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Health personnel and knee osteoarthritis: April as a reminder of a neglected risk

2026-04-27T15:02:43+02:00

Although often viewed as a condition of the general population, clinical observations indicate that a substantial proportion of knee-pain consultations due to osteoarthritis involve healthcare workers, suggesting a potential burden that exceeds expectations for age-matched adults. Existing research reports a high incidence of knee symptoms among healthcare workers, including a 47% prevalence of work-related knee musculoskeletal disorders in perioperative nurses. However, these studies focus on symptoms rather than diagnosed osteoarthritis, leaving the true burden of structural disease in this population understudied. Occupational demands such as prolonged standing, extensive walking, frequent pivoting, kneeling, squatting, and physically intensive patient handling impose ongoing stress that may accelerate joint degeneration. Increasing retirement age further extends years of exposure, increasing the risk of chronic musculoskeletal conditions. Despite this, knee osteoarthritis remains largely absent from occupational health and safety policies. Low-cost workplace interventions, such as structured movement breaks, brief strength exercises, and consistent access to assistive devices, represent promising approaches, even though current evidence remains limited, and further research is needed to confirm their preventive effect. Legislative measures, such as reduced working hours for older employees, may help mitigate cumulative strain. Emerging technologies, including robot-assisted patient handling, show the potential to reduce high-force exposures. Recognizing knee osteoarthritis as a preventable occupational health issue is essential for protecting the mobility, well-being, and professional longevity of the healthcare workforce.

Neutrophil gelatinase-associated lipocalin as a predictor of treatment outcomes in primary glomerulonephritis

2026-04-27T15:02:44+02:00

Background/Aim. Biomarkers for predicting disease course could facilitate treatment selection in primary glomerulonephritis (PGN). Data on the role of neutrophil gelatinase-associated lipocalin (NGAL) in PGN are limited. The aim of this study was to evaluate the significance of NGAL in predicting treatment outcomes in PGN. Methods. The study included a total of 60 PGN patients followed between 2012 and 2024. At diagnosis, serum NGAL (sNGAL) and urinary NGAL (uNGAL) were measured. Renal function parameters (serum creatinine, proteinuria) and disease outcome–development of end-stage renal disease (ESRD)–were assessed at baseline, after 5 years, and at the end of the follow-up period. The association between NGAL and clinical outcomes was analyzed using appropriate statistical tests. Results. At baseline, median sNGAL and uNGAL levels were 154.71 ng/mL and 13.94 ng/mL, respectively. During a median follow-up of 112 months, 8.33% of patients were lost to follow-up, and 20% developed ESRD. Patients who developed ESRD had higher sNGAL levels (p = 0.027). Using sNGAL, ESRD was fairly predictive (AUC = 0.709; p = 0.036), and sNGAL was associated with time-to-ESRD (Kaplan-Meier analysis, p < 0.001). The group with the highest sNGAL showed the lowest 5-year renal survival. Patients with stable or improved estimated glomerular filtration rate (eGFR) had higher uNGAL/creatinine ratio values (p = 0.049). Changes in proteinuria correlated negatively with sNGAL (p < 0.001) and uNGAL (p = 0.005). Conclusion. In PGN, sNGAL could be a predictor of ESRD development, potentially reflecting its pro-fibrotic activity. In contrast, the correlation between NGAL levels and change in proteinuria, as well as the associations between higher uNGAL/creatinine ratios and improved eGFR, suggest a complex and potentially protective role of NGAL in disease progression.

Comparative study between the efficacy of Isobar TTL and Isobar EVO systems for lumbar degenerative diseases and their effects on adjacent segment degeneration

2026-04-27T15:02:45+02:00

Background/Aim. Lumbar degenerative diseases (LDD) are diseases that occur due to normal aging and degeneration of the lumbar spine. In addition to conservative therapies, surgical procedures become necessary to achieve satisfactory clinical outcomes. The aim of this study was to evaluate the effectiveness of the Isobar TTL and Isobar Evolution (EVO) systems of dynamic internal stabilization in the treatment of LDD and their effects on adjacent segment degeneration. Methods. This research involved 78 LDD patients treated with Isobar TTL or Isobar EVO dynamic internal stabilization devices. Patients were divided into two groups: TTL (n = 40) and EVO (n = 38). Visual Analog Scale (VAS) pain ratings, Oswestry Disability Index (ODI) scores, and modified MacNab criteria effectiveness evaluations were performed preoperatively, 1 and 3 months postoperatively, and at the final follow-up. Range of motion (ROM) and intervertebral space ratio (IVSR) were measured preoperatively and after the final follow-up. Results. In almost two years, 37 TTL and 33 EVO patients completed every examination. After surgery, VAS and ODI ratings in both groups improved significantly compared to preoperative levels (p < 0.05). The surgical effectiveness of the TTL and EVO groups was rated as excellent or good using the modified MacNab criteria (91.89% and 93.94%, respectively). Preoperative ROM and IVSR values did not differ between the groups (p > 0.05). At the final follow-up, the EVO group had a significantly higher ROM than the TTL group (4.46 ± 1.19° vs. 2.58 ± 0.71°; p < 0.05) and the ROM of adjacent segments in the TTL group was significantly higher than that of the EVO group (6.74 ± 1.55° vs. 5.83 ± 1.32°; p < 0.05). The IVSR of the operated and surrounding segments did not change substantially from preoperative to final follow-up (p > 0.05). Moreover, there was no significant difference in IVSRs between the two groups for the operated and neighboring segments at the final follow-up (p > 0.05). Conclusion. Isobar TTL and Isobar EVO dynamic stabilization systems demonstrated good clinical outcomes. The ability of Isobar EVO to inhibit neighboring segment motion may prevent degeneration.

Quality of life of women with polycystic ovary syndrome of reproductive age

2026-04-27T15:02:45+02:00

Background/Aim. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, and it affects their physical and mental health and their quality of life (QoL). The aim of this study was to assess the QoL of women with PCOS of reproductive age. Methods. The study included 100 women, aged 18 years or above, diagnosed with PCOS. The Short Form Health Survey-36 (SF-36) was used as the research instrument. Mann-Whitney U test, Kruskal-Wallis test, and Spearman’s rank correlation coefficient were used to examine possible differences in QoL within the variables studied. Results. Women with PCOS living in rural areas had a significantly higher mean score in the vitality domain. A statistically significant, strongly positive correlation with the total QoL score was found for the Mental Component Summary (MCS) (p < 0.001) and Physical Component Summary (PCS) (p < 0.001) subscales. A statistically significant but weak negative correlation was found between self-rated health and the PCS (p = 0.021), the MCS (p = 0.004) and the total QoL score (p = 0.002), and age with the PCS (p = 0.023) and the total QoL score (p = 0.032). Conclusion. Women with PCOS in rural areas were more vital and had better QoL. Lower self-esteem regarding health is associated with poorer QoL, especially in the psychological domain. In women with manifest PCOS, early diagnosis and appropriate education can help alleviate certain symptoms and prevent serious complications.

Treatment of splanchnic artery aneurysms – single center results and experience

2026-04-27T15:02:46+02:00

Background/Aim. Visceral artery aneurysms (VAAs) are rare but potentially life-threatening conditions. With the increasing availability of diagnostic and therapeutic options, there is a growing need to determine the optimal treatment approach–endovascular (EV) vs. open surgical (OS) reconstruction. The aim of this study was to analyze treatment outcomes in patients with VAA at a single center and compare the efficacy of EV and OS approaches. Methods. The study included 27 OS (the OS group) or EV (the EV group) interventions for VAA, performed at our institution from January 2010 to November 2023, on 27 patients, 13 males and 14 females, with a mean age of 57 ± 13 years. Treatment decisions were reached by a multidisciplinary team of a vascular surgeon, an anesthesiologist, and an interventional radiologist. Results. Out of the 27 patients, 9 were treated in the emergency setting, with 6 of them having ruptured aneurysms. The most common was a splenic artery aneurysm, 50.0% of all VAAs. Thirteen patients underwent EV reconstruction, one patient underwent a hybrid approach, and 13 patients had OS reconstruction. Technical success was 24/27 or 88.9%. Eleven patients were treated by coil embolization, while two were treated with the implantation of a covered stent. In the EV group, mortality was nil. In 14 patients, OS treatment was performed with 9 VAA resections and arterial reconstructions (7 with Dacron graft, 1 with polytetrafluoroethylene graft, and 1 with autovenous graft), with 2 splenectomies and 3 aneurysm exclusions. Two patients died intraoperatively due to severe bleeding, and one after the procedure because of intestinal ischemic complications. Mean duration of hospitalization after OS or EV procedure was 7.43 and 4.92 days, respectively. Conclusion. Treating patients using the EV approach is safe, with less invasiveness and shorter hospital stays, suitable for elective and emergency cases when technically feasible. OS remains a reliable option at high-volume centers, particularly for complex cases unsuitable for EV approaches or in low-risk patients. Treatment decision should be guided by VAA characteristics (size, symptoms, location, morphology), patient comorbidities, and specific clinical context, such as prior abdominal surgeries.

Pulmonary actinomycosis – a diagnostic dilemma

2026-04-27T15:02:46+02:00

Introduction. Pulmonary actinomycosis is a chronic inflammatory infectious disease caused by anaerobic and/or microaerophilic bacteria of the genus Actinomyces spp. It causes non-specific symptoms in the patient and gives an atypical clinical and radiographic presentation. It is extremely rare and is characterized by the formation of abscesses and fistulas in the lungs or local fibrosis. In the differential diagnosis, diseases and pathological conditions from tuberculosis to neoplastic processes in the lungs must be considered. Case report. We present a 39-year-old patient with an infiltrative lesion in the apex of the right lung and non-specific symptoms. In this patient, actinomycosis was pathohistologically proven after surgical intervention. Within a period of just over a month, a multi-detector computed tomography of the chest and bronchoscopy with transbronchial biopsy and bronchial swab were performed twice. Initially, pulmonary actinomycosis was not suspected. After an atypical resection of the tumor mass in the apex of the right lung and histopathologically proven infection, the patient was treated with antibiotic therapy for 6 months. Further examination was carried out to prove a potential primary or secondary immunodeficiency. Conclusion. Patients with non-specific changes in the lung parenchyma should also be suspected of having actinomycosis, and after diagnosis, it is necessary to supplement the examination to confirm or exclude immunodeficiency.

The Death of Alcathous in the Iliad: The First Verifiable Description of Penetrating Cardiac Trauma

2026-04-27T15:02:47+02:00