Objective: This study aimed to identify clinical and laboratory predictors of kidney involvement and disease relapse in pediatric patients with IgA vasculitis (Immunoglobulin A vasculitis, IgAV). Materials and Methods: A retrospective cohort study was conducted on 173 children diagnosed with IgAV at the Children’s Clinical Hospital of the Medical University of Warsaw between 2018 and 2022. Patients were categorized into groups based on renal involvement (IgAVN+ vs. IgAVN−) and disease recurrence. The analysis included demographic data, clinical manifestations, allergy history, presence of infection, duration of hospitalization, relapse occurrence, the interval between the first and second hospitalization, and laboratory markers. Results: Renal involvement was observed in 42% of cases, while disease recurrence occurred in 9.25% of patients. IgAVN+ patients were older, had longer hospital stays, and more frequently exhibited gastrointestinal symptoms, consistent with previous research. A history of allergic conditions was more prevalent in both the IgAVN+ and recurrence groups. An increase in IgA levels over time was associated with a higher risk of nephropathic development. Patients with recurrences had higher IgM levels and an elevated neutrophil-to-lymphocyte ratio (NLR) (p = 0.07). In the ROC (Receiver Operating Characteristic) analysis, a cutoff value of 1.67 for NLR (AUC 0.71; p = 0.0002; sensitivity 0.87; specificity 0.58) was identified as a risk factor for disease recurrence. Conclusions: Older age at disease onset, gastrointestinal involvement, and allergies are associated with renal involvement in pediatric IgAV. Immune dysregulation, reflected by elevated NLR and IgM, may contribute to disease recurrence. It is important to monitor changes in IgA levels over time, as an increase in IgA concentration is a risk factor for the development of nephropathy. Additionally, calculating the NLR is recommended, as it may indicate the probability of disease recurrence.

Introduction and objective: Immunoglobulin A vasculitis is an autoimmune disorder resulting from immune complex accumulation in small blood vessels, causing skin, joint, abdominal, and kidney manifestations. This study evaluated the impact of the COVID-19 pandemic on the incidence and clinical course of immunoglobulin A vasculitis in paediatric patients. Materials and methods: A retrospective analysis of medical records from a single university paediatric hospital was performed to compare 117 patients presenting with immunoglobulin A vasculitis before and 57 after the COVID-19 epidemic announcement in Poland on 20 March 2020. Laboratory results, hospitalisation duration, preceding infections, clinical presentation, history of allergies and COVID-19 vaccinations, and the proportion of immunoglobulin A vasculitis patients among all admissions were analysed. Results: The study of 174 patients showed that their average age during the pandemic (5.51 ± 3.10) was significantly lower than pre-pandemically (6.98 ± 3.67) (p < 0.05). Before the pandemic, more hospitalised patients had immunoglobulin A vasculitis (1.14%) compared to during the pandemic (0.47%) (p < 0.05). Food allergies were also more common during the pandemic (20.8%) than before (8.8%) (p < 0.05). No significant differences were found in hospitalisation duration, and the incidence of immunoglobulin A vasculitis nephritis and abdominal symptoms (p = 0.194, p = 0.381, p = 0.968, respectively). Three patients had COVID-19 infection at admission. Conclusions: The pandemic led to fewer immunoglobulin A vasculitis hospitalisations but did not alter the clinical course of the disease or the incidence of immunoglobulin A vasculitis nephritis. In the context of the resurgence of COVID-19 infections, it is important to consider them as potential factors affecting immunoglobulin A vasculitis. Ongoing research is essential to understand these dynamics and guide effective clinical management of immunoglobulin A vasculitis amidst the evolving COVID-19 setting.

Introduction: This review evaluates the impact of plant-based diets on the inflammatory symptoms in patients with rheumatoid arthritis (RA). RA is a chronic autoimmune inflammatory disease affecting approximately 1% of the global population and significantly impairing quality of life. Although pharmacological treatment with disease-modifying antirheumatic drugs (DMARDs) remains the cornerstone of therapy, but non-pharmacological interventions, including dietary changes, are also being recognised as important. Plant-based diets that are rich in fibre, antioxidants, and unsaturated fatty acids, have demonstrated anti-inflammatory properties that may modulate disease activity and improve clinical outcomes in RA patients. A systematic analysis of clinical trials and observational studies reveals that vegan, vegetarian, and plant-forward dietary patterns contribute to significant reductions in disease activity scores (DAS28), inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and subjective pain and physical function assessments with vegan, vegetarian, and plant-forward dietary patterns. Proposed mechanisms include decreased pro-inflammatory cytokines, improved gut microbiota diversity, weight reduction, and modulation of immune pathways such as autophagy. While the results are promising, further large-scale randomised controlled trials are necessary to clarify the optimal dietary approaches and their long-term benefits in RA management.Objective: This review aims to assess the impact of plant-based diets on inflammatory symptoms in patients with rheumatoid arthritis (RA).Materials and Methods: A review of the available literature from the PubMed, Scopus, and Web of Science databases published within the last 20 years.

This narrative review examines whether Large Language Model (LLM)–based chatbots can help close the global mental health treatment gap while weighing their public-health risks. We synthesize peer-reviewed studies and relevant case reports to: (1) map the dimensions of the mental health treatment gap, (2) describe how recent LLM advances have changed chatbot capabilities, (3) explore how chatbots can address the dimensions of the gap, (4) evaluate evidence for clinical effectiveness, and (5) outline major safety, ethical, and policy concerns. Findings indicate that chatbots offer scalable, always-available, and low-cost support that can reduce barriers related to stigma, geographic and temporal access, affordability, and mental-health awareness. We found that the evidence supports chatbot interventions’ efficiency in small-to-moderate short-term reductions in depression and anxiety symptoms, while the long-term effects and use in other disorders remain largely unexplored. However, LLM chatbots also present clear risks: hallucinations and clinically inappropriate responses, amplification of stigma or bias, user dependence, and significant data-security vulnerabilities. Importantly, most widely used generalist LLMs lack rigorous clinical validation. We conclude that LLM chatbots are a persistent feature of the mental-health ecosystem whose benefits can be realized only with robust safety guardrails, transparent evaluation, integration into stepped-care pathways, and proactive regulation.

Introduction: Promoting natural labour with less medical interventions is one of main goals in modern obstetrics. Natural methods have gained more attention in recent years due to their potential to enhance cervical readiness, decrease the need for labour augmentation and shorten labour duration. Objective: This review aims to investigate the current clinical evidence on the effects of date fruits consumption during late pregnancy on childbirth stages and postpartum complications, particularly concentrating on cervical dilation upon hospital admission, frequency of spontaneous labour onset, and duration of different labour phases. Material and methods: A narrative review of 6 different randomized controlled trials and cohort studies investigating the impact of daily date intake in late-stage pregnancy on labour-related outcomes was conducted. Data that were extracted included cervical dilatation at hospital admission, frequency of spontaneous labour, need for oxytocin augmentation, and duration of all labour’s phases. Results: It was found that consumption of around 6–7 dates per day for 2-4 weeks before the estimated delivery date leads to increased cervical dilatation upon hospital admission, higher rates of spontaneous labour onset, shorter duration of all stages of labour (especially the latent and active phases of the first stage of delivery), and reduced need for oxytocin augmentation. Conclusions: Date fruit consumption appears to be a safe, easily accessible and natural intervention that may positively influence the initiation and progression of labour. However, large, well-designed trials in more diverse populations need to be conducted to further confirm these findings and to establish evidence-based guidelines.

Anorexia nervosa is a group of symptoms based on conscious restriction of food intake. Anorexia disrupts the body's homeostasis, so that the functioning of many organs is impaired. These dysfunctions involve the neuroendocrine system, the cardiovascular system, the skeletal system, the digestive system, and the reproductive system. Knowing the symptoms makes it possible to make an accurate diagnosis at an early stage of the disease. This is especially important given the increasing incidence and mortality rates. This article reviews the main clinical manifestations of AN. Attention is given to both pharmacotherapies and psychotherapy. The aim of the study: The purpose of this paper is to summarize the existing knowledge on mental anorexia nervosa. The article presents etiology, epidemiology, diagnosis, differentiation, clinical picture and treatment. The topic of eating disorders in pregnant women is also described. Material and method: In our article we used English databases such as PubMed and Google Scholar. We selected the articles according to key words such as eating disorders, osteoporosis, cardiomyopathy, hypoglycemia, psychotherapy, medical assessment, treatment. Conclusions: Eating disorders are a topic that unites many medical disciplines. The array of symptoms accompanying the disease clearly demonstrates the correlation of mental health with somatic health. Negative effects affect the skeletal system, neuroendocrine system, cardiovascular system, gastrointestinal system and reproductive system. Treatment is based on the use of pharmacotherapy, mainly using SSRI group drugs, as well as psychotherapy. A particularly appreciated current, among specialists, is cognitive-behavioral therapy.