Search Results (919)

Despite substantial progress in medical care, acute myocarditis remains a life-threatening disorder with a sudden onset, often unexpectedly complicating a simple and common upper respiratory tract infection. In most cases, myocarditis is triggered by viral infections (over 80%), with an estimated incidence of 10–106 per 100,000 annually. The clinical course may worsen in cases of mixed etiology, where a primary viral infection is complicated by secondary bacterial pathogens, leading to prolonged inflammation and an increased risk of progression to chronic active myocarditis or dilated cardiomyopathy. We present a case report illustrating the clinical problem of acute myocarditis progression into a chronic active form. A central element of host defense is the inflammasome—an intracellular complex that activates pyroptosis and cytokine release (IL-1β, IL-18). While these processes help combat pathogens, their persistent activation may sustain inflammation and trigger heart failure and cardiac fibrosis, eventually leading to dilated cardiomyopathy. In this review, we summarize the current understanding of inflammasome pathways and their dual clinical role in myocarditis: they are essential for controlling acute infection but may become harmful when overactivated, contributing to chronic myocardial injury. Additionally, we discuss both novel and established therapeutic strategies targeting inflammatory and anti-fibrotic mechanisms, including IL-1 receptor blockers (anakinra, canakinumab), NOD-like receptor protein 3 (NLRP3) inhibitors (colchicine, MCC950, dapansutrile, INF200), NF-κB inhibitors, and angiotensin receptor-neprilysin inhibitors (ARNI), as well as microRNAs. Our aim is to emphasize the clinical importance of early identification of patients at risk of transitioning from acute to chronic inflammation, elucidate the role of inflammasomes, and present emerging therapies that may improve outcomes by balancing effective pathogen clearance with limitation of chronic cardiac damage. Full article

Obesity is a complex, multifactorial disease wherein the excessive accumulation of adipose tissue leads to adverse health outcomes, such as diabetes, cardiovascular disease and musculoskeletal disorders. Obesity also impacts both the risk and the clinical prognosis of heart failure (HF). The accumulation of adipose tissue results in metabolic dysregulation, including increased levels of pro-inflammatory cytokines and adipokines. These alterations are strongly associated with the development and progression of HF. Another significant comorbidity in patients with HF is sarcopenia, characterized by progressive loss of muscle mass and strength, affecting the quality of life. The study aims to critically synthesize the mechanisms by which modern pharmacological treatments—sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 receptor (GLP-1R) agonists, and dual GIPR/GLP-1R agonists—modulate body mass composition, and to analyze the specific implications of these changes (e.g., visceral fat reduction versus lean mass loss) for heart failure (HF) prognosis and management. Full article

In the current research a series of new copper(II) complexes with novel acylhydrazone ligands were synthesized and their antibacterial and anticancer activities were determined. The complexes were characterized by molecular spectroscopy (FT-IR and UV-Vis) and conductivity measurements. Additionally, their structure was confirmed by single-crystal X-ray analysis. The crystallographic data revealed that all compounds are mononuclear Cu(II) species. The Cu(II) ion is four-coordinated by the ONO donor set from mono-deprotonated hydrazone ligand and one Cl^¯ anion, forming distorted square-planar geometry. The biological studies revealed that the compounds exhibit high antimicrobial activity, especially against Gram-positive bacteria, in some cases greater than the reference substances, and better activity than free ligands. The tested complexes possessed the lowest MIC and MBC values towards Staphylococcus epidermidis ATCC 12228 and Micrococcus luteus ATCC 10240. Furthermore, they showed no toxicity towards normal cell lines. Full article

Background: Since the introduction of the first GLP-1 receptor agonist (GLP-1 RA) in 2005, there has been a steady increase in the number of drugs available in this group, as well as an expansion of their indications and routes of administration. Aim: The aim of the study was to assess the clinical characteristics of patients treated with GLP-1 RA in Poland in 2018–2024, with particular emphasis on the disease entities constituting indications for treatment (like obesity and diabetes), and to analyse the frequency of use of individual drugs during the study period. Methods: A cohort study was conducted based on anonymised medical data from 300 outpatient clinics the largest private healthcare facilities in Poland (Luxmed), on consecutive patients who had at least one prescription for GLP-1 RA. The analysis covered the period from 1 January 2018 to 31 December 2024. Results: The number of patients using GLP-1 RA increased from 212 in 2018 to 12,836 in 2024. Obesity was diagnosed in 78% of all patients, most often in the groups using liraglutide and tirzepatide. The highest percentage of patients with type 2 diabetes was observed in the dulaglutide group (67%), while the lowest was in the tirzepatide group (15%). From 2022, the share of oral semaglutide steadily increased, reaching 50% of all semaglutide applications in 2024 in Poland. Conclusions: In the analysed group, GLP-1 RAs were most commonly used to treat obesity. The oral form of semaglutide was more frequently used in younger females with less aggravating medical history. Full article

Background/Objectives: Urgent hospitalization due to acutely decompensated heart failure (ADHF) is an unfavorable event in the trajectory of this disease. Patient condition during decompensation frequently limits opportunities to implement and optimize guideline-directed medical therapy (GDMT). To define the tasks of post-hospital care, it is essential to gain knowledge regarding the extent of GDMT implementation on the day of discharge after ADHF episodes. The purpose of this analisis was to evaluate GDMT changes during hospitalization due to ADHF, with a particular emphasis on patients with reduced ejection fraction. Methods: The analysis was conducted in a group of 262 patients hospitalized due to ADHF and with known left ventricular ejection fraction (LVEF). The HEROES study was a prospective, multi-center, observational study. Results: The mean age in the study group (196 men and 66 women) was 67.6 ± 14.6 years, with a mean LVEF of 33.9 ± 14.8%. Six patients died during hospitalization. In the analysis for the whole group (regardless of ejection fraction [EF]), ARNI (angiotensin receptor-neprilysin inhibitor)/ACEI (angiotensin-converting enzyme inhibitor)/ARB (angiotensin receptor blocker) use increased from 63.3% of the subjects at admission to 81.3% at discharge, beta-blocker use increased from 70.6% to 92.6%, MRA (mineralocorticoid receptor antagonist) use increased from 43.1% to 75.8%, and SGLT2i (sodium-glucose co-transporter 2 inhibitor) use increased from 30.1% to 75.0%. ARNI/ACEI/ARB therapy was optimized in 48.4% of the subjects, with optimization rates of 37.9%, 40.2%, and 44.1% for beta-blockers, MRAs, and SGLT2is, respectively. However, only 38 (22.0%) patients reached the level of treatment corresponding to “SGLT2i and ARNI/ACEI/ARB and betablocker and MRA in doses ≥ 50%”. Conclusions: In patients hospitalized due to ADHF in the HEROES study, the use of GDMT at discharge was significantly higher than at admission. In patients with reduced ejection fraction, GDMTs from all drug classes were prescribed to over 80% of patients. However, an insufficient number of patients attained high doses of GDMT, which emphasizes the need for effective dose up-titration in outpatient settings. Full article

Background: Free fatal falls (FFF) are a frequent occurrence in forensic medicine. Many variables, such as the victim’s sex, BMI, intoxication, height of the fall, and mental illness, can influence injury patterns. Previous studies identified fracture patterns and frequencies mostly with general anatomical detail, focusing on broad areas. As specific fractures might be roots for new statistical connections, this leaves a gap in our understanding. Using postmortem computed tomography, we aim to establish fracture frequencies and identify possible new statistical connections. Methods: In total, we retrospectively analyzed seventy-nine cases of confirmed deaths due to falls using the database of the Department and Institute of Forensic Medicine in Lublin. Our inclusion criteria were death due to free fall onto hard, non-deformable surfaces. We excluded cases of ground-level falls. All victims must have undergone postmortem computed tomography. Furthermore, each analyzed case documented individual intrinsic variables (sex, age, body mass, height, pre-existing mental conditions, and drug or alcohol use) and extrinsic variables (fall height, landing surface, time between the fall and death, and known cause of the fall). Results: Injuries in free fatal falls tend to focus on the axial skeleton. Suicides experience more severe, bilateral fractures, often involving the pelvis and limbs, while accidents tend to have unilateral injuries with rare limb involvement. We established new correlations with the height of the fall for the maxilla, mandible, anterior and posterior regions of the occipital bone, and the temporal bone. Moreover, our research confirmed previously noted correlations between the height of the fall and fractures of the limbs (and their individual bones), the lumbar vertebrae, and the chest. Conclusions: Our findings highlight that free fatal falls are characterized by distinct skeletal injury patterns that differ between accidents and suicides, with bilateral pelvic and limb fractures being particularly indicative of intentional falls. The integration of PMCT with autopsy improves the detection of these patterns. It provides valuable diagnostic and medico-legal insights, supporting a more precise determination of the cause and manner of death. Full article

Background/Objectives: Atrial fibrillation (AF) is a significant contributor to ischemic stroke; however, existing thromboembolic risk scores exhibit only moderate predictive accuracy. Lipoprotein(a) (Lp(a)), a genetically determined lipoprotein characterized by proatherogenic and prothrombotic properties, may play a role in cardioembolic events in AF. Nonetheless, its clinical relevance in this context remains ambiguous. The goal of this systematic review and meta-analysis was to look at the differences in circulating Lp(a) levels between AF patients who had an ischemic stroke and those who did not, as well as to see if Lp(a) could help figure out who is at risk of thromboembolic events. Methods: A thorough search was performed in PubMed/MEDLINE, Embase, Scopus, Web of Science, and CENTRAL until September 2025, in accordance with PRISMA 2020 and Cochrane Handbook guidelines. Eligible studies encompassed adults with AF and accessible data on Lp(a) concentrations, contrasting individuals with and without ischemic stroke. Results: Five observational studies involving 20,678 atrial fibrillation patients (3104 with ischemic stroke) were incorporated. The pooled analysis revealed markedly elevated Lp(a) concentrations in stroke patients relative to non-stroke controls (MD = 2.42 mg/dL; 95% CI 0.68–4.16; p = 0.007). Conclusions: While Lp(a) testing is not presently endorsed in AF guidelines, our results indicate a possible correlation with ischemic stroke risk. Nonetheless, these findings must be regarded with caution owing to significant heterogeneity, the predominance of Chinese cohorts, and the exceedingly low certainty of evidence as per GRADE assessment. Additional extensive, multi-ethnic, and rigorously designed prospective studies are necessary to ascertain whether Lp(a) constitutes an independent risk factor for ischemic stroke in atrial fibrillation. Full article

Excessive dietary salt intake remains a critical and underestimated global health concern, strongly associated with increased cardiovascular disease risk. While the relationship between salt and arterial hypertension is well established, accumulating evidence highlights additional, blood pressure-independent mechanisms linking high salt intake with the progression of atherosclerosis. Beyond its hypertensive effects, high dietary salt directly damages the vascular endothelium by disrupting the glycocalyx, reducing nitric oxide synthesis, and increasing endothelial stiffness and inflammation. Excess sodium also impairs glycosaminoglycan buffering capacity and promotes immune cell adhesion, even in normotensive individuals. Furthermore, salt-induced dysbiosis of the gut microbiota alters the metabolic and inflammatory environment, lowering beneficial short-chain fatty acids and increasing pro-atherogenic metabolites such as trimethylamine N-oxide. Recent findings also implicate salt-driven modulation of hematopoiesis via Th17 cytokines, which enhances the production of pro-inflammatory monocytes that accelerate plaque development. These findings support the notion that high salt intake may be an independent and modifiable residual risk factor for atherosclerotic cardiovascular disease. Reducing dietary sodium—particularly from processed foods—should therefore remain a central component of both primary and secondary cardiovascular prevention. Although the optimal range of salt intake remains under discussion, a moderate reduction to below 5 g/day is considered safe and beneficial. Full article

Background/Objectives: The most prevalent prolonged cardiac arrhythmia and a significant global health burden is atrial fibrillation (AF). Although its connection to AF is still unknown, lipoprotein(a) (Lp(a)), a genetically determined lipoprotein with pro-inflammatory and pro-atherogenic characteristics, has been linked to cardiovascular disease. The purpose of this study was to measure and assess the relationship between circulating Lp(a) levels and AF. Methods: In compliance with the PRISMA 2020 guidelines, a systematic review and meta-analysis were carried out using a protocol that was preregistered in PROSPERO (CRD420251153244). Comprehensive searches of PubMed/MEDLINE, Embase, Web of Science, Scopus, the Cochrane Library, and Google Scholar up until September 2025 were used to find observational studies comparing circulating Lp(a) levels in adults with and without AF. Results: Circulating Lp(a) concentrations were significantly higher in AF patients than in controls across 10 studies (pooled MD = 2.81; 95%CI: 1.58–4.05; p < 0.0001). In the subgroup analysis by geographical setting, studies conducted in Asia and studies from Europe/USA exhibited a statistically significant effect. Despite the extreme heterogeneity (I² = 99%), sensitivity analyses verified that the overall effect was stable. Conclusions: Our pooled analysis revealed a statistically significant association between Lp(a) and AF; however, the certainty of the evidence was rated as very low according to the GRADE methodology. To elucidate causality, enhance risk stratification, and investigate whether Lp(a)-lowering tactics could alter AF risk, large, prospective, multi-ethnic studies with standardized biomarker assessment are needed. Full article

Within the current administrative boundaries of the city of Lublin, fragments of roadside tree avenues of various historical origins and periods of establishment have been preserved, including former tree-lined roads leading to rural and suburban residences from the 18th and 19th centuries. This avenue once led to the manor in Konstantynów and now serves as the main road through the campus of the John Paul II Catholic University of Lublin (Katolicki Uniwersytet Lubelski—KUL). As one of the last surviving elements of the former rural landscape, the Konstantynów avenue represents a symbolic link between past and future. The research combines acoustic tomography and chlorophyll fluorescence analysis, providing a precise and non-invasive evaluation of the internal structure and physiological performance of 34 small-leaved linden trees (Tilia cordata Mill.). This methodological approach allows for early detection of stress symptoms and structural degradation, offering a significant advancement over traditional visual assessments. The study area is an intensively used urban campus, where extensive surface sealing beneath tree canopies restricts rooting space. The degree of surface sealing (paving) directly beneath the tree canopies was also measured. Based on the statistical analysis, a weak a non-significant weak negative correlation (r = −0.117) was found between the proportion of sealed surfaces within the Tree Protection Zone (TPZ) and the Fv/Fm vitality index, indicating that higher levels of surface sealing may reduce tree vitality; however, this relationship was not statistically significant (p = 0.518). The study provides an evidence-based framework for conserving historic trees by integrating advanced diagnostic tools and quantifying environmental stress factors. It emphasizes the importance of improving rooting conditions, integrating heritage trees into urban planning strategies, and developing adaptive management practices to increase their resilience. The findings offer a model for developing innovative conservation strategies, applicable to historic green infrastructure across Europe and beyond. Full article

This paper presents a review of studies on SGLT protein inhibitors, based on literature published between 2000 and 2025, sourced from the Scopus, ScienceDirect, Google Scholar and PubMed databases. The individual isoforms of SGLT proteins are briefly described, with attention to their distribution in the body and biological functions. Representative inhibitors and their potential biological effects are also discussed. Beyond the well-established glucose-lowering properties, characteristic of the extensively studied SGLT2 inhibitors, this review explores additional effects, including anticancer, anti-inflammatory, antioxidant, and neuroprotective activities. The analysis encompasses synthetic SGLT inhibitors, computer-designed molecules, and a wide range of naturally derived compounds, including medicinal plants and food-based substances. Importantly, the review deliberately excludes SGLT2 inhibitors, such as the well-known gliflozin class due to the abundance of existing reviews focused specifically on them. This review focuses on potential inhibitors of the SGLT1, SGLT3, SGLT4, SGLT5, and SGLT6 isoforms, emphasizing their diverse physiological roles beyond diabetes and cardiovascular disease, including applications in cancer therapy and neuroprotection. Particular attention is given to the SGLT1 isoform, for which numerous synthetic inhibitors with promising therapeutic potential have been identified. Additionally, natural compounds, especially those derived from medicinal plants and dietary sources, are extensively documented for their inhibitory effects. For the remaining isoforms (SGLT3–SGLT6), all available data on selective inhibitors were examined, alongside an evaluation of their possible therapeutic applications in light of current scientific knowledge. Full article

This study proposes a hybrid analytical framework for detecting chondromalacia using vibroacoustic (VAG) signals from patients with knee osteoarthritis (OA) and healthy controls (HCs). The methodology combines nonlinear signal decomposition, feature extraction, and deep learning classification. Raw VAG signals, recorded with a custom multi-sensor system during open (OKC) and closed (CKC) kinetic chain knee flexion–extension, underwent preprocessing (denoising, segmentation, normalization). Ensemble Empirical Mode Decomposition (EEMD) was used to isolate Intrinsic Mode Functions (IMFs), and Detrended Fluctuation Analysis (DFA) computed local (α₁) and global (α₂) scaling exponents as well as breakpoint location. Frequency–energy features of IMFs were statistically assessed and selected via Neighborhood Component Analysis (NCA) for support vector machine (SVM) classification. Additionally, reconstructed α₁/α₂-based signals and raw signals were converted into continuous wavelet transform (CWT) scalograms, classified with convolutional neural networks (CNNs) at two resolutions. The SVM approach achieved the best performance in CKC conditions (accuracy 0.87, AUC 0.91). CNN classification on CWT scalograms also demonstrated robust OA/HC discrimination with acceptable computational times at higher resolutions. Results suggest that combining multiscale decomposition, nonlinear fluctuation analysis, and deep learning enables accurate, non-invasive detection of cartilage degeneration, with potential for early knee pathology diagnosis. Full article

Kale (Brassica oleracea var. acephala) is a non-heading leafy vegetable of the Brassicaceae family, widely recognized for its dense nutritional profile and diverse phytochemical composition. This review provides a comprehensive and up-to-date synthesis of kale’s botanical characteristics, cultivation practices, chemical constituents, biological activities, and applications in pharmacy, functional foods, and cosmetics. Importantly, this work highlights the novelty of kale’s multifunctional role. Kale is particularly rich in vitamins (A, C, K), minerals (Ca, Fe, K), dietary fiber, glucosinolates, polyphenols, carotenoids, flavonoids, and chlorophylls, which contribute to its classification as a “superfood.” In this article the discussion of the health-promoting effects of glucosinolates and their enzymatic degradation products, such as isothiocyanates, indoles, and nitriles, highlighting their antioxidant, anti-inflammatory, anticancer, antimicrobial, and lipid-lowering properties, was performed. Moreover, key compounds including sulforaphane, indole-3-carbinol (I3C), and diindolylmethane (DIM) are emphasized for their roles in chemoprevention, hormonal regulation, and cellular protection. The review also summarizes recent in vivo and clinical studies demonstrating kale’s potential in reducing the risk of chronic diseases such as cardiovascular disorders, type 2 diabetes, and hormone-related cancers. The effects of kale on the composition of the gut microbiome, glycemic control, and cholesterol metabolism are also discussed. Advances in plant biotechnology, including micropropagation, somatic embryogenesis, and metabolite enhancement, are also discussed. Overall, this review supports the integration of kale into health-oriented dietary strategies and highlights its relevance in preventive medicine, food innovation, and cosmeceutical development. Full article

Background and Objectives: There is limited knowledge on ICD lead lifespan, the reasons for lead failure, and the influence of lead models. Our aim in this study was to compare the lifetime of individual lead models and the reasons for their extraction. Materials and Methods: We analyzed 3929 transvenous lead extractions (TLEs) (including 1068 ICD lead extractions). Results: The median age of an ICD lead removed (for all causes) was 61 months, three years shorter than that of PM leads. Old models with thick leads survived almost twice as long as thin and modern leads. ICD leads were removed due to infection (35.6%), mechanical damage (33.6%), and dysfunction (including perforation) (20.8%). Riata leads presented higher resistance to mechanical damage compared to Sprint Fidelis and Linox (dwell time medians; 124.0, 47.0 and 70.0 months). However, Durata leads presented higher resistance to mechanical damage compared to Sprint Fidelis and Linox (dwell time medians; 81.0, 68.0 and 70.0 months). Riata leads lasted almost twice as long as Sprint Fidelis. Linox leads lasted as long as theoretically fail-safe Sprint Quatro leads. Conclusions: 1. The median of ICD lead survival was three years shorter than that of PM leads. 2. ICD leads were most commonly removed due to infection, mechanical lead damage, and undamaged lead dysfunction (including perforation). 3. Old models of thick leads (Sprint, Ventritex, and Kainox) survived almost twice as long as thin leads from the transition period (Riata and Sprint Fidelis) and modern leads. Despite advances in the design of ICD leads, their lifetime has not changed significantly. Full article

Post-COVID-19 syndrome, also known as long-COVID, is characterized by a wide spectrum of persistent symptoms involving multiple body organs and systems, including fatigue, gastrointestinal disorders, and neurocognitive dysfunction. Emerging evidence suggests that gut microbiota dysbiosis and disruption of the gut–brain axis play a central role in the pathophysiology of this condition. Probiotics and their metabolites (postbiotics) have gained increasing attention as potential therapeutic agents given their immunomodulatory, anti-inflammatory, and antiviral properties. In this review, we discuss the current understanding of the antiviral mechanisms of probiotics, including reinforcement of intestinal epithelial barrier function, direct virus inhibition, receptor competition, and immune system modulation. Special emphasis is placed on short-chain fatty acids (SCFAs), lactic acid, hydrogen peroxide, and bacteriocins as key factors that contribute to these effects. SCFAs appear to be essential postbiotic compounds during post-COVID recovery. We also highlight recent clinical trials involving specific probiotic species, such as Lactiplantibacillus plantarum, Lacticaseibacillus rhamnosus, and Bifidobacterium longum, and their potential role in alleviating long-term COVID symptoms. Although the current results are promising, further research is needed to clarify the most effective strains, dosages, and mechanisms of action in post-COVID therapeutic strategies. Full article