Contemporary management of fetal therapy in prenatal cardiology. Statement of the Fetal Therapy Section of the Polish Society of Gynecologists and Obstetricians.

Fetal blood sampling: European Association of Gynaecologists and Obstetricians: 2nd Meeting, Paris, 4–5 September, 1987

Male patients with congenital urogenital anomalies and neuro-urological conditions represent a unique and underrecognized population at risk for infertility and sexual dysfunction. This chapter aims to review the embryological and developmental basis of these conditions and to clarify their direct effects on spermatogenesis, hormonal regulation, and sperm transport. We provide a detailed discussion of common anomalies—including bladder exstrophy, prune belly syndrome, cryptorchidism, and spinal dysraphism—as well as acquired neuro-urological disorders, such as multiple sclerosis, spinal cord injury, and cerebrovascular accident, highlighting their impact on reproductive health and quality of life. Key findings demonstrate that both congenital and neurogenic conditions disrupt male fertility through structural anomalies, impaired testicular development, endocrine dysfunction, and ejaculatory disorders. Contemporary management strategies—ranging from early orchiopexy, reconstructive and substitution phalloplasty, penile prostheses, and urinary tract reconstruction, to assisted reproductive technologies (ART) and sperm retrieval—can mitigate these challenges. Multidisciplinary care, involving functional and reproductive urology, endocrinology, neurology, and psychology, is shown to optimize fertility outcomes. Additionally, models of transitional urology illustrate how proactive fertility counseling and early intervention improve long-term reproductive prospects. In conclusion, congenitalism and neuro-urological disease exert profound effects on male reproductive health that extend beyond childhood survival into adulthood and family planning. Advances in surgical reconstruction, ART, and multidisciplinary care are improving outcomes; yet, long-term follow-up and fertility-preservation strategies remain critical. Future directions—including stem-cell therapy, neuromodulation, and AI-supported management—offer promise in addressing the unmet needs of this vulnerable population.

Aim The AGG (Working Group for Obstetrics and Prenatal Diagnostics, Section Maternal Diseases) has issued these recommendations to improve the detection and management of Toxoplasma gondii infection in pregnancy. Methods Members of the Task Force developed the recommendations and statements presented here using recently published literature. The recommendations were adopted after a consensus process by members of the working group. Recommendations This article focuses on the epidemiology and pathophysiology of Toxoplasma gondii infection in pregnancy and includes recommendations for maternal and fetal diagnosis, transmission prophylaxis, therapy, prevention, screening, and peripartum management.

To describe contemporary physical therapy practice and management of children with spina bifida (SB) in the context of the International Classification of Functioning, Disability, and Health (ICF) framework. A descriptive, cross-sectional electronic survey was sent to US pediatric physical therapy clinics and posted in the American Physical Therapy Association Pediatrics newsletter. Data were analyzed using content analysis. Codes were compared, refined, and condensed into categories. A total of 163 participants were included. Most assessments evaluated the ICF Activity component. Most frequently reported ICF components: impairments=decreased strength (17.9%), activity limitations=limited walking (22.5%), and participation restrictions=restricted socializing/playing with peers or siblings (22.6%). The most prevalent intervention was strength training. Physical therapists (PTs) in the United States are performing assessments and interventions supported by available evidence; however, knowledge translation and more research are needed to support best practices in PT management of children with SB.

Craniotomy, an essential neurosurgical operation, poses distinct difficulties in the realm of post‐operative care, specifically with regard to the management of wounds. Efficient wound management is critical in order to optimize the surgical outcomes, reduce complications and facilitate a speedier recovery. The purpose of this comprehensive review was to assess contemporary wound management approaches as they pertain to improved recovery following craniotomy. This was achieved by contrasting conventional methods with more recent and innovative techniques and analysing the effects of these approaches on patient recovery and surgical results. An exhaustive literature search was undertaken, comprising narrative reviews, clinical studies, peer‐reviewed articles and expert opinions. The emphasis was on the evolution of wound management strategies and techniques utilized after cranial section, as well as their contributions to patient recovery. The analysis reveals that while conventional wound management methods, including suturing and antiseptics, continue to be essential, innovative strategies such as negative pressure wound therapy, skin adhesives and advanced pain management protocols are becoming increasingly recognized. It has been demonstrated that these novel approaches improve recovery by decreasing the incidence of infections, enhancing patient comfort and producing superior cosmetic results. Nevertheless, obstacles continue to endure, including patient‐specific variables, technological and financial considerations and the enduring consequences of recovery. Thus the treatment of wounds during craniotomy recuperation necessitates an integrated strategy that incorporates conventional techniques alongside contemporary advancements. Progress in this domain necessitates the customization of approaches to suit the unique requirements of each patient, the resolution of identified obstacles and an emphasis on ongoing investigation and interdisciplinary cooperation. The ever‐changing terrain of wound management approaches underscores the ever‐changing character of neurosurgical treatment and the continuous endeavour to enhance patient results following cranial resection.

Currently, hybrid closed loop (HCL) systems represent the most advantageous therapeutic option for people with diabetes requiring intensive insulin therapy. They make it possible to achieve optimal metabolic control of the disease in any age group while improving the quality of life of children and adolescents with diabetes and their families.Therefore, we present recommendations for the use of HCL systems in children and adolescents focusing on systems currently available in Poland. These systems should be the first choice in terms of method of insulin therapy in the paediatric population. They can be implemented at any stage of diabetes management. These recommendations are based on scientific evidence and experts' experience. They include principles for the initiation, optimisation, and ongoing management of HCL therapy, as well as the required HCL-related education.

Badania endoskopowe u pacjentów poddanych leczeniu przeciwpłytkowemu i przeciwzakrzepowemu – wytyczne dotyczące postępowania. Rekomendacje Grupy Roboczej Polskiego Towarzystwa Gastroenterologii i Konsultanta Krajowego w dziedzinie Gastroenterologii

To review the contemporary management of gastrointestinal stromal tumor (GIST), including endoscopy, surgery, and systemic therapy, highlighting the aspects unique to small intestinal tumors. Tumor size, mitotic count, and site of origin are the three key prognostic factors, with mitotic count being the single strongest predictor of recurrence. Tumors arising in the small bowel have worse prognosis than those of comparable size and mitotic count arising in other organs. Endoscopy and endoscopic ultrasound-guided, fine-needle aspiration are key components in the diagnosis of GIST. The role of endoscopy in surveillance and resection remain investigational. Surgery, either open or laparoscopic, remains the only curative option, but recurrence rates are high. Adjuvant therapy with imatinib mesylate improves recurrence-free survival rates and may improve overall survival (OS) with longer duration of treatment. Neoadjuvant imatinib may play an important role in the management of patients with locally advanced disease. For patients with advanced disease, first-line imatinib and second-line sunitinib malate have improved progression-free and OS rates. Systemic treatment should be continued life-long or until treatment failure. Advances in the last decade have dramatically changed the management and prognosis of patients with primary and advanced GIST.

Chronic constipation is a prevalent disorder that affects patients' quality of life and consumes resources in healthcare systems worldwide. In clinical practice, it is still considered a challenge as clinicians frequently are unsure as to which treatments to use and when. Over a decade ago, a Neurogastroenterology & Motility journal supplement devoted to the investigation and management of constipation was published (2009; 21 (Suppl.2)). This included seven articles, disseminating all themes covered during a preceding 2-day meeting held in London, entitled "Current perspectives in chronic constipation: a scientific and clinical symposium." In October 2018, the 3rd London Masterclass, entitled "Contemporary management of constipation" was held, again over 2days. All faculty members were invited to author two new review articles, which represent a collective synthesis of talks presented and discussions held during this meeting. This article represents the first of these reviews, addressing epidemiology, diagnosis, clinical associations, pathophysiology, and investigation. Clearly, not all aspects of the condition can be covered in adequate detail; hence, there is a focus on particular "hot topics" and themes that are of contemporary interest. The second review addresses management of chronic constipation, covering behavioral, conservative, medical, and surgical therapies.

The choice of appropriate antithrombotic therapy in patients with atrial fibrillation (AF) undergoing percutaneous coronary interventions (PCI) should be approached prudently. Careful consideration is necessary, balancing the ischemic and bleeding risk. Traditionally, triple antithrombotic therapy comprising of aspirin, a P2Y12 inhibitor, and an oral anticoagulant is associated with high bleeding rates. Recent trials have evaluated the safety and effectiveness of dual antithrombotic therapy in AF patients undergoing PCI. These studies have shown a significant reduction in bleeding with no increase in ischemic events. Clopidogrel is the preferred P2Y12 agent in the dual antithrombotic regimens. The novel oral anticoagulants (NOAC) rivaroxaban and dabigatran have been evaluated as part of dual antithrombotic therapy and are preferred options for oral anticoagulation in AF patients undergoing PCI. Studies are in progress to evaluate the role of alternate NOACs in this clinical scenario. This review explores the contemporary management of antithrombotic therapy in AF patients undergoing PCI.

Outpatient co-management of the patient receiving oral ritodrine therapy

North American Fetal Therapy Network: intervention vs expectant management for stage I twin-twin transfusion syndrome

Systemic lupus erythematosus (SLE) is a complex, chronic autoimmune disease that causes multi-organ inflammation and damage. Left untreated or inadequately managed, SLE can lead to severe organ dysfunction, disability, and reduced quality of life. In Poland, the absence of standardized, evidence-based clinical guidelines tailored to local resources and practices has created inconsistencies in SLE management. The purpose of these guidelines is to provide clear, evidence-based recommendations for the treatment and management of adult patients with SLE in the Polish healthcare system. These recommendations aim to align clinical practices with international standards, optimize treatment strategies, standardize patient care, and improve health outcomes while guiding healthcare policy. The adaptation process follows the ADAPTE Collaboration guidelines, the GRADE methodology, and the Evidence to Decision (ETD) framework. An interdisciplinary Working Group (WG), comprising experienced rheumatologists, organ-specific specialists, young rheumatologists, and a patient representative, will develop the guidelines. Key steps will include: 1) creation of clinical questions using the PICO format; 2) systematic search of relevant international guidelines (EULAR, ACR) and national sources; 3) evaluation of identified guidelines using the AGREE II instrument to ensure methodological quality; 4) formulation of recommendations through consensus-based discussions, addressing clinical treatment, monitoring, and care organization. The guidelines cover pharmacological interventions for SLE, including hydroxychloroquine, glucocorticosteroids, immunosuppressive drugs biologics. Specific focus areas include treatment of organ-specific manifestations, management during pregnancy, treatment of disease flares, maintenance therapy, monitoring, and comorbidity management. The finalized document will undergo external review and be published in both Polish (on the Polish Society for Rheumatology website) and English (in the journal Reumatologia) as open access. Implementation strategies will include dissemination through scientific journals, presentations at conferences. These guidelines aim to provide a standardized framework for SLE management in Poland. By implementing evidence-based recommendations, they will support healthcare providers in improving patient outcomes, optimizing resource allocation, and addressing the unique challenges of SLE within the Polish healthcare system.

Third-line antiretroviral therapy in low-income and middle-income countries (ACTG A5288): a prospective strategy study

MP76-18 “PARTNER PROSTHESIS PANIC”: MANAGEMENT OF FEMALE SEXUAL DYSFUNCTION IN PARTNERS OF MEN UNDERGOING PENILE PROSTHESIS IMPLANTATION