Review of Medical Practice ISSN 2956-4441 ISSN on-line 2956-445X The journal has been published at the University since 2022 as a continuation of the quarterly „International Review of Medical Practice”, issued since 1995. Its formal acquisition, the change of title to „Review of Medical Practice”, and the assignment of new ISSN numbers have enabled further development while maintaining its scholarly mission, tradition, publication record, and continuity of volume numbering. The spectrum of interest of the journal includes original and clinical papers in the field of all medical sciences. The journal is available in databases, repositories, and online search tools: Index Copernicus EBSCO (Academic Search Ultimate; Central & Eastern European Academic Source - CEEAS) Google Scholar OPEN (CeON) Biblioteka Nauki Cyfrowa Biblioteka Narodowa Polona
Depresja u osób w wieku senioralnym jako problem zdrowia publicznego w Polsce. Przegląd literatury
The aim of the study is to determine the prevalence of depression in seniors on the basis of available literature. The article addresses the issue of depression in the senior population, analyzes factors influencing the occurrence of depressive symptoms, discusses the topic of suicide attempt within this age group, and presents coping strategies for dealing with this illness. Depression among older adults is a significant public health concern, and educating society is crucial due to the ongoing increase in the number of elderly individuals in the population and the rising incidence of depression, in order to effectively improve the quality of life for seniors.
Copyright (c) 2026 Review of Medical Practice https://creativecommons.org/licenses/by-nc-sa/4.0
Ciężki przypadek malarii powikłanej niedokrwistością autoimmunohemolityczną w przebiegu leczenia dożylnym artesunatem
Malaria is a severe parasitic disease caused by a protozoan of the Plasmodium genus, widespread in the worm climate tropical areas. High temperatures and humidity favor the multiplication of the malaria vector – the Anopheles mosquito, whose female is responsible for the transmission of the infection in the natural environment. The study presents a complicated case of malaria caused by P. falciparum with a high parasitemia of 11% and symptoms of multi-organ injuries – acute renal failure with black water fever and anuria, impaired consciousness related to ischaemia of the brain with cerebral malaria, hemorrhagic diathesis, respiratory distress, liver damage, hyperpyrexia, hypotension, which developed as a result of delayed diagnosis and transport of the patient to a tropical centre. The patient stayed in Guinea for 2 weeks for business purposes, without using pharmacological prophylaxis against malaria recommended for this geographical zone of the world. A similarly severe clinical picture of malaria was observed in a colleague from Belgium, who was treated at the same time in his country. The therapy included intravenous artesunate and symptomatic treatment, achieving complete eradication of parasitaemia from peripheral blood already on the 3rd day of antimalarial pharmacotherapy. In the 3rd week of hospitalization during the convalescence period, there were signs of rapidly deepening anaemia not related to recurrence of infection, ineffective therapy, or resistance to the antimalarial drugs used. Immunodiagnostic tests detecting the presence of immunoglobulin IgG coating the patient’s erythrocytes confirmed acute haemolytic anaemia of autoimmune aetiology following artesunate therapy. In the treatment of the rare complication, blood transfusions and systemic steroids were used with a positive therapeutic effect. Treatment of complicated cases of malaria requiring parenteral artemisinin preparations should be carried out in reference centres with documented practical experience in this field.
Ocena funkcjonowania osób z niepełnosprawnościami - aktualne perspektywy i wyzwania
The contemporary approach to functional assessment of persons with disabilities abandons the traditional medical model in favour of a holistic perspective based on the International Classification of Functioning, Disability and Health (ICF). The article analyses the evolution of disability models, moving from a medical approach, through social approaches, to the current bio-psychosocial model, which is reflected in the ICF. This classification replaced the earlier ICI DH (International Classification of Impairments, Disabilities, and Handicaps), which focused on health impairments. The new ICF approach assumes that disability is the result of interactions between a person’s health condition and environmental and personal factors. This classification does not evaluate people, but only describes their functioning in various spheres of life. The article discusses ICF-related, diagnosis-independent assessment tools such as WHODAS 2.0. It also presents the use of functional assessment in various contexts and discusses the role of modern technologies such as wearable sensors and artificial intelligence.
Selected Problems Related to a Stroke – a Physiotherapist’s Perspective
Stroke affects approximately 80,000 people in Poland annually. It is the third leading cause of death (second worldwide) and the leading cause of adult disability globally. Stroke poses a challenge for medical teams, especially physiotherapists, and a socioeconomic problem. Loss of locomotion and falls are significant after stroke (affecting 7% of people in the first week after stroke, gradually increasing to 55–73% after a year). The causes of falls after stroke are usually complex (balance disorders, locomotion deficits, cognitive impairment, depression, PTSD). Falls carry the risk of fractures, hospitalization, subsequent strokes, impaired concentration, motivation, sense of security, and fear of activity, limiting the patient’s participation in rehabilitation, daily life, and social life. The article provides epidemiological data on these issues, the overall costs incurred by states and societies for treatment, rehabilitation, and stroke-related services, and discusses the mental health of stroke survivors and their loved ones. It highlights the fact that physiotherapists can significantly improve not only the physical but also the mental health and well-being of stroke survivors. They spend relatively more time with patients than other healthcare professionals, often establish closer relationships with them, can be the first to highlight disturbing depressive symptoms that families sometimes overlook, can contact a psychologist, and above all, can strengthen motivation, for example, by conveying hope that physiotherapy will enable them to return to functioning and daily life.
World mental health report. Transforming mental health for all.
Mental health is critically important to everyone, everywhere. All over the world, mental health needs are high but responses are insufficient and inadequate. The World mental health report: transforming mental health for all is designed to inspire and inform better mental health for everyone everywhere. Drawing on the latest evidence available, showcasing examples of good practice from around the world, and voicing people’s lived experience, it highlights why and where change is most needed and how it can best be achieved. It calls on all stakeholders to work together to deepen the value and commitment given to mental health, reshape the environments that influence mental health, and strengthen the systems that care for mental health.
Polikarp Girsztowt (1827–1877) and His Few Words about Leprosy
Leprosy, although it did not occur directly on Polish soil, aroused the interest of doctors, especially those associated with Warsaw and the tsarist University of Warsaw. Among them, a special place is occupied by Polikarp Girsztowt, who devoted a lot of space to the problem of this disease in his unfinished book General and specific surgery, referring to the most outstanding experts in the problem.
Copyright (c) 2026 https://creativecommons.org/licenses/by-nc-sa/4.0
The Absence of Leprosy in the Polish Population from the 16th to the 21st Century
Leprosy appeared in Poland in the 13th century and eventually disappeared as an endemic disease by the 16th century. Since then, there has never been any local transmission. For over 500 years, only sporadic imported cases have been diagnosed (the last 2 in 2019). Historical data, supported by research on the Polish community in Brazil, indicate a significant resistance of the Polish population to the disease. Further studies should be conducted. However, mass emigration poses a potential threat of reintroducing leprosy to Poland.
autochthonous (native) and imported cases
Leprosy (Hansen’s disease) is one of the oldest known infectious diseases and, although now entirely curable, remains a significant global health concern. In Europe, cases of Hansen’s disease are rare and often underrecognized. The disease can be classified into 2 categories: autochthonous (native) cases and imported cases, primarily originating from endemic regions. Autochthonous cases persist in a few European countries, including Spain, Portugal, Greece, Italy, Russian Federation, and Estonia, where small, low endemicity foci remain. These cases are often familial and can persist over long periods due to localized transmission, despite gradual declines in prevalence. The eradication of such cases poses challenges due to the disease’s prolonged incubation period and potential for chronic persistence.
Rickettsial Infections and Q Fever as Underestimated Health Threats to Humans
Rickettsial diseases and Q fever are infectious zoonoses that are rarely considered in the differential diagnosis in everyday medical practice. Improperly collected epidemiological interview and a relatively uncharacteristic clinical picture result in significant diagnostic difficulties and underestimated assessment of its frequency in the human population. The paper describes the nature of the aetiological factors of these unusual infections, discusses the transmission routes of the pathogens, as well as clinical expression and principles of diagnostic and therapeutic procedures. The publication is a review based on the analysis of available scientific literature. Microorganisms of the genus Rickettsia, for which ticks are vectors, cause spotted fevers in humans. R. slovaca and R. raoultii are responsible for SENLAT (scalp eschar and neck lymphadenopathy after tick bite) while R. monacensis causes a disease similar to Mediterranean spotted fever. Typical symptoms of SENLAT include eschar at the site of the tick bite, lymphadenopathy, and local alopecia. R. helvetica infection can have a mild course with fever, headache, and muscle pain. The disease can also manifest with spotted skin rash, persistent muscle weakness, pericarditis or meningitis. Frequent R. monacensis symptoms include fever, headache, rash, and an inoculation eschar. Bacteria belonging to the genus Rickettsia can be classified into the following phylogenetic groups: ancestral, spotted fever group, typhus group, and a relatively recently identified transitional group. According to another systematic classification, these microorganisms can also be assigned to the following categories: spotted fever group, typhus group, Rickettsia bellii group, and R. canadensis group. The spotted fever group Rickettsia species found in Poland include R. slovaca, R. raoultii, R. helvetica, and R. monacensis. Vectors for these bacteria include ticks such as Ixodes ricinus and Dermacentor reticulatus. It is suggested that humans are incidental hosts of spotted fever group (SFG) rickettsiae. Infection is believed to occur during tick feeding on the patient's blood. Some SFG rickettsiae species are transmitted transovarially and transstadially in ticks, e.g., R. parkeri in the tick Amblyomma americanum and R. helvetica in I. ricinus. Therefore, ticks are also considered reservoirs for these microorganisms. However, the tick must be capable of maintaining the infection within its body. Environmental studies suggest that reservoirs of rickettsiae also include some animals such as Cervus nippon yesoensis (a subspecies of the eastern deer), European roe deer, and even mice. Besides tick-borne rickettsiae, other species require different vectors for transmission. Rickettsia prowazekii, causing epidemic typhus, is transmitted by the human louse (Pediculus humanus), with humans as the sole reservoir and source of infection. Infection occurs during louse feeding or by accidental inoculation of louse feces into damaged skin. Rickettsia typhi, responsible for endemic typhus, is transmitted by fleas, with rats, mice, and cats as natural reservoirs. According to the Polish Act on the Prevention and Control of Infections and Infectious Diseases in Humans of December 5, 2008 (Journal of Laws 2008, No. 234, item 1570, as amended), spotted fevers and other rickettsioses are subject to mandatory registration in Poland. According to annual epidemiological reports from the National Institute of Public Health in Warsaw, 10 cases were reported in 2023, including 6 requiring hospitalization (60%), corresponding to an incidence rate of 0.027 per 100,000 inhabitants. Patients mostly originated from the Mazowieckie Voivodeship.
Copyright (c) 2025 Review of Medical Practice https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Ticks in the Epidemiology of Selected Transmissible Infectious Diseases
Tick-borne diseases constitute a highly significant and continuously increasing health problem in Poland and Europe. The aim of the study is to discuss the most common infections caused by Borrelia burgdorferi s.l. and tick-borne encephalitis viruses, which are the most frequently reported tick-borne diseases in humans in European countries. The analysis included information on the nature of the etiological agent, clinical symptoms, diagnostic methods, treatment, and epidemiology of the mentioned diseases, collected based on current medical publications available in scientific databases. The study illustrates the scale of the problem and also draws attention to proper prophylaxis and appropriately selected diagnostics for patients with symptoms of infectious diseases.
Neglected Tick-Borne Diseases with a High Epidemiological Risk of Expansiveness
Tick-borne diseases constitute a group of unique infections with a gradually expanding geographical spread, extremely diverse, often uncharacteristic clinical expression and increasing pathogenicity for humans. Due to the promotion of an active lifestyle associated with tourist and recreational activities in the natural environment, often in forested areas, regions of lush meadows and wild pastures, the risk of accidental transmission of tick-borne pathogens to the human body is significantly increasing. On the other hand, prolonged life expectancy, often accompanying chronic diseases that reduce the efficiency of the immune system, as well as widely used immunosuppressive or immunomodulatory therapies are factors that significantly increase the risk of developing more severe symptoms and long-term clinical consequences of these rarely suspected infections. Anaplasmosis Etiological factor Human granulocytic anaplasmosis (HGA), formerly called granulocytic ehrlichiosis, is an infectious disease caused by microorganisms of the species Anaplasma phagocytophilum (formerly Ehrlichia phagocytophilum). These are Gram-negative bacteria, obligatory intracellular parasites, showing tropism to human neutrophilic granulocytes. Development cycle This disease can develop both in humans and animals. Infections have been recorded in numerous species of domestic and wild animals. Fatal cases have been observed among sheep, cattle, reindeer, deer, moose, dogs, and humans. The most common cause of HGA is a tick bite from the genus Ixodes. In Poland and Europe, this is usually I. ricinus. The presence of A. phagocytophilum has also been confirmed in other tick species occurring in Europe, such as I. hexagonus, I. trianguliceps, and I. persulcatus. Bacterial strains pathogenic to humans can be transmitted by ticks through transmission from horses, dogs, some species of ruminants, hedgehogs, foxes, or wild boars. Infection can also occur transplacentally, through blood transfusion from an infected person, or contact with meat of infected animals – however, these cases are sporadically recorded. Epidemiology Endemic areas of HGA worldwide include the northeastern and north-central parts of the United States and California. The first case in Europe was registered in Slovenia in 1995. HGA incidence is seasonal; most cases are recorded from April to October, related to atmospheric conditions favorable to infections. People living in rural areas, hunters, foresters, farmers, and those practicing outdoor sports are at particular risk. In Europe, HGA occurs much less frequently than in the USA. This is not due to differences in the occurrence of A. phagocytophilum among Ixodes ticks – in both cases it is about 3%. Approximately 300 cases of HGA in humans have been reported in Europe so far. This is relatively few considering the widespread presence of the pathogen in ticks and animals, as HGA is the most common tick-borne disease in Europe. This may be due to the often asymptomatic course of HGA. Cases are frequently reported in Austria, Belgium, Croatia, Czech Republic, France, the Netherlands, Germany, Norway, Portugal, Poland, Slovakia, Slovenia, Switzerland, Sweden, the United Kingdom, and Italy. Studies in Poland show the presence of antibodies indicating past HGA infection in 2–5% of healthy blood donors. In western Norway, this was found in 16% of similar blood samples. In Belgium, the value ranges from 14–17%, while in Switzerland it is only 1.13%. Tests for specific antibodies indicating past HGA infection are not routinely performed among donors.
Actinomycosis as an Unexpected Cause of Chronic General- ized Lymphadenopathy
Cervicofacial actinomycosis is the most common and classic form of a rare disease caused by bacteria belonging to the Actinomyces genus, but it sporadically causes generalized lymphadenopathy. The slow growth of the microorganism on in vitro media and the specific requirements of microbiological culture often make its isolation from biological material collected from swabs and tissue biopsies difficult. Clinical manifestations of actinomycosis may mimic malignancies of the head or neck, in which a delay in establishing a final clinical diagnosis is particularly unfavorable, such as Hodgkin’s or nonHodgkin’s lymphomas, cancer of the thyroid, oral cavity, pharynx and larynx, lung cancer or metastases from other internal organs. In the study, we present the case of a 43year old patient who was admitted to the university department for a differential diagnosis of cervical and axillary lymphadenopathy with suspected parasitic infection. Previously performed pathomorphological examinations of the material obtained from numerous lymph node biopsies did not confirm any neoplastic disease, and the image of the pathological changes observed in the computed tomography scan indicated a reactive inflammatory process. The enhanced multidirectional diagnostics was performed for infectious and connective tissue diseases, which failed to identify the cause of chronic lymphadenopathy. Retrospective microbiological revision of histopathological samples from enlarged lymph nodes allowed for the unexpected confirmation of actinomycosis. The patient received combined, targeted systemic antibiotic therapy, which resulted in regression of inflammatory changes in the lymph nodes. The presented case demonstrates the need to consider rare infectious diseases in the differential diagnosis of lymphadenopathy in everyday medical practice and draws attention to the possibility of revision of the diagnosis using preserved pathomorphological preparations.
Effect of Caesarean Section on Subsequent Child Development
Caesarean section is a method of terminating pregnancy and the most commonly performed obstetric surgical procedure worldwide, with the number of cesarean sections in Poland and globally continuously increasing. Obstetric and non-obstetric indications for cesarean section have been strictly defined by the Polish Gynecological Society. Currently, the most commonly used technique for this operation is the transverse incision via the Pfannenstiel approach. Surgical termination of pregnancy may have numerous consequences for child development. Children born by cesarean section often do not meet all the conditions necessary to initiate proper respiratory function and appropriate cardiovascular adaptation. Different colonization of the intestines by microorganisms in infants born by cesarean section is responsible for disturbances in the bacterial flora of the gastrointestinal tract, which may increase the risk of obesity and have many other serious consequences, such as the development of various diseases. Results of individual studies indicate that cesarean section carries an increased risk of asthma, allergic diseases, systemic connective tissue disorders, immune deficiencies, and intestinal diseases in the later development of the child. Children born by cesarean section, compared to those born naturally, are exposed during delivery to different physical, microbiological, hormonal, and medical factors. These influence physiological processes and consequently shape the child's health not only in the neonatal period but also during adolescence and adulthood.
Shingles and Its Preventative Possibilities in Poland
Shingles is an infectious disease caused by the varicella-zoster virus (Varicella-Zoster Virus, VZV). The virus reactivates in people who have had chickenpox in the past and after close contact with children with chickenpox, usually within family. It is estimated that almost every person has had contact with VZV in their lifetime, which translates into a potentially high incidence of shingles. Having shingles is associated with the risk of serious complications, both local and neurological, which can significantly reduce the quality of life of patients. Treatment of shingles and its complications is difficult and poses a great challenge, which also emphasizes the importance of preventive measures. This article discusses shingles as a disease and the possibilities of its prevention in Poland.
Paradoxical Skin Reaction in Patients with Rheumatoid Arthritis Treated with TNF-α Inhibitors
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by progressive joint damage driven by ongoing inflammation. The introduction of innovative therapies, including biological drugs, has significantly improved patients' quality of life by reducing the severity of joint destruction and slowing disease progression. Some patients undergoing biological therapy may experience adverse effects, including local skin reactions at the injection site and, much more rarely, generalized changes such as de novo psoriasis and other paradoxical skin reactions. This paper describes 2 cases of female patients with a long history of RA (68 and 73 years old), in whom administration of TNF-α inhibitors (Certolizumab pegol in the first, Etanercept in the second) led to allergic urticaria and paradoxical psoriasis. After discontinuation of these drugs, gradual symptom resolution was observed, allowing for alternative treatment with Tocilizumab – a drug from the IL-6 inhibitor group. Reduction of disease symptoms and regression of skin symptoms were achieved. According to literature data, using a drug with the same mechanism of action in the next line of therapy would be associated with a higher risk of psoriasis recurrence. The presented cases emphasize the need for careful monitoring of adverse effects of drugs used in biological therapy, especially regarding the induction of skin complications, not only local but also generalized.
Dapsone – Should It Be Considered as a Treatment Option for Acne, Rosacea and Hidradenitis Suppurativa?
Dapsone is a chemical compound belonging to the sulfone group, primarily used as a first-line treatment for leprosy. Beyond this indication, it possesses a broad spectrum of antibacterial, antiparasitic, immunosuppressive/immunomodulatory, and anti-inflammatory properties, playing a key role in the management of numerous dermatological conditions. It is considered the first-line therapy for dermatitis herpetiformis and erythema elevatum diutinum. Additionally, it is employed in the treatment of other skin disorders such as bullous pemphigoid, mucous membrane pemphigoid, cutaneous lupus erythematosus, among others. This article discusses the therapeutic potential of dapsone in the treatment of acne vulgaris, rosacea, and hidradenitis suppurativa. Furthermore, an overview of dosing regimens used in other dermatological diseases is provided.