Waldemar Brola

Introduction: Intracerebral haemorrhage (ICH) is a critical disease usually leading to severe disability or death. The management of patients with ICH is still a serious challenge for medical services. Aim of the research: The aim of the study was to identify factors influencing in-hospital outcome and mortality in patients with ICH. Material and methods: An observational, retrospective study included 8790 patients with acute stroke, including 813 patients with ICH, who had been hospitalised in the stroke units and consequently reported to the Pomeranian Stroke Register (PRUM) in the period 2009–2013. Results and conclusions: Factors that affected unfavourable outcome (mRS 3-5) of patients with ICH were as follows: unknown time of ICH onset (p = 0.019); living in a rural area (p = 0.019); motor deficiency (p < 0.001); and high NIHSS score on admission to hospital (median 11 (7–16), p < 0.001). Factors that caused higher in-hospital mortality were as follows: unknown time of ICH onset (p = 0.001); living in a rural area (p = 0.023); age over 80 years (p = 0.029); atrial fibrillation (p = 0.006); disturbance of consciousness (p < 0.001); and severe neurological condition on admission to hospital according to the NIHSS (median 19 (13–23), p < 0.001). Professional activity (p = 0.01) had a favourable impact on the functional outcome. Dyslipidaemia (p = 0.001) and preliminary diagnosis of cerebral stroke (p = 0.037) were factors that decreased the in-hospital mortality rate. Conclusions: The in-hospital prognosis and mortality of patients with ICH depend on the place of residence, which is associated with the possibility of rapid delivery to the Stroke Unit, the severity of the neurological condition, and the coexistence of serious comorbidities.

Background/Objectives: Eating-related difficulties in people with multiple sclerosis (MS) may reflect different behavioural and psychological processes, including emotional responses to illness-related stress, habitual overeating, attempts to control food intake, and broader self-management routines. Variable-centred analyses may obscure this heterogeneity by examining eating-related tendencies separately. This study aimed to examine whether habitual overeating, emotional overeating, and dietary restraint in adults with MS are better represented as one general continuum of eating-related difficulty or as distinct person-centred profiles that differ in coping styles, health locus of control, and MS self-management. Methods: This cross-sectional secondary analysis included 382 adults with definite MS. Latent class analysis used 30 binary My Eating Habits Questionnaire items. One-step latent class regression models examined coping and health locus of control. Linear regression compared self-management scores. The models were adjusted for sex, age, disease duration, and Expanded Disability Status Scale score. Results: A five-class solution was retained (BIC = 11,067.60; entropy = 0.920), comprising low difficulties, moderate mixed tendencies, two emotional eating/restraint profiles, and dysregulated overeating. Emotional eating with moderate restraint was associated with lower task-oriented coping and internal health control, and with higher emotion-oriented and avoidance-oriented coping and external health-control beliefs. Dysregulated overeating was associated with lower task-oriented coping, higher avoidance-oriented coping, and stronger powerful-others health beliefs. Self-management was higher for emotional eating with moderate restraint (B = 5.3, 95% CI 1.8 to 8.9; p = 0.003) and high emotional eating and restraint (B = 6.0, 95% CI 1.8 to 10.3; p = 0.005), versus low difficulties. Sensitivity analyses gave similar findings. Conclusions: Eating-related tendencies in MS formed distinct profiles rather than a single continuum. These profiles differed in coping and health-control patterns, suggesting that similar eating-related difficulties may occur in different psychological and self-management contexts. The higher self-management scores observed in restraint-related profiles should be interpreted cautiously and should not be taken to indicate that restrictive eating is adaptive. This study does not establish clinical classification or treatment recommendations. Instead, it provides a descriptive empirical basis for future studies testing whether these profiles are stable and whether they predict dietary, nutritional, psychological, and clinical outcomes.

Background/Objectives: Emotional overeating may be relevant to nutritional self-management in people with multiple sclerosis (MS), but its links with disease-related appraisals and psychological adjustment remain unclear. This study examined associations between perceived physical impact of MS and emotional overeating, considering illness acceptance and psychological distress. Methods: This secondary cross-sectional study included 382 adults with MS recruited from specialist clinical centres in Poland. Emotional overeating, perceived physical impact, illness acceptance, and psychological distress were assessed using the My Eating Habits Questionnaire, Multiple Sclerosis Impact Scale-29 physical subscale, Acceptance of Illness Scale, and 12-item General Health Questionnaire. Hierarchical regression and serial indirect-association models were adjusted for disease duration and Expanded Disability Status Scale score. Indirect associations were evaluated using 5000 bootstrap resamples. Results: Greater perceived physical impact was associated with emotional overeating at the bivariate level. In the adjusted regression model, greater psychological distress was associated with higher emotional overeating (B = 0.169, β = 0.312, p < 0.001); the model explained 20.1% of outcome variance. The total association between physical impact and emotional overeating was statistically significant (B = 0.038, p < 0.001), whereas the direct association was not (B = 0.010, p = 0.216). Indirect associations were supported through psychological distress alone (estimate = 0.016, 95% CI 0.009–0.025) and sequentially through lower illness acceptance and greater psychological distress (estimate = 0.006, 95% CI 0.003–0.009). Conclusions: Emotional overeating was more closely associated with psychological distress and illness adjustment than with perceived physical disease impact alone. Nutritional care may benefit from attention to emotional triggers for eating and psychological distress; longitudinal studies are needed to establish temporal relationships.

Alcohol misuse remains one of the most important modifiable risk factors for death and disability. In neurology, it is linked to central nervous system damage, ranging from acute encephalopathies and withdrawal complications, strokes and trauma, to chronic cognitive syndromes and structural damage affecting the cerebellum and corpus callosum. The clinical presentation is often non‑specific, and concomitant metabolic disturbances, liver disease, infections, and trauma may delay proper diagnosis. This article provides a concise, practical review of the most clinically relevant clinicopathological phenotypes associated with long‑term alcohol misuse and nutritional deficiencies. Issues discussed include key mechanisms (direct neurotoxicity of ethanol and its metabolites, oxidative stress, neuroinflammation, impaired energy metabolism, and thiamine and magnesium deficiency) as well as the clinical picture and diagnostic approach to Wernicke encephalopathy and Korsakoff syndrome, Marchiafava–Bignami disease, alcohol‑related cerebellar degeneration, and cortical laminar necrosis including Morel’s laminar sclerosis. Typical features on magnetic resonance imaging and principles of differential diagnosis with stroke, central nervous system infection, and metabolic encephalopathy are summarised. Long‑term consequences of prenatal alcohol exposure, referred to as foetal alcohol spectrum disorders, are also discussed. In acute presentations, immediate intravenous thiamine administration before glucose, together with the simultaneous correction of metabolic abnormalities, is emphasised as a time‑critical intervention. For chronic syndromes, sustained abstinence, rehabilitation, and psychological support remain the cornerstone of care.

Gliomas, particularly glioblastoma multiforme, remain among the most lethal brain tumours despite multimodal therapy. Increasing evidence indicates that systemic factors, including the gut microbiota, may influence glioma progression through immune, metabolic, and neurochemical pathways. We conducted a comprehensive systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines to synthesize recent evidence on the role of gut and intratumoral microbiota in glioma biology. Peer-reviewed studies published within the last five years were identified through structured searches of major biomedical databases, and original studies using human cohorts, animal models, or Mendelian randomization approaches were included. The 17 studies met the eligibility criteria. Glioma was consistently associated with gut dysbiosis characterized by a reduced Firmicutes:Bacteroidetes ratio and enrichment of Verrucomicrobia, particularly Akkermansia, alongside decreased short-chain fatty acids and altered neurotransmitter profiles, contributing to neuroinflammation, immune suppression, and blood–brain barrier dysfunction. Antigenic mimicry by Bacteroidetes-derived peptides may impair antitumour T-cell responses, while intratumoral Fusobacteriota and Proteobacteria appear to promote angiogenesis and pro-inflammatory chemokine expression. In contrast, SCFA-producing taxa such as Ruminococcaceae and probiotic genera including Lactobacillus and Bifidobacterium show protective associations. Evidence is limited by small cohorts and methodological heterogeneity. Standardized humanized models and integrated multi-omics approaches are required to clarify causal mechanisms and support microbiome-targeted therapies in glioma.

Background: Persistent postpartum pain (PPP) is a common condition after cesarean section (CS) that affects multiple domains of quality of life. PPP was defined as pain of any cause (not only related to surgery) appearing after CS and persisting for at least the three following months. The objective of this study was to calculate the incidence of PPP in women after elective CS and to analyze the associated risk factors. Methods: It was a retrospective cross-sectional study. An electronic patient-reported outcome tool (ePRO) was used to assess patients’ perception of their own health and to assess the presence and severity of pain. Results: Pain during pregnancy was reported by 66.14% of the study group. The most frequently reported localizations of pain were the lumbar spine, pubic symphysis, lower limbs, and sacrococcygeal region. The mean postoperative pain (day 0) defined by a Numeric Rating Scale was 5.44 (2.78 SD), and on the day of discharge (usually the third day after CS), it was 3.6 (2.29 SD). PPP occurred in 32.37% of women, was usually mild in nature, and had a little to moderate impact on function. Previous surgery raises the odds of PPP by 48.7% (OR = 1.487), pain during pregnancy raises the odds of PPP by 48.1% (OR = 1.481), and each additional point of the NRS on day 0 raises the odds of PPP by 16.6% (OR = 1.166). Conclusions: A higher risk of PPP could be found in women with pre-existing pain conditions, previous surgery, and severe postoperative pain. Persistent postpartum pain is not limited only to the area of surgery. Persistent back pain was reported by every second woman with PPP.

Introduction: The methods of multiple sclerosis (MS) treatment are evolving rapidly with numerous classes of disease-modifying therapies (DMTs). A more aggressive approach to early and effective treatment of MS with defined treatment target increases the chance of achieving a state of no no evidence of disease activity (NEDA). Currently, B cell–depleting monoclonal antibodies have been proven as high effective strategy for the treatment of relapsing-remitting MS (RRMS). Ofatumumab (OFA), anti-CD-20 monoclonal antibody is effective in treatment of RRMS, as it positively affects relapse rates, magnetic resonance imaging (MRI) measures of disease activity and disability progression.Material and methods: A retrospective observational study conducted in six MS clinical centers in Poland, including a cohort of patients with RRMS treated with OFA over a two-year period was presented.Results: The results of this study showed a statistically significant decrease in the relapse activity of the disease in the course of a year of OFA therapy. The percentage of patients free of relapses increased from 45% before treatment to 88% after one year of follow-up. Moreover, the disability assessment index measured by the Expanded Disability Status Scale (EDSS) remained stable after a two years of follow-up.Conclusions: In the presented study the high efficacy of OFA therapy in reducing recurrent disease activity as well as in inhibiting disability progression, with a favorable safety profile was confirmed. Moreover, it was emphasized that to achieve the best possible inhibition of disease activity and its progression, it is necessary to implement the treatment as soon as possible after the diagnosis.

Background: The primary objective of our preliminary study was to estimate the prevalence of temporomandibular disorders (TMDs) in people with multiple sclerosis (MS). Furthermore, we aimed to investigate whether there is a correlation between the presence of TMDs and the level of MS-related disability. Methods: The study was conducted at two centers in Poland dealing with the treatment of MS between March 2025 and April 2025. The study used an original survey questionnaire, the European Academy of Craniomandibular Diseases (EACD) questionnaire and the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). The study group included people with multiple sclerosis, while the control group consisted of healthy people without neurological deficits. The study group was examined using the following methods: the McDonald criteria and the Expanded Disability Status Scale (EDSS). Results: The study involved 90 people (45 in both groups). The majority of the study participants were women (80.0%), aged 20–30 years (51.1%) and people living in small towns (51.1%). The largest number of patients with MS were noted with RRMS (75.5%). The duration of the disease was on average 3.3 ± 2.4, and the EDSS score was on average 2.5 ± 1.5. People from the study group significantly (p ≤ 0.05; ES = 0.52–0.86) reported TMDs more frequently based on EACD (pain on opening the mouth: 86.7%; facial pain: 57.8%; joint locking: 28.9%; headaches: 75.3%). The diagnosis of TMDs was confirmed in 40.0% of people with MS and 11.1% of healthy volunteers (p ≤ 0.05). Patients most frequently reported muscle pain and disk displacement with reduction (p ≤ 0.05). The disability score in the MS group did not exhibit differences in the occurrence of TMDs (p > 0.05). Conclusions: The study showed that TMDs are more common in people with multiple sclerosis. The degree of disability did not differentiate the occurrence of TMDs. The authors intend to expand research on the influence of potential risk factors on the occurrence of TMDs in people with multiple sclerosis.

Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system (CNS) that is usually diagnosed between the ages of 20 and 40. Changes in the immune system also observed in cancer may suggest a higher prevalence of cancer in the MS patient population. In recent years, many highly effective immunosuppressive drugs have been introduced into disease-modifying therapy (DMT) which may be associated with a higher risk of cancer development in patients with MS. This paper presents current data on the oncological risk of individual drugs. In addition, it provides recommendations on the management for qualifying for DMT and monitoring the safety of the therapy from anoncological perspective. Keywords: multiple sclerosis oncological risk cancer immunomodulatory therapy

A working group convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society, the Polish Society of Family Medicine, and the Polish Society of Vaccinology has developed a consensus on supplementary data to the recommendations of the expert group of the Polish Society of Vaccinology, the Polish Society of Family Medicine, the Polish Dermatological Society, the Polish Association for the Study of Pain, and the Polish Neurological Society, and ECTRIMS/EAN of 2023 with regard to the currently available in Poland recombinant herpes zoster vaccine (RZV). It is intended for the prevention of herpes zoster and postherpetic neuralgia in individuals aged > 50 and individuals aged ≥ 18 who belong to herpes zoster risk groups. In Poland it is available with 50% reimbursement exclusively for patients aged 65 and older who have an increased risk of developing herpes zoster. This statement is based on the literature available as of 12 July 2024. The guidance will be updated as new data emerges. All data regarding the above-mentioned vaccine comes from clinical trials which have been reviewed, published and approved by the regulatory authorities and an increasing number of recommendations that might have an impact on real world data. Keywords: herpes zoster multiple sclerosis neuromyelitis optica spectrum disorders risk of herpes zoster indications for vaccination