Colorectal cancer (CRC) is the third most common malignancy worldwide and the second most deadly cancer. Scientists have projected that by 2040, the prevalence will reach up to 3.2 million new cases annually due to population aging, disadvantageous diet transformations, and elevated exposure to risk factors. In the past decades, the five-year survival rate in colorectal cancer has significantly increased to 65% due to the development of an early endoscopic diagnosis and new chemotherapeutic approaches. Fluoropyrimidines, such as 5-fluorouracil or capecitabine, are commonly used to treat CRC. One of the most fundamental mechanisms of 5-FU is based on the inhibition of thymidylate synthase. This action is responsible for the therapeutic, but also toxic, effects of the drug. In this short review, we discuss the possible effects of vitamin D activity on colorectal cancer cells in relation to fluoropyrimidines. PubMed, Embase, and Web of Science databases were searched up to January 2022 for studies on vitamin D and 5-fluorouracil interaction mechanisms. Original studies, case reports, and review articles were included.
Vitamin D or its analogs target multiple biochemical pathways and modulate numerous pathophysiolo-gical mechanisms in the course of colon cancer, including those related to the pharmacological sites of fluoropyrimidines. However, the available data concerning vitamin D–fluoropyrimidine pharmacological interactions are limited, especially regarding patients suffering from colon cancer and being treated with fluoropyrimidines.

This article characterizes the etiology of temporomandibular disorder with particular emphasis on emotional factors that have a major impact on the development of these dysfunctions and the most common their symptoms. They mainly affect people in the third and fourth decade of life and women predominate among this group of patients.
The article analyzes the current literature (Pub Med Database, Scopus and EMBASE) in relation to the conditions in the work environment, which often constitute important causes of emotional tensions, constant state of mental tension and susceptibility to the effects of stressors, which have an impact on the state of functioning of the musculoskeletal system of the masticatory system.
Despite the high frequency of temporomandibular disorders, unfortunately only a few studies describe the influence of harmful factors related to the work environment, and own experience (information from the patient’s interview) and data from the literature indicate a significant share of these factors in the devel-opment of temporomandibular disorder. The relationships and anatomical connections affecting the influence of stressors on the functioning of masticatory muscles and temporomandibular joints are also discussed. In conclusion, it should be stated that the work environment and the emotional tensions generated in it constitute a serious sociological problem and increase the risk of developing and intensify the symptoms of TMD.

TMD is a group of pathological changes including increased tension in the masticatory muscles, pain in the muscles and/or the temporomandibular joints, abnormal range of the mandibular movement or the presence of acoustic symptoms in the joints in the form of clicking or poping. The aim of the project was to compare the effectiveness of two methods of physiotherapeutic rehabilita-tion, used in adolescent patients with temporomandibular disorders.
Material and Methods: The material consisted of 68 patients, aged 14 to 17, of both sexes, generally healthy, who came to the Dental Prosthetics Department for treatment due to pain in the masticatory muscles. Dental examination and diagnostics revealed Ia in all cases in accordance with RDC/TMD protocol. Manual therapy was performed in group I (34 people) and kinesitherapy with massage was performed in group II (34 people). Patients were allocated randomly to both groups. Contraindications were considered for both methods.
Results: Within the first study, mean values of pain intensity between group I and group II were not significantly different (6.12 and 6.24 respectively). Within the second study significantly lower VAS scores in both groups have been revealed (0.92 and 0.74 respectively). Results of the first and second study differed significantly in both groups. Similar results were obtained for the maximum abduction of the mandible.
Conclusions: The results of the conducted studies indicate a beneficial effect of the assessed phy-siotherapeutic procedures in terms of functional rehabilitation of adolescent patients with temporoman-dibular disorders.

The aim of this article is to describe surgical technique and early results of Total Ankle Replacement (TAR) from lateral approach using Zimmer TM prosthesis. The study uses theoretical knowledge which is the result of research conducted by other authors, and practical knowledge due to the fact that our center performs that type of operation. Arthrodesis as the current standard in the treatment of advanced degenerative ankle disease, apart from its advantages, also has many disadvantages. The relative durability and reduction of the patient’s pain have been achieved at the expense of the adjacent joints. Their accelerated arthrosis is the result of compensatory loads as a consequence of change in foot biomechanics. That determined implementation of solutions that will guarantee elimination of pain in the ankle joint, preserve its motor function and improve gait, while having no negative impact on the mobility of adjacent joints.

Chronic pain in the head and face region has a predicted prevalence of 20% in Europe, and is more common in women than men. The etiology of temporomandibular disorder (TMD) is multifactorial, and high levels of psychological stress amplify its symptoms. We were interested in how headache reported in RDC/TMD is associated with stress. Individuals with an average age of 18 years were included in the study. They were all volunteer participants in a research project. Clinical evaluation of each subject was performed using the RDC/TMD dual-axis diagnostic system. All participants filled out the PSS-10 ques-tionnaire. A total of 138 individuals participated in the study, of which 107 were female. Headache was reported by 83 participants (59.4%), with females presenting higher scores on the PSS-10; this was statistically significant. A comparison between PSS-10 questionnaire results and headache level shows insignificant differences. However, the higher the stress level in the participant, the higher the headache score. Females are more susceptible to perceived stress, which can have an effect on TMD.

Malignant neoplasms are currently a severe medical challenge and the second leading cause of death worldwide. The modern anesthesia applied may improve the patient outcome. This paper presents a review of anesthesia management related to patients with gynaecologic malignancies. It includes the influence of the type of anesthesia on cancer recurrence, application of regional anesthesia in gynaecologic oncologic surgery, and selected aspects of anesthesia for robotic surgery. We performed a literature search on MEDLINE, EMBASE, Google Scholar, the Cochrane Central Register of Controlled Trials, and Clinical Trials. The database search focused on the topics related to anesthesia in gynecological oncology. The authors also contributed through individual, independent literature searches.

Platelet aggregation contributes to the pathogenesis of cardiovascular diseases. After activation it leads to dense granule secretion and 5-HT release. The question arises; how platelet aggregation is endogenously controlled during blood circulation. In preliminary studies, we observed that human plate-lets aggregate more rapidly when suspended in buffer as compared to those suspended in plasma (PRP). These observations point to the presence of an endogenous substance that may inhibit arachidonic acid– induced platelet aggregation. An analysis of plasma Cohn fractions demonstrated that most of the plasma inhibitory activity was associated with albumin–rich and α-globulin rich protein fractions. The identity of plasma endogenous inhibitors of platelet aggregation (EIPA) was established by affinity chromatography on Cibacron Blue F3G-A for specific removal of albumin. The association of α-globulins to EIPA activity was recognized as due to haptoglobin by affinity chromatography on a column of hemoglobin-sepharose. In addition, we also found that the distribution of EIPA activity varies according to sex and physiological state. These findings reveal that EIPA may act by modulation of arachidonic acid metabolism or seques-tering the fatty acid substrate.

The interstitial cells known as telocytes have been described in various organs. Their role in the normal physiology and pathogenesis of numerous diseases is well known. They have been described in the context of various diseases (gallstone disease, endometriosis, uterine myoma, hydronephrosis, myocardial infraction, psoriasis, etc.), while their impact on inflammation, involvement in angiogenesis, and repair highlights their part in local homeostasis. What is known about their relationship with the immune system? Their secretomes, genome, immune profiles, contacts with surrounding cells, and specific loca-lization allow us to give a possible explanation for their involvement in pathological pathways. This review aims to present the roles and features of telocytes in the context of intestinal immunity (the largest in our body), in the spleen, their interactions with immunocytes, and their place in stem cell niches.

The main target during management of a male pediatric patient with clinical signs of acute scrotum is the timely diagnosis, in order not to jeopardize the viability of the affected testicle. Thorough evaluation of the patient’s medical history, symptomatology, clinical and ultrasonographic findings, con-stitutes the basis of the diagnostic procedure. After comprehensive research of the relevant literature, we highlight the remaining difficulties in the evaluation of the clinical and ultrasonographic findings for the accurate diagnosis of the acute scrotum. In conclusion, it is worth emphasizing on the following: a. the most common diseases that come under the diagnosis of the acute scrotum may present with similar symptoms, b. in neglected cases the diagnostic approach becomes more difficult, constituting the evalua-tion of the pathognomonic clinical signs challenging, and c. inability to exclude the diagnosis of spermatic cord torsion should be an indication for the surgical exploration of the affected hemiscrotum.

Background: Autonomic dysfunction, impaired baroreflex sensitivity (BRS), and deranged circulatory homeostasis have been observed in chronic hyperglycemia and found to be associated with increased cardiovascular morbidity and mortality. However, the acute effects of hyperglycemia in healthy subjects have been rarely studied. The present study explores the effect of acute hyperglycemia on con-ventional and unconventional parameters of BRS in healthy young adults.
Methods: For the estimation of BRS beat-to-beat blood pressure (BP) and electrocardiogram were recorded in forty-two young, healthy subjects during fasting and at 1hr of the oral glucose load. Analysis of BRS was carried out by sequence and spectral method. Number of UP-, DOWN- and ALL-sequences between ramps of BP and RR-interval were calculated as an unconventional measure of BRS along with the other conventional parameters.
Results: We observed significant alteration of unconventional parameters of autonomic functions [the number of sequences of UP- (p = 0.0039) and ALL-sequences (p = 0.0233) of systolic BP and RR interval; and, UP- (p = 0.0380), DOWN- (p = 0.0417) and ALL-sequences (p = 0.0313) of mean BP and RR- interval] during acute hyperglycemia as compared to the fasting state. However, no significant changes were observed in any of the conventional parameters of BRS during acute hyperglycemia as compared to the fasting state.
Conclusions: Present study concludes that the unconventional parameters of BRS — the number of sequences between the ramp of BP and RR-interval — change significantly during acute hyperglycemia. However, the conventional parameters do not show significant changes during acute hyperglycemia. We may hypothesize that the relatively constant BRS is maintained at the expense of increased oscillations in the ramp of BP and RR-interval.

Purpose: Oral health and diseases are significant components of general health. However, oral health-care remains at the lowest of older patients’ priorities. The inability to obtain dental care can result in progression of dental disease, leading to a diminished quality of life and overall health. Teledentistry (TD) provides an opportunity to improve the quality of oral health services. The aim of our narrative review was to analyze the usefulness of teledentistry as a part of telemedicine to improve oral health in the elderly.
Materials/Methods: The PubMed database search was done for: teledentistry, oral health, oral- health related diseases, elderly, older adults.
Results: The applicability of TD has been demonstrated from children to older adults. Older adults have many obstacles in getting oral health care, including low income, lack health insurance, frailty, anxiety, depression, mobility problems or other handicaps. Available data suggests that the usefulness of TD in the provision of oral care in elderly people living in residential aged care facilities. Moreover, TD procedures were found to be as accurate as traditional face-to-face dental examinations, they was cost-effective and well accepted among patients and caregivers.
Conclusions: TD might be a very useful tool for professional education, improving access and patient satisfaction of dental care. However, such TD modes would be difficult to widely implementation in community-dwelling older people who cannot access dental care. The ongoing “Patient centric solution for smart and sustainable healthcare (ACESO)” project will add to the intelligent oral health solutions.

Tenosynovial Giant Cell Tumor (TGCT) is a group of typically benign lesions arising from the synovium of joints, bursae and tendon sheaths. Depending on their growth pattern and clinical course, they are divided into localized and diffuse types. It is predominantly caused by a mutation in the stromal cells of the synovial membrane leading to overexpression of the colony stimulating factor 1 that recruits CSF1R-expressing cells of the mononuclear phagocyte lineage into the tumor mass. The lesions contain mainly histiocyte-like and synovial cells accompanied by varying numbers of multinucleated giant cells, mononuclear cells, foam cells, inflammatory cells and hemosiderin deposits. The gold standard for detect-ing and monitoring the disease is MRI, where the characteristic hemosiderin accumulation can be best appreciated, but it is a histological examination that is most conclusive. The main treatment is surgical resection of all pathological tissue, but radio- and chemotherapy are also viable options for certain groups of patients.

Introduction: The COVID-19 pandemic has put healthcare systems worldwide under huge strain, resulting in a significant loss of their capacity and availability. Patients have become more reluctant to contact their doctors or call an ambulance in case of myocardial infarction (MI) symptoms onset. It has been accompanied by a significant decrease in the number of coronary angiography and PCI procedures performed.
Objectives: The aim of the study is to evaluate the role of online health information in the patient- dependent phase of MI management during the COVID-19 lockdown in Europe.
Methods: We analyzed Google Trends data on the popularity of phrases related to MI symptoms, respiratory tract infection, urological complaints, and terms unrelated to health, for the period of the first COVID-19 lockdown, along with the data from the corresponding weeks from 2017–2019 in seven European countries.
Results: The search volume for particular symptoms of myocardial infarction increased in all studied countries, compared to the analogous period from 2017–2019, with a significant increase in for chest pain, shortness of breath, fear, and palpitations in most countries. These changes have not been accompanied by increased interest in terms related to respiratory tract infection symptoms and urological complaints.
Conclusions: Our findings suggest that during lockdown, patients with MI symptoms may have tried to manage their complaints on their own, using information from the Internet. This demonstrates the growing role of the Internet in the patient’s decision-making process in the emergency situation, indicating a grow-ing need for reliable and freely available online information provided by healthcare professionals.

Pain in the masticatory muscles or temporomandibular joints may in some cases be a symptom of other afflictions occurring in this region. The aim of the study was to present the differential diagnosis of temporomandibular disorders (TMD) and other diseases in the craniofacial area, based on review of the literature. Using the key words: “differential diagnosis of TMD”, “pain of non-dental origin” and “chronic orofacial pain”, PUBMED and Scopus databases were systematically searched for articles in English from 2005 to 2020. Additionally, the PUBMED database was supplementarily reviewed using the keywords “Lyme disease orofacial symptoms” for the English-language articles published in the years 1996–2020. Out of 445 publications from PUBMED and Scopus databases as well as other sources, 57 articles describ-ing the pathogenesis and characteristic symptoms of diseases that may cause pain similar to that occurring in TMD as well as diagnostic methods used in differential diagnosis of TMD were selected for analysis. Dental and jawbones-related conditions, ear and maxillary sinus diseases, as well as ailments of neuro-pathic and vascular origin, were taken into account. Neoplastic processes taking place in this region and less often occurring diseases caused by viruses, bacteria and parasites were also described. Conclusions. Correct diagnosis of temporomandibular disorders is based on medical history and thorough physical examination, as well as results of additional tests. Pain localized in the head and neck structures may have diverse, sometimes complex aetiology, and may require multidisciplinary treatment. Observation of the patient’s behaviour and — in selected cases — the results of additional laboratory tests, also play a sig-nificant role.

Arterial stiffness is a characteristic of the arterial wall strongly associated with ageing and hypertension. It has been confirmed as a significant cardio-vascular risk factor. Despite available non- invasive measurement methods of central artery stiffening, it has not become a prevalent diagnostic marker in primary care so far. This article provides an overview of pathophysiology of arterial stiffness, possible diagnostic techniques, association with cardiovascular conditions and potential perspective of primary care to implement an additional distinctive parameter to evaluate cardiac risk.

5-fluorouracil (5-FU), which is a commonly used chemotherapy agent exerts undesired cardiac toxicity. Mitochondrial dysfunction is thought to be one of potentially important mechanisms of 5-FU- induced cardiotoxicity. α-ketoglutarate dehydrogenase (α-KGDHC) is the key regulatory enzyme of TCA cycle. The complex consists of multiple copies of three catalytic subunits: α-ketoglutarate dehydrogenase (E1), dihydrolipoamide succinyltransferase (E2) and dihydrolipoamide dehydrogenase (E3). α-KGDHC together with branched chain α-ketoacid dehydrogenase (BCKDHC) and pyruvate dehydrogenase (PDHC), are the members of 2-oxoacid dehydrogenases family that share some structural and functional similarities. Recently, it has been found that 5-FU stimulates BCKDHC in rat’s cardiac muscle. Therefore, we hypothesize that 5-FU modifies α-KGDHC activity and affects cardiac muscle metabolism. The aim of this study was to determine the effect of 5-FU on α-KGDHC activity and protein levels of E1 and E2 subunits of the complex in rat’s cardiac muscle. Wistar male rats were administered with 4 doses of 5-FU, 150 mg/kg b.wt. each (study group) or 0.3% methylcellulose (control group). α-KGDHC activity was assayed spectrophotometrically. The E1 and E2 proteins levels were quantified by Western blot. 5-FU administration resulted in stimulation of myocardial α-KGDHC activity in rats. In addition, E2 protein level increased in response to 5-FU treatment, while the E1 protein level remained unchanged. Up- regulation of α-KGDHC appears to result from change in E2 subunit protein level. However, the effect of 5-FU on factors modifying α-KGDHC activity at post-translational level cannot be excluded.

The dorsal capsule of the wrist and the DCSS may play a significant role in the conduction of nerve signals transmitted from proprioceptors present in SL to PIN, which is located above the dorsal capsule. Hence, this study aimed to determine if nerve fibers of PIN penetrate inside the dorsal capsule. The dorsal capsules of the wrist were dissected from both sides from 15 cadavers. Eventually, 30 dorsal capsules were dissected. It can be concluded that the PIN nerve fibers penetrate the dorsal capsule of the wrist, as the penetration was noticeable in every part evaluated.
The present study proves that afferent fibers from the mechanoreceptors of the SLIL potentially pass through the DCSS and subsequently through the dorsal capsule of the wrist to the PIN. This knowledge can surely be of great use for hand surgeons that perform procedures on the dorsal wrist.

There is a discrepancy between the research exploring e-learning at medical universities in Central/Eastern and Western European countries. The aim of the MeSPeLA study was to explore the understanding, experience and expectations of Polish medical students in terms of e-learning. Questionnaire containing open-ended and closed questions supplemented by focus group discussion was validated and performed among 204 medical students in Poland before COVID-19 pandemia. Several domains: understanding of e-learning definitions; students’ experience, preferences, expectations and perceptions of e-learning usefulness, advantages and disadvantages were addressed. The qualitative data were analyzed using an inductive approach. 46.0% of students chose a communication-oriented definition as the most appropriate. 7.4% claimed not to have any experience with e-learning. 76.8% of respondents indicated they had contact with e-learning. The main reported e-learning advantages were time saving and easier time management. The most common drawback was limited social interactions. The acceptance of the usage of e-learning was high. Medical undergraduates in Poland regardless of the year of studies, gender or choice of future specialization showed positive attitudes towards e-learning. Students with advanced IT skills showed a better understanding of the e-learning definition and perceived e-learning to be a more useful approach. The expectations and perceptions about e-learning in Polish medical schools seems similar to some extent to that in Western European and the United States so we can be more confident about applying some lessons from these research to Poland or other post-communist countries. Such application has been accelerated due to COVID-19 pandemia.

Objectives: The aim of the study was to assess the relationship between body composition, nutritional status and physical ability in elderly outpatients.
Method:. In this cross-sectional study, demographic data and medical history were collected from patients aged ≥60 years followed in the Geriatric Outpatient Clinic from October 2010 to February 2014. Body composition was examined using a dual-energy X-ray absorptiometry. Physical performance was assessed by gait speed (GS), Timed Up & Go Test (TUG), Six Minute Walk Test (6MWT). The nutritional status was evaluated using the Mini Nutritional Assessment (MNA) and serum albumin level.
Results: Mean age (± SD) of 76 patients (64.47% men) was 71.93 ± 8.88 yrs. The most common diseases were: hypertension (89.47%), coronary heart disease (81.58%) and chronic heart failure (68.4%). In multiple regression analyses, the factors significantly affecting GS were: age (B = –0.017, p ≤0.0001), good nutritional status (B = 0.038, p <0.01) and percent of lower extremity fat (B = –0.009, p <0.05). Longer TUG time was associated with poorer nutritional status (B = –0.031, p <0.01), older age (B = 0.01, p <0.01) and a higher number of comorbidities (B = 0.034, p <0.05). 6MWT was influenced negatively by age (B = –3.805, p <0.01) and percent of lower extremity fat (B = –2.474, p <0.05).
Conclusions: Age and nutritional status remain a strong determinant of physical fitness deterioration. Different measures of physical performance are influenced by different elements of body composition — no single element of body composition was found determining the deterioration of all assessed parameters of physical fitness.
Identifying the relationship between body composition, nutritional status and physical performance can help elucidate the causes of disability and target preventive measures.

Zinc oxide (ZnO) is a prominent n-type semiconductor material used in optoelectronic devices owing to the wide bandgap and transparency. The low-temperature growth of ZnO thin films expands diverse applications, such as growth on glass and organic materials, and it is also cost effective. However, the optical and electrical properties of ZnO films grown at low temperatures may be inferior owing to their low crystallinity and impurities. In this study, ZnO thin films were prepared by atomic layer deposition on SiO2 and glass substrates in the temperature range of 46-141℃. All films had a hexagonal würtzite structure. The carrier concentration and electrical conductivity were also investigated. The low-temperature grown films showed similar carrier concentration (a few 1019 cm−3 at 141°C), but possessed lower electrical conductivity compared to high-temperature (>200°C) grown films. The optical transmittance of 20 nm thin ZnO film reached approximately 90% under visible light irradiation. Additionally, bandgap energies in the range of 3.23-3.28 eV were determined from the Tauc plot. Overall, the optical properties were comparable to those of ZnO films grown at high temperature.

Co-Cr-Mo based sheet I-WP lattice was fabricated via laser powder bed fusion. The effect of microstructure and the I-WP shape on compressive mechanical response was investigated. Results of compression test showed that yield strength of the sheet I-WP was 176.3 MPa and that of bulk Co-Cr-Mo (reference material) was 810.4 MPa. By applying Gibson-Ashby analytical model, the yield strength of the lattice was reversely estimated from that of the bulk specimen. The calculated strength of the lattice obtained was 150.7 MPa. The shape of deformed lattice showed collective failure mode, and its microstructure showed that strain-induced martensitic transformation occurred in the overall lattice. The deformation behavior of additively manufactured sheet I-WP lattice was also discussed.

Fe-Cr-B-based metamorphic alloy coating layers were manufactured by plasma spray with a Fe-Cr-B-Mo-Nb composition (hereinafter, M+) powder. The microstructure and wear properties of the coating layers were investigated and compared with a metamorphic alloy coating layer fabricated with commercial M material. XRD analysis revealed that the M and M+ coating layers were composed of α-Fe, (Cr, Fe)2B, and some metallic glass phases. Wear test results showed that M+ coating layers had a superior wear resistance which had 1.48 times lower wear volume than M coating layers. Observations of the worn-out surfaces and cross-sections of the coating layers showed that M+ coating layer had relatively low oxides along the particle boundaries and it suppress a delamination behavior by the oxides.