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Introduction and purpose Cachexia is a complex and multifactorial syndrome, which is a current, worldwide treatment challenge, and concerns most of the patients with cancer. The issue is characterized by anorexia, skeletal muscle loss, adipose tissue wasting, involuntary weight loss, malnutrition, and poor appetite due to dysfunction of metabolism and chronic, systemic inflammation. Additionally, it impacts oncological treatment and a decline in Quality of Life. The review aims to explore the latest research, innovations, and potentials in the treatment of cachexia. Material and methods The review was based on research of articles published from 2019 to 2024 on the PubMed database using the following keywords: cancer cachexia, palliative care, and cachexia pharmacotherapy. Results Anamorelin, a selective ghrelin receptor agonist showed effectiveness in weight gain and appetite improvement. Also, myostatin inhibitors protect muscles and promote their growth due to suppression of myostatin. Ponsegromab, a GDF-15 inhibitor, significantly and directly enhanced muscle mass, appetite, and quality of life, with good safety. Modern anti-inflammatory medications like momelotynib or tocilizumab, reduced the concentration of pro-inflammatory cytokines and improved quality of life, however, but posed immunosuppression risk. Pentoxifylline declined inflammation and chemotherapy toxicity, and improved body weight and survival. Cannabinoids alleviated chemotherapy-induced nausea but were ineffective for weight and quality of life. Conclusions Therapeutic approaches target various aspects of cachexia due to its complex pathophysiology. Anamorelin, ponsegromab, and myostatin inhibitors have clinical potential. Modern anti-inflammatory drugs and pentoxifylline offer supportive benefits. Further research is vital for developing effective and safe treatment guidelines for cancer cachexia.

Introduction and objective Raynaud's phenomenon is a condition of unknown origin and complex pathophysiology, characterized by an excessive sensitivity to vasoconstriction of arteries in the hands, feet, auricles and nose, leading to a characteristic constellation of symptoms with at least two phase course: pallor and cyanosis. The aim of this work is to review surgical techniques for treating patients with Raynaud's phenomenon and to attempt to determine whether the results of current studies may support earlier initiation of surgical treatment. Review methods To prepare this review, the authors used PubMed and Google Scholar databases, searching the following keywords: "Raynaud's phenomenon", "Raynaud's phenomenon surgical management", "digital artery reconstruction" "sympathectomy", "arterial bypass", "venous arterialization". The search results were limited to studies in English from 2006 to 2024, as well as key studies from earlier years. Brief description of the state of knowledge Currently, patients who are qualified for surgical treatment in the course of Raynaud's phenomenon are those who have symptoms or non-healing ulceration despite of an appropriate pharmacological treatment. Current therapy using calcium channel blockers does not bring full satisfaction to patients. Therefore, the search for optimal therapy continues, with a particular focus on the development of microsurgical treatment techniques. Summary The occurrence of Raynaud's phenomenon, especially the pain and discomfort associated with it, significantly reduces patients' quality of life. Due to advances in the field of microsurgery and the discovery of new mechanisms responsible for the development of Raynaud's phenomenon, earlier patient qualification for surgical procedures is becoming possible. This gives hope for further development of surgical approaches and improvements in treatment outcomes. Keywords: Raynaud's phenomenon; sympathectomy; arterial bypass; venous arterialization

Introduction and purpose Probiotics are widely used by parents of children, as well as by heathcare professionals. Because of their long history of presence on the market they have become an evident addition to the treatment of gastrointestinal disorders. The aim of this review is to emphasize what are the current recommendations for the use of probiotics in children in antibiotic-associated diarrhea (AAD), acute diarrhea and functional constipation, determine what the safety of their use is, and what to look for when choosing a product. Material and methods For this review, we used the literature available in PubMed and Google Scholar using the following keywords: “probiotics”, “probiotics in pediatrics”, “gut microbiota”, “acute gastroenteritis”, “AAD in children”, “functional constipation”. Brief description of the state of knowledge Probiotics are often used in pediatrics despite their uncertain efficiency. At the same time, there is a focus on the quality, purity and appropriate dosage of preparations available on the market. Extra precaution must be taken when administering a preparation or refraining from administering a probiotic to children with immune disorders. The benefit of their use mostly in AAD in children is difficult to determine. Conclusion Probiotics may be considered during antibiotic therapy in children if a broad-spectrum antibiotic is being used, the duration of therapy is prolonged, or there are other risk factors for AAD in children. In acute gastroenteritis, probiotics can be considered; however, their effectiveness is limited. Probiotics should not be used in the treatment of functional constipation. It is preferable to use probiotics in the form of a medicine. The efficacy of probiotics is both strain-specific and disease-specific.

Introduction: Polycystic ovary syndrome(PCOS) is the most common endocrine disorder among women of reproductive age. It is characterized by clinical symptom caused by high androgen level such as acne, hirsutism and irregular menstrual cycles. The cause of PCOS is unknown but both genetic and environmental factors are believed to play a role. The key elements in the patogenesis of this syndrome are insulin resistance, hyperinsulinemia and hyperandrogenism. PCOS increases the risk of metabolic and cardiovascular diseases. The aim of this review is to describe the efficiency, safety and potential benefits of the ketogenic diet on the metabolic profile, hormonal balance and fertility in women with PCOS. Materials and methods: A literature review was conducted using the databases such as Pubmed and Google Scholar. Results: The ketogenic diet focuses on reducing carbohydrate intake while proportionally increasing fat and protein consumption. This diet reduces insulin resistance and positively impacts Patients’ metabolic profile and hormonal balance. This contributes to improve fertility in women, who often experience difficulty conceiving. Conclusion: The results of the studies show that the ketogenic diet has a positive effect on metabolic profile and hormonal balance in Patients with PCOS. However, further research is needed in larger groups of Patients and over longer periods of time to evaluate whether it can become an effective form of therapy for PCOS Patients.

Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome with a multifactorial pathogenesis. Leptin, a hormone produced by adipose tissue, plays a key role in regulating energy balance, metabolism, and inflammatory processes. Its impact on the cardiovascular system is dualistic: on one hand, leptin can contribute to the development of HFpEF by promoting inflammation and metabolic dysfunction; on the other hand, it may exert protective effects by reducing body weight and enhancing metabolic functions. This literature review examines current data on leptin's role in HFpEF, exploring both its detrimental and beneficial effects. The objective is to elucidate the mechanisms through which leptin influences the onset and progression of HFpEF, potentially guiding the development of more targeted therapeutic strategies.

INTRODUCTION AND PURPOSE OF THIS WORK Advanced age is a significant risk factor for the onset of cognitive decline. Nutritional interventions, including caloric restriction (CR) and intermittent fasting (IF), have garnered considerable attention for their potential neuroprotective effects. Emerging evidence suggests that these dietary approaches may attenuate age-related neurological deterioration. This review explores the mechanisms through which intermittent fasting may enhance cognitive function. METHODS AND MATERIALS For this review, we used the literature available in PubMed, searching the following keywords: “brain aging”, “cognition and diet”;”neuroprotection”;“caloric restriction”;“neuroplasticity”. The search results were limited to studies from 2005 to 2024, as well as key studies from earlier years. Authors took into consideration articles originally written in English. In the end, 25 articles were included in this review. BRIEF DESCRIPTION OF THE STATE OF THE KNOWLEDGE In recent decades, advancements in medical science and increased public awareness regarding health-promoting behaviors have contributed to a rise in life expectancy, leading to a growing elderly population. Consequently, the role of modifiable factors, such as dietary patterns, is proven to be an important elements which contributes to delaying brain aging. CONCLUSIONS The review indicates the evidence supporting the positive effects of intermittent fasting (IF) on cognitive function remains lacking. Nonetheless, numerous promising mechanisms have been identified but in short-term studies, suggesting potential benefits in mitigating cognitive decline. These findings underscore the necessity for longitudinal studies to comprehensively evaluate the long-term effects of IF on cognitive health.

Pelvic organ prolapse (POP) is a very common health problem, which affects increasing number of women. The etiology involves multiple factors, especially ageing or increased abdominal pressure. It refers to the downward displacement of the pelvic organs and its protrusion. This condition can significantly affect the quality of life, causing urinary and fecal incontinence, sexual dysfunctions and self-consciousness. The examination includes both physical and imaging studies. Patients can be offered an observations, pessaries and surgeries, such as obliterative and reconstructive surgeries. A literature for this review was gathered on PubMed and Google Scholar, using keyword “pelvic organ prolapse”, combined with “epidemiology”, “pathophysiology”, “risk factors”, “symptoms”, “complications”, “treatment”, “surgery” and “pessaries”.

Introduction Heart failure (HF) is a common clinical syndrome characterized by symptoms such as breathlessness and fatigue, affecting 1-2% of adults in developed countries. Standard treatment for heart failure with reduced ejection fraction (HFrEF) includes a "new quadruple" therapy comprising ARNI/ACE-I, beta-blockers, MRAs, and SGLT2i. However, a subset of patients remains inadequately managed, highlighting the need for new therapies like vericiguat. Vericiguat, an oral soluble guanylate cyclase (sGC) stimulator approved by the FDA in January 2021, shows promise for patients with heart failure with reduced ejection fraction (HFrEF). This review highlights vericiguat's pharmacodynamics, including its mechanism that enhances nitric oxide effects and promotes vasodilation, thereby improving hemodynamic status. Materials and Methods This review synthesizes recent literature on vericiguat sourced from PubMed and Cochrane databases, including studies published in English between 2023 and 2024. Eight relevant publications were selected based on strict inclusion criteria. Results Reviewed studies demonstrate that vericiguat significantly reduces NT-proBNP levels and lowers the risk of composite cardiovascular death or HF hospitalization. Notably, vericiguat showed efficacy in specific subgroups, including patients with chronic kidney disease and those in NYHA class III/IV. Conclusion Vericiguat is a promising candidate for inclusion in the "new quadruple" therapy for HF, particularly for patients with severe symptoms or chronic kidney disease. Further research is essential to clarify its benefits in stable HF patients and its comparative efficacy alongside current guideline-directed medical therapy.

Introduction and purpose of this work CPPD is an arthropathy related to calcium pyrophosphate crystals’ deposition in joints triggering an inflammatory response leading to local articular damage. CPPD mainly affects the large and weight-bearing joints.In this review paper, our aim is to outline the current knowledge on epidemiology, origins, clinical manifest, diagnostical tools, new guidelines of the (ACR) and (EULAR) and current treatment options for CPPD. Methods: We performed a systematic electronic search on PubMed, Medline and Google Scholar databases. The search results were limited to publications from 2002 to 2024, as well as key studies and reference books from earlier years. Brief description of the state of knowledge CPP crystals in joints can lead to an inflammatory response and lead to joint damage. CPPD is the third most common reason of arthritis. Its origin is rather idiopathic, but there has been research showing the linkage of this disease to genetical background and some metabolic disorders.The treatment is chosen based on the phenotype of the disease.conventional pharmacological treatment includes NSAIDs, colchicine and corticosteroids. New opportunities to CPPD treatment have appeared thanks to biological medications which inhibit the inflammatory process. Summary Early diagnosis of CPPD, distinguishing it from other forms of arthritis and identifying the possible co-occurring diseases such as gout, rheumatoid arthritis and osteoporosis can help the clinicians to apply the proper treatment . Most patients are seniors with several comorbidities, this is why it is important to choose the right treatment, which prevents exacerbation of the inflammatory process and ensures high quality of life for the patients.

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.