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Primary sclerosing cholangitis (PSC) is an inflammatory, cholestatic and progressively fibrotic liver disease devoid of effective medical intervention. PBC is a presumed immune-mediated liver disease of middle-aged women associated with significant morbidity and mortality. People living with PBC are frequently symptomatic, experiencing a quality-of-life burden dominated by fatigue, itch, abdominal pain, and sicca complex. Many drugs have been studied for treatment, including agents with choleretic and immunosuppressive properties. Future PBC licensed therapy will likely include peroxisome proliferator activated receptor (PPAR) pathway agonists, including specific PPAR-delta agonism (seladelpar), as well as elafibrinor and saroglitazar (both with broader PPAR agonism). Effective therapy reduces the need for transplantation and improves life expectancy.

Hemophilia is a genetically determined bleeding disorder characterized by a tendency for spontaneous bleeding, mainly into the joints, which can lead to arthropathy and significantly reduce the quality of a patient's life. The objective of this paper is to review the published literature on the impact of physical activity on the course of the disease and its role in current therapeutic protocols. Online databases were used to search for literature. The retrieved articles were analyzed. The review mainly included literature published after 2016. In the past, physical exercise was not recommended for people with hemophilia, primarily due to concerns about joint bleeding and the development of hemophilic arthropathy. Currently, regular, moderate physical activity plays a crucial role in the management of hemophilia, helping to strengthen muscles and improve joint stability, which can reduce the risk of bleeding. This shift in perspective is largely due to the availability of effective therapeutic options, mainly involving the replacement clotting factors. However, entirely new hopes for a permanent cure and the maintenance of physical fitness are brought by modern gene therapy treatments. Physical activity is essential for maintaining the health and fitness of individuals with hemophilia, and most exercises are safe due to effective prophylactic treatment. In addition to the benefits for joint health, regular exercise also helps prevent many lifestyle-related diseases.

Vitamin D is an essential nutrient that plays an important role in promoting overall health and well-being. Deficiencies of nutrients such as vitamin D are common in patients with autoimmune diseases. The incidence of these conditions is constantly increasing. As a result, patients are exposed to severe symptoms and discomfort in daily functioning. The causes, as well as the symptoms and complications they cause, are diverse, making diagnosis and treatment difficult. Therefore, during the clinical care of patients with AID, possible micronutrient deficiencies should be taken into account and, if observed, they should be treated with controlled supplementation. The aim of this article was to review the literature on the impact of low vitamin D status on the development of autoimmune diseases in the field of endocrinology.

Introduction and Purpose: More and more alternatives to traditional smoking are available on shop shelves. Are other ways of using nicotine healthier for us? What are the advantages and disadvantages? The aim of this article is to trace the health effects of new, popular alternatives to the traditional cigarette. Materials and methods: A literature search was conducted using the medical databases PubMed and Google Scholar. Articles were retrieved in English, employing the key words: “Iqos”, “Glo”, „ e-cigarette” and „ tobacco” appropriate configurations. Conclusions: Modern tobacco devices, such as IQOS and Glo, emit significantly less harmful substances than traditional cigarettes. In particular, emissions of carbon monoxide, formaldehyde and polycyclic aromatic hydrocarbons are significantly lower. Nevertheless, nicotine remains the main ingredient in these products, with serious health risks. Regular use of nicotine can lead to addiction, cardiovascular disease and problems with the nervous system and oral cavity. Inhaling aerosol from tobacco devices such as IQOS, Glo and disposable e-cigarettes can lead to damage to lung cells and other respiratory health problems. Despite the lower risks, the use of alternative smoking methods is still harmful to our health.

Current global statistics indicate nearly 20 million new cancer cases and close to 10 million cancer deaths annually. Demographic forecasts predict that the annual number of new cancer cases will reach 35 million by 2050, representing a 77% increase from the 2022 levels. These statistics highlight that oncology patients will increasingly be seen by doctors of all specialties. This is a particular patient population because, primarily, they are chronically ill with a severe disease and are treated with potent medications. The focus of both the doctor and patient is usually on the disease and the primary treatment, as these constitute the main therapeutic issue. Consequently, the aspect of physical activity, which is an adjunct, may not only be deprioritized but may also be entirely overlooked. Recent studies support the promotion of physical activity and exercise for adult oncology patients before, during, and after cancer treatment, across all types of cancer, including those with advanced disease. Lack of physical activity, reduced physical fitness, including exercise intolerance, and dependency are common consequences of cancer and its treatment. The vast majority of guidelines for those diagnosed with cancer suggest that physical activity is an essential part of care. Individualization and optimization of oncological treatment significantly improve prognosis for these patients. Simultaneously, there remains a continuous need for further research into the type, intensity, and duration of physical activity for cancer prevention, as well as the development of effective recommendations for patients during active cancer treatment and in remission.

Introduction and Purpose: Stroke is a common complication of one of the most common cardiac arrhythmias, atrial fibrillation. The aim of this study is to provide key information about these diseases and to compare the drugs used to prevent stroke. Materials and methods: A literature search was conducted using the medical databases PubMed and Google Scholar. Articles were retrieved in English, employing the key words: “VKA “, „NOAC”, „atrial fibrillation”, „anticoagulants“ and „stroke” appropriate configurations. Conclusions: According to the recommendations and available medical literature, the use of NOACs is usually the most appropriate choice for stroke prevention in patients with atrial fibrillation. However there are also clinical situations, in which the use of VKAs would be more appropriate.

Polycystic ovary syndrome (PCOS) is an endocrine disorder caused by multiple genetic and environmental factors, affecting women of reproductive age but extending across all stages of a woman's life [1]. Major symptoms in many PCOS patients include menstrual cycle irregularities, difficulties in maintaining normal body weight, excessive body hair growth, acne, and fertility problems. The prevalence of PCOS varies depending on the definition used, ranging between 6-20%, making it the most common endocrine disorder among women of reproductive age [2,3]. It accounts for approximately 80% of cases of anovulatory infertility, disrupting various stages of the reproductive axis. Evidence from numerous studies suggests that lifestyle modification should be the first-line therapy for women with PCOS [4]. This paper focuses on research evaluating the treatment of this condition through lifestyle changes, physical activity, and diet. Such therapeutic interventions can significantly improve clinical outcomes and the health profile of PCOS patients by promoting favorable changes in body composition, partially normalizing sex hormone levels, reducing inflammatory parameters, and improving mental health. Therefore, the adoption of comprehensive lifestyle modifications is crucial in the treatment of polycystic ovary syndrome.

Introduction and Purpose: We are increasingly seeing new trends on social media regarding intense strength training in pregnant women. How much should women in a physiological pregnancy exercise? The aim of this piece is to trace the guidelines and set a healthy limit for such an important aspect during pregnancy. Materials and methods: A literature search was conducted using the medical databases PubMed and Google Scholar. Articles were retrieved in English, employing the key words: “strength training”, “activity during pregnancy”, „intensive exercise” and „ physical activity guidelines” appropriate configurations. Conclusions: The available guidelines and medical literature show that it is worthwhile to regularly practise sport both during and in preparation for pregnancy. In a healthy, physiological pregnancy, there is a wide range of activities to choose from, through which health benefits can be achieved, such as strengthening muscles, improving performance, alleviating pregnancy complaints (constipation, pain, nausea) and improving wellbeing, and much more. However, there are contraindications to certain exercises for specific conditions during pregnancy. You should consult your doctor on a case-by-case basis.

Introduction and objective Inflammatory bowel disease (IBD), leading to inflammation in the gastrointestinal tract, causes a number of bothersome symptoms that contribute to the deterioration of patients' quality of life both physically and psychologically. Therapy methods based on pharmacotherapy in IBD often remain insufficient in the treatment of these disorders, so other factors affecting the course of IBD are being sought. The purpose of this review is to present risk and prevention factors for the development of inflammatory bowel disease based on diet and environmental factors. Abbreviated description of the state of knowledge The review has identified a number of factors that influence IBD. One of these is smoking, which shows a commonly detrimental effect on CD, while it has a protective effect in UC patients. Antibiotic therapy, by disrupting the composition of the endogenous intestinal microflora, contributes to an increased risk of IBD exacerbations. A review of the literature on surgical interventions does not allow a clear conclusion. Stress and psychiatric disorders increasing the production of pro-inflammatory cytokines, inhibiting the anti-inflammatory action of the vagus nerve increase the risk of IBD exacerbations. A healthy and balanced diet is an important aspect in the treatment of UC and CD. Scientific societies unanimously recognize breastfeeding and its effect on the development of the intestinal microflora as an important protective factor. On the other hand, introducing an elimination diet without a food intolerance confirmed by a blood test is unjustified and harmful. Summary Awareness of the risk factors for development and exacerbations in IBD patients is crucial. Further research into the impact of diet and environmental factors may support pharmacological treatment in achieving therapeutic success in patients with inflammatory bowel disease.