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Aleksandra Kuć,1 Daria Kubik,1 Klaudia Kościelecka,1 Wojciech Szymanek,2,3 Tomasz Męcik-Kronenberg4 1Student Research Group at the Chair and Department of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland; 2Hospital Emergency Department, St. John Paul II Mazovia Regional Hospital in Siedlce, Siedlce, Poland; 3Nursing at Collegium Mazovia Innovative University in Siedlce, Siedlce, Poland; 4Chair and Department of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, PolandCorrespondence: Aleksandra Kuć, 1E Street, Siedlce, 08-110, Poland, Tel +48 504 188 178, Email aleksandra.kuc@interia.plAbstract: Peripartum cardiomyopathy (PPCM) is a condition with an incompletely understood etiology, although many risk factors for this disorder have been mentioned. Preeclampsia (PE) is a rare but undoubtedly very important cause of PPCM. Early recognition and prompt treatment of preeclampsia and peripartum cardiomyopathy are essential to optimize pregnancy outcomes. An extensive manual search of major electronic databases was conducted in November 2021. The following literature review provides a comprehensive discussion of peripartum cardiomyopathy and preeclampsia and quantifies the prevalence of PE in women with PPCM. The authors highlighted aspects such as epidemiology, risk factors, cardiovascular changes, diagnosis and clinical presentation, and management and complications. Accumulating data indicate that both conditions have a similar pathogenesis characterized by vascular abnormalities. In both conditions we can observe an increase in interleukin-6 and gamma interferon, CCL2/MCP1, and decreased SOD activity. sFLT1 (a soluble form of fms-like tyrosine kinase 1), a substance with antiangiogenic and probably cardiotoxic effects, may be important. Preeclampsia and peripartum cardiomyopathy are characterized by recurrence rates that follow a similar pattern in subsequent pregnancies, and mortality remains a concern. Our analysis highlights the need to better understand the co-morbidity of PE and PPCM, and the need to qualify patients for the same clinical trials because of the common origin of these conditions.Keywords: pregnancy, PE, PPCM, conditions

Fungi such as Aspergillus spp. and Fusarium spp., which are commonly found in the environment, pose a serious global health problem. This study aims to present the results of epidemiological studies, including clinical cases, on the relationship between human exposure to some mycotoxins, especially zearalenone and aflatoxin, and the occurrence of reproductive disorders. In addition, examples of methods to reduce human exposure to mycotoxins are presented. In March 2023, various databases (PubMed, Google Scholar, EMBASE and Web of Science) were systematically searched using Google Chrome to identify studies evaluating the association between exposure to mycotoxins and the occurrence of complications related to impaired fertility or cancer incidence. The analysed data indicate that exposure to the evaluated mycotoxins is widespread and correlates strongly with precocious puberty, reduced fertility and increased cancer incidence in women and men worldwide. There is evidence to suggest that exposure to the Aspergillus mycotoxin aflatoxin (AF) during pregnancy can impair intrauterine foetal growth, promote neonatal jaundice and cause perinatal death and preterm birth. In contrast, exposure to the Fusarium mycotoxin zearalenone (ZEA) leads to precocious sexual development, infertility, the development of malformations and the development of breast cancer. Unfortunately, the development of methods (biological, chemical or physical) to completely eliminate exposure to mycotoxins has limited practical application. The threat to human health from mycotoxins is real and further research is needed to improve our knowledge and specific public health interventions.

Neurodegenerative disorders, which are currently incurable diseases of the nervous system, are a constantly growing social concern. They are progressive and lead to gradual degeneration and/or death of nerve cells, resulting in cognitive deterioration or impaired motor functions. New therapies that would ensure better treatment results and contribute to a significant slowdown in the progression of neurodegenerative syndromes are constantly being sought. Vanadium (V), which is an element with a wide range of impacts on the mammalian organism, is at the forefront among the different metals studied for their potential therapeutic use. On the other hand, it is a well-known environmental and occupational pollutant and can exert adverse effects on human health. As a strong pro-oxidant, it can generate oxidative stress involved in neurodegeneration. Although the detrimental effects of vanadium on the CNS are relatively well recognized, the role of this metal in the pathophysiology of various neurological disorders, at realistic exposure levels in humans, is not yet well characterized. Hence, the main goal of this review is to summarize data on the neurological side effects/neurobehavioral alterations in humans, in relation to vanadium exposure, with the focus on the levels of this metal in biological fluids/brain tissues of subjects with some neurodegenerative syndromes. Data collected in the present review indicate that vanadium cannot be excluded as a factor playing a pivotal role in the etiopathogenesis of neurodegenerative illnesses, and point to the need for additional extensive epidemiological studies that will provide more evidence supporting the relationship between vanadium exposure and neurodegeneration in humans. Simultaneously, the reviewed data, clearly showing the environmental impact of vanadium on health, suggest that more attention should be paid to chronic diseases related to vanadium and to the assessment of the dose-response relationship.

A growing number of reports point to the possible role of environmental factors in determining the age of onset of menopause. Specific metals, such as mercury, cadmium, arsenic and lead can lead to fertility disorders, to endocrine dysregulation, and in addition, their high blood concentrations correlate with the onset of menopause. Changing concentrations of hormones in the blood during this period of a woman's life can also have an impact on SARS-CoV-2 infection, and excessively high or low levels of metals may also be an important predictor for the course of COVID-19. Postmenopausal women are exposed to greater risk of serum biochemical changes, and with the possibility of nutritional disturbances, particularly involving trace minerals, the risk of age-related diseases is very high during this period. These adverse changes in serum trace minerals should be taken into consideration for the early diagnosis and prevention of menopause-related diseases. Dietary supplementation may be necessary, especially where levels are significantly reduced. We performed a manual search of scientific articles cited in major electronic databases (PubMed, EMBASE, Web of Science and Google Scholar) in November 2022 to identify studies relevant to the relationship between metals, COVID-19 and menopause. The effects of metals on the course of menopause is a broad topic and should certainly still be a subject of research, due to, among other things, continuing environmental pollution and the use of metals in many areas of life.

Sexuality is the one of the most important parts of human life. The aim of our study was to identify the factors influencing the onset and age of sexual initiation in students and drawing attention to the need to improve access to sexual education in Polish schools at a sufficiently high level. An original questionnaire with 31 questions was used for the study. Data were collected using the Google Forms tool. A total of 7528 students participated in the study and 5824 underwent sexual initiation. The mean age at sexual initiation was 18.1 years. Logistic regression analysis was performed to show factors influencing the onset of sexual activity, while linear regression analysis was used for factors influencing the age of sexual initiation. Religion, drug use, smoking, alcohol consumption, type of housing, and conversations with parents about contraception or sex affect the onset of sexual activity. The age of sexual initiation is affected by religion, the age of the first viewing of pornography, quality of life, the size of the city of residence, smoking and drug use.

Importance: Pregnancy-associated melanomas (PAMs)-this is how melanomas identified during the childbearing years or up to 1 year after birth have been defined, accounting for one third of women in whom it is diagnosed. The exact epidemiology of melanoma is difficult to determine. However, its incidence is undoubtedly increasing, most likely related to the increasing age of mothers., Objective: The purpose of this study was to review the prognosis, diagnosis, and treatment; the effect of melanoma on pregnancy; and the effect of pregnancy on melanoma and melanocytic lesions., Evidence Acquisition: An extensive manual search of major electronic databases was conducted in January 2022. The following literature review provides comprehensive coverage of PAMs., Results: Any new nevus detected during pregnancy and changes in the nevus regarding color, diameter, symmetry, or lesion border require medical evaluation. New therapies for malignant melanoma, such as immunotherapy and targeted therapy, have improved overall survival and progression-free survival, but their use is often contraindicated in pregnant patients. Melanoma is considered to be the neoplasm most commonly involving the fetus and placenta., Conclusions: There are reports where immunotherapy and targeted therapy used in the patient were not associated with serious consequences for the fetus, being a therapeutic option for the patient. The described cases of pregnancy outcome during modern melanoma treatment are extremely important and may allow to shape the optimal therapeutic regimen in pregnant women with melanoma., Relevance: Education of pregnant women in the context of observation of skin lesions as well as maintenance of oncological vigilance by physicians seem to be an important element in limiting difficult decisions related to therapy of more advanced disease. Further large-scale studies using modern treatment in pregnant women with melanoma are needed.

Due to the continuous development of palliative care and methods of pain relief in the last moments of patients’ lives, we are faced with the question of how long we should take measures to delay inevitable death for, without providing prolonged therapy against the patient’s will. For terminally ill and people experiencing unimaginable suffering, euthanasia is considered as one of the possible options for a dignified farewell. The aim of the study was to determine the views on euthanasia in a group of students from Polish universities. Questionnaire responses were analyzed for 9686 students (79.9% of women and 20.1% of men) aged 18−35 years. Respondents were asked to complete their own questionnaire on demographic data and attitudes toward euthanasia in the case of severe terminal illness or paralysis preventing independent living. Euthanasia was significantly more acceptable among women (85% vs. 75%, p < 0.0001; 69% vs. 62%, p < 0.0001) and non-believers [98% vs. 97% (denominations other than Christian), 84% (other forms of Christianity), 69% (Roman Catholic); p < 0.0001] in every case considered. Religious affiliation was the factor that most influenced attitudes toward euthanasia. Among the other elements influencing attitudes toward euthanasia, residence and field of study were distinguished. Considering the large sample size and specific conclusions, the article should be an important argument in the discussion on euthanasia.

Worldwide, there are about 121 million unintended pregnancies per year. The aim of the study was to assess the attitudes in different groups of students from 40 Polish universities towards pregnancy termination. In total, 9686 university students (20.1% male and 79.9% female) took part in our research. Questions about attitudes towards abortion in all possible circumstances were involved in the survey, which also included a socio-demographic questionnaire. Overall, 94.5% of women and 90.7% of men consider that abortion should be legal in the situation of a threat to the mother's life, while only 52% of women and 38.7% of men accept it in the case of a hard financial situation for the mother. Most students stand for abortion in the situation of a threat to the mother's life, in the case of rape, or in the case of a mortal fetus defect. Less than half of the students interviewed consider that abortion should be legal in the case of a hard financial situation for the mother or on the mother's demand. People who declare a religious affiliation more often disagree with abortion, even in the hardest cases such as a danger to the mother's life or a mortal fetus defect. The factor that influences the strongest on attitudes towards abortion is being an active Roman Catholic. The majority of students have a pro-choice attitude in respect of pregnancy termination.

The natural polysaccharides are promising compounds for applications in regenerative medicine. Gellan gum (GG) is the bacteria-derived polysaccharide widely used in food industry. Simple modifications of its chemical properties make GG superior for the development of biocompatible hydrogels. Beside reversible cationic integration of GG chains, more efficient binding is accomplished with 1-ethyl-3-[3-(dimethylamino)propyl]carbodiimide (EDC). However, the side-products of polymer cross-linking might affect viability and differentiation of stem cells introduced into the hydrogels. We found that O-acylisourea (EDU) stimulates autophagy-based vacuolation in both periodontal ligament and dental pulp stem cells. 24-h treatment of cells with GG extracts cross-linked with 15 mM EDC developed large cytoplasmic vacuoles. Freshly prepared EDU (2-6 mM) but not 15 mM EDC solutions initiated vacuole development with concomitant reduction of cell viability/metabolism. Most of the vacuoles stained with acridine orange displayed highly acidic environment further confirmed by flow cytometric analysis. Western blot of the LC3 autophagy marker followed by a transmission electron microscopy indicated the process is autophagy-dependent. We propose that the high reactivity of EDU with intracellular components initiates autophagy, although the targets of EDU remain unknown. Nevertheless, a burst release of EDU from GG hydrogels might modulate negatively cellular processes and final effectiveness of tissue regeneration., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

High-risk sexual behavior consists of activities and habits that put a person at increased risk of sexually transmitted infections (STIs) or unplanned pregnancy. Poland is currently experiencing a problem with increased STI rates, largely due to poor sexual education. Our exploratory study aims to evaluate the sexual behavior of students attending universities across Poland. The study covered 7678 students from 50 different faculties and universities across the country. The authors created an original questionnaire which consists of 31 questions which, among others, included demographic factors, sexual initiation, high-risk sexual behavior, STI's and religious beliefs. 78% of students have participated in sexual activity, among them 19% of students had 'casual sex' consisting of intercourse without the use of a condom, 27% had participated in sexual intercourse after the consumption of alcohol. Our study found that students who are influenced by religious belief tend to engage in sexual activity into their later years. The groups most exposed to the consequences of risky sexual behavior are mostly homosexual men, bisexual women, art students, and military students. Alcohol consumption is a strong factor contributing to risky sexual behavior. Sexual education in Poland should be improved.

Objective: The aim: Cancer is the second most common cause of death in Polish society. The healthcare system, already overwhelmed in many countries, has been further burdened by the outbreak of the SARS-CoV-2 pandemic. The healthcare system has become inefficient, especially in the oncology care sector. Surgeries, scheduled treatments, and follow-up appointments in some hospitals have been canceled or rescheduled to the "next available date after the end of the pandemic". This research aims to analyze the impact of the COVID-19 pandemic on the availability of medical care among oncological patients and compare them with the results of studies on the effects of postponement of oncology treatment., Patients and Methods: Materials and methods: The study included a group of 544 respondents from all over Poland. The research tool was a self-administered survey questionnaire., Results: Results: 37%, of those undergoing systemic treatment, experienced postponement of their treatment, and in the case of radiotherapy, it was 35%. Visits to the clinical oncologist/radiotherapist specialist were postponed in 51% of respondents. Imaging studies were delayed in 41.7% of respondents., Conclusion: Conclusions: The course of the COVID-19 pandemic has significantly impacted the health care system and, therefore, also on the availability of medical care among oncologicalpatients. The results signal an emerging problem. These visit shifts may negatively affect the outcome of cancer treatment. The potential risk of COVID-19 infection should beindividually balanced against cancer treatment delay in each patient. The ongoing pandemic, therefore, prompts a careful analysis of the effects of deferring cancer therapy.

Objective: The aim: Our work aims to investigate the therapeutic effect of art on children and adolescents with autism spectrum disorder (ASD) up to the age of 18 and to disseminate knowledge about its use as a part of therapy., Patients and Methods: Materials and methods: The authors created an anonymous online questionnaire addressed to parents and legal guardians of children and adolescents with and without ASD. The studied population comprised 190 subjects, of which 108 were a control group (children and adolescents without ASD) and 82 - a study group (children and adolescents with ASD)., Results: Results: Most respondents did not hear about the therapeutic use of art (59.5%). 20.73% of respondents with ASD participated in therapy using artistic activities. 82.4% participated in music therapy, 23.5% - in theater therapy, and 70.6% - in art therapy. These forms of therapy effectively improved disorders related to social relationships, speech, and atypical behavior., Conclusion: Conclusions: There is a positive therapeutic effect of art on children and adolescents with ASD. The therapeutic use of art among the respondents is not very widespread. Artistic activities have a positive impact on social relations, speech, and unusual behavior. Music and visual arts activities seem to positively impact social relationship disorders, while theater activities seem to impact speech disorders positively. Combining several arts in therapy is more beneficial than using just one. Art therapy is most often used at the age of 13 and older.

Objective: Introduction: Current information suggests the existence of two main transmission routes for SARS-CoV-2. This is the drip trajectory and contact transmission. The order to cover the mouth and nose in the public space has been introduced as one of the preventive measures to limit the spread of some virus-induced respiratory diseases, including COVID-19. Both medical and non-medical masks have become the most popular tool. Is there any evidence of their effectiveness? What can be the disadvantages of using them? The aim: To analyze social behaviour towards the order to cover the nose and mouth during the SARS-CoV-2 pandemic and to confront them with the results of research on the effectiveness of medical and non-medical masks., Patients and Methods: Material and methods: The study involved a group of 2512 respondents from all over Poland. The research tool was an original questionnaire containing 24 questions., Results: Results: 76.1% of the respondents declare that they always obey the current order. 83% use a material mask and 26.9% wear a surgical mask. 35.2% of respondents think that the order to cover their nose and mouth is not justified., Conclusion: Conclusions: The authors confronted the results of the questionnaire with the scientific research mentioned above. There is limited evidence to resolve the question - "Masks - protection or danger?" However, it is worth noting the small harmfulness and indirect evidence of benefits, which together have precedence over the lack of clear arguments supporting the use of masks by Polish society in times of epidemics.

Sporadic Creutzfeldt-Jakob disease (sCJD) is the most common spongiform encephalopathy caused by protein infectious agents called prions. Despite the lack of known treatment which would cure or at least slow down the progression of the disease, its proper diagnosis is extremely important, because of the large group of diseases that may imitate its course and for which a causal / symptomatic treatment has already been developed. The main problem that prevents the differential diagnosis is the lack of a commonly available and non-invasive procedure for antemortem finding the pathological PrPSc protein in a patient’s nervous system. In addition, the current WHO criteria are outdated and need to be updated due to the emergence of new diagnostic methods since their publication. The aim of this study is to collect the latest trends in the diagnosis of sporadic Creutzfeldt-Jakob disease, to draw attention to the need for careful differential diagnosis in patients with suspected sporadic Creutzfeldt-Jakob disease, and to verify the current criteria for its diagnosis and update.

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) may cause gastrointestinal damage in dogs., Hypothesis/objectives: To determine the extent to which lansoprazole, liquorice extract, and a herbal solution exhibit protective effects on colonic mucosa when administered to dogs concurrently with the NSAIDs carprofen or robenacoxib., Animals and Methods: Thirty-five healthy beagle dogs (15 male and 20 female) aged 13-14 weeks and weighing 4.3-5.5 kg at the beginning of the experiment were included. Endoscopy and biopsy of the caudal gastrointestinal tract were performed pretreatment and on the last day of a 21-day treatment period with (1) oral carprofen; (2) carprofen and the proton-pump inhibitor lansoprazole; (3) carprofen, liquorice extract, and a herbal solution that contained extracts of thyme, icelandic lichen, hyssop, and saponariae root; (4) robenacoxib; (5) robenacoxib and lansoprazole; (6) robenacoxib, liquorice extract, and herbal solution; or (7) an empty gelatin capsule. Statistical analyses were performed with the Kruskal-Wallis, Cochran's Q, and chi-squared test with p < 0.05 considered significant., Results: Both carprofen and robenacoxib tested damaged the colonic mucosa with most severe microscopic lesions following administration of robenacoxib with lansoprazole. The risk of histopathological lesions in the colon increased most rapidly in robenacoxib with lansoprazole (absolute risk increase -0.85) similar to robenacoxib only (-0.75), whereas the best result was recorded following the plant remedies together with carprofen (-0.15) and the plant remedies together with robenacoxib (-0.2)., Conclusions and Clinical Importance: Concurrent administration of liquorice extract and an herbal solution with robenacoxib was associated with decreased severity of the NSAID-induced mucosal lesions.