Background and purpose Owing to their peculiar features and rare occurrence, ruptured blood blister-like aneurysms (BBAs) of the internal carotid artery are challenging by both surgical and endovascular approaches and their proper management is uncertain. We therefore aimed to define the currently optimal treatment of ruptured BBAs in terms of mortality, outcome, rebleeding, and recurrence. Method An in-depth search of electronic databases, gray literature and internet resources for ruptured BBAs was performed and complemented by data retrieval during neurosurgical congresses. Clinical and radiological characteristics, intervention details, outcomes, and the impact factor of the source journal were pooled. Results The pooled cohort comprised 311 patients. Neither surgical nor endovascular methods had an impact on clinical outcome, aneurysm regrowth, remote bleeding, or complication rate. By contrast, aneurysm clipping was a predictor of intraoperative bleeding (OR 6.5; 95% CI 1.2 to 34.3), and stent-assisted coiling increased the likelihood of a second treatment (OR 4.1; 95% CI 1.3 to 13.1), its conversion to another modality (OR 4.7; 95% CI 1.4 to 16.0), and incomplete aneurysm obliteration (OR 2.6; 95% CI 1.0 to 6.6). Higher impact journals were more likely to publish papers on endovascular techniques, particularly flow-diverter stents. Conclusions None of the methods is unequivocally superior. Considering its inefficiency, stent-assisted coiling should be undertaken with caution. A time-delimited systematic review is needed to establish the most accurate treatment for ruptured BBAs.

Failed back surgery syndrome (FBSS) is complex and recurrent chronic pain after spinal surgery. Several important patient and surgery related risk factors play roles in development of FBSS. Inadequate selection of the candidates for the spinal surgeries is one of the most crucial causes. The guidelines suggest that conservative management featuring pharmacologic approaches and rehabilitation should be introduced first. For therapy-refractory FBSS, spinal cord stimulation (SCS) is recommended in selected patients. Treatment efficacy for FBSS has increased over the years with the majority of patients experiencing pain relief and reduced medicinal load. Improved quality of life can also be achieved using SCS. Cost-effectiveness of SCS still remains unclear. However evidence for SCS role in FBSS is controversial, SCS can be beneficial for carefully classified patients.

Introduction: Vitamin D is vital in the regulation of the calcium-phosphate metabolism, has a direct impact on the musculoskeletal system, and also affects numerous other systems. Widespread vitamin D deficiency and its detrimental effect on health have been reported globally. Data concerning vitamin D status in Polish adult population is scarce. Material and methods: Ambulatory patients of an outpatient clinic in Gdańsk were included in the study. Serum concentrations of 25(OH) D, parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium and phosphorus were determined. In a questionnaire declared UVB exposure, dietary vitamin D and calcium intake, and health status of the subjects were assessed. Non- and parametric tests, logistic regression and population attributable risk were applied in data analysis. Results: 448 adults were examined from February to mid-April 2012, 305 women and 143 men, aged 19 to 86 (mean 46.3 ± 14.9 years). Mean 25-hydroxyvitamin D concentration was 14.3 ± 6.6 ng/mL. 84.4% of subjects were vitamin D deficient (25(OH)D < 20 ng/mL); 13.2% presented insufficient (20–30 ng/mL), and 2.5% (or 11 subjects) sufficient 25(OH)D concentrations. Significantly higher 25(OH)D concentrations were found in subjects who reported more UVB exposure, supplemented vitamin D orally and those who declared more physical activity. 21% of subjects had elevated serum PTH concentration (i.e. > 62 pg/mL); mean parathormone was 48.6 ± 25.2 pg/mL. A linear correlation was found between the logarithm of PTH and logarithm of 25(OH)D concentrations (r = –0.21, p < 0.001). Conclusions: Results obtained here demonstrate the necessity of implementing a monitoring and prophylaxis programme of vitamin D deficiency in Poland. (Endokrynol Pol 2014; 65 (2): 105–113) Introduction: Vitamin D is vital in the regulation of the calcium-phosphate metabolism, has a direct impact on the musculoskeletal system, and also affects numerous other systems. Widespread vitamin D deficiency and its detrimental effect on health have been reported globally. Data concerning vitamin D status in Polish adult population is scarce. Material and methods: Ambulatory patients of an outpatient clinic in Gdańsk were included in the study. Serum concentrations of 25(OH) D, parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium and phosphorus were determined. In a questionnaire declared UVB exposure, dietary vitamin D and calcium intake, and health status of the subjects were assessed. Non- and parametric tests, logistic regression and population attributable risk were applied in data analysis. Results: 448 adults were examined from February to mid-April 2012, 305 women and 143 men, aged 19 to 86 (mean 46.3 ± 14.9 years). Mean 25-hydroxyvitamin D concentration was 14.3 ± 6.6 ng/mL. 84.4% of subjects were vitamin D deficient (25(OH)D < 20 ng/mL); 13.2% presented insufficient (20–30 ng/mL), and 2.5% (or 11 subjects) sufficient 25(OH)D concentrations. Significantly higher 25(OH)D concentrations were found in subjects who reported more UVB exposure, supplemented vitamin D orally and those who declared more physical activity. 21% of subjects had elevated serum PTH concentration (i.e. > 62 pg/mL); mean parathormone was 48.6 ± 25.2 pg/mL. A linear correlation was found between the logarithm of PTH and logarithm of 25(OH)D concentrations (r = –0.21, p < 0.001). Conclusions: Results obtained here demonstrate the necessity of implementing a monitoring and prophylaxis programme of vitamin D deficiency in Poland. (Endokrynol Pol 2014; 65 (2): 105–113)

Background/Objectives: Suicide is a complex issue resulting in approximately 700,000 deaths annually. Individuals with mood disorders or schizophrenia are at an increased risk. Pharmacological interventions, such as lithium, clozapine, and ketamine, show promise in reducing suicidality. Methods: A systematic search was conducted across Google Scholar, Scopus, and PubMed to identify studies evaluating the effects of lithium, clozapine, and ketamine on suicidality. Peer-reviewed articles published between 2014 and 2024 that focused on adult populations were included. After screening 1297 records, 49 studies met the eligibility criteria: 14 on lithium, 23 on ketamine, and 12 on clozapine. Results: Multiple studies highlight lithium’s significant anti-suicidal effects in patients with bipolar disorder, showing superior suicide risk reduction compared to valproate and other mood stabilizers. Ketamine has been shown to rapidly reduce suicidal ideation, with effects observable within hours and lasting up to a week. While most studies support its short-term efficacy, findings regarding its long-term benefits and the impact of repeated dosing remain inconsistent. Clozapine has consistently demonstrated a reduction in suicide risk for individuals with schizophrenia. Large-scale cohort studies report a significant decrease in suicide attempts and mortality when compared to other antipsychotics. Conclusions: Lithium, ketamine, and clozapine were proven to be effective in reducing suicidality. However, limited data, adherence challenges, and methodological differences across studies highlight the need for more robust, large-scale experimental research. Effective suicide prevention is an extremely complex topic and also requires consideration of healthcare and social system factors.

As global communities respond to the COVID-19 pandemic, there has been an increasing emphasis on public health strategies, like implementation of ‘lockdowns’, closure of educational institutions and offices, cancellation of events, and enforcement of social distancing measures to slow the rate of transmission. The main objective of this article is to find out how the public health interventions and national lockdown affected people’s perception and attitudes to limited mobility and how people reacted by their spatial mobility behaviours in new reality of the first weeks of COVID-19 pandemic in Poland. The study is based on the on-line survey research conducted among Polish residents supplemented by the analysis of data on changes in the spatial mobility based on Google dataset. The obtained results highlight high level of self-discipline in the population in response to restrictions and social distancing obligations, and as a result significantly lower spatial mobility level, before the restrictions began to be lifted. The size of the respondents’ place of residence had the greatest impact on changes in spatial mobility.