The effects of one-time soft tissue therapy on pelvic floor muscle electromyographic signals in women with urinary incontinence: A randomized intervention trial.

AIMS: To investigate the effects of one-time soft tissue therapy (STT) on pelvic floor muscle (PFM) electromyographic signals in women with stress and/or mixed urinary incontinence. METHODS: An intervention study conducted with 63 women with stress and/or mixed urinary incontinence. Participants were randomly assigned to either the one-time STT group (experimental group) or the control group. The same teaching model for voluntary contraction and relaxation of the PFM was used for all participants. Electromyographic signals from the PFM during functional tasks were the primary clinical outcome measures at baseline and immediately after the intervention. Electromyographic signals were analyzed using root mean square amplitude. RESULTS: There was no significant difference between groups in electromyographic PFM signals in prebaseline rest (mean difference: -0.146 [95% confidence interval (CI): -0.44 to 0.148; p = 0.470]), phasic contractions (mean difference: 0.807 [95% CI: 0.123-1.491; p = 0.459]), tonic contractions (mean difference: 1.06 [95% CI: 0.255-1.865; p = 0.302]), endurance contractions (mean difference: 0.896 [95% CI: 0.057-1.735; p = 0.352]) and postbaseline rest (mean difference: -0.123 [95% CI: -0.406 to 0.16; p = 0.591]) immediately after the one-time STT intervention. CONCLUSION: A one-time STT intervention does not appear to effectively alter electromyographic signal of the PFM in women with urinary incontinence. Due to the limitations of the study, further research is needed to confirm these results.

Comparative Efficacy of Ultrasound-Guided Cervical Fascial Infiltration versus Periarticular Administration of Autologous Conditioned Serum (Orthokine) for Neck Pain: A Randomized Controlled Trial Protocol Description.

BACKGROUND Neck pain is a prevalent and burdensome health issue, with autologous conditioned serum (ACS), like Orthokine, being a recognized treatment for musculoskeletal conditions due to its anti-inflammatory effects. However, the optimal ACS administration method for neck pain remains unclear. The existing literature lacks robust evidence, especially for different injection techniques. This study aimed to compare ACS infiltration into cervical fascia with periarticular administration to determine if the former is as effective in alleviating neck pain, offering a novel approach to its management. MATERIAL AND METHODS Our study is designed to be a single-center, prospective, randomized trial involving 100 patients. Group A (n=50) will receive ACS through fascial infiltration at tender points under ultrasound guidance, with 4 doses administered every 3 days. Group B (n=50) will receive ACS injections in the articular column (facet joints) using the same dosing schedule. We will collect data at T0 (before therapy), T1 (6 weeks after therapy), and T2 (12 weeks after therapy), assessing outcomes with the Numerical Pain Scale (NRS), Neck Disability Index (NDI), and Dynamic Proprioception Test (DPT). RESULTS Enrollment begins in August 2023, and the study is set to conclude in July 2024. If data analysis, manuscript preparation, and peer review proceed smoothly, we anticipate publishing the results in late 2024 or early 2025. CONCLUSIONS If fascial infiltration with ACS proves equally effective as the standard periarticular method, it offers promise for patients on long-term anticoagulant treatment. Paravertebral injections in such cases carry a significant risk of bleeding, making ACS infiltration a potentially safer alternative for managing neck pain in these individuals.

Effect of HVEM/CD160 Variations on the Clear Cell Renal Carcinoma Risk and Overall Survival.

Renal cell carcinoma (RCC) accounts for approximately 90-95% of all kidney cancers in adults, with clear cell RCC (ccRCC) being the most frequently identified subtype. RCC is known for its responsiveness to immunotherapy, making it an area of significant research interest. Immune checkpoint (IC) molecules, which regulate immune surveillance, are established therapeutic targets in RCC. The aim of this study was to analyze the influence of HVEM and CD160 gene polymorphisms on ccRCC susceptibility and patient overall survival (OS) over a ten-year period of observation. We genotyped three HVEM single nucleotide polymorphisms (SNPs): rs1886730, rs2234167, and rs8725, as well as two CD160 SNPs: rs744877 and rs2231375, in 238 ccRCC patients and 521 controls. Our findings indicated that heterozygosity within rs2231375 and/or rs2234167 increases ccRCC risk. Furthermore, in women, heterozygosity within HVEM SNPs rs8725 and rs1886730 is also associated with an increased ccRCC risk. The presence of a minor allele for rs1886730, rs2234167, rs8725, and rs2231375 was also correlated with certain clinical features of ccRCC. Moreover, rs1886730 was found to be associated with OS. In conclusion, our study highlights an association between HVEM and CD160 polymorphisms and the risk of developing ccRCC as well as OS.

Association Between Serum Vitamin D Levels and Physical Outcomes of Patients Who Underwent Rehabilitation Following Ischemic Stroke.

BACKGROUND Ischemic stroke is the most common cause of disability in adults. Deficiency of vitamin D in patients with cardiovascular diseases is increasing. Only a few studies have assessed the relationship between serum vitamin D levels and functional capacity and degree of disability. This study aimed to evaluate the association between serum vitamin D levels and physical outcomes of 94 patients who underwent physical rehabilitation following ischemic stroke. MATERIAL AND METHODS A group of 94 patients was enrolled; however, 80 patients (61.8±6.9 years) were included. They underwent a 6-week rehabilitation using proprioceptive neuromuscular facilitation (PNF, 60 min daily), mirror therapy (MT, 30 min daily), and occupational therapy (OT, 45 min daily). The Barthel Index (BI) and modified Rankin scale (mRS) were used for functional assessments. Laboratory blood tests for serum vitamin D and insulin-like growth factor 1 (IGF-1) levels were conducted. RESULTS There was a significant increase in BI scores (median difference=2.0 points [pts]; P<0.001) and IGF levels (median difference=124.6 ng/ml; P<0.001) after rehabilitation. There was a significant decrease in mRS scores (median difference=7.0 pts; P<0.001), but there was no significant difference in vitamin D levels (P=0.40). The effect of age (B=-0.01, P=0.04) and serum vitamin D level (B=-0.02, P=0.01) on the BI score was demonstrated. The effect of body mass index (BMI) results (B=-0.07, P=0.02) on the mRS score was observed. CONCLUSIONS Lower serum vitamin D levels and more advanced age may be associated with worse functional outcomes in first-ever ischemic stroke patients.

The Variations' in Genes Encoding TIM-3 and Its Ligand, Galectin-9, Influence on ccRCC Risk and Prognosis.

Renal cell cancer is the most common type of kidney cancer in adults, and clear cell renal cell carcinoma (ccRCC) is the most diagnosed type. T cell immunoglobulin and mucin-domain-containing-3 (TIM-3) belongs to immunological checkpoints that are key regulators of the immune response. One of the known TIM-3 ligands is galectin-9 (LGALS9). A limited number of studies have shown an association between TIM-3 polymorphisms and cancer risk in the Asian population; however, there is no study on the role of LGALS9 polymorphisms in cancer. The present study aimed to analyze the influence of TIM-3 and LGALS9 polymorphisms on susceptibility to ccRCC and patient overall survival (OS), with over ten years of observations. Using TaqMan probes, ARMS-PCR, and RFPL-PCR, we genotyped two TIM-3 single-nucleotide polymorphisms (SNPs): rs1036199 and rs10057302, and four LGALS9 SNPs: rs361497, rs3751093, rs4239242, and rs4794976. We found that the presence of the rs10057302 A allele (AC + AA genotypes) as well as the rs4794976 T allele (GT + TT genotypes) decreased susceptibility to ccRCC by two-fold compared to corresponding homozygotes. A subgroup analysis showed the association of some SNPs with clinical features. Moreover, TIM-3 rs1036199 significantly influenced OS. Our results indicate that variations within TIM-3 and LGALS9 genes are associated with ccRCC risk and OS.

Efficacy of Focused Extracorporeal Shock Wave Therapy in Chronic Low Back Pain: A Prospective Randomized 3-Month Follow-Up Study.

BACKGROUND Extracorporeal shock wave therapy (ESWT) is a modern physiotherapeutic method that is useful for treating musculoskeletal conditions. There are still limited data from well-designed studies evaluating the clinical efficiency of ESWT in low back pain (LBP). Therefore, this study aimed to assess the effectiveness of the focused ESWT (fESWT) in reducing pain and improving the functional status of patients with chronic LBP. MATERIAL AND METHODS The study involved 40 patients with L5-S1 discopathy with chronic LBP pain who were randomized into 2 groups: group A (n=20, mean age of 42.3±13.1 years) and group B (n=20, mean age of 45.4±14 years). Group A was an experimental group treated with an fESWT at the lumbar and sacral spine (0.15 mJ/mm², 1000 pulses, 4 Hz). Group B was a control group, treated with a sham fESWT. The treatment protocol in both groups included identical stabilization training (45 minutes, once a day, 5 days a week). Study outcomes included subjective pain with a visual analog scale (VAS) and Laitinen Pain Scale (LPS), and functional status using the Oswestry Disability Index (ODI). Measurements were made before and after treatments, as well as follow-up observations at 1 and 3 months following ESWT. The study was prospectively registered at the ISRCTN registry platform (no. ISRCTN13785224). RESULTS There was a significant analgesic effect (VAS and LPS) in both groups; however, it was significantly greater in the experimental group compared to the sham group (P<0.05). A more significant decrease in the perceived pain (VAS and LPS) was observed immediately after the active fESWT therapy. In follow-up observations (after 1 and 3 months), there were no significant between-group differences (P>0.05). Also, there was a significant effect in terms of functional state (ODI) for both groups (P<0.05); however, between-group comparisons revealed no statistically significant differences (P>0.05). CONCLUSIONS Focused ESWT with an exercise program can be effective in patients with chronic LBP. ESWT allows reducing pain, although it does not seem to significantly improve a patient's functional state.

The relationship between the level of physical activity, independence in daily activities, and life quality and satisfaction in women over 80 living in rural areas - a pilot study.

BACKGROUND: Better medicine and health care steadily increases the human life expectancy. Growing number of elderly people and the imbalance of population structure will affect many fields of life, including social security system, joborientation and culture. Therefore it is crucial that the elderly maintain not only good physical health but keep the ability to self-care as long as possible, stay functionally fit and express satisfaction of life in all domains. OBJECTIVE: This study aims to analyse the factors that affect the quality of life in different domains (physical, psychological, social and environmental), like the independence in performing everyday life activities and the level of physical activity of women above 80 years old, living in own households. MATERIALS AND METHODS: The study was performed from March to August 2015 in Opole, Lower Silesia and Silesia voivodeship, mosty in rural areas, on 67 women, age above 80 (average 82.9), who filled the standarized questionnaires of life quality (WHOQOL-BREF), physical activity (IPAQ), and self-maintenance in daily living (IADL, Lawton scale). RESULTS: The results show that the life satisfaction of women above 80 years old living in own households in rural areas is highest in the social and environmental domains, while is the lowest in physical health domain. There is a strong positive correlation between the level of physical activity, the level of self-maintenance and the life quality in four of its domains. CONCLUSIONS: Self-maintenance and higher level of physical fitness, which are the components of functional fitness, positively correlate with self-assesed life-satisfaction in all domains. It is crucial to stress the importance of physical activity in seniors, preferably in way of dedicated exercising of moderate and high intensity, that will bring benefits not only in domain of physical health but in overall well-being and higher life-satisfaction, the significant factors in healthy ageing.

Proprioceptive Neuromuscular Facilitation for Accessory Respiratory Muscles Training in Patients After Ischemic Stroke.

This study focused on how pulmonary function is affected by proprioceptive neuromuscular facilitation (PNF) of accessory respiratory muscles in the chronic post-stroke phase. The study involved patients who had had ischemic stroke 6 months or more before the PNF treatment investigated. The objective was to define the effect of PNF on bioelectrical resting and maximum activity of the accessory muscles. Patients were randomly assigned to PNF treatment and just positioning treatment as a reference for comparison; 30 patients each. Electromyography of accessory muscles was investigated before and after physiotherapeutic treatments. We found that there was a greater reduction in EMG activity in all muscles investigated after PNF compared to positioning treatment alone. A reduction of muscle activity due to PNF concerned both affected and unaffected body side, but it was greater on the affected side. We conclude that a reduction of the accessory respiratory muscle activity due to PNF treatment could be of benefit in chronic stoke patients in that it would help normalize breathing pattern and thereby prevent the development of hypoxia.

High Physical Activity Level May Reduce Menopausal Symptoms.

Background and Objectives: Menopause is a normal physiological change occurring at a woman's mid-life. During this time, women experience vasomotor, physical and physiological problems, which reduce their quality of life. Many women are searching for different, alternative methods to reduce the severity of menopausal symptoms. Physical activity (PA) is one of the recommended methods to reduce menopausal symptoms. The purpose of this study was to investigate the association between specific domains (physical activity during leisure time, at work, during transportation and household activities) and the menopausal symptoms. Materials and Methods: We included 305 women aged 40-65 in the study. All participants were divided into three groups according to menopausal status. The research tools used were the International Physical Activity Questionnaire (IPAQ) to assess physical activity level in four domains and the Menopause Rating Scale (MRS) to assess the severity of menopausal symptoms. The data analysis was performed by Chi-square test and analysis of variance (ANOVA) with post hoc Tuckey test. Results: Menopausal stage was significantly associated with the total MRS score (p < 0.001) and specifically the urogenital and somato-vegetative subscores (p < 0.001). Physical activity was significantly associated (p < 0.001) with leisure time (according to IPAQ domains). Most postmenopausal women had high PA level (59.66%). Significantly less women with high PA levels had severe urogenital symptoms: 10.82% of participant with a low PA level, 11.15% with a moderate PA level and 4.26% with a high PA level (p = 0.046). Conclusions: Physical activity during leisure time is associated to menopausal symptoms in Polish women. Women with high and moderate PA levels have less severe menopausal symptoms compared to inactive women. Middle-aged women with low PA levels at work suffer from more severe somato-vegetative symptoms.

[Post-stroke spasticity management including a chosen physiotherapeutic methods and improvements in motor control - review of the current scientific evidence.]

Cerebrovascular diseases based on stroke etiology concern millions of people worldwide, and annual rates of disease are still increasing. In the era of an aging society and suffering from a number of risk factors, in particular those modifiable, strokes and muscles' spastic paresis, subsequently resulting in damage of upper motor neuron structures will become a serious problem for the entire health care system. Effective management and physiotherapy treatment for post-stroke spasticity persisted, both in the acute and chronic, is still a significant medical problem in the interdisciplinary aspect. Care procedures for this type of patient becomes a kind of challenge for specialists in neurology, internal medicine, cardiology, dermatology or neurosurgery, but also for physiotherapists in their everyday clinical practice. The aim of this paper is to present the issues of cerebral stroke and resulting spastic hypertonia in terms of current pharmacological treatment and surgery, and primarily through the use of effective physiotherapy methods, the use of which was confirmed in the way of reliable scientific research in accordance with the principles of Evidence Based Medicine and Physiotherapy (EBMP).

[Extracorporeal shock waves (ESW) as an alternative treatment method for improving the limb muscles' spasticity after cerebral stroke - a systematic review of the literature].

Extracorporeal shock wave (ESW) is a physical factor, of which the clinical use is observed in a wide range of disorders, particularly musculoskeletal dysfunctions. Recently, one can observe that the list of indications for ESW treatment is continuously growing and adapting the increasingly different systemic diseases in terms of etiology and pathomechanism. Nevertheless, it should be remembered that the potential biological mechanisms of ESW stimulation conditioning advantageous and desirable therapeutic effects are not clearly explained. In the world of science is the lack of irrefutable evidence, supported by advanced research in the field of observation and recording biophysical mechanisms under the influence of ESW stimulation in a number of neurological disorders, especially in patients after stroke suffer from the damage of upper motor neuron (UMN). The aim of this paper is to provide an overview of current research reports evaluating the efficacy and safety of ESW in reducing a post-stroke spasticity of limbs and recover a motor finctions in stroke patients. A number of 8 research articles were qualified into review, only in English, which appeared in the years 2005 - 2015. The following summary includes a total group of 83 patients with spasticity of the lower limbs and 79 in the upper limbs. Review of scientific reports were based on international medical databases. All classified papers were characterized in detail, taking into account the methodology of research, patient characteristics, establish treatment parameters, as well as the results obtained on the basis of subjective and objective indicators. Despite a promising effectiveness of ESW therapy, the results of which have been described so far in several pilot studies, there is a legitimate need for further verification of this subject of research in terms of clinical application.

Kinesiology Taping does not Modify Electromyographic Activity or Muscle Flexibility of Quadriceps Femoris Muscle: A Randomized, Placebo-Controlled Pilot Study in Healthy Volleyball Players.

BACKGROUND: Kinesiology taping (KT) is a popular method of supporting professional athletes during sports activities, traumatic injury prevention, and physiotherapeutic procedures after a wide range of musculoskeletal injuries. The effectiveness of KT in muscle strength and motor units recruitment is still uncertain. The objective of this study was to assess the effect of KT on surface electromyographic (sEMG) activity and muscle flexibility of the rectus femoris (RF), vastus lateralis (VL), and vastus medialis (VM) muscles in healthy volleyball players. MATERIAL AND METHODS: Twenty-two healthy volleyball players (8 men and 14 women) were included in the study and randomly assigned to 2 comparative groups: "kinesiology taping" (KT; n=12; age: 22.30 ± 1.88 years; BMI: 22.19 ± 4.00 kg/m(2)) in which KT application over the RF muscle was used, and "placebo taping" (PT; n=10; age: 21.50 ± 2.07 years; BMI: 22.74 ± 2.67 kg/m(2)) in which adhesive nonelastic tape over the same muscle was used. All subjects were analyzed for resting sEMG activity of the VL and VM muscles, resting and functional sEMG activity of RF muscle, and muscle flexibility of RF muscle. RESULTS: No significant differences in muscle flexibility of the RF muscle and sEMG activity of the RF, VL, and VM muscles were registered before and after interventions in both groups, and between the KT and PT groups (p>0.05). CONCLUSIONS: The results show that application of the KT to the RF muscle is not useful to improve sEMG activity.

[Evaluation of the effectiveness of extracorporeal shock wave therapy in selected musculoskeletal system disorders of the inflammatory etiology--a critical review of the literature]. / Ocena efektywnosci zewnatrzustrojowej fali uderzeniowej w wybranych schorzeniach narzadu ruchu o etiologii zapalnej --krytyczny przeglad pismiennictwa.

Extracorporeal shockwave therapy (ESWT) is a modern method from the scope of physical medicine. In Poland, atthe end of the last decade, ESWT has become an extremely popular form of treatment for many diseases, especially musculoskeletal. The aim of this study is to provide an overview of the most up to date scientific reports assessing the effectiveness of ESWT in the most common musculoskeletal system disorders of the inflammatory etiology. To review, there were qualified 15 subjects of research works in English language only, which were published between 2002-2013. The following summary includes a total amount of 1326 patients. Review of the scientific reports ware made based on international medical databases review. All qualified articles were characterized in detail in terms of material and research methods with a precise determination of treatment parameters, as well as the results achieved separated fora specific diagnosis. Despite the beneficial therapeutic effects as a result of ESWT treatment, which are described in numerous publications, there is a justified need for further observation the progress of scientific research, in particular with regard to the effectiveness and safety of ESWT.

[Physiotherapy potentials improve the calf muscle pump function in chronic venous insufficiency]. / Mozliwosci fizjoterapii w usprawnianiu funkcji pompy miesniowej goleni w przewleklej niewydolnosci zylnej.

Mechanism of the calf muscle pump plays a major role in venous blood return from peripheral parts of blood vessels of lower extremities. It enables a smooth venous blood movement from the deep venous system segment located below in a direction to the segment lying above which effectively prevents a distal blood stasis and veno-lymphatic edema of lower limbs. Calf muscle pump dysfunction together with disorders in the construction of blood vessels walls and with endurance weakness of valves, leads to venous hypertension and contributes to the development of venous insufficiency. The aim of this paper is to demonstrate the theoretical basis including venous return physiology and the mechanism of lower limbs venous--muscle pump as well as provide practical application of physiotherapy methods to support the properfunction of presented calf muscle pump. Examples in the field of physical medicine, compression therapy and kinesiotherapy for improving the efficiency of lower extremity muscles, providing a physiological venous return.

Dry Needling with the Use of FRSc Technique in Addition to Standard Rehabilitation Program for Chronic Low Back Pain: A Randomized Controlled Trial Using Both PROMs and Measurement Tools.

Purpose: Dry needling (DN) has gained popularity for musculoskeletal conditions, but its commercial use often surpasses scientific evidence. The novel Five Regulatory Systems Concept (FRSc) of DN shows potential therapeutic mechanisms, including chronic low back pain (LBP). However, rigorous clinical assessment with patient-reported outcome measures (PROMs) and objective measures are necessary. This study aimed to evaluate the effect of DN according to pain levels, postural control and selected gait parameters in patients with chronic LBP. Patients and Methods: This prospective, double-blinded, randomized controlled study involved 30 patients with LBP allocated in the experimental (n=15, rehabilitation+ FRSc DN) or control group (n=15, rehabilitation + sham DN). The Roland-Morris questionnaire (RMQ) and Visual Analog Scale (VAS) were used as PROMs. Moreover, the posturography method for posture and balance control and the treadmill for gait analysis were used as objective tools. Measurements were taken before and immediately after the intervention and during 1- and 3-month follow up. Results: There was a statistically significantly greater improvement in the RMQ in the experimental group compared to the controls (p=0.923 before and p<0.001 after treatment, as well as p<0.001 after 1 and 3 months). Despite the favorable analgesic effect, a significant advantage of the experimental group over the controls in this respect is worth noting (p=0.001 in favor of DN in all intergroup comparisons concerning results from the subjective assessment of pain (VAS). A statistically insignificant post-treatment improvement in balance and postural stability was noted in both groups, although the effects appeared to be short-term. Surprisingly, again, DN had no advantage over sham interventions. In both groups, all changes in the swing phase were statistically insignificant (p=0.201 for the dominant and p=0.283 for the non-dominant side) for the initial swing phase. In both groups, all changes in the stance phase were statistically insignificant (p=0.480 for the dominant and p=0.410 for the non-dominant side of the body). Conclusion: DN based on the FRSc appears promising as an effective adjunct to standard rehabilitation for LBP, showing improvements in functional performance and pain reduction.

Safety of Epidural Hyaluronic Acid Injections in Managing the Symptoms of Lumbar Foraminal Stenosis: A Prospective Preliminary Study.

Lumbar foraminal stenosis (LFS) of degenerative origin is a common reason for distorted neurodynamics of nerve roots, causing radicular pain that is difficult to resolve with conservative treatments. A hyaluronic acid (HA), providing a sliding layer in the mechanical interface of a nerve root in a narrowed lateral recess, could potentially improve its neurodynamics and the trophic, leading to radicular pain reduction and improvement of function. This study aimed to assess the usefulness of ultrasound-guided HA epidural injections combined with neuromobilization in the conservative treatment of LFS. A group of 10 consecutively admitted patients with MRI-confirmed LFS and reduced straight leg raise (SLR) test results were qualified for a single HA epidural injection along with self-performed neuromobilization. Three measurement tools were used for primary outcomes: the numeric rating scale (NRS) for pain intensity, the Oswestry disability index (ODI) and the Roland-Morris questionnaire (RMQ) for disability level, and the angle of pain-free elevation in the SLR test as a functional assessment. The treatment was accomplished in all patients (100%). Overall, 60% of the patients completed all follow-up visits. There were no statistically significant differences regarding the results of the NRS, ODI, or RMQ; however, a statistically significant increase in the results of the SLR test was noted (p = 0.015). Three patients reported a flare-up of the symptoms shortly after injection but without neurological deficits. In conclusion, an epidural HA injection combined with a self-administered exercise program is a promising method and might be a beneficial way to enhance the neurodynamics of nerve roots in LFS and offer an option for steroid treatment. However, this method of epidural HA administration in LFS should be verified in further studies to confirm its efficiency and safety.

Assessment of Changes in Serum C-Reactive Protein Levels in Patients after Ischemic Stroke Undergoing Rehabilitation-A Retrospective Observational Study.

Inflammation plays a key role in the pathogenesis and prognosis of ischemic stroke. C-reactive protein (CRP) is an inflammatory biomarker of inflammation and may reflect the progression of vascular disease. Using a biomarker such as CRP to predict recovery rather than mortality may present clinical value in providing rehabilitation. The primary aim of the study was to analyze changes in serum CRP levels in patients after ischemic stroke during the regenerative-compensatory period and to assess the usefulness of CRP as a potential biomarker during the rehabilitation period. The project was carried out as a retrospective analysis of prospectively collected data from post-stroke patients from the Department of Neurological Rehabilitation of the Regional Specialist Hospital in Wroclaw. A group of 52 patients, after their first-ever ischemic stroke with subsequent hemiplegia, was finally qualified to participate in the study. Serum CRP levels were determined during blood laboratory tests. The Modified Rankin Scale (mRS) and Barthel Index (BI) were used to assess functional outcomes. Rehabilitation using neurophysiological methods was applied five days a week (each session lasted 60 min, and the entire period was 42 days). At the first test, serum CRP levels were found to be above 5 mg/L in 19 patients, the second test in 12 patients, the third test in five patients, and the fourth test in 9 patients. Only three patients had values higher than 5 mg/L in all consecutive assessments (p > 0.05). There was a statistically significant increase in BI scores after therapy (p < 0.001) as well as a decrease in the mRS score by 2.2 points (p < 0.001), in CRP values by 5.02 mg/L (p = 0.019), and in cortisol levels by 2.5 nmol/L (p = 0.002). Statistically significant relationships were observed between the CRP levels after rehabilitation and the corresponding mRS scores (rs = 0.29, p = 0.038). Furthermore, the effect of BMI on CRP levels was demonstrated (B = 0.20, p = 0.038). In conclusion, despite demonstrating a significant relationship between CRP levels and corresponding mRS scores, CRP levels alone may not serve as an independent predictor of long-term functional outcomes in ischemic stroke patients undergoing rehabilitation.

The influences of selected clotting and fibrinolysis factors on survival of patients with kidney tumors - a prospective study.

Introduction: Multiple studies suggest that cancer leads to activation of clotting and fibrinolysis pathways, elevating the risk of thromboembolic events. Kidney cancer is often complicated by clotting disorders. In this study, we hypothesized that preoperative clotting and fibrinolysis parameters are altered in healthy volunteers and kidney tumor patients. We also hypothesized that these differences may be associated with survival in patients who have undergone operations due to kidney tumors. Material and methods: In this study, 96 patients with kidney tumors and 30 healthy volunteers were recruited at a single university center. All patients were assessed for pre-operative serum concentrations of tissue factor (TF), tissue factor pathway inhibitor (TFPI, total TFPI, full-length TFPI, truncated TFPI), plasmin-antiplasmin complex (PAP), thrombin-antithrombin complex (TAT), von Willebrand factor (vWF), clotting factor XIII A1 (FXIIIA1), D-dimers, and fibrinogen. Additionally, standard peripheral blood morphology was evaluated. Results: Malignant kidney tumors were diagnosed in 85 of 96 tumor patients. In patients with kidney tumors, there were statistically significantly higher concentrations of fibrinogen, D-dimers, TAT, PAF, TF, TFPI, vWF, FXIIIA1, and leukocyte counts compared to the control group. Statistically significant correlations were found between multiple parameters. This points to significant clotting system alterations. Cox stepwise hazard analysis showed that pre-operative fibrinogen and D-Dimer concentrations were significantly associated with survival. Conclusions: In patients with kidney tumors, multiple clotting and fibrinolysis parameters are significantly altered. Routine pre-operative measures should include determination of fibrinogen and D-dimer concentrations as these markers aid in prediction of survival probability.

Artificial Intelligence in Urooncology: What We Have and What We Expect.

INTRODUCTION: Artificial intelligence is transforming healthcare by driving innovation, automation, and optimization across various fields of medicine. The aim of this study was to determine whether artificial intelligence (AI) techniques can be used in the diagnosis, treatment planning, and monitoring of urological cancers. METHODOLOGY: We conducted a thorough search for original and review articles published until 31 May 2022 in the PUBMED/Scopus database. Our search included several terms related to AI and urooncology. Articles were selected with the consensus of all authors. RESULTS: Several types of AI can be used in the medical field. The most common forms of AI are machine learning (ML), deep learning (DL), neural networks (NNs), natural language processing (NLP) systems, and computer vision. AI can improve various domains related to the management of urologic cancers, such as imaging, grading, and nodal staging. AI can also help identify appropriate diagnoses, treatment options, and even biomarkers. In the majority of these instances, AI is as accurate as or sometimes even superior to medical doctors. CONCLUSIONS: AI techniques have the potential to revolutionize the diagnosis, treatment, and monitoring of urologic cancers. The use of AI in urooncology care is expected to increase in the future, leading to improved patient outcomes and better overall management of these tumors.

Variation in the gene encoding the co-inhibitory molecule BTLA is associated with survival in patients treated for clear cell renal carcinoma - results of a prospective cohort study.

Introduction: The successful introduction of immune checkpoint blockade approaches to renal-cell carcinoma (RCC) treatment indicates the importance of molecules regulating the T cell response to RCC risk and progression. Material and methods: In this study, we evaluate the association of variations in the CTLA-4, BTLA and CD28 genes with overall survival (OS) of RCC patients and specifically clear cell RCC (ccRCC) patients. The following single nucleotide polymorphisms (SNPs) previously genotyped using the RFLP method or TaqMan SNP Genotyping Assays were analyzed: CTLA-4 gene: c.49A>G (rs231775), g.319C>T (rs5742909), g.*6230G>A (CT60; rs3087243), g.*10223G>T (Jo31; rs11571302); CD28 gene: c.17+3T>C (rs3116496), c.-1042G>A (rs3181098); BTLA gene: rs2705511, rs1982809, rs9288952, rs9288953, rs2705535 and rs1844089. Results: During long term observation (6.5 years) we discovered that possessing the A allele at BTLA rs1844089 SNP, together with advanced disease (stage ≥ 3, tumor grade > 3, tumor diameter ≥ 70 mm), is an independent risk factor of death which increases the hazard ratio (HR) of death by more than two-fold (HR = 2.21, 95% CI: 1.28-3.83). Furthermore, the OS of patients bearing this allele is 6 months shorter than for homozygous (GG) patients (42.5 vs. 48.2 months). Conclusions: Our results indicate for the first time that genetic variation within the gene encoding BTLA is significantly associated with overall survival in clear cell renal cell carcinoma patients.