Radosław Mlak

Introduction and objective: Proliferative verrucous leukoplakia (PVL) is recognized as a distinct oral potentially malignant disorder (OPMD). It is characterized by progressive, persistent, multifocal oral leukoplakia that changes in clinical appearance and histopathological features over time,...

Background: Prognosis after myocardial infarction (MI) remains heterogeneous despite contemporary reperfusion and secondary prevention, and biomarkers that capture post‐MI recovery, treatment response, and long‐term risk are still limited. Noncoding RNAs have therefore attracted interest as biomarkers of post‐MI risk and recovery. Methods: We conducted a scoping review of human studies evaluating circulating or blood‐derived noncoding RNAs, including microRNAs, long noncoding RNAs, circular RNAs, and tRNA‐derived small RNAs/tRNA‐derived fragments, measured after MI in relation to prognostic phenotypes, clinical outcomes, or treatment‐response end points. Results: Forty‐six studies were included. Most were observational, focused on plasma or serum microRNAs, and used quantitative reverse transcription–polymerase chain reaction, but sample size, sampling phase, normalization strategy, end point definition, follow‐up duration, and validation approaches varied substantially. Reported associations clustered around reperfusion‐related injury/no reflow or microvascular obstruction, left ventricular remodeling or dysfunction, clinical events, including major adverse cardiovascular events and mortality, and a smaller group of treatment‐response phenotypes. Directional signals included miR‐30e, miR‐660‐5p, TUG1 , and MALAT1 for no reflow; LIPCAR , MICRA , miR‐320a, miR‐1254, and miR‐22‐3p for remodeling or ventricular recovery; miR‐145, miR‐223‐3p, miR‐126‐3p/miR‐223‐3p, HCG11 /miR‐532‐3p, and exosomal miR‐186‐5p dynamics for clinical events; and BANCR or selected tRNA‐derived small RNAs/tRNA‐derived fragments for treatment‐response heterogeneity. The most plausible candidates were phenotype specific rather than universal, with event‐related microRNA models, imaging‐linked remodeling markers, and no‐reflow/microvascular obstruction–associated candidates appearing more mature than isolated injury‐linked diagnostic microRNAs or single‐study treatment‐response signals. Conclusions: Overall, noncoding RNAs show promise as adjunctive post‐MI biomarkers, but clinical translation requires phase‐aligned sampling, assay standardization, external validation, and direct testing of incremental value beyond established clinical, imaging, and protein‐biomarker models.

Background: Composite immunonutritional biomarkers reflecting systemic inflammation, nutritional status, and immune competence have emerged as promising tools for perioperative risk stratification in colorectal cancer (CRC). However, their prognostic value during the perioperative period following minimally invasive CRC surgery remains unresolved. This study aimed to evaluate the association between perioperative inflammatory biomarkers, including the neutrophil-to-lymphocyte ratio (NLR), hemoglobin–albumin–lymphocyte–platelet (HALP) score, and Host Index (H-index), and short-term postoperative outcomes after minimally invasive colorectal cancer surgery. Methods: This retrospective single-center study included 105 patients who underwent minimally invasive curative-intent surgery for CRC between 2023 and 2025. Biomarkers were assessed preoperatively and during the first four postoperative days. Severe postoperative morbidity was defined as a Comprehensive Complication Index (CCI) ≥ 20.9. Results: Among all parameters, NLR measured on postoperative day 3 demonstrated the highest apparent discriminatory ability for severe complications (AUC = 0.87, 95% CI: 0.74–0.95; sensitivity 91.7%; specificity 73.7%). Preoperative HALP was the most informative preoperative marker (AUC = 0.78, 95% CI: 0.66–0.87; sensitivity 76.5%; specificity 87.7%). Conclusions: Perioperative inflammatory and immunonutritional biomarkers are associated with postoperative morbidity following CRC surgery. Preoperative HALP and postoperative day 3 NLR demonstrated the strongest apparent discrimination for CCI ≥ 20.9; however, these findings require confirmation in larger, independent prospective cohorts.

The rewarding effects of psychostimulants are strongly influenced by social context, yet the underlying neurochemical and neuropeptidergic mechanisms remain unclear. This study examined the role of oxytocin (OT) and vasopressin (AVP) in context‐dependent reward induced by subchronic mephedrone treatment in rats. Using classic‐ and social‐conditioned place preference (CPP) we assessed reward and later—monoamine levels in the prefrontal cortex (PFC) and hippocampus, plasma OT and AVP levels, and mRNA expression of oxytocin (OTRs) and vasopressin V1A (AVPV _1A Rs) receptors in the nucleus accumbens (NAc) and hippocampus. Pharmacological manipulations of OTRs and AVPV _1A Rs were used to evaluate their role in social‐CPP. We confirmed that mephedrone (5 mg/kg) induced social‐ but not classic‐CPP. In classic‐CPP, mephedrone elevated PFC dopamine, an effect abolished under social conditioning, which instead reduced hippocampal serotonin and noradrenaline. Social context alone lowered baseline monoamines, suggesting dampened neurochemical signaling. Social conditioning increased plasma OT and AVP, whereas mephedrone selectively reversed the OT rise. At the receptor level, mephedrone up‐regulated AVPV _1A R mRNA in the hippocampus and OTR mRNA in the NAc, indicating central adaptations distinct from peripheral peptide changes. Behaviorally, social‐CPP was abolished by OTR agonism (carbetocin) or AVPV _1A R antagonism (SR49059), while OTR antagonism (L‐368,899) or peripheral AVP had no effect. These findings show that mephedrone‐induced social reward is shaped by OT and AVP systems. Social context modulates peripheral neuropeptides and engages central receptor adaptations in the hippocampus and NAc, influencing behavioral outcomes. This study provides insights into the neurobiological mechanisms through which the social environment alters drug reward.

Background: Recent research has drawn attention to potential systemic inflammation in patients with inherited epidermal differentiation disorders (EDD)—rare genetic skin conditions that may contribute to vascular dysfunction. Objective: This study assessed selected vascular, inflammatory, and biochemical parameters in 20 patients with selected EDD and 20 matched healthy controls. Methods: Assessments included Doppler ultrasound, ankle-brachial index, intima-media thickness (IMT), and laboratory profiling focused on lipid metabolism and systemic inflammation. Results: EDD patients showed significantly lower LDL cholesterol and higher interleukin-17A (IL-17A) than controls. IMT values were similar across groups and disease types, but correlated positively with age, body weight, waist circumference, triglycerides, and glucose, and negatively with reactive lymphocytes. No link was found between IMT and self-reported cardiovascular symptoms. Conclusions: In patients with selected EDD, we observed a distinct biochemical profile characterized by lower LDL cholesterol and higher IL-17A concentrations, without accompanying structural arterial changes—carotid IMT and ABI did not differ from controls and remained stable at short-term follow-up. These alterations may reflect disease-specific disturbances of lipid and inflammatory homeostasis rather than classical atherosclerosis. Although they could be of theoretical relevance to long-term vascular health, no structural arterial abnormality was demonstrated. Longitudinal studies incorporating endothelial function testing are needed to clarify their significance.

Background: Minimally invasive surgery is the standard approach in colorectal cancer (CRC), yet the clinical value of robotic-assisted surgery (RAS) compared with laparoscopy remains under debate. This study aimed to compare surgical quality using textbook outcome (TO) and textbook oncological outcome (TOO) in patients undergoing minimally invasive resection for locally advanced CRC. Methods: A retrospective analysis of patients with locally advanced CRC (cT2-4N0-2M0) treated in a high-volume centre was performed. Patients undergoing laparoscopic or robotic surgery were included. Propensity score matching (PSM) was applied to balance baseline characteristics. TO was defined as an optimal perioperative course without complications, conversion, reintervention, prolonged length of stay, or mortality. TOO extended TO by including oncological parameters such as R0 resection and adequate lymph node yield. Results: A total of 123 patients were included (80 laparoscopic, 43 robotic), with 80 patients analyzed after PSM (40 per group). RAS was associated with significantly higher rates of intracorporeal (97% vs. 18.9%) and mechanical anastomoses (96.9% vs. 48.6%). No differences were observed in postoperative complications, reintervention rates, length of stay, or mortality. Although the comprehensive complication index was lower in the robotic group, this did not translate into improved TO or TOO rates. After matching, TO was achieved in 72.5% of RAS and 85.0% of laparoscopic cases (p = 0.1745), while TOO rates were also comparable between groups. No independent predictors of TO or TOO were identified in multivariable analysis. Conclusions: Robotic surgery for locally advanced CRC provides comparable perioperative safety and oncological quality to laparoscopy. The implementation of RAS in a high-volume centre does not compromise short-term outcomes, supporting its safe integration into clinical practice.

Hemodialysis (HD) and hemodiafiltration (HDF) procedures have limited efficacy regarding removal of selected toxins. Tryptophan (Trp) metabolites formed through the kynurenine (KYN) pathway are known to contribute to kidney failure (KF) complications, some of which may affect the survival of neurons. The aim of this study was to investigate the removal of Trp and its metabolites, KYN, kynurenic acid (KYNA) and 3-hydroxykynurenine (3-OHKYN) in patients treated by HD or HDF and the impact of patients' comorbidities on toxins removal. The study was conducted in 50 patients with KF. Serum level of free fractions of Trp and its metabolites were measured before and after a dialysis session through high performance liquid chromatography. The serum concentration of Trp, as well as 3-OHKYN/KYN ratio remained unchanged, whereas the concentration of KYN, KYNA, 3-OHKYN, together with KYN/Trp ratio significantly decreased after dialysis procedures. The indices KYNA/KYN and KYNA/3-OHKYN increased. In patients with heart failure, higher reduction ratio (RR) of KYN was found, whereas in patients with diabetes higher KYN RR and lower KYNA RR was observed. In patients without residual kidney function, KYNA RR was significantly higher compared to patients with preserved diuresis. RR of all tested metabolites did not differ between HD and HDF treated patients. In KF, Trp metabolites were removed from the blood during dialysis procedures with different efficacies. Targeted strategies to lower KYN pathway metabolites concentration may be beneficial in patients with KF and selected comorbidities.

Background: Epidermal differentiation disorders (EDDs) are rare, chronic skin diseases with significant psychosocial impact on patients and families. Their daily management requires complex care, placing caregivers at risk of stress and anxiety. Few studies have systematically examined anxiety and coping strategies in this group. Objectives: To compare anxiety levels and coping styles between caregivers of children with syndromic or nonsyndromic EDD and caregivers of healthy children. Methods: In this cross‐sectional case‐control study, 39 caregivers of children with EDD and 39 matched controls were recruited from a dermatology clinic. Anxiety was assessed with the State‐Trait Anxiety Inventory (STAI) and coping styles with the Coping Inventory for Stressful Situations (CISS). Sociodemographic and clinical data were collected. Results: Caregivers of children with EDDs reported significantly higher trait anxiety than controls (79.5% vs. 53.8%; p = 0.017). Task‐oriented coping (TOC) was less frequent among EDD caregivers, with more than half showing low TOC compared with less than one‐third of controls (56.4% vs. 28.6%; p = 0.019). High avoidance‐oriented coping (AOC) was observed more often in controls (21.4% vs. 5.6%; p = 0.044). Anxiety was greater among caregivers of boys than girls (95.7% vs. 56.2%; p = 0.003). Avoidant coping was associated with greater child symptom severity, including pruritus and redness. Conclusions: Caregivers of children with EDD experience high anxiety and rely less on adaptive coping strategies. These findings emphasize the need for early, family‐centered psychosocial interventions to support caregiver well‐being and improve outcomes for affected children.