The ultrasound specialists face a substantial issue with work-related musculoskeletal disorders (WMSDs), characterized by occupation-related pain, reaching an estimated frequency of up to 90.5%. The type and location of pain vary depending on the sonographers specialty and the specific anatomical areas being examined. Our study aimed to assess the prevalence and intensity of pain among Polish doctors from various specialties conducting ultrasound examinations. The study has been performed between July and December 2023, involving 90 participants (51.9% women) actively practicing ultrasound diagnostics. The data collection process utilized a structured questionnaire developed by the researchers for this study. The questionnaire covered personal factors, including gender and age, and work-related aspects like workplace, specialty, sonography experience, and the types of examinations conducted. Statistical analysis involved both descriptive statistics and correlation analysis. The age distribution ranged from 26 to 74 years, with mean (SD) of 43.1 (12.2) years. The leading specialties among physicians were radiology (22.2%) and internal medicine (22.2%). Among all physicians, 65.6% reported pain during or after ultrasound scans, with a mean (SD) pain intensity of 6.17 (2) in a 1-10 scale. The analysis indicated no correlation between age and gender and the occurrence of discomfort. WMSDs pose a significant risk to Polish sonographers, especially those specializing in vascular surgery, general surgery and obstetrics and gynecology specialties. The study underscores a notable deficit, with only 10% of the personnel reporting training in ergonomics for ultrasound work.

Background and Objectives: In case of the ineffectiveness of pharmacological and non-pharmacological treatments in managing chronic neuropathic pain, spinal cord stimulation (SCS) with BurstDR™ stimulation may reduce pain and increase the quality of life. The term “burst” refers to a series of stimulation impulses that are compressed into small packets and separated by intervals of latency. Materials and Methods: A group of 30 consecutive patients who received the BurstDR™ stimulator using the minimally invasive percutaneous method was selected. Patients selected for our study underwent numerous spinal surgeries before SCS implantation. In the study, analgesics and co-analgesics and their doses used by patients before and 6 months after SCS implantation were examined and compared. Using the visual analogue scale (VAS), pain was compared before and after the procedure. Patients` quality of life was assessed using the Oswestry Disability Index (ODI). Results: We observed a significant reduction in opioid daily doses by an average of 32.4% (±36.1%) and a reduction in paracetamol daily doses by an average of 40% (±33.4%). There was a reduction in pregabalin doses as well. Ketoprofen daily dose reduction was 85.4 mg. The mean VAS difference before and after procedure was 3.9 (±2.3), and the mean difference in ODI was 12.9 (±9), which benefits operative treatment. The VAS and ODI results were statistically significant as well. Conclusions: According to our research, BurstDR™ stimulation improves the quality of life by reducing doses of analgesics and the level of pain.

WPROWADZENIE: W ostatnim czasie obserwuje się wzrost liczby opublikowanych artykułów dotyczących sztucznej inteligencji w dziedzinie medycyny, szczególnie w obszarze neurochirurgii. Badania dotyczące integracji sztucznej inteligencji z praktyką neurochirurgiczną wskazują na postępującą zmianę w kierunku szerszego wykorzystania narzędzi wspomaganych sztuczną inteligencją w diagnostyce, analizie obrazu i podejmowaniu decyzji.MATERIAŁ I METODY: W badaniu oceniono efektywność ChatGPT-3.5 i ChatGPT-4 na Państwowym Egzaminie Specjalizacyjnym (PES) z neurochirurgii przeprowadzonym jesienią 2017 r., który w czasie przeprowadzania badania był najnowszym dostępnym na stronie Centrum Egzaminów Medycznych (CEM) egzaminem z oficjalnie udostępnionymi odpowiedziami. Próg zdawalności egzaminu specjalizacyjnego wynosi 56% poprawnych odpowiedzi. Egzamin składał się ze 116 pytań jednokrotnego wyboru, po wyeliminowaniu czterech z uwagi na ich niezgodność z aktualną wiedzą. Ze względu na poruszane zagadnienia pytania podzielono na dziesięć grup tematycznych. Na potrzeby gromadzenia danych obie wersje ChatGPT zostały poinformowane o zasadach egzaminu i poproszone o ocenę stopnia pewności co do każdej odpowiedzi w skali od 1 (zdecydowanie niepewny) do 5 (zdecydowanie pewny). Wszystkie interakcje odbywały się w języku polskim i były rejestrowane.WYNIKI: ChatGPT-4 wyraźnie przewyższył ChatGPT-3.5 z różnicą wynoszącą 29,4% (p < 0,001). W przeciwieństwie do ChatGPT-3.5, ChatGPT-4 z sukcesem osiągnął próg zdawalności dla PES. W testach ChatGPT-3.5 i ChatGPT-4 odpowiedzi były takie same w 61 pytaniach (52,58%), w obu przypadkach były poprawne w 28 pytaniach (24,14%) i niepoprawne w 33 pytaniach (28,45%).WNIOSKI: ChatGPT-4 osiąga większą poprawność w udzielanych odpowiedziach w porównaniu z ChatGPT-3.5, prawdopodobnie dzięki zaawansowanym algorytmom i szerszemu zbiorowi danych treningowych, co podkreśla lepsze zrozumienie złożonych koncepcji neurochirurgicznych.

Introduction: Artificial intelligence (AI) has evolved significantly, driven by advancements in computing power and big data. Technologies like machine learning and deep learning have led to sophisticated models such as GPT-3.5 and GPT-4. This study assesses the performance of these AI models on the Polish National Specialty Exam in ophthalmology, exploring their potential to support research, education, and clinical decision-making in healthcare. Materials and Methods: The study analyzed 98 questions from the Spring 2023 Polish NSE in Ophthalmology. Questions were categorized into five groups: Physiology & Diagnostics, Clinical & Case Questions, Treatment & Pharmacology, Surgery, and Pediatrics. GPT-3.5 and GPT-4 were tested for their accuracy in answering these questions, with a confidence rating from 1 to 5 assigned to each response. Statistical analyses, including the Chi-squared test and Mann-Whitney U test, were employed to compare the models’ performance. Results: GPT-4 demonstrated a significant improvement over GPT-3.5, correctly answering 63.3% of questions compared to GPT-3.5’s 37.8%. GPT-4’s performance met the passing criteria for the NSE. The models showed varying degrees of accuracy across different categories, with a notable gap in fields like surgery and pediatrics. Conclusions: The study highlights the potential of GPT models in aiding clinical decisions and educational purposes in ophthalmology. However, it also underscores the models’ limitations, particularly in specialized fields like surgery and pediatrics. The findings suggest that while AI models like GPT-3.5 and GPT-4 can significantly assist in the medical field, they require further development and fine-tuning to address specific challenges in various medical domains.

Background: Ultrasound is a non-invasive imaging technique that provides real-time evaluation of anatomical structures. While versatile in examining various organs, it can be physically demanding for physicians due to the need for challenging positions, causing musculoskeletal pain and potentially work-related diseases over time. The study aimed to assess the ergonomics of abdominal and breast ultrasound, identify the most challenging anatomical area, determine which part of the examination causes the greatest strain, and evaluate the overall ergonomic impact of the entire procedure. Methods: This single-center study involved 4 radiologists and focused on breast and abdominal ultrasonography. Kinematic data were recorded using the Noraxon Ultium Motion inertial system to track body movements during the ultrasound procedures. Five critical segments were identified while examining the liver, right kidney, left kidney, right breast, and left breast. Ergonomic assessment was performed using the Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA) methods, evaluating postural risks and physical strain during each segment and the whole procedure. Results: Both RULA and REBA assessments yielded median total scores of 6.0–7.0 and 6.0–7.5, respectively, reflecting consistently medium to high musculoskeletal loading. Examinations of the left breast and left kidney were associated with the most demanding postures. These elevated scores demonstrate that abdominal and breast ultrasonography imposes substantial ergonomic strain, potentially increasing the risk of work-related musculoskeletal disorders. Conclusions: The high ergonomic risk scores indicate an urgent need to modify scanning techniques and workstation design to reduce musculoskeletal strain in sonographers. Implementing ergonomic improvements is essential to prevent occupational injuries and promote long-term health.

Nervous system and corneal disorders are major causes of permanent disability worldwide, largely due to the limited regenerative capacity of ectoderm-derived tissues. Therefore, the development of accessible and ethically acceptable cell-based therapies promoting the repair and regeneration of these tissues is of considerable translational importance. In this study, we aimed to comparatively evaluate the ectodermal differentiation potential of human adipose-derived stem cells (ADSCs) and human amniotic epithelial cells (hAECs) in vitro, with hAECs serving as a reference cell population with established ectodermal plasticity. Primary ADSCs and hAECs were characterized phenotypically using flow cytometry and functional differentiation assays. Cells were subjected to a directed ectodermal differentiation protocol and assessed via morphological analysis, immunostaining for ectoderm-associated proteins, and RT-qPCR analysis of lineage-specific genes. ADSCs exhibited morphological changes following differentiation, including a more epithelial-like phenotype and an increased nucleus-to-cytoplasm ratio. Immunostaining revealed the induction of nestin and OTX2 expression after differentiation, which was particularly pronounced in ADSCs. Gene expression analysis demonstrated statistically significant upregulation of the ectoderm-related genes EN2, SOX1, and PAX6 exclusively in hAECs. Results suggest that in ADSCs the differentiation process was only partially activated. In conclusion, our findings further support the suitability of hAECs as a reference cell line for studies investigating ectodermal differentiation protocols, while also demonstrating that ADSCs exhibit a limited but detectable capacity for acquiring ectoderm-specific characteristics under defined in vitro culture conditions.