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Lenalidomide (LEN) is widely used immunomodulatory drug (IMiD). Nonetheless, despite its efficacy, over time patients become resistant to LEN and relapse. Due to high clinical relevance, drug resistance in MM is being thoroughly investigated. However, less is known about predictors of good response to LEN-based treatment. The aim of this study was to identify molecular pathways associated with good and long response to LEN. The study included newly diagnosed MM patients (NDMM) and MM patients treated with first-line LEN and dexamethasone (RD) who achieved and least very good partial remission (VGPR). RNA was isolated from MM cells and new-generation sequencing was performed. Obtained results were validated with qRT-PCR. A global increase in gene expression was found in the RD group compared to NDMM, suggesting the involvement of epigenetic mechanisms. Moreover, upregulation of genes controlling the interaction within MM niche was detected. Next, genes controlling immune response were upregulated. In particular, the gene encoding the IL-17 receptor was overexpressed in the RD group which is a novel finding. This should be emphasized because IL-17-related signaling can potentially be targeted, providing the rationale for future research. Establishing the molecular background associated with long-lasting and profound response to LEN may improve LEN-based chemotherapy regimens and facilitate the development of adjuvant therapies to enhance its anti-MM activity.

Fibroblasts are mesenchymal cells which physiologically possess numerous functions and belong to basic cellular components necessary to maintain tissue homeostasis and are essential for extracellular matrix formation and maintenance. In addition, fibroblasts are of paramount importance in regeneration and wound healing as they interact with the immune system. These unique properties determine their great utility in cell therapies in the field of regenerative medicine. This review summarizes the mechanisms of action and clinical applications of fibroblast-based therapies as well as highlighting the future perspectives including the use of allogeneic cells.

Bernstein fits implemented into R allow another route for Kruskal-Wallis power-study tool development. Monte-Carlo Kruskal-Wallis power studies were compared with measured power, a Monte-Carlo ANOVA equivalent and with an analytical method, with or without normalization, using four simulated runs, each with 60–100 populations (each population with N = 30,000 from a set of Pearson-type ranges): random selection gave 6300 samples analyzed for predictive power. Three medical-study datasets (Dialysis/systolic blood pressure; Diabetes/sleep-hours; Marital-status/high-density-lipoprotein cholesterol) were also analyzed. In three from four simulated runs (run_one, run_one_relaxed, and run_three) with Pearson types pooled, Monte-Carlo Kruskal-Wallis gave predicted sample sizes significantly slightly lower than measured but more accurate than with ANOVA methods; the latter gave high sample-size predictions. Populations (run_one_relaxed) with ANOVA assumptions invalid gave Kruskal-Wallis predictions similar to those measured. In two from three medical studies, Kruskal-Wallis predictions (Dialysis: similar predictions; Marital: higher than measured) were more accurate than ANOVA (both higher than measured) but in one (Diabetes) the reverse was found (Kruskal-Wallis: lower; Monte-Carlo ANOVA: similar to measured). These preliminary studies appear to show that Monte-Carlo Kruskal-Wallis power studies, based on Bernstein fits, might perform better than ANOVA equivalents in many settings (and provide reasonable results when ANOVA cannot be used); and both Monte-Carlo methods appeared to be considerably more accurate than the analytical version analyzed.

Background Little data are available for non-abscess abdominal fluid collections (AFCs) after pancreatic surgery and their clinical implications. We sought to analyze the natural history of such collections in a population of patients subject to routine postoperative imaging. Methods From 1995 to 2011, 709 patients underwent pancreatic resections and routine postoperative monitoring with abdominal ultrasound according to a unit protocol. AFCs were classified as asymptomatic (no interventional treatment), symptomatic (need for percutaneous drainage of sterile, amylase-poor fluid), and pancreatic fistula (drainage of amylase-rich fluid). Results Ninety-seven of 149 AFCs (65 %) were asymptomatic and resolved spontaneously after a median follow-up of 22 days (interquartile range, 9–52 days). Among 52 (35 %) AFCs requiring percutaneous drainage, there were 20 pancreatic fistulas and 32 symptomatic collections. A stepwise logistic regression model identified three factors associated with the need for interventional treatment, i.e., body mass index ≥25 (odds ratio, 3.23; 95 % confidence interval (CI), 1.32 to 7.91), pancreatic fistula (odds ratio, 2.93; 95 % CI, 1.20 to 7.17), and biliary fistula (odds ratio, 3.92; 95 % CI, 1.35 to 11.31). Conclusions One fourth of patients develop various types of non-abscess AFCs after pancreatic surgery. Around half of them are asymptomatic and resolve spontaneously.

Although much is known about the pathophysiology of severe COVID-19, there are still areas that remain to be determined. It is well established that the pivotal molecular event is a hyperinflammatory response also referred to as a cytokine storm. The aim of this retrospective cohort study was to determine miRNAs which might be predictive for the admission to the intensive care unit (ICU). We analyzed blood samples from 210 COVID-19 patients and the control group consisted of 80 healthy individuals. Results revealed the miRNA expression pattern has the potential to predict the severity of COVID-19, reflecting the clinical symptoms of the infection, such as the need for oxygen therapy and concomitant pneumonia. In particular, low expression of miRNAs miR106a-5p, miR17-5p, miR181a-5p, miR191-5p, miR20a-5p and miR451a, especially in the initial phase of the disease, is associated with an unfavorable clinical course of SARS-CoV-2 infection (admission to the ICU).

Background Little data are available supporting the feasibility and safety of early oral feeding in patients after total gastrectomy. The aim of this study was to analyze the potential applicability of early provision of oral diet in these settings. Methods Medical records of 353 patients who underwent total gastrectomy for gastric cancer between 2006 and 2012 were retrospectively analyzed. Early oral feeding was defined as clear liquid diet on postoperative day (POD) 1 followed by gradual introduction of solid diet on POD 2 to 3. Late oral feeding was defined as initiation of liquid diet from POD 4 to 6 and gradually advancing to solid diets. Results Early oral feeding was implemented in 185 of 353 (52 %) patients. Prompt provision of food did not increase the risk of anastomotic failure (odds ratio 0.924, 95 % confidence interval 0.609–1.402, P  = 0.709). The number of reoperations and in-hospital mortality rates was unaffected by the timing of nutritional intervention. Early feeding tended to be associated with fewer surgical (15 vs 24 %, P  = 0.027) and general (8 vs 23 %, P < 0.001) complications. However, subsequent multivariate regression models failed to confirm significant correlations between timing of oral meals and postoperative morbidity. Conclusion Our findings suggested that early oral feeding is feasible and safe after total gastrectomy for gastric cancer. However, benefits of such early nutritional interventions require further studies.

Oral mucositis (OM) is a common and significant complication of chemotherapy and radiotherapy, particularly in patients undergoing hematopoietic stem cell transplantation (HSCT). This retrospective observational study assessed the effectiveness of oral cryotherapy in reducing the incidence and severity of OM in 258 HSCT recipients treated at a single transplant center in Poland between 2018 and 2024. Patients were divided into two groups: 199 received cryotherapy as part of their conditioning regimen, while 59 did not. Cryotherapy was administered using ice chips from 10 min before chemotherapy infusion to two hours afterward. OM occurred in 48% of the cryotherapy group versus 68% in the control group, representing a statistically significant 20% relative risk reduction ( p  = 0.008). Furthermore, the incidence of severe OM (grades 3–4) was significantly lower in the cryotherapy group ( p  = 0.006). No significant differences were observed in platelet engraftment or hospitalization duration. Although neutrophil engraftment was slightly delayed in the cryotherapy group, this finding lacked clinical relevance. Overall, the results support cryotherapy as a safe, cost-effective, and easily implementable strategy for OM prevention in the HSCT setting. Further prospective studies are warranted to validate these findings and optimize treatment protocols.

Introduction Multiple myeloma (MM) is an incurable malignancy that arises from precursory conditions, specifically monoclonal gammopathy of unknown significance (MGUS) and smoldering multiple myeloma (SMM). The pathogenesis of MM remains largely elusive, particularly in the context of epigenetics. Purpose The aim of this study was to uncover new bioinformatic insights related to the pathogenesis of MM in the context of epigenetic analysis using the NGS method. Patients and methods A total of 60 patients with MM and MGUS were enrolled in the study. Myeloma CD138 + cells were isolated from the collected bone marrow using an immunomagnetic method and used to analyze the DNA methylation profile using the MethylationEPICv2.0 BeadChip Kit. Peripheral blood plasma was used to analyze the expression profile of circulating miRNAs using the miRNAseq method. Additionally, global epigenetic assessment allowed for the selection of several target genes and assessment of their expression using the qRT-PCR method. Results Our in-depth analysis allowed us to focus on two genes, PHOX2A and CDH2 , which play significant roles in carcinogenesis, and their increased expression is associated with poor prognosis in oncological patients. We observed a decrease in the methylation level associated with these genes in patients with MM compared with those with MGUS, whereas the mRNA expression level was increased. Moreover, among patients with MGUS compared with MM, patients with MGUS presented upregulation of specific miRNAs, namely, miR-208b-3p, and miR-320c, which act as inhibitors of the aforementioned genes. Conclusions Ultimately, identifying genes implicated in the progression of MM may pave the way for the refinement of current treatment protocols or the development of novel therapeutic strategies centred on epigenetic modifications or gene therapies. Additionally, the expression profile of circulating miRNAs may prove useful in selecting molecules that will constitute a good biomarker of disease progression from the preclinical to the fully symptomatic stage.

Aesthetic medicine is a rapidly developing field of medicine. Every year the number patients who undergo cosmetic ambulatory procedures increases. The COVID-19 pandemic affected all branches healthcare including aesthetic medicine. Therefore, establishing safety protocol is of a paramount importance in order to provide safe and ethical care. 

Purpose: Esthetic medicine is a rapidly developing field of medicine that is not only beneficial in terms of external appearance, but also significantly improves overall quality of life. Currently, pigmented and vascular skin lesions are more prevalent due to multiple environmental factors and are a characteristic manifestation of skin aging. The development of modern laser therapy has contributed to the successful management of multiple skin conditions. The aim of our study was to show the effect of concomitant reduction of both vascular and hyperpigmented skin lesions located on the facial area after repetitive 532 nm laser therapy and to emphasize that the detection of such observation was possible due to the implementation of System of Skin Analysis and Assessment. Patients and Methods: We retrospectively analyzed 100 patients' records with \"VISIA\" Skin Analysis System after 532nm laser therapy. Results: Laser therapy significantly decreased VISIA scores for all tested lesions, ie, macules, pigmented and vascular lesions (p<0.0001 for all). The efficacy of laser treatment was not significantly different regarding skin phototype (p>0.05) and did not correlate with age of participants (p>0.05). The more laser sessions were performed, the higher improvement in vascular lesion VISIA scores was observed (r=0.26, p=0.0097). Conclusion: 532 nm laser therapy is effective regarding vascular and hyperpigmented skin lesions located on the facial area. The System of Skin Analysis and Assessment is a good tool to test the treatment efficacy during regular follow-up procedure. Keywords: laser therapy, aesthetic medicine, cosmetic dermatology, VISIA, pigmented skin lesions, vascular skin lesions, skin aging