Maternal-fetal medicine is a dynamically developing field, which enables not only to diagnose and treat maternal diseases but also condtions of an unoborn child developing in a womb. Fetal therapy is a highly specialized branch of maternal-fetal medicine which offers surgeries before birth. Prenatal intervensions aim to correct or diminish unfavorable effects of a fetal congenital defect. However, the starting point for a succesful intrauterine therapy is always a thorough prenatal diagnosis and an extensive knowledge regarding fetal pathophysiology in each case. Fetal surgery is now an established but still rapidly evolving specialty, born from the rationale that destructive embryologic processes, recognized early in gestation, can be curtailed by prenatal correction. Prenatal surgical techniques have evolved from highly invasive interventions involving hysterotomy to minimally- invasive fetoscopic interventions. However, there is still space for research aiming to find solutions including pharmacological treatment. In this review we aimed to present various conditions in which fetal surgery has been attempted and the present the current status of this specialty.

The use of therapeutic ultrasound continues to grow. A focused ultrasonic wave can increase the tissue temperature locally for the non-invasive cancer treatment or other medical applications. The authors have designed a seven-element annular array transducer operating at 2.4 MHz. Each element was excited by sine burst supplied by a linear amplifier and FPGA control circuits. The acoustic field, generated by a transducer was initially numerically simulated in a computer and next compared to water tank hydrophone measurements performed at 20, 40 and 60 mm focal depth. The results showed good agreement of the measurements with theory and the possibility to focus the ultrasound in the preselected area. The total acoustic power radiated by the annular array was equal to 2.4 W.

The aim of this study was to compare effect of combinations of intravenous isotonic sodium bicarbonate (NaHCO3), acetate Ringer, lactate Ringer and small-volume hypertonic sodium chloride (NaCI) solutions along with oral electrolyte solutions (OES) on the treatment of neonatal calf diarrhea with moderate dehydration and metabolic acidosis. Thirty-two calves with diarrhea were used in the study. Calves were randomly assigned to receive acetate Ringer solution (n=8), lactate Ringer solution (n=8), isotonic NaHCO3 (n=8) and 7.2% saline solutions (n=8), and two liters of OES were administrated to all calves orally at the end of intravenous administration. Blood samples for blood gas and biochemical analyses were collected at 0 hours and at 0.5, 1, 2, 4, 6 and 24 hours intervals. All the calves had mild to moderate metabolic acidosis on admission. Increased plasma volume and sodium concentration, but decreased serum total protein were observed within 0.5 hours following administration of hypertonic 7.2% NaCI + OES, compared to other 3 groups. In conclusion, administration of intravenous hypertonic 7.2% NaCI solution in small volume along with OES provided fast and effective improvement of dehydration and acid-base abnormalities within short time in treatment of calf diarrhea with moderate dehydration and metabolic acidosis.

In this contribution an optical method of controlling the state of soft biological tissues in real time, exposed to laser radiation is discussed. The method is based on the assumption that the change dynamics of the amplitude of the scattered diagnostic radiation (λ = 635 nm) is compatible with the change dynamics of the tissue inner structure exposed to the Nd:YAG laser radiation (λ = 1064 nm). In this method the measurement of the tissue temperature is omitted. Exemplary results of the laboratory research on this method and an interpretation of the results are presented.

Groundbreaking findings in immune cell research reveal how Hodgkin lymphoma develops.

The purpose of the studies was to estimate efficiency of delivering nebulised drugs into the lower respiratory tract through endotracheal tubes (ET tubes) which are commonly used in the treatment of uncooperative patients. Water solution of Disodium Cromoglycate (DSCG) was nebulised with a constant air flow (25 l/min). Experimental studies were done for eight ET tubes with varying sizes (internal diameter, length) and made of two different materials. Size distribution of aerosol leaving ET tubes was determined with the use of aerosol spectrometer. Fine Particle Fraction (FPF) and Mass Median Aerodynamic Diameter (MMAD) were calculated for the aerosol leaving each tube. Additionally, mass of the Disodium Cromoglycate deposited into each endotracheal tube was determined. ET tubes can significantly influence the parameters of delivered aerosol depending on their diameter. FPF of aerosol delivered in to the respiratory tract is lower if small endotracheal tubes are used. However, MMAD and FPF for large endotracheal tubes are almost identical with MMAD and FPF from nebuliser. The results indicate that a substantial fraction of large droplets is eliminated from the aerosol stream in long endotracheal tubes (270 mm). In this case the mass of drug delivered through ET tubes is reduced but the content of small droplets increases (high value of FPF).

This paper presents a brief survey of our research in which we have used control theoretic methods in modelling and control of cancer populations. We focus our attention on two classes of problems: optimization of anticancer chemotherapy taking into account both phase specificity and drug resistance, and modelling, and optimization of antiangiogenic therapy. In the case of chemotherapy the control action is directly aimed against the cancer cells while in the case of antiangiogenic therapy it is directed against normal cells building blood vessels and only indirectly it controls cancer growth. We discuss models (both finite and infinite dimensional) which are used to find conditions for tumour eradication and to optimize chemotherapy protocols treating cell cycle as an object of control. In the case of antiangiogenic therapy we follow the line of reasoning presented by Hahnfeldt et al. who proposed to use classical models of self-limiting tumour growth with variable carrying capacity defined by the dynamics of the vascular network induced by the tumour in the process of angiogenesis. In this case antiangiogenic protocols are understood as control strategies and their optimization leads to new recommendations for anticancer therapy.

The use of hyperbaric oxygen therapy (HBOT) is an accepted method of supporting wound healing in human medicine. Yet, because of the risk of complications associated with HOBT, a safer modification of the therapy, known as L-HOBT (lower pressure and lower oxygen concen- tration), is increasingly used nowadays. Therefore, due to the lack of literature reports regarding the clinical use of L-HBOT in animals, the authors decided to present the results of L-HBOT supportive treatment of postoperative wounds after hemimastectomy compared to classic treat- ment. The study group included 12 bitches divided into two groups: group A (assisted L-HBOT) and group B (classic treatment). In addition to conventional treatment, the supportive therapy included 1.5 hours of hyperbaric chamber therapy for 5 consecutive days, starting 24 hours after surgery (1500hPa pressure and 26% oxygen concentration in the chamber). The patients were followed and evaluated throughout the course of the treatment by two independent doctors. The results of the treatment revealed no negative clinical impact of L-HOBT supportive therapy on the body of the animals. At the same time, postoperative wounds after L-HOBT healed faster and with fewer postoperative complications compared to the control group. This resulted in a shorter treatment period, terminating with an earlier skin suture removal.

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.

Psychotherapist and psycho-oncologist Justyna Pronobis-Szczylik talks about the need for tenderness and the insensitivities of the healthcare system.

W badaniach w dziedzinie genetyki molekularnej poczyniono w ostatnich latach ogromne postępy, które mają szerokie zastosowanie praktyczne. Jednocześnie potwierdzono, że nie wszystko, czego dostarczają współczesne badania genetyczne, jest dobre i korzystne dla ludzi. W szczególności odkrycie metody CRISPR/CAS9 umożliwiło bardzo skuteczną ingerencję w cechy dziedziczne jednostki, co zmusiło lekarzy, prawników, etyków, socjologów, teologów i przedstawicieli Kościołów do zajęcia jasnego stanowiska w tej kwestii. Potrzeba dalszego rozwoju naukowego wymaga określenia granic badań w celu uniknięcia nieodwracalnych szkód w puli genowej ludzkości. Celem niniejszego artykułu jest analiza dokumentów Magisterium Kościoła katolickiego w zakresie bieżących kwestii bioetycznych wynikających z nowych odkryć naukowych oraz przedstawienie zasad chrześcijańskich w kontekście możliwości oferowanych przez edycję molekularną z wykorzystaniem CRISPR/CAS9. Stanowisko Kościoła katolickiego wobec aktualnych osiągnięć w dziedzinie biomedycyny, nawet w czasach znaczących odkryć biomedycznych, opiera się na holistycznym spojrzeniu na ludzkie życie, jego wartość i misję. W najgłębszym znaczeniu tego słowa terapia genowa powinna być terapią konkretnej choroby danego organizmu, która szanuje integralne dobro osoby ludzkiej. Interwencje kliniczne mające na celu poprawę genomu jednostki, a tym samym społeczeństwa, są niedopuszczalne. Życie ludzkie nie może stać się przedmiotem eugenicznej mentalności pozytywistyczno-materialistycznej. Urząd Nauczycielski Kościoła promuje rozwój naukowy dla wspólnego dobra ludzkości, a jednocześnie dąży do zachowania godności i integralności każdej istoty ludzkiej.

Stem cells exist and can do a lot. For several decades, bone marrow and umbilical cord blood transplants containing haematopoietic stem cells have been used in the treatment of blood diseases. Genetic modifications (gene therapy) of such cells help to cure complex immunodeficiencies and severe anaemias. The limbal stem cells taken from the eye and properly multiplied can regenerate the damaged cornea, and the epidermal stem cells help in the treatment of severe burns and some hereditary, severe skin diseases. Promising experimental research is under way on other uses of stem cells. However, these cells are appropriately selected, having real ability to differentiate into specialized cells whose malfunction is the cause of the disease. Therapeutic applications of stem cells are apparently limited to date. Meanwhile, the Internet is full of advertisements for supposedly miraculous treatments for almost any disease. Stem cells have become a modern synonym of the Holy Grail. A wonderful dish, transforming every drink into elixir of health, youth and long life. Stem cells from a single source, e.g., umbilical cord blood, or so-called cells, although without proven properties of stem cells, are offered in commercial private clinics as a panacea for autism, cerebral palsy, spina bifida, eye diseases, amyotrophic lateral sclerosis and dozens other disorders. Without justification for their action in these diseases, without convincing evidence of safety, but for a high fee. This article discusses stem cells and misunderstandings about including any cells among them. It draws attention to the real possibilities and confirmed uses of stem cells and presents the problems, doubts and dangers for patients associated with commercial offers of treatments using “stem” cells. The author cites the positions of scientific institutions and societies warning against premature commercialization of unjustified and potentially dangerous therapies.

The aim of this study was to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) among parents of children with autism spectrum disorder (ASD) through reducing psychopathology, improving quality of life, and developing psychological skills (psychological flexibility, self-compassion, and ego-resiliency). The study was quasi-experimental in the form of a four-week ACT intervention; three measurements were obtained (baseline, one week after training, one month after training). It involved 60 participants divided into three groups: two criteria groups (ACT in the off-line form, N=20, ACT in the on-line form, N=20), and one control group (N=20). The results showed a significant improvement in the area of quality of life and the level of psychological skills among parents participating in the ACT training, and this improvement was maintained both a week and a month after the end of the training. The form of participation in the training did not differentiate the groups, which may indicate their equivalence. In addition, significant intergroup differences were shown between participants from the criterion groups and those from the control group, as the subjects who did not participate in the training were characterized by lower quality of life and lower level of psychological skills, and higher intensity of psychopathological symptoms. The results can be used both in designing further scientific research and in clinical practice, especially in the psychological care of families of persons diagnosed with ASD, with special focus on the area of developing psychological skills and the use of short-term therapeutic methods.

This paper conducts a comparative analysis of internal conflict’s intensity among students according to three parameters (loneliness, guilt, and resentment), taking into account digital technology use. The research was conducted in 2020 in Moscow (Russian Federation) among 98 university students, who were diagnosed with intrapersonal conflict. Interviewing methods and Gestalt therapy were used to reduce the intensity of internal conflicts. The level of three parameters among students at the beginning and at the end of the study was taken into account: loneliness, resentment, guilt. The number of students with a high level of loneliness decreased 25 times (p≤0.001) after therapy. The number of students with an average level of loneliness increased because students with a high level of loneliness moved into this category. The number of students with a maximum level of resentment decreased fivefold, and there was a 17-fold decrease in students with a high level of resentment (p≤0.001). There were no students with a maximum level of guilt after the consultation, while the number of students with a high level of guilt decreased only 0.5 times (p≤0.05) because students from the previous category moved to this one. The most popular activities among students were Internet use (100% of students), reading books (61 students, p≤0.05 compared to the Internet use), and watching TV (32 students, p≤0.01).

This study aims to test the effectiveness of online Mindfulness-Based Cognitive Therapy in increasing the resilience of Covid-19 patients. It has applied a website-based cyberpsychology approach to providing Mindfulness- Based Cognitive Therapy interventions. The online program was delivered over six sessions. These were carried out across four meetings, each of which lasted 30-120 minutes. The study is pre-experimental, using a single group pre-test to post-test experimental design. There were 5 patient participants with Covid-19, 1 male and 4 female. They were aged 20-27 years. All were either asymptomatic or presented only mild symptoms. The Connor Davidson Resilience Scale (CD-RISC) was used to measure pre- to post-intervention change in resilience, and a negative emotion scale was used to derive emotion ratings after each session. Results were analysed using a Wilcoxon signed-rank test. This showed a value of Z = -2.023 (p < 0.05), with a mean rank of 3.00, and a sum of ranks of 15.00. The analysis indicates that online Mindfulness-Based Cognitive Therapy can significantly increase resilience in Covid-19 patients.

W zbiorze wykładów Analiza i metafizyka Peter Strawson, określając swoje stanowisko metafilozoficzne, odwołuje się do dwóch analogii: filozofii rozumianej jako terapia oraz filozofii uprawianej jako rodzaj gramatyki myślenia. Zarówno owe analogie, jak też przeciwstawienie filozofii analitycznej innemu typowi filozofii, skupionej na badaniu „kondycji ludzkiej”, rodzą pewne wątpliwości i pytania. Ich zbadanie może pozwolić lepiej zrozumieć ogólną postawę filozoficzną Strawsona, również w kontekście dzisiejszej filozofii „głównego nurtu”, a ponadto stać się przyczynkiem do charakterystyki refleksji filozoficznej jako takiej.

In this paper the biofeedback therapy application is presented. The application is implemented in desired biofeedback system based on RaspberyPI. The EEG signal is taken using popular headset with forehead probe and ear reference one. A patient is trying to focus on desired task and should keep attention level above threshold, the threshold is given and monitor by therapist. The success factor during one therapy session should be more than about 80%, so therapist have to control the threshold. The application consists algorithm for automatic threshold correction based on interview with experienced therapist.

Significant impact factor and psycho-emotional stress in the etiology of dysfunction indicate the need of the routine approach in the treatment of patients with temporomandibular joint disorders to be changed. The aim of the study was to obtain data, documented test results as to the efficiency of progressive muscle relaxation in the treatment of pain caused by temporomandibular joint disorders, as a supplement to previous methods using occlusal splint and other physical therapies. The study included 100 patients of both sexes, aged from 20 to 35 years who were diagnosed with pain due to temporomandibular joint disorders accompanied with high muscle tension of musticatory muscles which were treatment by relaxation therapy. All patients underwent physical examination, specialized functional examination of the masticatory system in accordance with the Polish version of the study RDC/TMD (The Research Diagnostic Criteria of Temporomandibular Disorders, Axis I — physical assessment, Axis II — assessment of psychosocial status and pain — related disability) and assessment of psycho emotional factor and stress, based on the survey developed for their own purpose. The results of the research were obtained using specialized statistical package “R” i386 3.2.3. The results of examinations aft er relaxation therapy showed a signifi cant reduction in the intensity of myofascial pain in all patients. Progressive muscle relaxation can be successfully used as an supportive therapy treatment of patient with dysfunction.

Authors, mostly specialists on rehabilitation and orthopedic surgery prove that arthrofibrosis is a commonly overlooked phenomenon, which may lead to serious limitation in the range of movement, leading to limitation in patients quality of functioning. The main goal of this article is to emphasize the importance of understanding a such complex condition. Non typical patomechanism, lack of biomarkers dedicated to this dysfunction and general lack of under-standing in this pathology causes that risk factors and the most effective strategies remain vastly unknown. Pathophysiology of the arthrofibrosis in the joints is definitely multifactorial, but intense production of collagen seems to be the main factor. Most modern pharmacological methods concentrate on the regula-tion of collagen fiber production and reducing the inflammation. Inflammation from joint contractures stimulates the proliferation of activated cells that results in the production of extracellular matrix macromolecules to form fibrotic tissue that is deposited into the capsule, thereby resulting in fibrosis.
Lack of unified classification scale is caused by relatively high variation of the functions fulfilled by particular joints and each treatment plan should be constructed individually. Quality of surgical treatment and physical therapy play a major role in both prevention and treatment of such complex condition as arthrofibrosis.
Both iatrogenic mistakes and overly aggressive manual therapy are some of main factors increasing the risk of this pathological condition. Introducing properly conducted physical therapy treatment in the early stage is crucial to main the range of movement and preventing this significant problem.

Introduction: Proper use of insulin infusion sets (IIS) plays an important role in pump therapy of patients with type 1 diabetes mellitus (T1DM). We assessed the habits associated with the use of IIS in patients with T1DM treated with insulin pump.
Materials and Methods: This study included 79 T1DM patients who were examined for the presence of lipohypertrophy (LH) and retrained for proper IIS use. They completed a standard ques-tionnaire regarding IIS at the time of study entry and at the follow-up.
Results: At baseline, most of the patients declared to have been using a plastic cannula (n = 68; 86.1%), changing the infusion set regularly (n = 65; 82.3%), and placing the infusion sets on the abdomen wall (n = 68; 86.1%). The most common rotation habit was the “curve pattern” on both sides of the umbilicus (n = 16; 20.3%). After a median of 23 weeks (IQR 20–34), 58 patients were available for the follow-up. A rise in the proportion of patients who declared to change IIS regularly (n = 48; 82.8% vs. n = 57; 98.3%, p = 0.016), change IIS every 2 to 3 days (n = 27; 46.6% vs. n = 35; 60.3%, p = 0.043), use “crisscross” rotation (n = 5; 8.8% vs. n = 12; 21.4%, p = 0.027) was observed. There were less patients reporting not having repeatable rotation manner (n = 15; 26.3% vs. n = 2; 5.4%, p = 0.009).
Conclusions: A substantial proportion of T1DM patients on pump therapy declare that they do not follow the recommended principles of IIS use. The intervention consisting of LH assessment and retrain-ing of proper use of IIS might be effective in improving patient compliance.

Respiratory disturbances frequently accompany stuttering. Their influence on lung ventilation can be assessed by measurement of the end-tidal CO2 concentration (EtCO2). The effectiveness of the CO2-based visual feedback method of breath regulation (VF) designed for stuttering therapy was tested in this study. The aim of the study was to answer the question if the VF helps to reduce respiratory disturbances in stuttering and increase speech fluency. 20 stuttering volunteers aged 13-45 years took part in the 3-parts test consisting of: 1. speaking without any techniques improving speech fluency, 2. learning the VF method, 3. VF-assisted speaking. The CO2/time signal and an acoustic signal of an utterance were recorded during the test. Significant increase of FE - the factor of breath ergonomics during speaking (based on both signals), from 47% to 71% (P < 0.01), and significant decrease of %SS - the percent of syllables stuttered, from 14% to 10% (P < 0.01) were received for VF-assisted utterances compared to the utterances without VF assistance. The results indicate that the VF can help to eliminate respiratory disturbances in stuttering and increase speech fluency.

Novel tendinopathy treatment protocols should be assessed for safety. The goal of this work was to compare differences in selected systemic inflammatory marker concentrations after two treatment protocols for collagenase induced Achilles tendinopathy in sheep. 14 sheep (aged 5 and 6 years, Polish Mountain Sheep breed, weight 60-70kg) were injected with bacterial collagenase type 1A-S (Clostridium histolyticum, C-5894, Sigma Aldrich, Poznań, Poland) bilaterally to Achilles tendons. Subsequently, the animals were injected with Platelet Rich Plasma (7 sheep) or Adipose Derived Stem Cells (7 sheep) to induced tendinopathy foci. Left limbs of all sheep were additionally treated with Radial Pressure Wave Therapy (RPWT) focused above the tendinopathy origins. Treatment progress was controlled by ultrasound scans, and tendon samples were taken on the 126th day of the experiment. Serum Amyloid A (SAA) concentration showed mild elevation before the experiment (2 sheep from group I, 4 sheep from group II) and two days after the intratendinous growth factors injection ( 4 sheep from group I, 3 sheep from group II) combined with RPWT (mean 22,63 mg/L and 53, 6 mg/L respectively). Haptoglobine (Hp) concentration increased from 0 to 0,01 g/L in 2 animals from group I two days after injection. These values declined to 0 during the course of the treatment. Fibrinogen (Fb) concentrations were within reference levels throughout the research, although mild elevation was observed before the treatment course in 6 sheep from group I and 1 sheep from group II. In conclusion, addition of RPWT to growth factors injections in the treatment of yatrogenic Achilles tendinopathy in sheep did not induce systemic inflammatory response.

Background: Pet therapy could help individuals improve their emotions; and physical and mental health. It also could be effective in the treatment of pain, anxiety, depression, and fatigue. The aim of this study was to determine the effectiveness of pet therapy, concurrent with common medication on positive, negative, cognitive and motor symptoms of schizophrenia. Methods: This was a randomized control trial. Statistical population of the current study included all patients who were admitted to the Razi Psychiatric Center of Tehran and received a diagnosis of schizophrenia based on a clinical interview and DSM criteria by a psychiatrist. Thirty six patients were recruited using snowball sampling. Members of the experimental group were transported by a bus to that spot at 9 a.m on the planned days, in the company of the researcher and a nurse. Patients gave care of the rabbits (including feeding, tidying their cages, moving their cages) for 24 sessions of 90 minutes, three days per week during autumn 2016. The One-way covariance test was also used to evaluate effects of Pet therapy on positive, negative, cognitive and motor symptoms of schizophrenia. Results: finding indicated that considering scores of pre-test for positive, negative and cognitive symptoms, there is a significant difference between the two controls and experimental groups, respectively, (F = 17.04, p < 0.05), (F = 17.39, p < 0.05), (F = 152.12, p < 0.05). Conclusion: Pet therapy could be successfully applied by parents, psychologists and care givers of these patients. We suggest using pet therapy for treatment of other psychiatric disorders as well and preferably like dogs and cats.

The aim of this work is to present problems related to tinnitus symptoms, its pathogenesis, hypotheses on tinnitus causes, and therapy treatment to reduce or mask the phantom noise. In addition, the hypothesis on the existence of parasitic quantization that accompanies hearing loss has been recalled. Moreover, the paper describes a study carried out by the Authors with the application of high-frequency dither having specially formed spectral characteristics. Discussion on preliminary results obtained and conclusions are also contained.