Medicine and Public Health

Background:
We present a clinical case of Amyand’s hernia complicated by acute appendicitis.
Material and methods:
A 71-year-old male presented with an incarcerated right inguinal hernia. Intraoperatively, a gangrenous, perforated appendix with associated purulent collection was identified, consistent with a type three Amyand’s hernia.
Results:
This case highlights the diagnostic and therapeutic challenges of Amyand’s hernia. Due to its rarity and nonspecific presentation, the diagnosis is often made intraoperatively. Timely intervention and appropriate surgical strategy are essential to prevent complications.
Conclusions:
Amyand’s hernia should be considered in the differential diagnosis of complicated inguinal hernias. Surgical management must be adapted to the intraoperative findings.

Background:
Operating rooms worldwide are one of the major sources of plastic waste. In this work we have speculated, that it is possible to limit the amount of waste produced during laparoscopic and open hepatectomies significantly, based on the analysis of single use items and the possibilities of replacing them with multiple use items. For this purpose, all waste produced during , straightforward laparoscopic and open liver resections were analyzed, then divided into two groups: obligatory and non-obligatory waste.

Material and methods:
During one open and one laparoscopic hepatectomy procedure, we have analyzed all waste produced as the result of the procedures. The waste was divided into two groups: obligatory and non-obligatory waste.

Results:
All items used for each operation was separated from the waste bins after operation inside the OR. The members of the research team (M.W. O.P. and A.L.K) discussed each item and qualified it to one of the two categories: obligatory waste or non-obligatory waste. After assigning all waste items into one of the two groups, the non-obligatory waste was packed and weighted (Figure 1). The total weight and number of waste bins used for non-obligatory waste was recorded. Non-obligatory waste after laparoscopic hepatectomy weighted 3800 grams and was packed into two waste bins while after open hepatectomy the non-obligatory waste weighted 1400 grams and was packed into one waste bin.

Conclusions:
Even a small reduction in cost of one procedure can translate globally into big savings for the hospitals and obviously for less environmental impact of the hospital waste.

Background:
This research aims to examine the potential of artificial intelligence (AI) within the field of psychiatry and to evaluate the potential for modern technologies to supplant psychiatric specialists in the future. Present applications of AI in the diagnosis, therapy and monitoring of patients are presented, considering both the advantages and limitations of these solutions. Ethical, social and legal aspects related to the employment of artificial intelligence in psychiatric care are also discussed.

Material and methods:
The paper is based on a review of the scientific literature. A total of 16 publications addressing the application of artificial intelligence in psychiatry were selected and examined using keywords related to artificial intelligence and psychiatry. Relevant studies were identified, and key concepts extracted, systematized, and analyzed to address the research objectives. Results: Research on the use of artificial intelligence in psychiatry is limited and not yet fully explored, as the implementation of AI in medicine, particularly in psychiatry, remains a relatively new and developing field. The analyzed studies provide insight into current applications of AI in psychiatric diagnostics, therapy, and patient monitoring. Despite promising progress, the findings consistently emphasize that although AI offers valuable support in clinical practice, it cannot replace human psychiatrists, particularly in areas requiring empathy, emotional sensitivity, and complex interpersonal relationships.

Results:
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Conclusions:
Artificial intelligence can support psychiatrists in data analysis, early diagnosis, and personalized treatment, but it cannot replace the human element of empathy and patient care. Ethical and legal challenges also limit its full implementation, so AI should be viewed as a supportive tool rather than a substitute for specialists.

Background:
Postponing procreation becomes an increasing problem in developed countries. Maternal aging contributes to intensive development of assisted reproduction techniques (ART). The aim of the study was to analyze the results of in vitro fertilization in women of very advanced maternal age (AMA, ≥42Y) using autologous oocytes (AO) or donor oocytes (DO) compared to women ≤35Y.

Material and methods:
This was a retrospective study of AMA women who underwent intracytoplasmic sperm injection (ICSI) using AO or DO. The control group consisted of young patients with age ≤35Y.

Results:
In group of AMA patients, the AMH level was significantly lower (0.56 ng/ml) than in young patients (3.6 ng/ml), which corresponded to obtaining a significantly lower number of oocytes (1.6±0.4 vs 12±4 oocytes/cycle), (p < 0.001). In older patients with AO only 0.4±0.1 blastocysts/cycle were obtained compared to 1.9±0.7 when DO were used and 3.8±1.1 from young women. Euploidy rate of blastocysts obtained after fertilization of AO of AMA patients was 26% in compare to 57% in a group of young women and 54% in the group of older patients with DO. The implantation rate was significantly lower in the group of older patients with AO (28%) compared to the other groups (50%, 59%), (p < 0.001).

Conclusions:
AMA patients must be aware that IVF procedure does not guarantee pregnancy and the birth of a healthy child and they should be offered pre-implantation PGT-A diagnostics due to the high risk of chromosomal defects. These patients should also be informed about the much higher effectiveness of IVF using DO.