abierto de la producción científica del personal del Servicio Gallego de Salud (Sergas) de los años 2014 a 2019, su evolución a través de las distintas vías de acceso y qué volumen se podría depositar en el repositorio institucional. METODOLOGÍA: A partir de una exportación de Sophos, la herramienta que mide la producción científica del Sergas, se analiza el conjunto de publicaciones en las que participa al menos un autor con filiación institucional del Sergas. Se utilizaron las APIs de Unpaywall, DOAJ y la función Find Full Text de EndNote para determinar si el artículo tenía una versión de texto completo disponible. RESULTADOS: La producción científica del Sergas de 2014 a 2019, excluidas las comunicaciones a congresos, asciende a 7.792 artículos de los cuales el 44.10% de pueden clasificar como de acceso abierto real (dorado, bronce o híbrido), el 51.16% están publicados en revistas que permiten el auto-archivo y solo un 4.75% no admiten acceso abierto o no ofrecen información sobre su política de acceso. Estos artículos se publicaron en 1.695 revistas diferentes, de las cuales 409 siguen el modelo de acceso abierto dorado. CONCLUSIONES: El 95% de los artículos revisados pueden estar disponibles para el usuario final por alguna de las vías de acceso abierto y podrían ser depositados en el repositorio institucional./ This paper studies the open access availability to the Galician Health Service (SERGAS) staff´s scientific production between 2014 and 2019, its evolution through the different open access routes and the volumen of publications that could be deposited in the institutional repository. METHODOLOGY: Based on an export from Sophos, (the tool that measures the scientific production of the SERGAS), this paper analizes the set of publications in which at least one author with SERGAS institutional affiliation. The APIs of Unpaywall, DOAJ and the Find Full Text function of EndNote were used to determine whether the article had a full-text version available. RESULTS: The SERGAS scientific production between 2014 and 2019, excluding conference contributions, amounts to 7,792 articles. 44.10% of those articles can be classified as real open access (gold, bronze or hybrid), 51.16% are published in journals that allow self-archiving and only 4.75% do not support open access or do not provide information on their access policy. These articles were published in 1,695 different journals, 409 of wich follow the gold open access model. CONCLUSIONS: 95% of the articles reviewed would be available to the end user through one of the open access routes and could be deposited in the institutional repository.

This paper highlights the important leadership role of the public health sector, working with other governmental sectors and nongovernmental entities, to advance environmental public health in Latin America and the Caribbean toward the achievement of 2030 Sustainable Development Goal 3: Health and Well-Being. The most pressing current and future environmental public health threats are discussed, followed by a brief review of major historical and current international and regional efforts to address these concerns. The paper concludes with a discussion of three major components of a regional environmental public health agenda that responsible parties can undertake to make significant progress toward ensuring the health and well-being of all people throughout Latin America and the Caribbean.

Prophylaxis against edema involves the removal of excess lymph fluid from a specific area of the body. The presence of lymph accumulation, is a sign of abnormalities in the functioning of the lymphatic system, which has lost the ability to properly transport lymph. Swelling otherwise known as lymphedema is among the chronic diseases that adversely affect the functioning of human systems. Lymphedema is one of the most common disorders of the lymphatic system. Its correct function is to drain lymph into the lymphatic vessels, and from there it travels to the lymph nodes. Its malfunction is the failure to drain the lymph into the lymphatic vessels or the lymph nodes. As a result of the abnormal lymph circulation, swelling usually occurs in the lower and upper extremities. The swelling at first appears to be painless, but over time it becomes hard thus reducing the functional capacity of the limbs. Over time, the skin and subcutaneous tissue can become infected, which can affect the formation of a cancer such as lymphosarcoma. Increasingly, so-called dynamic Plastering is being used to assist and alleviate lymphedema. Kinesiology Taping (KT) otherwise known as dynamic patching enables the reduction of swelling by elevating the skin, thus increasing the surface area between the skin and fascia. This results in body fluids having more room to flow freely to the lymph nodes, and this reduces our swelling and lymph accumulation in the extremities.[2] The purpose of this paper is to show the use of Kinesiology Taping to reduce lymphedema. The paper is based on a review of articles in reputable journals from past years.

The main goal of the current overview is to assess major trends in studying of fine motor skills neurobiology.Materials and techniques. PubMed (MedLine), Embase databases have been used for Information search. Search depth is 5 years (2016 – 2021). 12 papers that are more relevant to the topic have been chosen from the primary paper array (n=49). MAXQDA (Verbi Software GmbH, Germany) has been used for content analysis.Results and discussion. The current state is characterized by interdisciplinary integration using both complex experimental laboratory models and modern bionic and information technologies.Conclusion. Contemporary trends in the problem studying is the widespread utilization of information technologies and the development of approaches to neurorehabilitation with motor deficiency consideration. Fine motor skills recovery in patients with CNS lesions requires further interdisciplinary integration.

Chronic diseases of the osteoarticular and muscular system belong to a group of health problems that lead to a limitation of the organism's efficiency, making it difficult or impossible for individuals to function normally. Of the forms of treatment used for chronic diseases of the osteoarticular system, rehabilitation is by far the most common. These activities are mainly financed by the National Health Fund, as well as by social insurance. A complementary role is played by local governments that finance medical rehabilitation for their residents in the form of health policy programmes, implemented as public health tasks. An important argument in favour of rehabilitation at the self-governmental level is the long waiting time for medical rehabilitation services financed by the National Health Fund. The aim of the paper was to show the role of local government in increasing access to therapeutic rehabilitation services for patients with musculoskeletal diseases. The paper discusses such issues as the importance of musculoskeletal diseases for the efficiency of individuals, organization and financing of guaranteed services in curative rehabilitation, as well as increasing access to these services at the local government level.

Communication management in sports organizations requires not only the use of formal tools, such as an official website, fan page or official TV channel. Effective communication should also be based on informal methods, in which the main role is played by interactions between the sports organization and its stakeholders. One such form is viral marketing, which involves sharing files with humorous, social or image content on social networks, messengers, blogs and e-mail. In the case of such forms, due to the wide range and speed of spreading opinions, especially negative ones, about the company, its services or products, it becomes necessary to control the emerging opinions. Management of information with a viral potential allows you to reach stakeholders in an informal way, influencing the building of a positive image, response in crisis situations or creating communities. The purpose of this paper is to analyze the degree of viral marketing use in sports clubs. The research was conducted in October 2021 on different social media. However, due to the extensive scope of the research, this paper focuses on the social network Facebook. The research is concerned with determining the use of viral marketing potential in information management and identifying the characteristics of this form of influencing stakeholders. Due to the limited volume of the article, the main subject of the study is the Polish clubs of the highest level of competition against the background of examples from abroad. The main hypothesis of this article assumes that Polish clubs do not fully use the viral potential and communication activities are based on official messages. Communication management is based on peer benchmarking and replication of what others are doing. It is also assumed that departments responsible for communication in sports clubs do not fully use foreign models.

Today’s economic reality requires entrepreneurs to introduce many changes, especially those of an organisational nature. The period following COVID-19 pandemic will require organizations to create new values, and a broader view of responsibility, to build mutual trust, and to adapt to the new reality. This paper introduces the principles of Corporate Social Responsibility (CSR), with a focus on ecology as one of the areas of CSR. It can be seen that the pandemic has accelerated environmental targets in many companies. This is due not only to the regulations aligned with the governmental environmental policy, but to an increasing extent also with changing social expectations. The aim of the article was to demonstrate the applicability of ecological, environment-friendly solutions as an example of CSR in the management of sports and leisure enterprises. CPOR studies show that most young people take responsibility for the state of their environment. The training of the test subjects also plays an important role here (CBOS, Environmental Awareness of Poland, 2020) It is assumed that the introduction of eco-friendly solutions in the operation of sports and leisure businesses is noticed and appreciated only by young participants in physical activity. The survey focuses on specific environmental solutions to create a socially responsible corporate image and how these companies operate in a changing environment. The results of the studies carried out for this paper are intended to help answer the question of the importance of emphasising environmental aspects and adapting to change by integrating eco-innovation into the CSR strategies of sports and leisure companies, whether these solutions are perceived by the purchasers of sports and leisure services, as they affect their image. and whether they lead to better relations with market participants.

Purpose: The aim of the paper is to present the economic situation of two publicly listed companies: GKS Katowice (Poland) and Olympique Lyonnais (France). Both enterprises have different ownership models: Olympique Lyonnnais is a privately owned club, and GKS Katowice belongs to a municipal government. However, both clubs operate in the realities of different market economic system (Poland and France) and also at a different level of economic development. It is common that football companies function under uncertainty and risk. This is heightened by additional characteristic factors for this type of activity such as uncertainty of outcome in sports competition. The adoption of professional sport activities also automatically runs to the risk, but this is not the only problem that the company has to face. In addition, both clubs had to deal with new challenges: COVID-19 pandemic and lockdowns. The paper presented the functioning of both football companies during the COVID-19 pandemic and lockdowns. Methodology: The first part of this research study discusses some particular points of the business strategy and risk management in the context of football companies’ management. The economic and financial situation of two football companies is presented, namely: Olympique Lyonnais and GKS Katowice. The focus is on sports, economic and financial criteria to assess the standing of football companies. This paper combines the conclusions from secondary data analysis, content analysis of web­sites as well as qualitative and quantitative analysis. The study also employs a comparative analysis. Research and practical limitations: Football companies are in the need to take several actions: a) continuously search for new sources of financing and diversification of activities, b) conclude long sponsorship agreements. Building a solid financial foundation and looking into the future can help football companies get through times of various crises and the COVID-19 pandemic.

The Pan American Health Organization (PAHO) and its Member States have been leading the efforts to eradicate wild poliovirus in the Region of Americas since smallpox's successful elimination in 1971. The region became the first to be certified free of wild poliovirus in 1994. However, in July 2022, an unvaccinated patient with no recent travel history was diagnosed with poliomyelitis in the United States of America. In response to the emergence of a circulating vaccine-derived poliovirus in the United States, PAHO established the Polio Incident Management Support Team. This team has been coordinating response efforts, focusing on: coordination, planning, and monitoring; risk communication and community engagement; surveillance and case investigation; vaccination; and rapid response. In this paper, we identified and documented best practices observed following establishment of the Incident Management Support Team (September 2022–2023) through a comprehensive review and analysis of various data sources and country-specific data from the polio surveillance dashboard. The aim was to share these best practices, highlighting technical support and implementation of polio measures by Member States. Despite several challenges, the Americas region remains polio-free. Polio risk is declining, with a July 2023 assessment showing fewer countries at medium, high, and very high risk. This progress reflects improved immunization coverage, surveillance, containment, health determinants, and outbreak preparedness and response. The PAHO Polio Incident Management Support Team has played a key role in supporting these efforts.

Introduction. Vitamin D is required for bone and mineral metabolism and participates in the regulation of the immune response. It is also linked to several chronic diseases and conditions, usually in populations of European descent. Brazil presents a high prevalence of vitamin D deficiency and insufficiency despite the widespread availability of sunlight in the country. Thus, it is important to investigate the role of vitamin D as a risk factor for disease and to establish causal relationships between vitamin D levels and health-related outcomes in the Brazilian population. Objective. To examine genetic variants identified as determinants of serum vitamin D in genome-wide association studies of European populations and check whether the same associations are present in Brazil. If so, these single nucleotide polymorphisms (SNPs) could be developed locally as proxies to use in genetically informed causal inference methods, such as Mendelian randomization. Materials and methods. We extracted SNPs associated with vitamin D from the genomewide association studies catalog. We did a literature search to select papers ascertaining these variants and vitamin D concentrations in Brazil. Results. GC was the gene with the strongest association with vitamin D levels, in agreement with existing findings in European populations. However, VDR was the most investigated gene, regardless of its non-existing association with vitamin D in the genomewide association studies. Conclusions. More research is needed to validate sound proxies for vitamin D levels in Brazil, for example, prioritizing GC rather than VDR.

Resumen: El cáncer de cuello uterino es un problema de salud mundial, presentando una alta tasa de incidencia y mortalidad, sobre todo en países en vías de desarrollo. La historia natural del cáncer de cuello uterino es bien conocida, desde una infección por virus papiloma humano (VPH), progresión a lesiones precancerosas y posteriormente el desarrollo del cáncer invasor. Es una enfermedad que puede ser prevenible, mediante programas de vacunación y de tamizaje bien realizados, permitiendo controles adecuados y tratamientos quirúrgicos de enfermedades preinvasoras. La Organización Mundial de la Salud (OMS) en el año 2020 propuso la iniciativa global de eliminar el cáncer cervical, planteando la estrategia 90-70-90. Se requiere la vacunación del 90% de las jóvenes menores a 15 años, lograr al menos dos tamizajes de VPH antes de los 45 años y que el 90% de las pacientes con lesiones de alto grado y/o cáncer tengan tratamiento oportuno. El objetivo de esta revisión es describir la realidad nacional e internacional de la prevención del cáncer de cuello uterino, destacando los avances en prevención, tanto primaria como secundaria, para lograr disminuir su incidencia. Abstract: Cervical cancer is a global health challenge, with high incidence and mortality rates, particularly in countries with lower levels of human development. The progression of cervical cancer is well understood, from human papillomavirus infection to precancerous lesions and invasive cancer. This disease can be prevented through effective vaccination and early detection programs, which allow timely treatments, especially for pre-invasive conditions. In 2020, the World Health Organization launched a global initiative to eliminate cervical cancer, introducing the 90-70-90 strategy. This intervention seeks 90% vaccination coverage in girls under 15 years of age, at least two HPV screenings before the age of 45, and timely treatment for 90% of diagnosed patients. This paper aims to describe national and international updates in cervical cancer prevention, highlighting the progress of primary and secondary prevention with regards to decreasing its incidence.

More than 8 million older people in Latin America depend on long-term care (LTC), accounting for 12% of people aged ≥ 60 years and almost 27% of those aged ≥ 80. It is crucial to develop sustainable strategies for providing LTC in the area, including institutional care. This special report aims to characterize institutional LTC in four countries (Brazil, Chile, Costa Rica and Mexico), using available information systems, and to identify the strategies adopted to support institutional care in these countries. This narrative review used nationwide, open-access, public data sources to gather demographic estimates and information about institutional LTC coverage and the availability of open-access data for the proportion of people with LTC needs, the number of LTC facilities and the number of residents living in them. These countries have a larger share of older people than the average in Latin America but fewer LTC facilities than required by the demand. National surveys lack standardization in defining disability, LTC and dependency on care. Information about institutional care is mainly fragmented and does not regularly include LTC facilities, their residents and workers. Data are crucial to inform evidence-based decisions to favor prioritization and to support advances in promoting policies around institutional LTC in Latin America. Although information about institutional care in the region is fragmented and insufficient, this paper profiles the four selected countries. It highlights the need for a better structure for datadriven LTC information systems. The lack of information emphasizes the urgency of the need to focus on and encourage research into this topic.

Introduction: Competency-based medical education (CBME) is being adopted worldwide. The aim of this paper is to discuss the evolution of CBME and address some perceived challenges in CBME curriculum development and implementation in postgraduate (residency) medical education. Methods: This is an opinion paper based on lived experiences and personal beliefs. The authors have professional training in medical education and are actively involved in CBME research, curriculum development and implementation around the world. Results: The issue of local and system-wide context seems to be of particular importance to individuals, programs, institutions, governing bodies and other stakeholders involved in the development and implementation of CBME programs. CBME has evolved differently at different places, and there are concerns regarding the fidelity of implementation. Stakeholders have been dealing with challenging questions in their CBME journeys, which reflect the varied, complex and dynamic nature of health and education systems. Recently, scholars have established core components of any CBME program. Discussion and conclusions: CBME design should benefit from ground-up strategies that consider the local context. It is essential to approach implementation with a quality improvement lens and pay special attention to the fidelity and integrity of the core CBME components.

The purpose of this paper is to delve into the ethical aspects experienced by the healthcare team when they receive the directive to limit therapeutic effort or a do-not-resuscitate order. From an interpretative, qualitative paradigm with a content analysis approach, a process based on three phases was conducted: pre-analysis in which categories were identified, the projection of the analysis, and inductive analysis. During 2023, interviews were conducted in the clinical setting of a high-complexity hospital in Chile with 56 members of the healthcare teams from critical and emergency units, from which four categories emerged: a) the risk of violating patients’ rights by using do-not-resuscitate orders and limiting therapeutic effort; b) the gap in the interpretation of the legal framework addressing the care and attention of patients at the end of life or with terminal illnesses by the healthcare team; c) ethical conflicts in end-of-life care; and d) efficient care versus holistic care in patients with terminal illness. There are significant gaps in bioethics training and aspects of a good death in healthcare teams facing the directive to limit therapeutic effort and not resuscitate. It is suggested to train personnel and work on a consensus guide to address the ethical aspects of a good death.

Introducion and purpose Millions of people use contact lenses every day. Their primary and most common use is correcting refractive errors. Despite their beneficial purpose, contact lens use has many complications. It is estimated that 5 to 50% of patients may develop at least a single complication. The state of knowledge Contact lens-related complications are multifactorial. One of the main reasons for contact lens discontinuation is contact lens discomfort. Patients most often report dryness, burning, and irritated eyes. Other disorders can be briefly divided into conjunctival and corneal complications. The most common conjunctival and allergic complication of contact lens use is giant papillary conjunctivitis. Other significant conditions involving the conjunctiva can also be superior limbic keratoconjunctivitis or allergic or toxic conjunctivitis. Corneal complications, on the other hand, seemed to be much more severe. These include superficial punctate keratitis, peripheral corneal ulceration, and contact lens-related keratitis. Also, abrasion can occur due to improper eye hygiene or mechanical damage during lens replacement. It should also be remembered that prolonged use of lenses can lead to hypoxia and corneal edema. Summary This paper briefly outlines the possible complications of contact lens use. It is important to remember that despite their appropriate use, sometimes significant complications can occur. Noteworthy, corneal, or conjunctival complications require discontinuation of the lenses and appropriate treatment.

Abstract: Although food insecurity presents a decreasing trend worldwide, some regions recently observed an increase in hunger levels. Such was the case in Brazil between 2014 and 2018, during and after the great Brazilian recession, and between 2020 and 2021, during the COVID-19 pandemic. This paper describes the evolution of food insecurity in Brazil between 2004 and 2022 using Brazilian National Household Sample Survey (PNAD), Brazilian Household Budget Survey (POF) and Continuous PNAD. Households were classified in 20 types of arrangements, and the most vulnerable living arrangements between 2004 and 2018 were identified by multinomial logistic models. Overall, households headed by women (single blacks, whites or in couples) with or without children were the most prone to food insecurity. As for the evolution of food insecurity in Brazil between 2018 and 2022, logistic models were applied to estimate moderate and severe food insecurity levels among the 20 household types. Additionally, effects of the emergency aid and idiosyncrasies of the COVID-19 pandemic were estimated.