Medicine and Public Health

Background:
With regular cold baths, winter swimmers (individuals swimming in low-temperature water) develop adaptation to the cold. Apoptosis is a fundamental process of the immune system; its main role consists in maintaining cell homeostasis to prevent the development of pathological conditions. .This study focuses on a unique and interesting aspect of winter swimming, providing vital insights into the immune system's physiological adaptations to harsh environments. The study investigates a relatively under-researched area, the impact of winter swimming on leukocyte apoptosis, which is a novel and relevant contribution to the fields of sports physiology and immunology, as understanding how regular exposure to cold water influences immune cell apoptosis can provide broader insights into the human body's adaptive mechanisms to extreme environments.

Material and methods:
The study group consisted of 9 male winter swimmers. After a bath, blood samples were collected from the ulnar vein. Blood smears were stained with the Hemacolor method. By light microscopy (1000×) under immersion, apoptotic forms were counted in the whole preparation relative to 100 leukocyte forms.

Results:
Apoptotic leukocyte forms were very rare in the participants’ blood. Out of the 9 subjects, only 3 individuals exhibited 2–3% of leukocyte apoptotic forms.

Conclusions:
The findings demonstrate that low water temperature does not cause significant leukocyte apoptosis in winter swimmers, which is an important finding. This suggests that regular exposure to cold water may improve immunological resilience, which is a favourable adaptation for those who participate in this sport.

There are two models for legitimizing the redistribution: an entitlement-based model and one based on solidarity. In both cases we are dealing with moral obligation; however, not imperative. In the legal model, one often refers to s.c. imperfect duty, while in the solidarity model we are dealing with a moral duty based on values. I defend the idea of justifying redistribution by referring to the principle of solidarity combined with the idea of sustainable development. This a philosophical paper in healthcare ethic. The result of the discussion is my proposal to combine categories of sustainable development and solidarity to provide justofication for the global redistribution of healtcare resources. Solidarity is a pragmatic and proactive relationship, flexible and open to the various beliefs and motivations of the cooperating parties. Therefore, the language of solidarity is more universal and promising in the work of building a global health system in which developing countries can feel safe and treated fairly, rather than a language that speaks of entitlements, obligations and charity. Building a climate of trust and pursuing socially responsible sustainable development policies do not require strong theories of justice or other rigid legal or ethical doctrines. Such doctrines can even be harmful. Meanwhile, the discourse relating to solidarity, trust-building and cooperation to achieve realistic and reasonable goals at the transnational public health level is relatively undoctrinaire, and instead flexible and open to a variety of interpretations. In the realities of international politics and cooperation, these are serious advantages.

Background:
Cytomegalovirus infection represents the most common congenital and acquired infection. The symptomatology is very broad and usually non-specific, ranging from asymptomatic forms to status with organ damage or even to severe systemic infection. This makes CMV infection mimic other disorders and diseases.

Material and methods:
Here we report two cases of CMV infection diagnosed after the second month of life in children who were referred to the infectious disease ward for extended diagnosis. Despite the late identification of infection, the clinical manifestation (psychomotor retardation, hearing loss, lenticulostriate vasculopathy) suggested a diagnosis of congenital infection was highly probable.

Results:
The further diagnostic process led to the correct diagnoses of congenital heart defect and cystic fibrosis, and administration of adequate specialist treatment.

Conclusions:
CMV infections are common and it is worthy to remember that the diagnosis of CMV infection can be not the only one in multisymptomatic infants so the thorough differential diagnostics is necessary.

Background:
We present two cases of pericardiocentesis due to anorexia nervosa in young women.

Material and methods:
A twenty-year-old and a twenty-four-year-old female with a history of anorexia nervosa were admitted to the cardiac surgery department due to pericardial effusions.

Results:
Both cases needed urgent pericardiectomy. Our patients did not show any signs of acute heart failure during the hospitalization. Due to their primary diagnosis, they needed psychological support and their food intake required monitoring.

Conclusions:
Pericardial effusions are common in adolescent AN patients, and echocardiography monitoring is necessary to prevent the progression of acute cardiac tamponade.

Background:
Awake glioma surgery in pregnant patients occurs rarely and is a huge challenge for the whole therapeutic team, requiring the cooperation of a neurosurgeon, an anaesthetist, a speech therapist and an obstetrician. In this paper we present the case of a 31-year-old patient in 22 hbd with low grade glioma (LGG) of the left temporal lobe. The patient was admitted to the outpatient clinic, having experienced transient speech disorders for about a week. An MRI examination revealed an extensive tumour in the left temporal region. The speech cortical centres were mapped using fMRI and the awake surgery was tailored. The surgery was performed under neuroleptanalgesia with dexmedetomidine and remifentanil and regional anaesthesia. The speech centres were located. The tumour was completely removed, revealing astrocytoma fibrillare WHO II. The patient’s speech was continuously monitored, as well as the foetal vital functions. The course of the pregnancy was uneventful. In the 48th month after the first operation, the patient underwent a reoperation due to tumour recurrence with consecutive protonotherapy. Currently, 88 months after the first operation, the patient and child both remain in very good condition

Conclusions:
Few cases of glioma resection with intraoperative awakening in pregnant women have been described in the literature. The awake method seems to be an optimal treatment option.

Background:
Neuroblastoma is the most common malignant tumor occurring in early childhood. Most of them are located in the adrenal glands. Extra-adrenal localization is rare.

Material and methods:
In this paper, we present a case of congenital neuroblastoma, which was identified in the neonatal period. The tumor was located in the posterior mediastinum in the paravertebral region.

Results:
It was not identified in the prenatal period and did not cause displacement of the thoracic organs. In this article, we provide obstetric, neonatal and pathomorphological descriptions from the autopsy

Conclusions:
We emphasize the need for screening ultrasound examinations in newborns.