Infantile hemangiomas are the most common benign vascular tumors in infancy. This review includes an update on the current knowledge on pathogenesis, a discussion on indications for treatment, and a review of the mechanisms underlying the different treatment methods. Although most infantile hemangiomas require only active observation because of their natural course, which results in involution, about 10% present with complications that require immediate treatment. The basic treatment includes systemic and topical options. In cases of insufficient response or rebound growth, other forms of treatment should be considered. In some cases, combined therapy might be initiated.

Cryptorchidism, the absence of one or both testicles in the scrotum, is the most common anomaly of genitourinary tract in males. The pathogenesis of undescended testes is unknown however the role of inflammation, tissue remodeling and oxidative stress is postulated. The aim of this study was to explore the role of HSP-70, MMP-3, MMP-17 and IL-8 in possible pathogenic pathways connected with cryptorchidism. Cryptorchid patients with high scrotal and inguinal canal localization were included. The study group consisted of 63 patients aged 12–24 months, whereas the control group included 17 healthy infants with the same demographic characteristics. The analysis of plasma samples was carried out using ELISA enzyme-linked immunosorbent assay technique. The plasma concentration of MMP-17 in boys with cryptorchidism was significantly higher compared to the control group (p = 0.0365). The concentration of plasma IL-8, MMP-3, and HSP-70 in boys with cryptorchidism increased in comparison to the control group but these increases were not statistically significant (p > 0.05). A positive correlation was found between plasma MMP-17 and HSP-70 concentration (r = 0.5153; p < 0.0001). Our results demonstrate that MMP-17 and HSP-70 might be involved in pathogenesis of cryptorchidism and are in line with current knowledge that high temperature has a negative influence on male gonads.

Infantile hemangiomas (IH) are the most prevalent benign vascular tumors diagnosed in the pediatric population. Propranolol, a nonselective beta-adrenergic receptor antagonist, is the first-line treatment for IH. In this study, we aimed to assess the changes in plasma levels of HIF-1α, MMP-2, MMP-9, and TIMP-1 in patients with IH before and after one month of propranolol treatment. Twenty children with IH and sixteen control subjects, admitted to the Department of Pediatric Surgery and Urology for elective inguinal hernia surgery, were included in this study. Blood plasma samples were obtained twice from the IH group (before and one month after initiating propranolol treatment) and once from the healthy control group. Patients treated with propranolol exhibited higher levels of MMP-2 both before (p = 0.0008) and after (p = 0.0006) treatment compared to the control group. The control group had higher levels of MMP-9 than the study group before propranolol treatment (p = 0.0267), but MMP-9 levels increased significantly after propranolol treatment in the study group (p = 0.0281). Plasma levels of TIMP-1 were considerably higher in the study group both before (p = 0.0097) and after (p = 0.0013) propranolol treatment compared to the control group. Additionally, HIF-1α levels were higher in the study group and showed an upward trend following propranolol treatment compared to the control group (p = 0.0114). This study provides insight into the plasma levels of MMP-2, MMP-9, TIMP-1, and HIF-1α involved in the involution of infantile hemangiomas during the early stage of propranolol treatment.

Introduction: Pectus excavatum is the most common congenital chest wall deformity, characterized by posterior displacement of the sternum and adjacent costal cartilages. In severe cases, it can impair cardiopulmonary function and negatively affect the quality of life due to physical limitations and psychosocial distress.Aim: To present current modifications of the Nuss procedure and assess their impact on the safety, postoperative outcomes, and patient comfort of surgical treatment for pectus excavatum.Methods: A narrative review based on a comprehensive analysis of relevant literature was conducted, focusing on advancements and technical modifications of the original Nuss technique.Results: Since its introduction in 1998, the Nuss procedure has become the standard minimally invasive approach for correcting pectus excavatum. Various modifications – such as changes in bar design, stabilization methods, use of thoracoscopy, and postoperative pain management protocols – have improved surgical outcomes and reduced complication rates. These advancements have increased the procedure’s safety and patient comfort, while maintaining high correction efficacy.Conclusions: The evolution of the Nuss procedure has significantly enhanced the surgical management of pectus excavatum. Ongoing refinements continue to optimize patient outcomes, making the technique safer, more comfortable, and more widely applicable across age groups.

Background: Pectus excavatum is the most common congenital chest wall deformity and it may impair cardiovascular function, pulmonary mechanics, exercise capacity, and quality of life. Although minimally invasive repair of pectus excavatum (MIRPE) is the current standard surgical treatment, the perioperative dynamics of myocardial injury, inflammation, and their relationship with functional and echocardiographic changes remain incompletely understood, particularly in pediatric patients. Objective: The objective is to prospectively evaluate the perioperative dynamics of cardiac troponin and the change in right ventricular free-wall longitudinal strain as co-primary endpoints, and—as secondary outcomes—additional biochemical markers, echocardiographic parameters, pulmonary function, exercise capacity, and quality of life in children and adolescents undergoing MIRPE. Methods: This is a single-center, prospective, observational cohort study to be conducted at the Department of Pediatric Surgery and Urology, University Children’s Clinical Hospital, Medical University of Bialystok, Poland. Sixty pediatric patients (approximately 14–18 years of age) undergoing primary minimally invasive repair of pectus excavatum will be enrolled. Biochemical markers, including troponins, natriuretic peptides and inflammatory markers will be assessed before surgery and during the first 72 h postoperatively. Echocardiography, pulmonary function tests (spirometry and body plethysmography), the 20 m shuttle run test (Léger), and quality-of-life assessments will be performed preoperatively and during postoperative follow-up. Longitudinal changes will be analyzed using appropriate statistical methods for repeated measurements. Discussion: This study is expected to provide a comprehensive evaluation of the cardiovascular, pulmonary, biochemical, and functional consequences of minimally invasive repair of pectus excavatum in pediatric patients. The findings may improve the understanding of the perioperative myocardial response, cardiac remodeling, and functional recovery following the MIRPE and contribute to optimizing perioperative assessment and long-term follow-up in this patient population.

Cervical discopathy is commonly associated with pain in the cervical spine which may affect patients’ quality of life. If conservative treatment fails to relieve the pain for at least 6 months and/or if neurological deficit progresses, the surgical treatment is taken under consideration. The aim of this study was to evaluate health-related quality of life (HRQOL) and disability of patients after single- and multi-level anterior cervical discectomy and fusion (ACDF) with standalone polyetheretherketone (PEEK) cages. The study evaluated how ACDF influenced particular aspects of patients’ quality of life in the context of radiological outcome. The study included 30 consecutive patients with single- or multi-level cervical disc herniation. Patients underwent clinical and radiological evaluation before and one year after the ACDF procedure. For each patient, we assessed the severity of cervical pain with a numerical rating scale (NRS) and filled the neck disability index questionnaire (NDI). The health-related quality of life was assessed with the Polish version of 36-Item Short Form Survey (SF-36). A significant decrease in all NDI aspects indicates a significant improvement after surgery. The quality of life in all aspects assessed with SF-36 scale was also improved. A moderate decrease in cervical spine mobility coexisted with a good outcome of the neurosurgical procedure. In the opinion of patients, the most important aspect after the cervical spine surgery is the reduction of pain severity. ACDF surgery is an effective method to reduce the severity of pain in patients with degenerative disc disease. ACDF improves the quality of patient’s life. According to the study results the physical role improved most significantly; the least improvement was noted in role-emotional aspect. Up to 83% of patients achieved a reduction of the NDI index by 5 or more points after surgical treatment which proves the high effectiveness of the surgical treatment. No statistically significant difference was noted between patients with single and multi – level discopathy. Up to 97% of patients who underwent ACDF reported a significant decrease in pain severity measured with NRS.