In the present study, we aimed to assess the anti-SARS-CoV-2 antibodies in population or in convalescents 6 months after infection with COVID-19. The study population consisted of 2 groups, i.e. group I: 232 post-COVID-19 patients, and group II: 544 patients from a population cohort. Detection of anti-N antibodies was performed with Elecsys Anti-SARS-CoV-2 and anti-S antibodies with LIAISON SARS-CoV-2 S1/S2 IgG tests. After the Omicron wave, gradual increase in the prevalence of the analyzed antibodies was observed in the general population - up to 92.5% of anti-S and 69.7% of anti-N antibodies. In the COVID-19 convalescents, 6 months after infection, 4.3% and 3.7% did not generate significant titer of anti-S and anti-N antibodies, respectively. Among patients, who were vaccinated, 1% did not generate anti-S antibodies. Median age of those who did not respond was higher than those who responded. Sex did not influence the results. Comparison of anti-N and anti-S antibodies 6 months after infection in the whole group showed higher anti-N titer in patients who suffered from the disease than in the general population. In the general population, 17.4% of participants had anti-N antibodies, and 9% had anti-S antibodies, despite no prior vaccination or history of COVID-19. High prevalence of anti-N antibodies in patients reporting no history of COVID-19 during last wave, even after official end of the pandemics suggests high prevalence of SARS-CoV-2 in the environment and frequent asymptomatic or unspecific COVID-19, what is of high importance from the public health perspective.

Background/Objectives: Sudden cardiac death (SCD) remains a major global health concern and represents one of the most common causes of mortality due to cardiovascular diseases. The wearable cardioverter–defibrillator (WCD) is an innovative, non-invasive medical device designed to provide continuous heart monitoring and immediate defibrillation in patients at risk for SCD. The study aimed to assess the efficacy of WCD usage in patients awaiting decision on therapy with implantable cardioverter–defibrillators (ICDs). Methods: We explored the clinical applications, benefits, and limitations of WCD usage within the BIA-VEST registry in Poland over the years 2021–2023. The study included 10 patients with a mean age of 49.1 ± 12.02 years. Results: All patients demonstrated good tolerance and compliance with the LifeVest WCD, wearing it for an average of 93.1 days, about 22.8 h per day (95.7% of the time). No interventions from LifeVests were recorded, and there were no effective, ineffective, or inadequate discharges. After the first follow-up echocardiography, five patients still required ICDs. Due to improved LVEF and overall condition in six out of ten patients undergoing WCD bridge therapy, ICD implantation was finally waived. Conclusions: The WCD acts as a bridge to therapy, such as ICD implantation or cardiac surgery, and may be particularly beneficial for patients with transient or evolving conditions, such as structural heart diseases and life-threatening ventricular arrhythmias.

Background/Objectives: Cardiovascular diseases are the leading cause of death worldwide. The preventive efforts to reduce the burden are crucial. Primary causes of cardiovascular diseases include lipid disorders. The variety of available medications influences cardiovascular risk and allows for improvement. However, discontinuation or infrequent initiation of lipid-lowering therapies remains a problem. This study aimed to investigate predictors of lipid-lowering therapy escalation. Methods: 431 patients with known concentrations of Lipoprotein (a) (Lp (a)) acquired as part of routine cardiovascular risk assessment from the HELPE-R registry, hospitalised in the University Clinical Hospital in Białystok were included in this study. Escalation of treatment was defined as the initiation of any form of lowering therapy or an increase in the potency or dose of statins. The analysis of the influence of various factors on the decision about escalation was performed. Results: The median age was 69.00 years. The escalation of therapy occurred in 48.49% of patients. Not reaching the LDL-C goal was the strongest predictor of escalation (OR: 9.177). The other factors increasing the probability of escalation included acute coronary syndrome (OR: 3.913), prediabetes (OR: 2.372), chronic coronary syndrome (OR: 2.217), dyslipidemia (OR: 2.354), hypertension (OR: 1.734), carotid artery stenosis (OR: 1.625), and obesity (OR: 1.543). There was no effect of past MI and stroke on the escalation of lipid profile. Lp (a) did not affect the escalation. Conclusions: The decision about escalation of lipid-lowering therapy is mainly influenced by classical risk factors and established atherosclerotic disease. Lp (a) did not affect the escalation, despite growing interest among medical practitioners.

Background: Lyme borreliosis (LB) is one of the most commonly diagnosed tick-borne diseases globally, caused by Borrelia spirochetes. Despite advances in laboratory diagnostics, both overdiagnosis and underdiagnosis of LB remain significant issues. Nonspecific symptoms such as chronic fatigue or musculoskeletal complaints are often misattributed to LB, creating controversy and delaying appropriate diagnosis and treatment.Objective: To analyze clinical data and diagnostic results of patients referred to the Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, with suspected LB, and to assess the frequency of its clinical forms.Material and methods: A retrospective analysis was conducted on medical records of patients hospitalized with suspected early or late LB at the Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, from January 2018 to June 2023. Diagnostics included ELISA and Western blot tests for IgM and IgG antibodies against Borrelia. Initial diagnoses were based on tick exposure and clinical presentation.Results: Records of 819 hospitalized patients were analyzed: 497 (60.7%) men and 322 (39.3%) women, mean age 55.7 ± 14.8 years. LB was diagnosed in 426 (52%) patients, including 24 (5.6%) with neuroborreliosis and 7 (1.7%) with erythema migrans. In 395 cases, symptoms and results did not clearly confirm LB, yet antibiotics were used to assess response. In 393 patients (48%), LB was excluded; the most common alternative diagnoses were osteoarthritis (31.3%) and other musculoskeletal disorders (25.1%)Conclusions: Overdiagnosis of LB may result in unwarranted antibiotic use, while delayed treatment can lead to late-stage disease. A key issue is the lack of differential diagnostics, delaying proper management of serious conditions like MS, rheumatoid arthritis, or cancer. Notably, many patients received empirical antibiotics despite not meeting clinical-serological criteria, distorting disease incidence. The current LB reporting system also requires revision, as it promotes overdiagnosis.

Anomalies of coronary artery origins are rare but significant conditions that can range from benign to life-threatening. Early detection through imaging is crucial in preventing adverse outcomes. The treatment strategy varies depending on the type and severity of the anomaly, ranging from pharmacological treatment to surgery. A 22-year-old male patient, after syncope, after excluding other causes, had an exercise drill test, which was clinically negative and ECG-positive. Angio-CT revealed an undeveloped left main coronary artery (LMCA), and the circulation was supplied through the right coronary artery (RCA). The RCA provides the left anterior descending artery (LAD), and the LAD retrogradely supplies the left circumflex artery (LCX). The myocardial perfusion scintigraphy showed a slight lack of perfusion in the anterior wall (6% of total perfusion). The patient was qualified for further observation. A 77-year-old female underwent cardiac CT due to stenocardia. CT showed a lack of LMCA. The initial segment of the RCA gave rise to the left coronary artery (LCA), which encircled the aortic bulb posteriorly and bifurcated into branches resembling the LCX and LAD. After the Heart Team consultation, the patient was deemed eligible for conservative treatment. Angio-CT is a valuable tool for detecting coronary artery anomalies.

Despite the availability of numerous lipid-lowering agents, the treatment of lipid disorders remains a public health challenge. A substantial portion of patients, especially those with severe dyslipidemia or familial hypercholesterolemia (FH), fail to achieve the LDL-C goal. The leading causes of suboptimal LDL-C control include underprescription and poor adherence; however, in rare cases, it may result from an unusual biological response to treatment. In the presented case, a 78-year-old female with a history of transient ischemic attack and myocardial infarction was diagnosed with a heterozygous variant of FH and true statin intolerance following trials of simvastatin, rosuvastatin and pitavastatin. Initially, inclisiran was added to ezetimibe, leading to an unexpected increase in LDL-C. Due to the patient’s refusal of another statin re-challenge and the unavailability of bempedoic acid, nutraceuticals were introduced. After 6 months, inclisiran was discontinued because only a 22% reduction in LDL-C was achieved, likely attributable to the nutraceutical’s effect. Another PCSK9 inhibitor, evolocumab, was subsequently initiated. Shortly after the treatment onset, the patient complained of paraesthesia in the upper extremities and discontinued therapy. LDL-C levels increased by 7% after one month of treatment with evolocumab. The patient refused treatment with lipid apheresis. Possible causes of poor response to PCSK9 inhibitors include elevated lipoprotein(a) and FH.