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Zackary Falls,1,* Xueqing Zhang,2,* Peter L Elkin,1 David Jacobs,3 Edward M Bednarczyk,4 Walter Gibson,4 Gail P Jette,5 Kenneth E Leonard6,* 1Department of Biomedical Informatics and Clinical and Research Institute on Addiction, University at Buffalo, The State University of New York, Buffalo, New York, USA; 2Department of Biostatistics and Clinical and Research Institute on Addiction, University at Buffalo, The State University of New York, Buffalo, New York, USA; 3School of Pharmacy and Department of Epidemiology and Environmental Health, University at Buffalo, the State University of New York, Buffalo, New York, USA; 4School of Pharmacy, University at Buffalo, The State University of New York, Buffalo, New York, USA; 5Division of Outcomes, Management, and Systems Information, Office of Addiction Services and Supports, Albany NY, United States; 6Department of Psychiatry and Clinical and Research Institute on Addiction, University at Buffalo, The State University of New York, Buffalo, New York, USA*These authors contributed equally to this workCorrespondence: Kenneth E Leonard, Department of Psychiatry and Clinical and Research Institute on Addictions, University at Buffalo, 1021 Main Street, Buffalo, NY, 14203, USA, Email Kleonard@buffalo.eduIntroduction: Opioid use disorder (OUD) and opioid overdose (OD) have shown to be strongly associated with alcohol use disorder (AUD). As a potential target population for secondary prevention, we examined the incidence and timing of OUD/OD among clients seeking treatment for alcohol problems and how this has changed over the three waves of the opioid epidemic corresponding to the primary opioid involved in fatal ODs, prescription painkillers (2007– 2009), heroin (2010– 2012), and fentanyl (2013– 2016). We also examined social determinants of health as predictors of OUD/OD.Methods: Clients (N = 59,186) presenting for a first treatment for alcohol use problems were extracted from the Client Data System (CDS) of the New York State Office of Addiction Services and Support (OASAS) and New York State (NYS) Medicaid Data Warehouse. Using this cohort, we employed the Kaplan–Meier method to determine the survival probabilities for patients admitted in each of the three waves of the epidemic.Results: Patients in Cohort 3 (2013– 2016) were diagnosed with OUD/OD more rapidly than patients in Cohort 1 (2007– 2009) or Cohort 2 (2010– 2012), although the overall estimated OUD/OD rate was comparable across the three cohorts.Discussion: These findings provide a useful estimate of the incidence and the expected time frame of an opioid use disorder in clients with an alcohol use problem. Moreover, it suggests that as the opioid epidemic progressed, OUD/OD developed more rapidly but the overall prevalence did not increase.Keywords: opioid use disorder, opioid overdose, substance use, alcohol, incidence

Hydrogels are a unique class of macromolecular networks that can hold a large fraction of an aqueous solvent within their structure. They are suitable for biomedical area including controlled drug delivery and for technical applications as self-adhesive materials for bonding of wet surfaces. This paper describes photoreactive self-adhesive hydrogels based on acrylics crosslinked using UV radiation. They are prepared in ethyl acetate through radical polymerization of monomers mixture containing 2-ethylhexyl acrylate (2-EHA), butyl acrylate (BA), acrylic acid (AA) and copolymerizable photoinitiator 4-acryloyloxy benzophenone (ABP) at presence of radical starter 2.2’-azobis-diisobutyronitrile AIBN. The synthesized acrylic copolymers were determined by viscosity and GPC analysis and later modified using ethoxylated amines. 4-acryloyloxy benzophenone (ABP) was used as crosslinking monomer. After UV crosslinking the properties of these novel synthesized hydrogels, such as tack, peel adhesion, shears strength, elongation and water adsorption were also studied.

Photocurable materials which are obtained on the basis of urethane acrylate resins are often used in the industry for the production varnishes or protective coatings. The main disadvantage which is connected with the utilization of these varnishes is their unpleasant smell during the process of production and curing. This work presents the photocurable varnish which was obtained on the basis of aliphatic urethane acrylate and R-(+)-limonene. The utilization of this raw materials allows to obtain the smelling coatings. The aim of this work were the studies on the influence of limonene molecules on the mechanical properties of the UV-cured coatings. These studies showed that the coatings with limonene molecules retain their properties, and are characterized by the very good adhesion, cohesion and high gloss. These kinds of varnishes can be applied for preparation of appropriate protective coatings on the surface of wood, metals, and nail plates. These protective coatings have not only pleasure smell but also can have the bactericidal and fungicidal properties. The studies performed with Escherichia coli ATCC29425 and Candida albicans confirmed these properties.

Purpose: We examined associations between vaccine confidence and COVID-19 vaccine uptake among gay, bisexual, and other men who have sex with men (GBMSM). Methods: Computer-assisted self-interviews were conducted among 249 GBMSM participating in mSTUDY from May to October 2021-a cohort of GBMSM with a history of substance use in Los Angeles. Data were collected using a vaccine confidence index. The association between vaccine confidence and COVID-19 vaccine uptake was assessed using multivariable log-binomial regression. Results: Two-thirds (64.7%) of GBMSM reported receiving at least one dose of COVID-19 vaccine. Vaccine confidence was positively associated with COVID-19 vaccine uptake. Participants expressed neutral attitudes on government trust and vaccine safety. Perceived health benefit and vaccine effectiveness were statistically significantly associated with vaccine uptake (adjusted prevalence ratio [APR] = 1.59, 95% confidence interval [CI]: 1.20-2.16; APR = 1.51, 95% CI: 1.07-2.15). Conclusions: Public health programs should prioritize public benefit and vaccine effectiveness messaging to advance vaccination among GBMSM who use substances.

The principles of employing Police officers are regulated by the Act of April 6, 1990 on the Police, professional pragmatics of an autonomous nature. In the discussed pragmatics, the legislator divided the exhaustive catalog of reasons for dismissal from service into two reasons - obligatory and optional. The impetus for undertaking the research issues covered in this article was the construction of one of the reasons for optional dismissal from service. Namely, in accordance with Art. 41 section 2 point 5 of the Police Act, a police officer may be dismissed from service when an important interest of the service requires it. The construction of the service's interest is nothing more than the normative construction of a general clause, which by its nature is unspecified. Therefore, the closed catalog of grounds for dismissal from service remains open in this respect. The legislator deliberately and consciously uses this construction to make the generally closed catalog of reasons for dismissal from service more flexible. It should be stated, however, that although the Police authority is provided with a large area of freedom in the process of applying the law, the clause in question is not the basis for the authority to make arbitrary and instrumental assessments. The service interest clause, despite its undefined nature, refers to extra-legal criteria with a semantic context defined by the name of the criterion.

The principles of management control and coordination of management control are described in Section I, Chapter 6 - Articles 68 - 71 of the Act of August 27, 2009 on Public Finance. Detailed rules on the manner of preparation and specimens of documents required by the provisions of the aforementioned Act are established in the Decree of the Minister of Finance of September 29, 2010 on the activity plan and the report on its implementation, and in the Decree of the Minister of Finance of December 2, 2010 on the model statement on the state of management control. Requirements relating to the establishment, evaluation and improvement of management control systems for the public finance sector are specified in Announcement No. 23 of the Minister of Finance dated December 16, 2009 on management control standards for the public finance sector. Guidance on monitoring and evaluating the adequacy, effectiveness and efficiency of management control is provided in Announcement No. 3 of the Minister of Finance dated February 16, 2011 on detailed guidelines for self-evaluation of management control for units in the public finance sector. The guidelines supporting effective risk management in units of the public finance sector are announced in Announcement No. 6 of the Minister of Finance of December 6, 2012 on detailed guidelines for the public finance sector on planning and risk management. The article analyzes the legal regulations of Articles

Tax proceedings are a separate type of administrative proceeding, which is conducted by tax authorities. It has the character of an authoritative, public-law concretization, a unilateral legal relationship in the field of tax law. The provisions governing the proceeding include both the Tax Ordinance and the Code of Administrative Procedure. The purpose of tax proceedings is to assess tax... Administrative proceedings are both a series of procedural actions, regulated by procedural law, taken by public administration bodies and other procedural entities to resolve an administrative matter in the form of an administrative decision, and a series of procedural actions taken to verify a previously issued administrative decision. Administrative procedure, also called formal administrative law, procedural administrative law or administrative procedure, is one of the three parts of administrative law.

Abstract Background Angelman syndrome (AS) is a rare neurodevelopmental disease caused by imprinting disorders that impede the production of the ubiquitin E3A ligase protein (UBE3A). AS affects multiple systems, with the main symptoms including epilepsy, psychomotor disorders and speech development disorders. To date, no study has been conducted in the Polish population to verify the condition's diagnosis and treatment process. Results Seventy patients with the median age of 60 months were included into the analysis. 80% of patients were diagnosed with deletion, 19.9% with a mutation of UBE3A gene, 4.3% with paternal uniparental disomy (UPD) and 2.8% with an imprinting defect. The mean age of first symptoms was 5 months, while the mean age of diagnosis was 29 months (earliest in deletion group at 23 months), and the median duration of diagnosis process was 7 months. The average time to a clinical geneticist appointment was 3 months. 37.9% of the patients initially received a different diagnosis. Epileptic seizures were present in 88.6% of the individuals. 98.6% of the studied group were under care of a pediatric neurologist, 47.1% of a gastroenterologist. A ketogenic diet was used in 7.1% of patients. Caregivers identified finding a specialist suitable for AS patients and access to genetic testing as the biggest problems. Conclusions The care of patients with AS in Poland is carried out according to the European and world standards, however there is an impeded access to clinical geneticist, and the knowledge about rare diseases among primary healthcare physicians could be improved. Moreover, access to AS care specialists and coordination of care is limited. There is a need for creation a specialized centers and databases for AS patients.

Abstract Environmental concerns and climate protection are gaining increasing emphasis nowadays. A growing number of industries and scientific fields are involved in this trend. Sustainable electronics is an emerging research strand. Environmentally friendly and biodegradable or biobased raw materials can be used for the development of green flexible electronic devices, which may serve to reduce the pollution generated by plastics and electronics waste. In this work, we present cytocompatible, electrically conductive structures of nanocarbon water-soluble composites based on starch films. To accomplish this goal, potato starch-based films with glycerol as a plasticiser were developed along with a water-soluble vehicle for nanocarbon-based electroconductive pastes specifically dedicated to screen printing technology. Films were characterized by optical microscopy, scanning electron microscopy (SEM) mechanical properties and surface free energy.

The fragmentation reactions of neutron-rich unstable nuclei 81Ga and 82Ge at 250 MeV/nucleon have been studied in order to search the optimal mean for the production of very neutron-rich nuclei in the vicinity of 78Ni. The newly measured cross sections were compared with various calculations, showing a good agreement with EPAX3.01. The present work provides experimental insights into the two-step scheme—fragmentation following fission—as a method to produce very neutron-rich nuclei through a combination of ISOL and fragmentation of post-accelerated beams of unstable nuclei. Our results enable an evaluation of the potential of the two-step scheme in the production of very neutron-rich nuclei for the 78Ni region. The two-step scheme using fragmentation of a post-accelerated 81Ga beam could be an option to produce neutron-rich nuclei around 78Ni when the 81Ga beam intensity reaches 1.0×108 pps, compared to the one-step scheme with fission of 238U.

Pulmonary-renal syndrome is called alveolar hemorrhage accompanied by glomerulonephritis. The above condition can occur as a manifestation of ANCA-associated granulomatosis with vasculitis. The course of the disease varies from mild, limited inflammation to rapid progression with multi-organ changes that can be life-threatening. The mainstay of therapy is immunosuppression - both in the acute phase of the disease and after clinical improvement. Unfortunately, common causes of death in addition to complications of the disease include side effects of immunosuppressive treatment. A 72-year-old man is transferred to the Nephrology Unit for acute kidney injury of unclear etiology. On the basis of clinical examination, laboratory and imaging studies, a diagnosis of systemic small vessel inflammation with c-ANCA occupying the kidneys, lungs and intestines was made. Due to acute respiratory failure, the patient was transferred to the ICU, where renal replacement therapy, plasmapheresis, steroid pulses and cyclophosphamide were administered. After clinical improvement, it was decided to continue cyclophosphamide therapy and monitor blood IgG levels. Unfortunately, 4 months later, the patient died of multiple organ failure caused by septic shock of bacterial etiology. In the described case, age and comorbidities were the biggest risk factors for infectious complications of immunosuppression. The population is aging, so it is necessary to analyze the current standards of immunosuppressive treatment to improve the prognosis of the elderly.

Introduction Buerger's disease (BD) is an inflammatory disease with an etiology that is still not fully understood. It involves venous and arterial vessels, of small and medium caliber, of the lower and upper extremities (Cacione et al., 2020). This inflammation predominantly affects young, tobacco-smoking men, usually those before the age of 40. Literature data relating to peripheral arterial disease in general, put the prevalence of BD at between 0.5%-5.6% in Western European countries (Liu et al., 2023; Öztan et al., 2023). In this paper, we summarized the latest literature reports on rare clinical images and new directions in the treatment of Buerger's disease. Aim of the study The purpose of this systematic review was to compile the latest literature on the etiology, atypical disease presentation, associations with other diseases and modern treatment of Buerger's disease. Materials and methods The materials used by our team were obtained from a review of the currently available literature in the PubMed database. To search for articles, we used keywords such as: Buerger’s disease, thromboangiitis obliterans, thrombosis, atherosclerosis, Peripheral arterial disease, vasculitis. Conclusion In addition to its characteristic clinical presentation, Buerger's disease can present under a number of atypical forms. Such examples, less common conditions in the course of BD are intestinal vascular involvement mimicking the condition of acute abdomen, infertility condition due to gonadal involvement in the patient, possible correlation between the level of ASA (anti-sperm antibodies) and reduced fertility, the occurrence of nail lesions, renal complications, including the nephrotic syndrome, ocular or psychiatric manifestations. It is important for the clinician, in the diagnostic and therapeutic process at the onset of the described symptoms, not to exclude the possibility of an uncommon course of BD, to make a correct diagnosis and undertake optimal treatment.

Introduction. Cardiovascular disease is a leading cause of morbidity and mortality among patients with type 2 diabetes mellitus. The emergence of flozins, a class of sodium-glucose co-transporter-2 inhibitors, has introduced a novel therapeutic avenue with potential cardiovascular benefits beyond glycemic control. Objective. This review aims to synthesize current evidence on the role of flozins in managing cardiovascular risk among patients with T2DM, examining their efficacy, safety profile, and mechanisms of action. Review methods. A comprehensive literature search was conducted using databases, covering studies published between 2015 and 2024. Clinical trials, meta-analyses, and observational studies evaluating the cardiovascular outcomes associated with flozins in T2DM patients were included. Brief description of the state of knowledge. Research shows that flozins improve glycemic control and provide significant cardiovascular protection, reducing major adverse cardiovascular events, heart failure hospitalizations, and cardiovascular mortality in T2DM patients. These benefits are likely due to hemodynamic changes, enhanced cardiac function, and reduced inflammation and oxidative stress. Summary. Flozins represent a promising therapeutic option for reducing cardiovascular risk in T2DM patients. Their dual benefits on both metabolic and cardiovascular health position them as a cornerstone in the management of T2DM. Further research is needed to fully elucidate their long-term benefits and safety in diverse patient populations.

This paper provides a comprehensive overview of sport-related concussions, highlighting the critical importance of understanding their mechanisms, diagnosis, and management. Sport-related concussion is a frequent and complex pathology whose physiopathological mechanisms are not completely understood yet. Concussions, a subset of traumatic brain injuries, are prevalent in contact sports and pose significant risks to athletes' long-term health. The review covers the pathophysiology of concussions, emphasizing the biomechanical forces involved and the resultant neurological disruptions. Athletes seldom report concussive symptoms, which makes the diagnosis a challenge. Therefore, diagnostic challenges are explored, with a focus on clinical assessment tools, neuroimaging, and biomarkers. Additionally, the paper discusses current management strategies, including return-to-play protocols, and the role of education in concussion prevention. The review underscores the need for ongoing research to enhance diagnostic accuracy, improve treatment outcomes, and establish more effective prevention strategies, ultimately aiming to safeguard athletes' well-being.

A desmoid tumor is a clonal fibroblast proliferation, occurring in deep soft tissues with a significant recurrence tendency. Aggressive fibromatosis is a rare disease. The prevalence in the population ranges from 2 to 4 cases per million. Mentioned neoplasms are highly unpredictable in terms of development. Typically, in the course of desmoid tumors, metastases do not occur, but they often infiltrate the surrounding tissues, which may be associated with numerous complications. There are currently no randomized standards of therapy designated, which is undoubtedly a challenge when referring to treatment. To a 37 year old patient, due to a pathological mass in the abdomen, the MR examination was performed. It showed the presence of an irregular, heterogeneous structure on the right side of the abdominal cavity. A laparotomy was performed. During the procedure adhesions were released and the giant abdominal tumor was removed in one block with part of the duodenum, caecum, ascending colon and part of ileum. End-to-end duodenal anastomosis and stapled, side-to-side ileo-transverse anastomosis were used. The surgical field was being drained. The postoperative course was uneventful. Tissue material was collected for a routine, histopathological examination in which the intra-abdominal form of fibromatosis was diagnosed. The macroscopic image describes a tumor with dimensions of 25.0 cm x 25.0 cm x 20.0 cm.

Epithelial-to-mesenchymal transition (EMT) contributes significantly to chemotherapy resistance and remains a critical challenge in treating advanced breast cancer. The complexity of EMT, involving redundant pro-EMT signaling pathways and its paradox reversal process, mesenchymal-to-epithelial transition (MET), has hindered the development of effective treatments. In this study, we utilized a Tri-PyMT EMT lineage-tracing model in mice and single-cell RNA sequencing (scRNA-seq) to comprehensively analyze the EMT status of tumor cells. Our findings revealed elevated ribosome biogenesis (RiBi) during the transitioning phases of both EMT and MET processes. RiBi and its subsequent nascent protein synthesis mediated by ERK and mTOR signalings are essential for EMT/MET completion. Importantly, inhibiting excessive RiBi genetically or pharmacologically impaired the EMT/MET capability of tumor cells. Combining RiBi inhibition with chemotherapy drugs synergistically reduced metastatic outgrowth of epithelial and mesenchymal tumor cells under chemotherapies. Our study suggests that targeting the RiBi pathway presents a promising strategy for treating patients with advanced breast cancer.

Background: Patients with alcohol use disorder (AUD) and high-risk opioid use are at risk of serious complications. The purpose of this study was to estimate the prevalence of and factors associated with high-risk opioid use in patients with an alcohol use problem from 2005 to 2018. Methods: This repeated cross-sectional study analyzed data from first admissions for alcohol treatment (2005–2018) to the NYS Office of Addiction Services and Supports merged with Medicaid Claims Data. High-risk opioid use was defined as opioid dose ≥50 morphine mg equivalents (MME) per day; opioid prescriptions overlapping ≥7 days; opioids for chronic pain >90 days or opioids for acute pain >7 days. Results: Patients receiving ≥50 MME increased from 690 to 3226 from 2005 to 2010; then decreased to 2330 in 2018. From 2005–2011, patients with opioid prescriptions overlapping ≥7 days increased from 226 to 1594 then decreased to 892 in 2018. From 2005–2010, opioid use >7 days for acute pain increased from 133 to 970 and plateaued after 2010. From 2005–2018, patients who received opioids >90 days for chronic pain trended from 186 to 1655. White patients, females, age 36–55, patients with chronic and acute pain diagnoses had the highest rates of high-risk use. Conclusions: The prevalence of high-risk opioid use in patients with alcohol use problems increased from 2005 to 2011, and generally decreased after 2010. However, prevalence of opioids >90 days for chronic pain trended up from 2005 to 2018. High-risk opioid use among patients with AUD emphasizes the need to develop interventional strategies to improve patient care.

Abstract Introduction Human papillomavirus (HPV) vaccination protects against HPV-associated cancers and genital warts. Healthy People 2030 goal for HPV vaccine uptake is 80%, but as of 2021, only 58.5% of adolescents are up to date in Georgia. The purpose of the study is to assess the attitudes, vaccine practices, facilitators, and barriers to receiving the HPV vaccine in southwest Georgia. Methods We conducted 40 semi-structured interviews in the United States from May 2020-Feburary 2022 with three different audiences (young adults, parents, and providers and public health professionals) guided by the P3 (patient-, provider-, practice-levels) Model. The audiences were recruited by multiple methods including fliers, a community advisory board, Facebook ads, phone calls or emails to schools and health systems, and snowball sampling. Young adults and parents were interviewed to assess their perceived benefits, barriers, and susceptibility of the HPV vaccine. Providers and public health professionals were interviewed about facilitators and barriers of patients receiving the HPV vaccine in their communities. We used deductive coding approach using a structured codebook, two coders, analyses in MAXQDA, and matrices. Results Out of the 40 interviews: 10 young adults, 20 parents, and 10 providers and public health professionals were interviewed. Emerging facilitator themes to increase the uptake of the HPV vaccine included existing knowledge (patient level) and community outreach, providers’ approach to the HPV vaccine recommendations and use of educational materials in addition to counseling parents or young adults (provider level) and immunization reminders (practice level). Barrier themes were lack of knowledge around HPV and the HPV vaccine (patient level), need for strong provider recommendation and discussing the vaccine with patients (provider level), and limited patient reminders and health education information around HPV vaccination (practice level). Related to socio-ecology, the lack of transportation and culture of limited discussion about vaccination in rural communities and the lack of policies facilitating the uptake of the HPV vaccine (e.g., school mandates) were described as challenges. Conclusion These interviews revealed key themes around education, knowledge, importance of immunization reminders, and approaches to increasing the HPV vaccination in rural Georgia. This data can inform future interventions across all levels (patient, provider, practice, policy, etc.) to increase HPV vaccination rates in rural communities.

Introduction Understanding changes in vaccine hesitancy, overall and by sociodemographic characteristics, may highlight sub-populations for whom more intensive efforts are needed to increase vaccine uptake and confidence.Methods We analyzed data using the CDC’s Research and Development Survey (RANDS), a nationally representative survey of U.S. adults ≥18 years, collected from 17 May 2021–30 June 2021 (n = 5,458) and 3 November 2022–12 December 2022 (n = 6,821). We assessed changes in vaccine hesitancy, changes in vaccine attitudes and attitudes, and factors associated with hesitancy toward both vaccines in general and COVID-19 vaccines among a nationally representative sample of U.S. adults.Results Although COVID-19 vaccination (≥1 dose) increased from 67.2% (2021) to 74.7% (2022), COVID-19 vaccine hesitancy increased from 40.7% to 44.6% during the same period. During the same period, hesitancy toward both COVID-19 vaccines and vaccines in general increased among those who were aged ≥65 years and who were non-Hispanic White. However, COVID-19 vaccine hesitancy decreased among non-Hispanic Black adults. Current or former smokers were more hesitant toward vaccines in general (aPR = 1.13, 95%CI: 1.03–1.24) and toward COVID-19 vaccines (aPR = 1.08, 95%CI: 1.01–1.16) compared to never smokers. Among adults who did not receive any COVID-19 vaccines, COVID-19 vaccine hesitancy increased from 86.6% in 2021 to 92.4% in 2022. Furthermore, belief in the overall social benefit of the COVID-19 vaccine decreased from 47.5% to 25.1%.Conclusion This study highlights concerning trends in vaccine hesitancy and uptake of the COVID-19 and other recommended vaccines. We found that some high-risk groups (e.g. smokers) and population subgroups have become more vaccine hesitant, suggesting the need for improved and intensified strategies to increase vaccine confidence and uptake. Future research may focus on qualitative inquiry to understand specific concerns and determinants contributing to increased hesitancy among these groups to help inform interventions and communication campaigns to support vaccination.

ABSTRACTSexual behaviour of adolescents is contextual, with various determinants affecting sexual activity and age of sexual debut. Insight into sexual activity among young adolescents has the potential to influence appropriate sexual and reproductive health interventions. For this analysis, adolescents were recruited as part of the Tumaini smartphone game efficacy trial. Data collection included a self-administered behavioural survey and blood test for HIV and HSV-2. Descriptive statistics were calculated for demographics and measures of sexual behaviour and behavioural intent based on gender and sexual experience, with associations assessed using chi-square tests, t-tests and Wilcoxon rank sum tests as appropriate. We enrolled 996 adolescents, mean age 14 years and 2.2% HSV-2 positivity. Overall, 15% of the adolescents were sexually experienced, this being associated with lower socio-economic status (p = 0.01), household food insecurity (p = 0.008), a living situation without both parents (p

Introduction: Myxoedema coma is a severe and rare manifestation of hypothyroidism that requires immediate and effective intervention. Traditional treatment involves the use of levothyroxine, a synthetic thyroid hormone. Liquid levothyroxine presents an alternative formulation that may offer advantages in the critical care setting, particularly when gastrointestinal absorption is impaired. Aim of the Study: This narrative review aims to evaluate the efficacy and application of liquid levothyroxine in the treatment of myxoedema coma, comparing it to other available forms and providing insights into its clinical use. Materials and Methods: A comprehensive literature search was conducted using databases such as PubMed, Medline, and Cochrane Library. Studies, clinical trials, case reports, and reviews were included if they addressed the use of liquid levothyroxine in myxoedema coma. Data were extracted and analyzed to assess the pharmacokinetics, administration protocols, outcomes, and comparative efficacy of liquid levothyroxine. Results: The review identified several key studies and case reports indicating that liquid levothyroxine offers superior bioavailability and faster onset of action compared to oral tablets, particularly in patients with compromised gastrointestinal function. Case studies demonstrated improved clinical outcomes and recovery times with liquid levothyroxine, highlighting its potential benefits in the acute management of myxoedema coma. Conclusion: Liquid levothyroxine appears to be a promising alternative for the treatment of myxoedema coma, offering enhanced absorption and rapid therapeutic effects. While preliminary data are encouraging, further research and clinical trials are necessary to establish standardized treatment protocols and confirm its efficacy. Understanding the role of liquid levothyroxine in this critical condition can enhance treatment strategies and improve patient outcomes.

Introduction: Pelvic organ prolapse is a descent of pelvic organs such as the bladder, cervix, apex of the vagina, and rectum which create herniation and slide into the direction of the vagina entrance. Pelvic prolapse is caused by ligament and muscle weakness, and its risk increases with age, parity, and obesity. Proper exercise and weight loss can be a key component of pelvic prolapse management, especially in the I-III stages. Those interventions may decrease the need for pelvic surgery and the risk of complications that can arise from it. Purpose of the study: This study aimed to explore the effectiveness of weight loss and exercise on pelvic organ prolapse (POP) symptoms and staging. Materials and methods: A comprehensive analysis of research papers available on PubMed, and Google Scholar was undertaken using the keywords: ‘weight loss pelvic prolapse’, ‘exercise in pelvic prolapse’, ‘pelvic floor dysfunction’, ‘pelvic floor muscle training’, ‘hypopressive exercises’, ‘biofeedback prolapse’ Results: Conventional weight loss does not reduce the intensity of the pelvic prolapse symptoms. However, weight loss that is achieved via bariatric surgery is effective in reducing symptoms arising from pelvic organ prolapse. Furthermore, the bigger the amount of weight loss the greater improvement in symptoms. Pelvic floor muscle training showed improvement in symptoms and in the staging of pelvic organ prolapse. Hypopressive exercises are not as effective as pelvic floor muscle training. Biofeedback and supervised exercises are helpful in proper exercise execution, and thus may improve the strength of the pelvic floor muscles.

Introduction: Traumatic brain injury (TBI) is one of the most common causes of death and long-term disability. The consequences following TBI can be persistent and cause life-long implications for survivors. Treatment of TBI may be complex and involve large monetary costs. The frequent injury mechanisms are traffic-related, falls, violence or sport-related accidents. Higher risk of brain injury and its complications indicate that people affected by brain trauma may benefit from the prophylactic and post-traumatic use of certain supplements both in the context of physical performance and in the event of potential injury. Aim of the Study: This narrative review examines the current literature of the role of supplementation before and after TBI and its effects on the patient's outcome. Materials and Methods: A comprehensive search was performed using PubMed and Google Scholar focusing on the literature published up to April 2024. The review included randomized controlled trials, meta-analyses, systematic reviews that focused on the use of creatine monohydrate, omega-3 fatty acids, magnesium and zinc in TBI and among the general population. Data of pathophysiology and epidemiology of TBI and safety profile of supplements were involved. Results: The evidence indicates that the role of supplementation with creatine, omega-3 PUFAs and zinc is important in mitigating secondary damage after TBI, as well as in protecting against damage if administered before injury. Conclusion: Because of the complex and multifactorial nature of the TBI more studies are required to constitute an effective nutrition-based strategy for reducing the cognitive and behavioral deficits associated with this injury. The evidence supporting multiple dietary components to improve a patient's outcome seems strong and the cost of its implementation is low. A group of particular interest that may benefit additionally are athletes who use dietary supplementation in their daily routine.

Introduction: Parkinson’s disease (PD) is a fast-growing neurodegenerative condition caused by the deficiency of dopamine (Bloem et al., 2021). Main symptoms include tremor, bradykinesia, muscular rigidity and postural instability (Ye et al., 2023). Although PD treatment primarily involves pharmacotherapy, physical activity-based treatments such as tango dance can improve the quality of life of patients. Aim of the study: This narrative review aims to assess the impact of the therapeutic benefits of tango dance therapy for people with PD. Materials and methods: A comprehensive literature search was conducted in the PubMed database up to 2024. The review included randomised controlled trials, case reports, and pilot studies focused on the impact of tango on PD. Results: Several studies have evaluated the impact of tango on patients with PD. Some of them found that tango improves dynamic balance and walking, reduces the risk of falling, improves body awareness, stability, and emotional well-being among patients with PD. Conclusions: The impact of tango on PD is not yet conclusively documented, and further research is needed.

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition marked by painful nodules and abscesses. It frequently coexists with autoimmune diseases, complicating management. Autoimmune conditions such as thyroid disorders, irritable bowel syndrome (IBS), systemic lupus erythematosus (SLE), and psoriasis are common in HS patients, necessitating a comprehensive care approach. Aim of the Study: This review evaluates the prevalence and impact of autoimmune diseases—autoimmune thyroid disorders, IBS, SLE, and psoriasis—on individuals with HS. Materials and Methods: A literature search of PubMed, Scopus, and Web of Science from 2018 to 2024 identified studies relevant to HS co-morbidities based on quality and relevance. Results: HS shows significant links with autoimmune thyroid disorders, IBS, SLE, and psoriasis. HS patients often have higher rates of hypothyroidism, hyperthyroidism, IBS, and SLE compared to the general population, suggesting shared inflammatory mechanisms. Conclusion: Recognizing co-morbid autoimmune diseases is vital for effective HS management. These associations emphasize the need for a multidisciplinary approach and further research to enhance understanding and treatment strategies.

Introduction: Constipation is a widespread digestive issue characterized by infrequent bowel movements and difficulty in passing stools. While conventional treatments include dietary fiber, laxatives, and lifestyle changes, recent studies have suggested that kiwifruit may offer a natural and effective alternative. This narrative review evaluates the efficacy of kiwifruit in managing and alleviating symptoms of constipation. Aim of the study: The primary aim of this study is to synthesize existing research on the effectiveness of kiwifruit in treating constipation. By examining various clinical trials and observational studies, the review aims to elucidate the therapeutic benefits and mechanisms of action of kiwifruit in improving bowel function. Materials and Methods: A comprehensive literature search was performed using databases such as PubMed, Scopus, and Google Scholar. Data were extracted and analyzed regarding the frequency of bowel movements, stool consistency, and overall gastrointestinal health following kiwifruit consumption. Results: The review identified that regular consumption of kiwifruit significantly enhances bowel function in both constipated and non-constipated individuals. Clinical trials consistently report increased stool frequency, softer stool consistency, and reduced colonic transit time. The beneficial effects are attributed to the high fiber content of kiwifruit and the presence of the enzyme actinidin, which promotes digestion and bowel movements. Kiwifruit was found to be well-tolerated with minimal adverse effects. Conclusion:Kiwifruit appears to be a promising natural remedy for constipation, providing substantial improvements in bowel movement regularity and stool characteristics. Its high fiber content and unique enzymatic properties contribute to its effectiveness. Further research is recommended to explore the long-term benefits and potential applications of different varieties of kiwifruit in diverse patient populations.