Background: Numerous reports indicate the educational deficiencies of medical students in delivering bad-news-related skills. Evaluation of the performance of training programs in this area should be one of the key components of the educational process. The purpose of this study was to analyze medical students’ preferences and educational needs regarding DBN (delivering bad news). The effect of clinical experience on the self-assessment of skills was analyzed. Methods: The quantitative survey was conducted using the CAWI technique. The study involved 321 fifth- and sixth-year medical students from 14 medical universities in Poland. Pearson’s χ² test was used for statistical analysis. The profile of respondents for categorical variables was determined by KMeans analysis. Results: As many as 75.1% of students revealed that they did not feel sufficiently prepared for DBN. Only 18.7% reported having adequate competence in this area. More than half of the inquired students (63.6%) witnessed a situation during their clinical practice in which a physician provided a patient with information about an unfavorable diagnosis. These students were less likely to declare that they could not deliver BN (43.4%) than students who had no such experience (58.2%). As many as 86.3% of the respondents reported the need for more time in DBN skills training. Students mostly preferred active teaching methods. Conclusions: Understanding students’ learning needs and preferences can help medical schools optimize their education programs to develop DBN-related competencies.

Purpose: The aim of our study was to analyze students’ emotional experiences and coping mechanisms regarding the situation of delivering bad news (DBN). Patients and Methods: 291 fifth- and sixth-year students from 14 medical universities took part in our study. Their responses were analyzed from the perspective of their experience – whether the individuals received bad news, delivered bad news themselves, witnessed bad news being delivered, or had no experience at all. We used content analysis (CA) to examine the responses and analyzed classified variables using χ² tests, logistic regression, and predictive modeling with multiple correspondence analysis (MCA). Results: Students who had experience as a deliverer were more likely to experience failure and guilt (p=0.005). Predictions of anxiety (59.3%), stress (41.9%), and sadness (33.7%) were the highest in the students with no DBN experience. These students were most likely to make statements suggesting lack of methods and strategies for coping with difficult emotions. Students, who were immersed in DBN experiences, more often expressed the need to talk about their emotions with an experienced doctor, a family member or a friend, and used those conversations as a coping strategy. Conclusion: The most important aspects that influence the quality of delivering bad news are both communication skills and emotional context. Training regarding DBN should not only contain those two elements, but also consider the development of coping mechanisms.

Background: We aimed to identify which attitudes and emotions accompany latter-year medical students as they experience situations where bad news is communicated. Methods: A cross-sectional study was conducted using the computer-assisted web interview (CAWI) methodology in a group of 321 fifth- and sixth-year medical students from 14 medical universities in Poland. Correlations were analyzed using Pearson’s χ² test. For the categorical variables, subject profiles were analyzed using K-means clustering. Results: Students’ self-assessments of their competence in delivering bad news (DBN) differed depending on the type of experience they had with it. More than half of the students had observed a situation of DBN (63.6%) and as many as 26.5% of the participants had received bad news themselves. These two groups were less likely to declare a lack of DBN-related skills (43.4% and 33.4%, respectively) than others. In this study, 9% of the students had personally delivered bad news. Only 13.4% of these students rated their DBN skills as insufficient. They were also the least likely to express concern regarding high levels of stress (29.6%) and anxiety (48%). Conclusions: The ability to personally deliver bad medical news to a patient was the most effective form of gaining experience in DBN. Being a bearer of bad news may help students develop their own strategies for coping with difficult emotions and develop their professional competences, leading to improved medical care and patient comfort.

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by progressive joint destruction and immunometabolic complications, notably rheumatoid cachexia. This review article investigates the significance and efficacy of resistance exercise in mitigating myopenia, sarcopenic obesity, and systemic inflammation in RA patients. The objective is to elucidate the underlying molecular mechanotransduction pathways, the role of myokines, and the clinical outcomes of progressive resistance training (PRT). A comprehensive review of the current literature, including recent randomized controlled trials and meta-analyses, was conducted to evaluate clinical and physiological effects. The findings indicate that PRT effectively counteracts muscle atrophy by activating the mTORC1 pathway and exerts potent anti-inflammatory effects via the release of muscle-derived interleukin-6 (IL-6). Furthermore, PRT demonstrates synergistic potential with modern biological and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs). Clinically, properly dosed PRT improves functional capacity, reduces cardiovascular risk, and alleviates patient-reported outcomes such as fatigue and sleep disruption, without exacerbating synovial inflammation or radiographic progression in stable RA. We conclude that structured resistance training is a crucial, evidence-based non-pharmacological therapy for RA — warranting equal consideration alongside standard aerobic exercises — and provide structured dosing guidelines based on the FITT-VP framework.

Background: Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible central vision loss in older adults. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy has transformed disease management, but the expanding range of agents and evolving dosing strategies has complicated therapeutic decision-making. Objective: To summarize the anti-VEGF agents currently available for nAMD, compare their efficacy, safety and durability, and evaluate contemporary treatment strategies used to optimize long-term visual outcomes while minimizing treatment burden. Methods: A narrative literature review was conducted using PubMed and Google Scholar. Eligible publications included landmark randomized trials, real-world studies, systematic reviews, meta-analyses, consensus statements and international clinical guidelines addressing anti-VEGF pharmacotherapy and treatment regimens in nAMD, prioritizing high-quality evidence. Key Findings: Ranibizumab, aflibercept 2 mg, brolucizumab, faricimab, aflibercept 8 mg and the recently approved ophthalmic formulation bevacizumab-vikg all preserve or improve visual acuity. Functional outcomes are broadly comparable across agents, with meaningful differences confined to durability, anatomical fluid control and safety, most notably the intraocular inflammation signal associated with brolucizumab. Treat-and-extend dosing matched fixed dosing for visual acuity while requiring fewer injections and outperformed pro re nata regimens. Faricimab and aflibercept 8 mg maintained intervals of 12 weeks or longer in most patients, and switching agents improved anatomical outcomes in insufficiently responding eyes. Conclusions: Contemporary management of nAMD centers on individualized anti-VEGF therapy guided by disease activity, treatment response and patient-specific factors. Longer-acting agents and emerging approaches are expected to further improve disease control while reducing the burden of repeated intravitreal injections.

Traumatic triangular fibrocartilage complex (TFCC) tears are an important cause of ulnar-sided wrist pain, reduced grip strength, restricted forearm rotation, and distal radioulnar joint (DRUJ) instability. Their diagnosis and management remain challenging because morphological abnormalities do not always correlate with symptoms or functional impairment. This narrative review summarizes contemporary concepts in the diagnosis, treatment, and rehabilitation of traumatic TFCC tears, with particular emphasis on modern imaging and arthroscopic technologies. English-language publications were identified through PubMed without restrictions on publication year. The reviewed evidence indicates that diagnosis should integrate the mechanism of injury, physical examination, bilateral assessment of DRUJ stability, and imaging findings. Magnetic resonance imaging and magnetic resonance arthrography improve visualization of TFCC lesions, but incidental abnormalities and variable diagnostic performance limit their use as isolated decision-making tools. DRUJ stability appears to be a key factor in treatment selection. Structured non-operative management may provide satisfactory outcomes in patients with a stable DRUJ, whereas persistent symptoms, mechanically unstable tears, and foveal detachment may require surgical intervention. Contemporary arthroscopic options include all-inside repair, suture-anchor fixation, and transosseous techniques, although current evidence does not establish a single superior method. Postoperative rehabilitation protocols remain heterogeneous, and validated criteria for progression and return to work or sport are lacking. Future research should focus on standardized diagnostic pathways, comparative evaluation of repair techniques, objective functional monitoring, and patient-centered return-to-activity outcomes. Modern technologies should support, rather than replace, integrated clinical and functional assessment.