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Introduction and purpose A pilonidal cyst also known as a pilondial sinus, is an inflammatory condition that occurs in the intergluteal region, which can lead to serious infections. It most commonly affects young men, with risk factors including the presence of hair in this area, excessive sweating, obesity, and poor hygiene. Symptoms include a lump, pain, and purulent discharge from openings in the skin. Diagnosis involves taking a medical history, a physical examination, and often an ultrasound. The aim of this paper is to present and compare the available methods for treating pilonidal cysts. Materials and methods Literature available in PubMed databases were reviewed using the following keywords: ‘’Pilonidal cyst’’, ‘’Hair cyst’’, ‘’Abscess’’, ‘’Treatment of pilonidal cyst’’,’’ Bascom II method’’,’’ Limberg flap’’,’’ Suchorski technique’’, ‘’V-Y or Z skin flap reconstruction’’,’’ the Karadakis’’ Results The available treatment methods can be divided into conservative and invasive approaches. Conservative methods include hair removal and improved hygiene. Among the surgical methods, there are traditional excision techniques and modern methods such as excision using the Bascom II method, Limberg flap, Suchorski technique, or V-Y or Z skin flap reconstruction. The Karadakis method, which involves shifting a skin flap, is particularly effective for obese patients. Conclusion Treatment of pilonidal cysts depends on the stage and symptoms. Abscesses require urgent surgical intervention, while asymptomatic cysts can be treated conservatively or surgically.

Introduction and objective Osteoporosis is a disorder that leads to a decrease in bone mass, accompanied by a disruption in bone structure, resulting in an increased risk of bone fractures. It affects a large number of people worldwide and constitutes a significant social and economic problem. It primarily affects older individuals, especially postmenopausal women. Fractures associated with osteoporosis diminish the quality of life. Osteoporosis often remains asymptomatic and is difficult to diagnose, typically identified incidentally following a low-energy fracture. Diagnosis of osteoporosis involves measuring bone mineral density using dual-energy X-ray absorptiometry (DEXA). Osteoporosis is diagnosed when bone mineral density is found to be more than 2.5 standard deviations (SD) below the mean bone mineral density of healthy young adults with peak bone mass. Modifiable risk factors for osteoporosis include lack of physical activity, calcium deficiency in the diet, and alcohol consumption. Review methods The article was based on scientific papers retrieved from the PubMed website and scientific literature. The focus was on papers from 2016 to 2024. Articles written in English were utilized. Brief description of the state of knowledge Physical activity encompasses any muscular movement that increases energy expenditure beyond the resting metabolic rate, including weight-bearing exercises, strength training, high-intensity strength exercises, and balance and mobility training. Weight-bearing exercises yield the best results in osteoporosis prevention, recommended to be performed three times a week. Summary Physical activity is a scientifically proven preventive factor against osteoporosis, reducing the frequency of falls and increasing bone mineral density. Initiating physical activity at a young age yields significant benefits for bone strength.

Introduction: Herbal medicine has been growing in popularity over the last few years. One of the most often used herbal remedy is Withania somnifera, more widely known as Ashwagandha Now known for its anti-stress, anti-inflammatory, antioxidant, anti-cancer, anti-anxiety properties it ranks as a cure-all. However, there is a rising amount of alarming reports regarding its safety. It has been observed that its effects are not always beneficial, and for some patients the risks of taking it may be greater than the promoted benefits. Aim of study: The aim of this paper is to evaluate possible risks connected to Withania Somnifera consumption based on available research articles and case reports. Materials and methods: This article is based on the literature found in the PubMed Database from the period of 2004-2024 with the use of keywords such as “Ashwagandha”; “Withania Somnifera”, “herbal medicine”;”complementary medicine”;“liver injury”; “thyrotoxicosis”; “adrenal insufficiency”;”autoimmune diseases”. Results: The outcomes of all the reviewed studies in this paper indicate that Withania Somnifera might cause a wide range of side effects. They include herb induced liver injury, endocrine complications such as thyrotoxicosis and adrenal insufficiency, acute graft rejection in a kidney transplant recipient and possible contribution to the onset of new autoimmune disease in patient with the history of autoimmune disorders. Conclusion: Further long-term research is needed on the Ashwaghanda’s benefits but particularly on its safety and potential side effects. The common education on the risks of taking herbal supplements should be carried out among health professionals and the rest of the society. Ashwagandha should not be used by patients with liver, endocrine and autoimmune disorders as well as transplant recipients.

Introduction and purpose Acne is one of the most common dermatological conditions, especially in adolescents. The etiology of acne is complex, and many factors influence the formation of lesions. Local inflammation, a proliferation of Propionibacterium acnes, hormonal influences with particular importance of androgens, hyperkeratinization, and excessive sebum production are essential in the pathogenesis. The factors stimulating these processes are complex and not always clear. Therefore, in our work, we focused on investigating the connection between a high-glycemic diet and the formation of acne lesions. The state of knowledge The link between diet and acne has been only mentioned in the literature for many years. However, the development of science has made it possible to understand the exact pathogenesis of acne and the relationship of acne lesions to specific dietary components. Of all the diet products, a high glycemic index diet stands out as the one with the most significant impact. Foods with a high glycemic index, i.e. those with a high amount of simple sugars, through an increase in the expression of factors such as insulin, IGF-1 cause excessive sebum production in the sebaceous glands and even an increase in inflammatory infiltration, which further exacerbates acne lesions. In the following review paper, we have looked at the metabolic pathways and hormonal changes that link the consumption of high glycemic index foods to the formation of acne lesions and described several original papers that unequivocally demonstrate the critical role of this diet on acne formation. Summary Based on the literature, we emphasize that in acne treatment, it is necessary not only to focus on medications but, above all, to look at the patient holistically, modifying the lifestyle with particular importance on modifying the patient's diet by lowering its glycemic index.

Introduction: Psoriatic arthritis is a chronic disease involving peripheral arthritis, spondylitis, dactylitis (inflammation of the whole digit) and enthesitis. It is a disease equally prevalent in both genders. Psoriatic arthritis coexists with several conditions, including metabolic syndrome, obesity, cardiovascular disease, inflammatory bowel disease, and liver disease. The reciprocal effects of comorbidities with psoriatic arthritis are demonstrated by recent research. There are several risk factors associated with the condition that might hasten or worsen its symptoms. Aim of the Study: The purpose of this paper is to present a thorough analysis of the research that has been done on comorbidities and risk factors for psoriatic arthritis. With an emphasis on changeable elements that might impact the disease's progression, the goal is to illustrate the multifaceted nature of psoriatic arthritis. The intention is also to highlight comorbidities that need to be considered while treating a patient with the illness. Materials and methods: An analysis of papers available in PubMed and Google Scholar was performed using the following key words: psoriatic arthritis, psoriatic arthritis and lifestyle, psoriatic arthritis and comorbidities, psoriatic arthritis and cardiovascular risk, psoriatic arthritis and gastrointestinal diseases, psoriatic arthritis and physical activity, psoriatic arthritis and diet, psoriatic arthritis and alcohol, psoriatic arthritis and smoking. Conclusions: Psoriatic arthritis is a chronic disease that affects many areas of patients' lives. It is critical to consider the connections that exist between this illness and other comorbidities. In order to provide a patient with this ailment with the best care possible, variables that might exacerbate the illness's progression must also be taken into consideration. Patients' mental health should get particular attention, and lifestyle modifications should be promoted.

Introduction The rising prevalence of electronic cigarette (e-cigarette) use has prompted concerns regarding its potential health implications. While much attention has focused on respiratory and cardiovascular effects, injuries, oral trauma, and bone fractures linked to e-cigarette use have received less scrutiny. This paper aims to comprehensively review the landscape of injuries, oral trauma, and bone fractures induced by e-cigarettes, shedding light on this underexplored facet of e-cigarette-related harm. Material and Methods This literature review has analyzed 16 papers. Inclusion criteria: researches and case reports published after 2015. PubMed and Google Scholar has been searched to identify the papers. Analysis of the Literature Existing literature suggests a growing incidence of injuries, oral trauma, and bone fractures associated with e-cigarette use, albeit with limited systematic investigation. Mechanisms underlying these injuries range from device malfunctions to inadvertent impacts during use. Case reports highlight a spectrum of injuries, including oral burns, dental trauma, and skeletal fractures, often involving the face and mouth regions. Conclusions Despite the lack of comprehensive epidemiological data emerging evidence underscores the need for heightened awareness and preventive measures to mitigate e-cigarette-related injuries. Enhanced education, regulation of e-cigarette devices, and promotion of safer usage practices are crucial steps towards reducing the burden of e-cigarette-related harm on oral and skeletal health.

Introduction and purpose Non-specific and specific lower back pain syndrome is one of the leading causes of musculoskeletal disability and affects more than half of the population worldwide. The aim of this paper is to confront the problem of lumbar pain, possible diagnostic options, conservative and surgical opportunities with long term satisfactory rate. State of knowledge The paper reviews literature on lower back pain syndrome, sciatica, radiculopathy and lumbar disc herniation in regards to detection of the problem, classifying it and possible methods of resolvement. The WHO defines lower back pain as one of the leading causes of musculoskeletal dysfunction and it focuses on reducing the occurrence by programs like WHO Rehabilitation 2030 Initiative, UN Decade of Healthy Ageing and others. The paper also focuses on non surgical options of treatment. Material and method A review of the literature available in the “PubMed” and Google Schoolar was conducted. We focused on differential diagnosis depending on clinical presentation and possible treatment methods depending on symptoms, pathogenesis of the disorder and available procedures. Summary Our review managed to present the current state of development, possible differential diagnosis, prevalence of neural compressions, sciatica and radiculopathy in different diagnostic options. By receiving multiple studies we confront varied opinions of specialists regarding the approach to lower back pain syndrome and favorable forms of care. Additionally we came to the conclusion that the difference of patients' long term satisfactory rate in regards to nonoperative and operative treatment is not significant, and flattens over the years.

Gilbert’s syndrome is the most common inherited jaundice worldwide. It affects 5-10% of the population. It is caused by a mutation of the UGT1A1 gene, which results in impaired bilirubin metabolism. It is a benign disease and does not affect the life expectancy of patients. Patients with Gilbert’s syndrome should be alert to factors that exacerbate the course of the disease, interactions with medications taken and possible comorbidities such as hemolytic anemia, cholelithiasis or schizophrenia. However, it is the responsibility of physicians with such patients under their care to properly educate patients. Gilbert’s syndrome carries not only the consequences associated with the mutation, but also has many benefits that patients may not be fully aware of. Mildly elevated bilirubin levels have an antioxidant and anti-inflammatory effect, which prevents the development of lifestyle diseases and cancer. Ongoing clinical trials suggest that this could be a great step toward new treatments for diseases affecting the entire human population. PURPOSE OF THE WORK: This review paper aims to show Gilbert’s syndrome as a multifaceted disease and to sensitize doctors' attention to patients with the described mutation. MATERIALS AND METHODS: An analysis of papers available in PubMed and Google Scholar was performed using the following key words: Gilbert’s syndrome, bilirubin, UDP-glucuronosyltransferase, Gilbert’s syndrome harmful and protective aspects, iatrogenic Gilbert’s syndrome RESULTS: The result of the work is to present Gilbert’s syndrome as a disease that carries medical problems directly related to the mutation, but also, in some cases, has a protective effect on affected individuals. The work highlights the complexity of the problem.

Introduction and purpose: Diabetes has emerged as a global lifestyle disease, with an alarming rise in cases, particularly of type 2 diabetes. In Poland, over 3 million people are diagnosed, and an estimated 4 million cases are expected by 2030. Effective treatment involves a multifaceted approach, including dietary intervention, physical activity, and pharmacological options. Incretins, such as glucagon-like peptide-1 (GLP-1), play a pivotal role in carbohydrate metabolism regulation, and GLP-1 analogs have become essential in managing type 2 diabetes. This paper explores the development and mechanisms of GLP-1 analogs, detailing their impact on insulin secretion, gastric emptying, and weight reduction. Description of the state knowledge: Various GLP-1 receptor agonists, including exenatide, liraglutide, dulaglutide, semaglutide, and the novel tirzepatide, are discussed. These drugs exhibit diverse pharmacokinetics, modes of administration, and effects on glucose metabolism and weight. Despite their efficacy, there is a concerning trend of off-label use, particularly for obesity treatment, leading to shortages for patients with valid prescriptions. This misuse is fueled by para-advertising on social media platforms, contributing to a surge in prescriptions and reimbursement costs. To address this, guidelines for GLP-1 analog use in obesity treatment are proposed, emphasizing the need for a stable drug supply and normalizing drug availability. Summary: In 2023, concerns intensified with reports of counterfeit GLP-1 analogs, prompting regulatory interventions. The paper concludes by underscoring the critical role GLP-1 analogs play in diabetes and obesity treatment, while emphasizing the importance of responsible prescription practices, guidelines adherence, and regulatory vigilance to ensure patient safety and mitigate the risks associated with misuse and counterfeit drugs.

Effective body posture entails the correct alignment of body parts in relation to each other and is crucial for preserving balance, stability, and the efficient operation of muscles and joints. The major types of posture abnormalities such as lordosis, kyphosis and scoliosis can lead to alterations in various areas of the body, such as stomatognatic system. The potential correlation between malocclusion and body posture remains a subject of controversy. The aim of this review is to investigate and evaluate the association between posture defects and malocclusion on the basis of literature. This literature review has analyzed 18 studies. Inclusion criteria: clinical researches published after 2010, regarding children and adults. PubMed and Google Scholar has been searched to identify the papers. In 18 analyzed studies, 2133 patients were enrolled (including 979 children aged 4-18). A positive correlation between scoliosis and different types of malocclusion has been proven by six papers. There are also other noteworthy dependencies, such as overjet and pelvic torsion, kyphosis and sagittal position of mandible, skeletal Class III and torticollis, cross bite and scapula plane. Adolescent Idiopathic Scoliosis significantly affects the stomatognathic system, leading to issues like crossbite, crowding, increased overjet, overbite, partial open bite, and midline deviation. Orthopedists should collaborate with orthodontists for comprehensive treatment, particularly during developmental stages.

This scientific paper focuses on the treatment of breast cancer, one of the most common cancers among women. Despite increased awareness and the popularity of screening tests, statistics indicate a significant rise in incidence. The paper presents breast-conserving treatment methods, including brachytherapy, as a modern technique with promising outcomes. It describes the physical properties of ionizing radiation used in brachytherapy, discussing the photoelectric effect, Compton effect, and the phenomenon of pair production. The paper then delves into the biological effects of ionizing radiation, emphasizing the dependence on the cell cycle phase. It highlights lethal, sublethal, and potentially lethal cellular damage, categorizing the effects of radiation interaction into early and late responses. The discussion transitions to the application of brachytherapy in breast cancer treatment, focusing on various techniques such as LDR, PDR, and HDR. The paper provides a detailed description of brachytherapy's use in breast-conserving treatment, considering contraindications, treatment planning, and Accelerated Partial Breast Irradiation (APBI) techniques. The radioisotopes used in brachytherapy are also presented, with special attention to Iridium-192. The physical and practical aspects related to this isotope are discussed, along with other commonly used radioisotopes such as Cesium-137, Cobalt-60, and Strontium-90. The paper concludes with a summary, emphasizing the significance of brachytherapy in breast cancer treatment and outlining its prospects for development. The authors highlight precision and shortened therapy duration.

Introduction and purpose: In our work, we focused on presenting the role of collagen supplementation and its impact on skin and joint health. We considered studies discussing the differences in the effects of collagen from various plant and animal sources. We also examined the influence of the degree of hydrolysis on the absorbability of the supplement. The aim of the paper is to comprehensively summarize knowledge on collagen supplementation, differentiating between its sources and forms. Material and methods: In our paper, we endeavored to address the subject of oral collagen supplementation comprehensively. We explored studies about various forms and sources of collagen. We also delved into the collagen supplementation impact on skin and joints health and impact of additives in enhancing the positive effect of collagen . State of knowledge: Oral collagen supplementation can be beneficial for skin and joints health. It promote collagen synthesis in human body increasing strength of skin and joints. The higher the degree of collagen hydrolysis, the more easily it is absorbed by the body. Additives in the form of vitamin C and A can enhance collagen synthesis. Results and conclusions: This review article indicates a growing interest in oral collagen supplementation and its impact on health. Although there are encouraging findings regarding positive effects, further research is necessary to better understand and determine the optimal conditions for achieving maximum supplementation benefits. This information may be crucial for clinical decisions made by physicians regarding joint reinforcement and anti-aging effects on the skin.

Introduction and purpose The term "probiotic" rooted in Latin, signifies 'for life,' reflecting the historical use of fermented products for therapeutic purposes. While browsing many websites devoted to healthy eating or popular science topics, we often came across the topic of probiotic food without any confirmation by scientific research. The aim of this paper is to confirm or exclude the presence of probiotics in popular foods. State of knowledge The paper reviews literature on the health benefits of various food that is traditionally considered probiotic, focusing on how they impact on varied health conditions. Defined by the WHO as living microorganisms conferring health benefits when consumed adequately, probiotics, mainly bacteria from Lactobacillus and Bifidobacterium genera, play a vital role in maintaining gut microbiota balance, regulating digestion, supporting the immune system and influencing mental and cardiovascular health. In addition, the paper also searches for scientific basis for their action. Material and methods A review of the literature available in the “PubMed” and Google Schoolar was conducted. We focused on checking whether the microorganisms contained in pickled food meet the WHO criteria for probiotics. Summary Our review managed to prove the probiotic effect of almost all presented food, except for miso. By reviewing many articles, we shed a lot of uncertainty on the repeated myth about the lack of probiotic effect of cucumbers preserved in vinegar and what is more, we found scientific assumptions about the probiotic effect of vinegar itself. Fermented food contains numerous strains of bacteria that are resistant to acid, bile and temperature in the human digestive tract and can be effectively used as a source of probiotics. Additionally, compared to probiotics from the pharmacy, fermented products provide not only probiotics, but also nutritional value, valuable fiber and vitamins, benefiting to our health.

Introduction and purpose: The purpose of this scientific paper is to review the current knowledge of the effects of red wine on human health, particularly with regard to cardiovascular disease. State of Knowledge: Since the 1990s, red wine has gained its status as a health-promoting alcohol through the French Paradox - when drunk in moderate amounts, it protects against cardiovascular disease. The authors have collected scientific papers on the health effects of alcohol, red wine and resveratrol-a polyphenol that is the main component with health-promoting effects of wine. On their basis, they analyzed the assumptions of the positive effects of wine reaching inconclusive conclusions. Summary: Despite the fact that both ethanol and resveratrol have a positive effect in in vitro studies, in population studies their effect is much less significant, either because the negative behavioral-health effects in the case of ethanol are omitted or the actual effective doses of resveratrol are omitted.

Context: Angular gyrus is an anatomical structure of the brain located in the parietal lobe, taking part in writing and reading, language-use, memory and attention and spatial recognition. It is supplied by the angular gyrus artery, which is one of the caudal branches of the middle cerebral artery. One of the clinical pathologies of the angular gyrus artery is the ischemic stroke of the angular gyrus in the dominant hemisphere, responsible for the presence of Gerstmann Syndrome: left-right disorientation, agraphia, alexia, acalculia and finger agnosia. This systematic review aims to present the variety of anomalies of the main cerebral artery and the angular gyrus artery. Objective: Preparing a systematic review of papers describing the course anomalies of the angular gyrus artery. Materials and methods: PubMed and Google Scholar electronic databases was searched for phrases: ‘Angular gyrus artery’, ‘Artery of angular gyrus’, ‘Middle cerebral artery branches’, ‘Branches of middle cerebral artery’, ‘Gerstmann Syndrome’ published between years 2015 and 2023. Also 3 papers published before 2000 were used. From the selected 30 papers, 6 were used to prepare this analysis. Results: The middle cerebral artery, from which arises the angular gyrus artery, is marked by a significant variety of its division, mainly the number of the dividing trunks of the artery. Depending on the type of the division, the angular gyrus artery can arise from the upper, middle or lower trunk and vary in sizes. It can also appear as a singular or two separate branches. Instances of the anomaly of both the angular gyrus artery and posterior parietal artery are rare, but reported. Conclusions: The angular gyrus artery is characterised by a number of anomalies in its course, separation from the middle cerebral artery, diameter and branching.

Introduction and purpose: Currently, the role of the gut microbiota in the pathogenesis of different diseases is being widely researched, the understanding of whether the dysbiosis of the gut flora demonstrates the significant role in Alzheimer disease (AD) is accentuated. The aim of this paper is to summarize the existing paper about the role of the gut microbiota - its diversity, stability and composition in this condition. The search was conducted using PubMed and Google Scholarship databases. Brief description of the state of knowledge: It is still uncertain if alteration in gut microbiome is a consequence of AD or its risk factor, but some findings suggest that the intestinal flora is able to influence the activity of the brain and lead to its dysfunctions. There is also the association between composition of the gut microbiome and AD. Results indicate that affected patients had less heterogeneity in their microbiome and the progression of AD led to alterations in the bacterial flora. Introducing modifications of the gut microbiota is considered as a therapeutic option for AD. Following personalized diet, probiotics, prebiotics and synbiotics administration or fecal microbiota transplantation (FMT) may be beneficial for affected patients. Conclusions: The subject of the role of the gut microbiota merits further research as foregoing results of conducted studies are pointing to its possibly meaningful role. Presently, still more data is needed as most of the research was collected on animal models and the analysis conducted on humans remains insufficient. We conclude that further studies are warranted in order to fully understand the pathophysiology of the disease and the possible usefulness of microbiome therapy.

Introduction and purpose: Apples are a widely consumed fruit globally and are known to be a great source of nutrition. Studies have shown that apples contain high levels of antioxidants, dietary fiber, and vitamins that contribute to numerous health benefits. This paper aims to provide a comprehensive review of the impact of apples on human health. State of knowledge: The paper reviews the current literature on the health benefits of apples, focusing on their impact on various health conditions such as cancer, cardiovascular diseases, diabetes, and obesity. Additionally, it examines the role of apples in improving intestinal, immune, and cognitive function. The paper also discusses the potential mechanisms by which apples exert their health benefits, such as high levels of flavonoids, polyphenols, and dietary fiber. Summary: In conclusion, the vast body of evidence reviewed in this paper supports the notion that consuming apples regularly can contribute to better health outcomes. They may help reduce the risk of chronic diseases, such as cancer, cardiovascular diseases, and diabetes, as well as promote healthy gut microbiota and immune function. Despite the controversy surrounding the use of pesticides in apple cultivation, the benefits of consuming apples outweigh the risks. Therefore, it is highly recommended to include apples as part of a balanced and nutritious diet to promote optimal health and wellbeing. As the saying goes, "An apple a day keeps the doctor away".

Introduction and aim Diabetic foot ulcer (DFU) is a chronic condition that affects an increasing number of people each year[1]. Healing the ulceration requires cooperation between patients, specialists and scientists in order to achieve satisfactory results. Treating this type of wound is not only a therapeutic challenge[1,2,3,4,5,6], but also an economic one, which is why so much scientific research has already been made on this phenomenon[2,3]. Still scientists continue their quest for new cost-effective alternatives to current therapeutic options that would be consistent with contemporary knowledge and available engineering capabilities in pursuance of creating techniques and new dressings that will accelerate the healing of DFUs[2,3,7,8]. Factors such as stress, obesity, certain medications, and chronic diseases appear to negatively affect the process of repair [1,9,10,4,6,11]. Studies prove that aloe vera gel due to its healing properties, can be considered as a potential dressing that will expedite the mending process of diabetic foot ulceration[12,13,14]. In this paper, we performed a literature review of the applicability of aloe vera in the healing process of DFUs. Materials and methods Searching the available literature, including randomized clinical trials and systematic reviews, we drew on databases focusing on the effects of treatment for diabetic foot ulceration using Aloe vera. Conclusion: The current scientific research on the use of Aloe vera gel in diabetic foot ulcer treatment indicates that this method is safe, effective and inexpensive[2,3]. However the difficulty of treatment and the increasing prevalence of this type of wound pose a challenge to finding new solutions and exploring mechanisms in which aloe vera can have a possible role in the wound healing process. Nevertheless, this paper presents a promising impact of Aloe vera gel applicability in the healing process of diabetic foot ulcer.

Introduction and purpose: Currently, as the frequency of obesity is alarming, the role of many factors that could contribute in preventing and treating this condition are being researched, among them the certain food with beneficial health profiles - one of them is soybeans, specifically the isoflavones it contains. Populations that consume soy are known for lower risk of various disorders - among them obesity. The aim of this paper is to summarize the existing paper about the role of these bioactive components in the treatment of this condition. The search was conducted using PubMed and Google Scholarship databases. Brief description of the state of knowledge: Obesity is one of the leading challenges in today’s healthcare as it leads to various chronic diseases that are fraught in consequences. Current knowledge is pointing into the association between composition of the soy isoflavones and the lower risk of obesity. Results of the studies indicate that patients affected with obesity could benefit from introducing soy isoflavones into their diet along with other necessary modifications. Conclusions: Soy isoflavones are potential agents in the holistic obesity treatment. Consumption of isoflavones merits further recognition as foregoing results of conducted studies are pointing to its possibly meaningful role. It is worth mentioning that consumption of soy isoflavones is not only an anti-obese factor, but also presents various other health benefits and when consumed rationally poses no risk to human’s well being. We conclude that further studies would enable us to fully reveal the potential of those polyphenols.

The period of compulsory school attendance is a mentally very challenging period for children in foster care, which can be impacted by complex developmental trauma stemming from the child's experience in foster care with cumulative and chronic traumatic events in his/her biological family. These events have taken place over a long period of time in interpersonal relationships usually related to caregivers, in the form of abandonment of the child by the caregiver, changing caregivers, lack of safe space and necessary support for the child from the family and school, and/or deficiencies in the provision of coordinated health and social care for both the child and the foster parents. The paper presents research findings supported by a statistical analysis of health and school difficulties in children in foster care related to their school attendance. The purpose of the research was to support the quality and coordination of services of non-profit organizations providing social, health and educational services to foster families and their children during school attendance to support the school success and well-being of children. The study was implemented as part of a dissertation at the University of South Bohemia in České Budějovice in the Czech Republic on the topic of promotion of the health, social and psychological well-being of school-aged children in the context of their school and family environment. The authors carried out a questionnaire survey in the Czech Republic among a selected sample of respondents, who were foster parents of children aged 6 to 15 attending primary school in the Pardubice Region. In a total sample of 102 respondents, we identified two different groups. One group – 64 respondents with healthy children and another group – 38 respondents with children with health difficulties. The aim of the research was to compare the assessments of the intensity of school difficulties of children in foster care in groups of respondents with or without a child with health difficulties or mental illness in their foster care. The hypothesis of a difference in assessments of school difficulties in children with/without health difficulties was formulated and statistically tested (H0: ratings of the intensity of difficulties are the same in both groups). Statistical testing of the hypothesis utilised the non-parametric Mann-Whitney test with the test results being significant at the level of significance p

Aim. The paper aimed to update the study on accelerated biological aging as a complication of cancer therapy with a focus on diagnosing and prognosing the disease course. The authors independently searched scientific literature for the systematic review within databases PubMed, Scopus and Cochrane in the period from 2018 to 2024, using combinations of keywords “cancer”, “biological aging”, “replicative aging”, “antitumor therapy”, “markers of cellular senescence”, “coronary artery calcium” and selected full-text publications written in English and Ukrainian with level 1–3 evidence. People affected by cancer grow old faster. This could be related to malignant growth biology as well as to methods of anticancer therapy received. Cytostatics, targeted, hormonal and immune drugs damage not only malignant, but also benign cells, which leads to violations of replication with sustained cell cycle arrest and other phenotypic signs – macromolecular damage, metabolic changes, production of a specific senescence-associated secretome. Clinically, this is manifested by reduced work capacity, weakness, chronic organ dysfunction, cardiovascular disorders, progression of coronary atherosclerosis, hypertension, diabetes, dyslipidemia, sarcopenia, cognitive disorders, a de novo development of tumors and premature death. Biological markers of cellular senescence include the expression of lipofuscin, Ki67, p21 WAF1/Cip1 or p16 INK4a. A clinical marker of aging is the deposition of calcium salts within coronary arteries based on the Agatston score detected using multidetector computed tomography. Conclusions. A better understanding of the cancer consequences associated with accelerated biological aging might suggest new therapeutic strategies and improve the quality of life among cancer survivors. Rehabilitation measures through changes in diet, caloric restriction, aerobic exercises and pharmacological senolytic therapy should be a part of a patient’s daily routine after completion of radical cancer treatment.

Iodine-induced thyrotoxicosis (IIT) is an abnormal function of the thyroid gland towards increasing caused by excessive iodine intakes of the body. The main reasons for the development of IIT are effects of increased amounts of iodine in people with long-standing iodine deficiency, medical procedures with exposure to radiographic iodinated contrast media as well as long-term treatment with iodine-containing drugs, primarily amiodarone. Aim: to describe an original practical case of the type 2 amiodarone-induced thyrotoxicosis development, to analyze the peculiarities of its clinical manifestations, to evaluate the possibilities for pharmacological correction of thyropathy, and to show the importance of the thyroid gland function systematic monitoring to prevent amiodarone-associated thyroid complications on the example of a particular patient taking antiarrhythmic therapy for a long time. A 71-year-old patient S. was on inpatient treatment in the Endocrinology Department of MNE “Zaporizhzhia Regional Clinical Hospital” ZRC with diagnosed thyrotoxicosis based on complaints, laboratory and instrumental examinations, which was probably caused by long-term amiodarone treatment. A vitally important situation for the patient was the compression of mediastinal organs of unspecified genesis, which significantly complicated swallowing in the first place and impaired food passage into the stomach. Additional examinations using imaging methods were contraindicated due to thyrotoxicosis, since iodine-containing contrast agents could not be used. Surgical decompression of mediastinal organs was also not considered due to the presence of concomitant pathology which greatly increased the operative risk. Treatment of thyrotoxicosis with the use of thyrostatic drugs in dynamics did not result in a significant decrease in serum levels of thyroid hormones. It was decided to prescribe glucocorticoids. The patient started prednisolone therapy at a dose of 30 mg per day. A week later, positive dynamics were obtained as a reduction in compression phenomena. The patient began to swallow normally and take food independently. According to the treatment regimen, the dose of prednisolone and methimazole was gradually reduced to maintenance. On the 17th day of hospital stay, the patient was discharged for further treatment in an outpatient setting. After 4 months, the patient was examined by an endocrinologist. A palpable decrease in the thyroid gland size was noted. There were no objective signs of thyrotoxicosis. Based on laboratory tests, TSH was 1.28 μIU/ml (0.38–4.31 μIU/ml), free T4 was 15.52 ng/dL (0.82–1.63 ng/dL). The patient was capable of eating independently and did not complain of swallowing disorders or other clinical manifestations of mediastinal compression. He continued to take prednisolone at a dose of 5 mg per day, tyrosol 5 mg per day. Conclusions. Thus, the paper has described and analyzed the clinical case of the patient with type 2 amiodarone-induced thyrotoxicosis. Findings have indicated that cessation of amiodarone and management with glucocorticoids in view of ineffective thyrostatic treatment resulted in positive response to therapy of thyropathy in the patient. The importance of routine thyroid function monitoring to prevent amiodarone-induced thyroid complications of long-term antiarrhythmic therapy has also been shown.

Introdution: Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract, characterized by the cyclical onset and resolution of symptoms. It is a progressive disease that leads to intestinal damage and even disability. This disease can occur in any segment of the digestive system, from the mouth to the anus. The typical symptom is segmental inflammation in the small or large intestine, which is separated by healthy sections. The inflammation usually starts in the mucosa but, over time, spreads to the entire thickness of the intestinal wall, which can lead to intestinal damage, scarring, and the subsequent formation of fistulas and strictures. Inflammatory lesions most often occur in the last segment of the ileum, followed in order by the small and large intestines and the large intestine itself. Aim of the study: The purpose of this paper is to provide a general overview of Crohn's disease, focusing on oral symptoms. Materials and methods: An analysis of scientific articles available in Pubmed and Google Scholar databases was conducted. The study used publications from recent years that were most pertinent to the topic under discussion. The search process consisted of using the following keywords: “crohn's disease”, “oral manifestations”, “oral healh”, “Crohn's disease symptoms”. Results: In addition to the classic intestinal symptomatology, Crohn's disease can also manifest in the oral cavity. Symptoms that appear in the oral cavity may be early harbingers of Crohn's disease, occur concurrently with its onset, or manifest themselves several years after the onset of the condition. They most commonly involve the lips, buccal mucosa and gums. According to Malins and colleagues, these lesions can be divided into specific and non-specific ones. Conclusions: Crohn’s disease diagnoses are increasing, and early awareness of symptoms is crucial for timely diagnosis and prevention of complications.

Introduction and purpose Achalasia is the most prevalent primary esophageal motility disorder, marked by improper relaxation of the lower esophageal sphincter (LES), increased resting pressure in the LES, and a lack of peristalsis in the esophagus. Symptoms include difficulty swallowing (dysphagia), regurgitation, chest pain, and weight loss. Due to the nonspecific nature of these symptoms, diagnosis can be delayed by several years. Since the underlying cause of achalasia is still unknown, treatment options focus on alleviating symptoms by targeting the lower esophageal sphincter. Materials and methods This paper is based on a literature review sourced from PubMed, using the following keywords: achalasia, POEM, laparoscopic cardiomyotomy, pneumatic dilation, and botulinum toxin injection. Results Various treatment options are available for achalasia, each offering unique features and results. The main approaches include Peroral Endoscopic Myotomy (POEM), Laparoscopic Myotomy (LM), Botulinum Toxin Injection, and Pneumatic Dilation (PD). Conclusion Each treatment differs in its level of invasiveness, duration of symptom relief, risk of complications, and the likelihood of requiring additional interventions. The selection of the most suitable option is influenced by individual patient factors, such as the type and severity of achalasia, overall health, and personal preference

Introducion and purpose Millions of people use contact lenses every day. Their primary and most common use is correcting refractive errors. Despite their beneficial purpose, contact lens use has many complications. It is estimated that 5 to 50% of patients may develop at least a single complication. The state of knowledge Contact lens-related complications are multifactorial. One of the main reasons for contact lens discontinuation is contact lens discomfort. Patients most often report dryness, burning, and irritated eyes. Other disorders can be briefly divided into conjunctival and corneal complications. The most common conjunctival and allergic complication of contact lens use is giant papillary conjunctivitis. Other significant conditions involving the conjunctiva can also be superior limbic keratoconjunctivitis or allergic or toxic conjunctivitis. Corneal complications, on the other hand, seemed to be much more severe. These include superficial punctate keratitis, peripheral corneal ulceration, and contact lens-related keratitis. Also, abrasion can occur due to improper eye hygiene or mechanical damage during lens replacement. It should also be remembered that prolonged use of lenses can lead to hypoxia and corneal edema. Summary This paper briefly outlines the possible complications of contact lens use. It is important to remember that despite their appropriate use, sometimes significant complications can occur. Noteworthy, corneal, or conjunctival complications require discontinuation of the lenses and appropriate treatment.

Background: Creatine, a naturally occurring compound plays a crucial role in cellular energy metabolism, particularly in tissues with high energy demands like muscles and the brain. Beyond its well-established role in physical performance enhancement, recent research has revealed its potential benefits for cognitive functions and mood regulation. This review paper aims to comprehensively analyze the existing literature on creatine supplementation's effects on cognitive functions and mood. State of Knowledge: Findings suggest that creatine supplementation enhances memory, attention, and executive functions, especially under conditions of stress or sleep deprivation. Moreover, it exhibits mood-stabilizing effects, potentially offering relief for symptoms of depression and fatigue. Creatine's ability to augment brain energy metabolism, alongside its neuroprotective properties, underlies its cognitive and mood-enhancing effects. While generally safe, caution is advised, particularly in populations with kidney diseases or those using medications affecting kidney function. Summary: Creatine emerges as a promising adjunct therapy for enhancing cognitive functions and promoting emotional well-being beyond its traditional role in physical performance.The review underscores the need for further research to elucidate the precise mechanisms of creatine's effects and explore its synergistic potential with other cognitive-enhancing supplements.

Introduction: Neurodegenerative diseases pose a significant diagnostic challenge due to the increasing elderly population and the rising prevalence of these conditions. State of Knowledge: Differential diagnosis among these diseases is particularly challenging; thus, numerous clinical trials have been conducted to identify markers that could facilitate accurate disease diagnosis. Among various diagnostic approaches, imaging techniques play a crucial role, especially magnetic resonance imaging (MRI), which includes advanced modalities such as proton magnetic resonance spectroscopy (¹H-MRS). ¹H-MRS offers a non-invasive assessment of neurometabolite profiles, providing critical information that aids in precise diagnosis. Conclusions: With ongoing clinical trials, the importance of ¹H-MRS in diagnosing neurodegenerative diseases continues to grow. This paper reviews the results of recent and relevant clinical trials examining changes in ¹H-MRS in the most prevalent neurodegenerative diseases.

Alzheimer's disease is the most common form of dementia and is a challenge for the modern world due to the due to aging populations. Researchers are trying their best to understand the mechanisms of onset and find effective ways to treat and prevent this disease. The purpose of the following paper is to present the impact of physical activity in the development of Alzheimer's disease. Numerous studies confirm that regular workouts have a positive reflection in the form of slowing the aging of the brain and alleviation of neuropsychiatric symptoms in affected individuals. During muscle work irisin is produced, which plays an important role in the formation of neurons and exhibits an anti-inflammatory effects. This review also looks at the aspect of maintaining proper composition of the gut microbiota, whose imbalance can promote the process of neuronal inflammation and cognitive dysfunction. Attention is also given to issues of training intensity and the effect of of exercise on blood flow in the brain. All of these elements play an important role in preventing and slowing down neurodegeneration.

Infections with the human papillomavirus (HPV) are one of the most common sexually transmitted diseases and are the main cause of precancerous changes and cervical cancer development. However, mere infection does not guarantee the development of disease or carcinogenesis. For this to occur, high-risk types of HPV must integrate into the host cell genome, transitioning into a persistent form of infection. Following the discovery of risk factors for HPV infection and factors predisposing infection to a persistent form, the number of studies investigating the correlation between vaginal dysbiosis and infection has significantly increased. Numerous studies document a significant association between the state of vaginal bacterial flora and HPV infection, leading to the development of plentiful studies on infection pathogenesis, risk factors, prevention, and treatment methods using bacteria. In this paper, based on recently published studies and current state of science knowledge, we will outline the topic of vaginal microbiome, emphasize the importance of bacteria inhabiting the vagina for human health, and identify the problem of changes in vaginal microflora. We would like to contribute to the dissemination of knowledge about the vaginal microbiome and general knowledge about taking care of its health. We will also summarize available treatment methods based on bacterial environment and discuss those methods for which research is currently underway or should be initiated.

Introduction: Duchenne muscular dystrophy is a genetic X-linked recessive disorder. This condition is characterized by progressive loss of muscle tissue. Thus, it results in deterioration and inability to perform basic motor skills such as independent movement or breathing. Due to progressive muscle weakness, patients with advanced stages of DMD require mechanical ventilation, feeding, and rehabilitation. Furthermore, alterations in cardiac muscle lead to cardiomyopathy. Despite advanced supportive treatment, DMD is a fatal disease. Purpose: The aim of the paper is to present, using a case study description, the current standards of treatment for patients with Duchenne muscular dystrophy as well as the current state of knowledge and new discoveries regarding this medical condition. Material and methods The patient's medical records were analyzed and available literature in PubMed was reviewed to write this article using the keywords: „Duchenne muscular dystrophy”; „cardiomyopathy”; „mechanical ventilation”; „gene therapy”; Conclusions Early detection of respiratory and circulatory insufficiency improves the patient's quality of life. Many patients with an advanced stage of Duchenne muscular dystrophy need specialized treatment, for example, in the intensive care unit. Therefore there is an urgent need for new treatment methods, such as gene therapies, which can slow down or break the course of the disease. New discoveries and the implementation of new treatment standards can enhance the quality of life for patients and extend their lifespans.

Introduction: In the last few years, obesity has become a central issue with more than 2.6 billion people worldwide being overweight or obese. While the risks associated with this condition and its rising significance are widely known, the effect of this attention on screening and treatment remains unsatisfying. This paper explores multiple treatment strategies and evaluates their effectiveness in preventing obesity-related complications. Review methods: We conducted our study as a literature review, with data being gathered via PubMed and Embase. The state of knowledge: Physical activity, behavioral therapy, and proper nutrition remain the foundation for obesity therapy. However, in many cases these approaches are insufficient. Recently, there has been a dynamic development of bariatric surgery and new drugs, which in comparison to lifestyle modification, result in better long-term results and improved quality of life. New surgery procedures, such as sleeve gastrectomy and adjustable gastric banding, have shown to be one of the most effective but still carry a risk of complications. As an alternative pharmacotherapy could be considered with currently used medications including liraglutide, semaglutide, tirzepatide, phentermine-topiramate, orlistat, and bupropion-naltrexone. Conclusions: Growing treatment options allow physicians to choose more targeted approaches, based on the patient’s risk factors, overall health status, and compliance.

Introduction and purpose : Type 2 diabetes is currently a serious problem worldwide. Each year, the number of individuals with carbohydrate metabolism disorders is increasing. This is due to an unhealthy lifestyle, lack of physical activity, and a diet rich in highly processed foods. Currently, the treatment of type 2 diabetes is based on the use of oral antidiabetic medications, with the first choice often being a derivative of biguanides, such as metformin. Berberine has been used in China for many years as a hypoglycemic agent, and its efficacy is compared to metformin preparations. This paper focuses on the benefits of using berberine in patients with prediabetes or type 2 diabetes and compares the effects of berberine preparations to classical medications used in diabetes treatment. Material and methods : The literaue was reviewed in PubMed and Google Scholar scientific database in 2013-2023 using the following keywords : berberine, diabetes mellitus type 2, hyperlipidemia, hyperglicemia Conclusions : The studies included in this manuscript have shown that berberine is a promising agent for adjunctive treatment in type 2 diabetes. It exhibits a range of positive effects such as lowering blood glucose levels, improving lipid profile, with no serious adverse effects reported. However, further research is needed to confirm these findings and develop an effective treatment plan.

Introduction In recent years, there has been tremendous development in medicine, including diabetology. A significant portion of these achievements pertains to pharmacological treatment. However, one should not overlook the advancement of devices necessary for monitoring glucose levels, such as glucometers or CGM and FGM systems. In this paper, I want to focus on how the use of glucose monitoring systems affects the course of diabetes. Aim of the study The aim of this study was to determine the impact of glucose monitoring systems (CGM and FGM) on parameters of metabolic control in diabetes. Materials and methods The article was created based on the PubMed and Scholar databases. The literature was analyzed using the following keywords: Continuous glucose monitor, CGM, flash glucose monitoring, FGM, type 1 diabetes, type 2 diabetes, diabetes mellitus, Metrics of Glycemic. Results Research has confirmed that the use of continuous glucose monitoring systems lowers HbA1c in patients with both type 1 and type 2 diabetes regardless of age and treatment modality. Furthermore, the use of CGM and FGM reduces the number of hypoglycemic episodes and increases time in range (TIR). Conclusions Thanks to the results obtained from numerous studies, it can be assumed that the use of continuous glucose monitoring systems is not only an adjunct to diabetes therapy but also an important component of it. With this technology combined with modern medications, we can achieve better glycemic control and, consequently, improve the quality of life of patients with diabetes.

In recent years there has been a significant increase in the popularity of electronic cigarettes among adolescents and young adults worldwide. E-cigarettes have reached the market without the extensive preclinical toxicology testing or long-term safety studies required for conventional therapeutics and medical devices. Their effectiveness as a smoking cessation intervention, their impact at the population level and whether they are less harmful than combustible tobacco products are highly controversial. Studies show measurable adverse biological effects on organ and cell health in humans, animals and in vitro. E-cigarette use also increases the risk of respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma. There is a serious risk of complications associated with e-cigarette use, such as EVALI (E-cigarette or Vaping Product Use-Associated Lung Injury) - serious lung damage associated with, especially for adolescents. This paper reviews the effects of e-cigarettes on respiratory health.

Introduction and purpose: Polycystic ovary syndrome is the most common endocrinopathy in women, with a prevalence ranging from 10% to 13%. Oxidative stress and decreased antioxidant levels contribute to the development of various diseases, and one of them is polycystic ovary syndrome. The aim of this review is to provide an overview of the current knowledge about the effects of antioxidant administration in PCOS treatment. A brief description of the state of knowledge: Oxidative stress is an imbalance between increased levels of reactive oxygen species and a decreased efficiency of antioxidant mechanisms, which can potentially cause damage. The harmful effects of free radicals might be neutralized by antioxidants obtained from the diet, such as polyphenols, vitamins C, and E. These compounds improve several aspects of the PCOS pathomechanism, including hormonal imbalance, glucose metabolism, lipid profile, and ovarian functionality. Conclusions: The outcomes of all the reviewed studies in this paper indicate that antioxidants such as resveratrol, curcumin, vitamin C and E, N-acetylcysteine, and melatonin have therapeutic potential in the management of PCOS. However, currently antioxidant therapies cannot be recommended in PCOS therapy since there is a need for more prospective randomized clinical trials on a larger sample to establish a long-term effects of antioxidants supplementation in PCOS, the optimal dosage, and finally to assess which antioxidant is the most efficient in PCOS treatment.

Introduction: Bladder cancer is one of the most common cancers in the world. There are two forms of bladder cancer: non-muscle invasive bladder cancer and muscle invasive bladder cancer. A common treatment method for non- muscle invasive bladder cancer is intravesical BCG (Mycobaterium bovis) therapy after radical tumor resection. It is estimated that half of patients will have an insufficient response to BCG treatment. Patients using this type of therapy also report side effects more and more often. Aim of the study: The aim of this article is to discuss the latest discoveries in the treatment of non-muscle invasive bladder cancer when BCG therapy is insufficient. Material and Methods: The paper was created based on the PubMed and Scholar database. The literature was reviewed using the key words: „bladder cancer”; „BCG”; „treatment”; „side effects”; „novel therapies”. Results: The research shows that novel therapies are effective and safe compared to the use of BCG. In such patients, atezolizumab, metformin or intravesical magnesium sulfate infusions may be used as an alternative. An innovative solution is the use of HIVEC - heated chemotherapy administered intravesically. There are also drugs that potentiate the action of BCG, making the therapy more effective. These include: sasanlimab and rapamycin. Due to the side effects experienced by patients, the use of intravesical BCG is often replaced with intravesical infusions of chemotherapy drugs. Conclusion: The research shows that novel therapies are effective compared to the use of BCG. Unfortunately, more research is needed to standardize the treatment of non-muscle invasive bladder cancer.

Introduction Ashwagandha, a traditional Indian plant, is gaining increasive attention from scientists worldwide due to its potential health benefits, especially in the context of its antibacterial and anticancer properties. Aim of the study The aim of this review was to discuss recent findings regarding the impact of Withania Somnifera on antibacterial effect and its potential applications in anticancer therapy. Materials and methods: The paper was created based on the Pubmed and Google Scholar database. The literature was reviewed using the keywards: ,,Ashwagandha”, ,,Withania Somnifera”, ,,antibacterial ”, ,,anticancer”, ,,side effects”, ,,breats cancer”. Results Studies have confirmed Withania Somnifera, exhibits significant anticacterial and anticancer effects. It inhibits the growth of both Gram-negative and Gram-positive bacteria. Futhermore, it demonstrates anticancer activity, especially in breast cancer, by stimulating apoptosis, induction of cytotoxic effects on cancerous cells and increasing cell sensitivity to radiation. Conclusion Despite promising results, futher research on the benefits of Ashwagandha, particulary in the long term, is essential. There is growing need of more research of the potencial benefits of Ashwagandha in the treatment of various disorders including cancer and bacterial infections and to develop more effective therapeutic strategies. The need for large randomized studies comparing long term clinical effectiveness is emphasized

Introduction: In the last few years, obesity has become a central issue with more than 2.6 billion people worldwide being overweight or obese. While the risks associated with this condition and its rising significance are widely known, the effect of this attention on screening and treatment remains unsatisfying. This paper explores multiple treatment strategies and evaluates their effectiveness in preventing obesity-related complications. Review methods: We conducted our study as a literature review, with data being gathered via PubMed and Embase. The state of knowledge: Physical activity, behavioral therapy, and proper nutrition remain the foundation for obesity therapy. However, in many cases these approaches are insufficient. Recently, there has been a dynamic development of bariatric surgery, which in comparison to lifestyle modification, results in better long-term effects and improved quality of life. New surgery procedures, such as sleeve gastrectomy and adjustable gastric banding, have shown to be one of the most effective, but they carry a risk of complications. Conclusions: Growing treatment options allow doctors to choose more targeted strategies, based on the patient’s risk factors, overall health status, and compliance. Improvements in surgery, especially laparoscopic techniques have opened new possibilities for patients with morbid obesity.

Introduction and purpose: Citrus bergamia, commonly known as bergamot, is a unique plant native to the Calabria region in Italy, prized for its fragrant fruits and versatile applications. Historically utilized for extracting essential oil, bergamot has garnered attention for its therapeutic properties, particularly its Bergamot-derived Polyphenolic Fraction (BPF), which exhibits lipid-lowering, antioxidant, and anti-inflammatory effects. This paper aims to provide a comprehensive summary of existing research on the therapeutic potential of BPF in humans. Brief description of the state of knowledge: BPF has shown promise in supporting wound healing, alleviating neuropathic pain, and exhibiting antimicrobial properties. Research highlights BPF's role in modulating lipid metabolism, particularly in reducing LDL cholesterol and triglycerides while increasing HDL cholesterol levels. Additionally, BPF demonstrates anti-inflammatory effects, accelerating the recovery process in conditions such as non-alcoholic steatohepatitis (NASH) and potentially influencing pathways involved in cancer cell proliferation and apoptosis. Further studies explore BPF's impact on bone metabolism, erectile dysfunction, and its potential in dermatological applications, particularly in counteracting photoaging. Conclusions: While existing studies underscore the promising therapeutic effects of BPF in various medical domains, further research is warranted to establish its efficacy and safety for broader clinical use. Continued investigation on a larger scale holds the potential to develop BPF as a valuable physiotherapeutic strategy across diverse medical fields.

Finger flexor pulley injuries are the most common overuse injuries sustained by climbers. These injuries are caused by forceful gripping techniques specific to climbing, making them uncommon in non-climbing activities. With the growing popularity of climbing, there is a rising need for accurate diagnosis and improved treatment methods. This paper explores current diagnostic techniques, including physical examination, ultrasound, and magnetic resonance imaging. It also discusses treatment options, which range from conservative rehabilitation to surgery, depending on the severity of the injury. Finally, it emphasizes the importance of injury prevention through proper warm-up and avoiding excessive strain.

Introduction and purpose: Polycystic ovary syndrome (PCOS) is the most common endocrine disease in the female reproductive age. As treatment guidelines include lifestyle changes, various diet types are being evaluated in terms of efficacy among them ketogenic diet (KD) which was also assessed in terms of its influence on another ovarian related disease - ovarian cancer. The aim of this paper is an analysis of the available scientific data in respect of the role of the KD as a part of the therapy of ovarian related disorders. The search was conducted using PubMed and Google Scholarship databases. Brief description of the state of knowledge: Ketogenic diet demonstrates favorable effects in the hormonal profile of PCOS-affected women. It was also noticed that its administration results in the reduction of BMI and the improvement in glycemic parameters. Most of the research was conducted by linking the ketogenic diet with the caloric restriction. In the matter of ovarian cancer the results are unclear; some of the research states the improvement of the quality of life of the participants, but there is some alarming data of the possible role of KD in enhancing the tumor growth. Conclusions: Ketogenic diet merits further research as a possible factor in the treatment of PCOS as foregoing results are pointing to its efficacy. Nevertheless, still more data is needed to determine its role as studies were conducted within a short period of time with relatively small research groups. There are also other limitations such as the lack of comparison with other dietary patterns with the caloric deficit which makes it difficult to deduce the main profitable factor. When it comes to ovarian cancer the results of the current data are also unclear and unambiguous with the possible negative effects.

Introduction and purpose: Hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is a rare and complex vascular disorder characterized by abnormal blood vessel formation. It can present significant challenges in diagnosis and management, as it is currently estimated up to 90% of those affected are never diagnosed. Despite its rarity, HHT can carry substantial implications for patients and their families, at times requiring comprehensive medical care and support. This paper aims to provide an in-depth exploration of HHT, encompassing its epidemiology, genetics, clinical manifestations, diagnostic approaches, and current management strategies. Moreover, we hope to point out possible areas in need of future research. Description of the state knowledge: HHT is an autosomal dominant genetic disorder that affects 1 in 5-10,000 people. Its most prominent symptoms include telangiectasia of skin and mucous membranes, recurrent epistaxis, gastrointestinal bleeding and arteriovenous malformations in vital organs. In the vast majority of cases, it is caused by a mutation in one of the following genes: ENG, ACVRL1, SMAD4; however, mutations in other genes have been described to cause a similar or much the same constellation of symptoms. Treatment options are focused on managing symptoms and improving quality of life, but possible new treatment options are being researched that could change the landscape of HHT management. Summary: HHT is a severely underdiagnosed disease that has seen a surge of researchers’ interest in recent years. We firmly believe that, combined with plummeting costs of genetic testing and possible new treatment options, means that HHT will become increasingly important in physicians’ everyday practice.

Introduction Vegetarianism is an eating pattern centred on plant-based food. It encompasses many diets that differ in terms of whether they contain goods originating from animals, like milk and eggs. Nowadays, vegetarianism is increasing in popularity in developed nations, particularly in Europe. Individuals choose vegetarian diets for reasons related to health, ethics, or ecology. The rising popularity of vegetarian diets is not limited to adults but is also increasing among children. Aim of the study Vegetarian diets are generally considered to be beneficial for health. However, there are concerns over the ability to meet the dietary requirements necessary during infancy, youth, and adolescence on a vegetarian diet. Therefore, the primary aim of this systematic review is to answer questions about the efficacy of a plant-based diet in meeting the nutritional requirements of children and how to avoid the risk of nutritional deficiencies among vegetarian children. Material and methods Article provides an overview of the current literature about the vegetarian diet in children. The information has been collected from a comprehensive search of electronic databases, scientific journals, and statement papers published by nutrition and paediatric organisations. Results Following a vegetarian diet can be a beneficial decision for all children, assuming that it is properly organised and well balanced. The majority of paediatric and nutrition organisations do not recommend more strict diets for children, such as a vegan diet, which fully excludes not only meat but all animal products.

Purpose. To conduct an analysis of the first experience of using abdominal VAC therapy during the implementation of Damage Control Surgery (DCS) tactics in the treatment of combat surgical abdominal trauma during large-scale combat operations. Material and methods. An analysis of the use of abdominal VAC therapy in the conditions of the advanced surgical group of the Military Mobile Hospital at the Role II of medical support in 45 wounded with penetrating gunshot wounds to the abdomen and damage to internal organs was carried out. Results. The paper describes the injuries of the abdominal organs in the case of a combat surgical injury of the abdomen, which underwent abdominal VAC therapy at the Role II of medical care. The technique of using abdominal VAC therapy in the irrigation mode is described in detail, with the specifics of its implementation for various injuries. The features of performing abdominal VAC therapy during the evacuation of the wounded are highlighted. The purpose of abdominal VAC therapy at the Role II of MS in the conditions of large-scale combat operations, indications, contraindications to its use and the peculiarities of its implementation in combat surgical abdominal trauma are summarized. Conclusions. Abdominal VAC therapy for combat surgical injury of the abdomen is the optimal way to temporarily close the abdominal cavity at the end of the I phase of the DCS tactics at the Role II of combat medical support, which allows you to remove pathological exudate effectively from the abdominal cavity and rehabilitate it (including during medical evacuation to the next level of medical care ) and is preparation for performing reconstructive operations and final closure of the abdominal cavity in the III phase DCS tactics.

Introduction: Recent research are focused on natural compounds for preventing cardiovascular diseases, with emphasis on tyrosol and hydroxytyrosol in olive oil. Cardiovascular diseases are linked to risk factors, and adopting a Mediterranean diet rich in these compounds is recognized for reducing risks. Understanding these compounds' actions may inform new strategies for preventing and treating cardiovascular diseases. Aim: The aim of this paper is a systematic review of articles and research regarding the Role of tyrosol and hydroxytyrosol in Cardioprotection Review methods: An systematic review of scientific literature was conducted using the following keywords: Tyrosol, hydroxytyrosol, cardioprotection, cardiovascular diseases, olive oil cardioprotective role. Thirty-four articles published until 2023 were searched and analyzed. Abbreviated description of the state of knowledge: Tyrosol and hydroxytyrosol, prominent in olive oil, are studied for their potential cardioprotective properties. Linked to a Mediterranean diet, these compounds show promise in reducing cardiovascular disease risk. They counter oxidative stress, improve lipid profiles, and modulate inflammatory processes. Clinical studies suggest their positive impact, with tyrosol also explored as a potential anticoagulant. Ongoing research aims to uncover optimal doses and mechanisms, highlighting their significance in cardiovascular health. Conclusions: Tyrosol and hydroxytyrosol, found in olive oil, show promise in cardioprotection by combating oxidative stress, improving lipid profiles, and modulating inflammation. Clinical studies suggest their positive impact on cardiovascular health. Tyrosol has potential as a anticoagulant and exhibits antioxidant effects. These compounds present a compelling avenue for future therapeutic interventions, with emphasis on understanding mechanisms and optimizing supplementation.

Introduction: Anorexia Nervosa (AN) stands as a severe mental disorder characterized by the highest mortality rate within the realm of psychiatric conditions. Its etiology encompasses genetic, neurobiological, environmental, and developmental factors. Recent investigations have shed light on the potential impact of the gut microbiota on the genesis and progression of AN. Aim of the Study: The aim of this paper is to provide a comprehensive review of the existing findings on relationship between gut dysbiosis and AN. The intention is to present new perspectives that contribute to a more detailed understanding of the multifaceted nature of this serious disorder. Description of the State of Knowledge: The gut microbiota takes a central role in modulating various physiological processes. Dysbiosis, which refers to an imbalance in gut microbiota composition, has recently drawn attention because of its association with several mental disorders. In the context of AN, studies have shown reduced microbial diversity and notable changes in specific bacterial populations. The influence of the gut microbiota on AN includes disturbances in the digestive system, changes in eating behaviours, and associations with related conditions such as anxiety and depression. Mechanisms such as the gut-brain axis, hormonal regulation and molecular mimicry contribute to these associations. Conclusions: Recognition of the pivotal role played by the gut microbiota in AN opens up avenues for potential therapeutic interventions. Pro- and prebiotics, along with fecal transplantation, emerge as promising modalities in the treatment of AN. Ongoing research is essential to further elucidate this evolving field, ultimately facilitating the development of targeted interventions for individuals with AN.

Introduction and purpose: Palliative care is designed to ensure proper comfort in living and dying, primarily by alleviating suffering in patients for whom medical interventions have proved ineffective. In situations where suffering is unbearable, palliative care offers "last resort" treatment, namely palliative sedation. This involves the intentional administration of sedative drugs to the patient to reduce the level of consciousness, even inducing sleep, in order to control suffering caused by conditions that are resistant to other treatments. The aim of this article is to present various perspectives on palliative sedation. Description of the state knowledge: Topics discussed include: cessation of hydration and nutrition, loss of patient control over decision-making in treatment progression after the induction of pharmacological coma, the principle of double effect, complications arising from the use of indiscriminate polypharmacy, and views on life shortening through palliative sedation or its comparison to euthanasia. The distinction between palliative sedation and euthanasia is explored, with arguments on both sides contributing to ongoing debates. The paper concludes by advocating for comprehensive guidelines and interdisciplinary assessments to ensure ethical and patient-centered decision-making in the application of palliative sedation in terminally ill patients. Summary: A discussion is necessary on the creation of acceptable and appropriate procedures that would not arouse the controversies currently associated with the use of palliative sedation.

Introduction: This review paper aims to discuss the effects of insulin resistance, and its association with various metabolic diseases. Insulin resistance (IR), characterized by diminished tissue responsiveness to physiological insulin levels, is a key component in various metabolic diseases, including type 2 diabetes, cardiovascular disorders (CVDs), obesity, and non-alcoholic fatty liver disease (NAFLD). State of knowledge The consequences of IR are profound; in type 2 diabetes, it hinders glucose utilization by muscle cells, leading to hyperglycemia, muscle damage, and loss of mass and strength. IR also plays a central role in NAFLD, promoting lipid accumulation, hepatic inflammation, fibrosis, and cell death. Materials and methods: A review of chosen literature in the PubMed and Google Scholar databases was conducted, using the following key words: „Insulin resistane”, „Insulin resistance in obesity”, „Obesity”, „Insulin resistance NAFLD”, „Diebetes”, „Insulin resistance CVD” Summary: The consequences of insulin resistance are far-reaching. In the context of type 2 diabetes, it impedes glucose utilization by muscle cells, resulting in hyperglycemia and subsequent muscle cell damage, contributing to loss of mass and strength. Insulin resistance is also a central player in the pathogenesis of non-alcoholic fatty liver disease (NAFLD), fostering lipid accumulation, hepatic inflammation, and, ultimately, fibrosis and cell death. Conclusions: In conclusion, understanding insulin resistance is paramount in addressing the rising prevalence of metabolic diseases globally Controlling insulin resistance emerges as a crucial aspect of managing these metabolic disorders and their complications. Further research into the mechanisms of IR formation and effective intervention strategies is imperative for improving public health outcomes.

Introduction: Alpha-1 antitrypsin (AAT) is a glycoprotein produced by liver, belonging to the serine protease inhibitor family. Alpha-1 antitrypsin deficiency (AATD) is very common autosomal recessive genetic disease caused by point mutation in SERPINA1 gene. Mutations in the alpha-1 antitrypsin gene lead to production of misfolded AAT resulting in impaired release into the blood. This disorder leads to destruction of connecting tissue especially in lungs and to accumulation of retarded protein in the liver. Purpose: Most studies addressing AAT deficiency focus on presenting symptoms related to the lungs and liver. We want to take a broader look at this issue, so we have closely examined scientific reports on the presentation of the disease in organs other than the lungs and liver. The goal is to gather holistic knowledge about the disease to enhance awareness and treatment. Material and methods: In our paper, we endeavored to address the issue of AAT deficiency comprehensively. We explored symptoms with an emphasis on organs beyond the liver and lungs. We also delved into the etiology, diagnosis, treatment, and prognosis of this disease. Discussion: The clinical symptoms of alpha 1 antitrypsin deficiency extending beyond the liver and lungs remain inadequately described. We know that AAT deficiency can lead to excessive destruction of connective tissue in any organ, not just the lungs and liver. Unfortunately, this condition continues to go undiagnosed, and the number of scientific publications on symptoms from other organs is too limited. This affects the insufficient attention given by doctors to tissue destruction in organs other than the lungs and liver.

Introduction and purpose The term "probiotic" rooted in Latin, signifies 'for life,' reflecting the historical use of fermented products for therapeutic purposes. Defined by the WHO as living microorganisms conferring health benefits when consumed adequately, probiotics, mainly bacteria from Lactobacillus and Bifidobacterium genera, play a vital role in maintaining gut microbiota balance, regulating digestion, supporting the immune system and influencing mental and cardiovascular health. While browsing many websites devoted to healthy eating or popular science topics, we often came across the topic of probiotic food without any confirmation by scientific research. The aim of this paper is to confirm or exclude the presence of probiotics in popular foods. Material and method In our work, we will look at individual products with an emphasis on verifying whether the microorganisms they contain meet the WHO criteria of probiotics. Results Our review managed to prove the probiotic effect of almost all presented food, except for miso. By reviewing many articles, we shed a lot of uncertainty on the repeated myth about the lack of probiotic effect of cucumbers preserved in vinegar and what is more, we found scientific assumptions about the probiotic effect of vinegar itself. Conclusion Fermented food contains numerous strains of bacteria that are resistant to acid, bile and temperature in the human digestive tract and can be effectively used as a source of probiotics. What is more, compared with probiotics from the pharmacy, pickles provide not only probiotics, but also nutritional values, valuable fiber and vitamins. They seem to be a versatile supplement for our health.