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METHODS OF TREATMENT FOR STRESS URINARY INCONTINENCE (SUI): A REVIEW OF CURRENT RESEARCH
No full textResearch objectives: This study aims to provide a comprehensive analysis of treatments for Stress Urinary Incontinence (SUI). Through a detailed discussion and review of the evidence, we examine conservative, pharmacological, and surgical approaches, highlighting their therapeutic benefits. This review also synthesizes the current literature to summarize the advantages and limitations of each method in relation to specific patient groups.
Methods: A literature search was conducted in PubMed and Google Scholar, with emphasis on publications from 2015-2025. The search strategy included terms such as ‘stress urinary incontinence’, ‘pessary’, ‘surgical intervention’, and ‘treatment choice’.
Key findings and conclusions: Stress urinary incontinence (SUI) is a common condition affecting women across a wide range of ages. Effective management requires an individualized approach in which the therapeutic method is selected based on the severity of symptoms, the patient’s anatomical characteristics, coexisting chronic diseases, reproductive plans, and personal expectations regarding treatment outcomes.
First-line therapy for SUI consists of conservative methods, including pelvic floor muscle training, behavioral modification, weight reduction, pessary use, and topical estrogen therapy in postmenopausal women. Although the benefits of duloxetine have been demonstrated, its clinical utility is limited by adverse effects and contraindications during pregnancy, resulting in a restricted role for pharmacotherapy in SUI management. When conservative treatment fails to provide adequate improvement, surgical intervention should be considered. Current evidence supports the mid-urethral sling (MUS) as the preferred surgical method due to its long-term effectiveness and favorable safety profile. MUS has largely replaced earlier techniques such as Burch colposuspension, although the latter may still offer advantages in selected patient groups.
In summary, the treatment of SUI encompasses a wide range of therapeutic options, each with distinct benefits and limitations. Therefore, shared decision-making that incorporates the patient’s medical characteristics and individual preferences is crucial for achieving optimal treatment outcomes
OPEN VERSUS LAPAROSCOPIC NEPHRECTOMY FOR RENAL TUMORS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF PERIOPERATIVE, FUNCTIONAL AND ONCOLOGIC OUTCOMES
No full textBackground: Renal tumors are increasingly detected early due to widespread imaging. For localized tumors, particularly stage T1, partial nephrectomy (PN) is the standard of care, offering oncological efficacy while preservingrenal function. Laparoscopic partial nephrectomy (LPN) has been increasingly adopted, yet comparative outcomes with open partial nephrectomy (OPN) remain actively evaluated.
Aim: To systematically review perioperative, functional, and oncological outcomes of LPN versus OPN in patients with localized renal tumors, including the impact of tumor anatomical complexity.
Materials and Methods: A systematic literature search of PubMed identified comparative studies of LPN versus OPN for T1–T1b renal tumors. Extracted data included operative time, estimated blood loss, complications, renalfunction, oncological outcomes, and tumor complexity assessed by nephrometry scores.
Results: LPN showed perioperative advantages, including reduced blood loss and shorter hospital stay, with operative time generally comparable to OPN in experienced centers. Early and long-term renal function, measured by estimated glomerular filtration rate, was similar between approaches. Oncological outcomes, including positive surgical margins, recurrence-free survival, cancer-specific survival, and overall survival, were equivalent. In anatomically complex or selected T1b tumors, LPN achieved acceptable perioperative and oncological outcomes when performed in experienced centers.
Conclusions: Laparoscopic partial nephrectomy is a safe and effective alternative to open surgery for localized renal tumors, offering perioperative benefits without compromising renal function or oncological control. Tumor complexity and patient characteristics are more influential determinants of outcomes than surgical approach. LPN should be considered a standard option in centers with expertise in minimally invasive nephron-sparing surgery
LIVER RESECTION VERSUS RADIOFREQUENCY ABLATION FOR EARLY-STAGE HEPATOCELLULAR CARCINOMA: AN EVIDENCE-BASED NARRATIVE REVIEW OF ONCOLOGICAL OUTCOMES AND TREATMENT SELECTION
No full textBackground: Surgical resection (LR) and radiofrequency ablation (RFA) are established curative options for early-stage hepatocellular carcinoma (HCC), yet their relative benefits remain debated, particularly regarding long-term survival, recurrence control, and patient selection.
Objectives: To synthesize contemporary evidence comparing liver resection and radiofrequency ablation for early-stage HCC, with a focus on oncological outcomes, recurrence patterns, perioperative safety, and clinically relevant subgroups.
Methods: An evidence-based narrative review was conducted using structured searches of PubMed/MEDLINE and the Cochrane Library. Systematic reviews, meta-analyses, randomized controlled trials, and high-quality observational studies comparing LR and RFA in early-stage HCC were included. Outcomes of interest comprised overall survival (OS), recurrence-free or disease-free survival (RFS/DFS), tumor recurrence, perioperative morbidity, and cost-effectiveness. Findings were synthesized qualitatively.
Results: Randomized controlled trials consistently demonstrated no statistically significant difference in overall survival between LR and RFA. In contrast, meta-analyses and propensity-adjusted observational studies suggested improved long-term survival following resection in selected patients with preserved liver function. Across comparative studies, recurrence-free survival and local tumor control consistently favored resection. Subgroup analyses indicated comparable survival outcomes between modalities in patients with very small tumors, impaired hepatic reserve (Child–Pugh class B), and elderly populations, while tumor size and anatomical location emerged as key modifiers of treatment efficacy.
Conclusions: Liver resection provides superior local tumor control, whereas overall survival remains largely comparable between modalities in carefully selected patients. Treatment selection should be individualized, integrating tumor characteristics, liver function, patient comorbidities, and procedural risk within a multidisciplinary framework
GLP-1 RECEPTOR AGONISTS AND COLORECTAL CANCER: BIOLOGICAL PLAUSIBILITY AND CURRENT EVIDENCE
No full textBackground: Colorectal cancer (CRC) remains one of the leading causes of cancer-related morbidity and mortality worldwide. Besides tumor-intrinsic factors, CRC risk and progression are strongly influenced by metabolic dysfunction - including obesity, insulin resistance, and T2DM. These implications emphasize the need for therapeutic strategies that address both tumor biology and the metabolic context.
Objectives: This review examines the emerging role of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in colorectal cancer biology, synthesizing mechanistic, preclinical, and human evidence to evaluate their potential relevance beyond well-known glycemic control.
Methods: We integrate experimental studies, animal models, and epidemiologic and clinical data to evaluate the effects of GLP-1RAs on colorectal cancer–related pathways, tumor growth and progression, and resulting clinical outcomes, with special attention given to metabolic and signaling mechanisms.
Key Findings: Preclinical evidence suggests that GLP-1RAs may modulate pathways involved in cancer cell proliferation, survival, metabolism, angiogenesis, and invasion, including PI3K/Akt/mTOR, ERK, and hypoxia-associated signaling. In vivo models showcase inhibitory effects on tumor growth and metastatic potential, heightened in metabolically dysregulated settings. Human observational studies report heterogeneous but generally neutral to protective associations between GLP-1RA exposure and CRC risk, while randomized trials have primarily addressed cardiometabolic outcomes rather than being tumor-focused.
Conclusions: Collectively, current evidence supports a biologically plausible role for GLP-1 receptor signaling in colorectal cancer growth and progression. Definitive clinical data are lacking, but evidence regarding GLP-1RAs justifies further investigation into their potential relevance
EFFECTIVENESS OF ORAL COLLAGEN SUPPLEMENTATION IN IMPROVING SKIN ELASTICITY AND HYDRATION: A LITERATURE REVIEW
No full textBackground: Oral collagen supplementation has gained popularity as a strategy for supporting skin health, particularly in the context of aging and disturbances of the extracellular matrix. Evidence suggests that hydrolyzed collagen peptides may affect skin hydration and elasticity by stimulating fibroblast activity and collagen synthesis.
Aim: The aim of this review was to assess the effectiveness of oral collagen supplementation in improving skin elasticity and hydration based on current scientific literature.
Material and methods: A literature review was conducted using the PubMed, Cochrane Library, and Google Scholar databases. Randomized controlled trials, meta-analyses, and systematic reviews published since 2018 that evaluated the effects of oral collagen supplementation on skin hydration and/or elasticity were included.
Results: Most studies indicate that hydrolyzed collagen supplementation is associated with a moderate, statistically significant improvement in skin hydration and elasticity. More pronounced effects were reported for low-molecular-weight collagen peptides and supplementation lasting at least 8–12 weeks. However, analyses limited to studies of the highest methodological quality showed reduced effect sizes.
Conclusion: Available evidence suggests that oral collagen peptides may support improvements in skin hydration and elasticity, although the magnitude of this effect remains uncertain. The most consistent benefits have been observed with low-molecular-weight preparations used for a minimum of 8–12 weeks. Further well-designed studies are required to determine optimal supplementation regimens
SAFETY PROFILE OF PRE-WORKOUT SUPPLEMENTS AND ENERGY DRINKS IN AMATEUR SPORTS: A NARRATIVE REVIEW OF CARDIOVASCULAR AND NEUROPSYCHIATRIC RISKS
No full textIntroduction: The consumption of multi-ingredient pre-workout supplements (MIPS) and energy drinks has become ubiquitous in amateur sports. While these products promise enhanced performance and focus, they often contain high doses of stimulants and proprietary blends that pose significant health risks when used without medical supervision.
Aim: The aim of this narrative review is to analyze the safety profile of pre-workout supplements and energy drinks, specifically focusing on cardiovascular, neuropsychiatric, and metabolic risks associated with their acute and chronic consumption.
Material and methods: A narrative review of current literature was conducted using PubMed, Google Scholar, and Web of Science databases. The analysis focused on original papers, systematic reviews, and case reports regarding caffeine intoxication, MIPS safety, and adverse events in athletes.
Results: Epidemiological data indicates that over 50% of regular pre-workout users experience side effects such as tachycardia, palpitations, and nausea. High-risk behaviors, such as consuming multiple servings ("double scooping"), significantly increase the risk of adverse cardiovascular events. While moderate caffeine intake (e.g., coffee) appears safe for young athletes, the supraphysiological doses found in supplements can lead to severe toxicity, anxiety, and sleep disturbances. Furthermore, fatal cases of caffeine intoxication confirm the lethal potential of unsupervised supplementation.
Conclusions: Education regarding the risks of "stacking" supplements and exceeding recommended doses is critical. Athletes should be encouraged to use safer, natural alternatives and prioritize sleep and nutrition over pharmacological stimulation
POST-TRANSPLANT DIABETES MELLITUS (PTDM) IN PATIENTS AFTER LIVER TRANSPLANTATION – DIAGNOSIS AND TREATMENT
No full textLiver transplantation is an effective method for treating end-stage liver failure and certain liver cancers. Survival after this procedure is associated with the development of comorbidities, including before diagnosed diabetes mellitus and new diagnosed post-transplant diabetes mellitus (PTDM). Its pathophysiology differs from that of type 2 diabetes in the general population and reflects a complex interplay between pre-existing metabolic vulnerability (e.g. obesity, insulin resistance, impaired fasting glucose), perioperative stressors, and chronic immunosuppression. Commonly used immunosuppressive drugs, such as calcineurin inhibitors (particularly tacrolimus), mTOR inhibitors, and glucocorticosteroids, affect not only pancreatic function but also contribute to weight gain and chronic inflammation. Therapeutic goals should therefore be individualized according to time since transplantation, comorbidity burden, risk of hypoglycemia, and liver graft and renal function.
Aim of the study: The objective of this study is to summarize recent literature on the diagnosis and treatment of PTDM and type 2 diabetes mellitus after liver transplantation.
Materials and methods: In this narrative review, we searched the PubMed database to analyze the latest evidence on the treatment and diagnosis of PTDM, and type 2 diabetes mellitus diagnosed before liver transplantation.
Results: We discuss diagnostic approaches as well as pharmacological and non-pharmacological treatment strategies for these metabolic disorders in patients receiving long-term immunosuppression.
Conclusions: Interdisciplinary care and integration of lifestyle interventions are essential to optimize metabolic and cardiovascular risk management in liver transplant recipients. There remains a strong need for further clinical trials evaluating the safety and efficacy of oral antidiabetic agents in this specific patient population
NEPRILYSIN INHIBITORS (ARNI) IN THE TREATMENT OF CHRONIC HEART FAILURE — A SYSTEMATIC REVIEW AND CRITICAL APPRAISAL OF THE EVIDENCE
No full textAngiotensin receptor–neprilysin inhibitors (ARNI), with sacubitril/valsartan as the prototypical agent, have fundamentally transformed the pharmacological treatment paradigm of chronic heart failure (HF) [6,11,36,47,48,49,50]. This systematic review synthesizes the available clinical evidence, with a particular focus on the therapeutic efficacy of ARNI across the full continuum of left ventricular ejection fraction [3,4,17,50]. In patients with heart failure with reduced ejection fraction (HFrEF), pivotal randomized trials have consistently demonstrated the superiority of ARNI over conventional angiotensin-converting enzyme inhibitors in lowering cardiovascular mortality and HF-related hospitalizations, while also promoting favorable reverse myocardial remodeling [2,9,10,11,18,26,30,39,41,43,44,49]. In contrast, among individuals with preserved or mildly reduced ejection fraction, the principal clinical benefit is reduction in recurrent HF hospitalizations, with numerically greater treatment effects reported in women [1,3,7,18,23]. In addition, sacubitril/valsartan exhibits clinically relevant renoprotective effects and a favorable safety profile in complex patient populations, including those with diabetes mellitus or advanced chronic kidney disease [4,10,11,18]. Contemporary clinical guidelines position ARNI as a cornerstone of quadruple guideline-directed medical therapy, recommending early initiation during hospitalization and proactive dose up-titration to optimize clinical outcomes [7,8,11,13,21,31,47,48,49,50]. Addressing barriers to implementation—such as treatment-related hypotension and therapeutic inertia—remains essential to reduce the considerable global burden of heart failure [5,7,28,29,34,38]
THE MICROBIOTA–GUT–BRAIN AXIS IN MENTAL HEALTH: MECHANISMS, CLINICAL EVIDENCE, AND EMERGING THERAPEUTIC STRATEGIES
No full textInteractions between intestinal microbiota and the central nervous system have become one of the most dynamic areas of biomedical research. Accumulating evidence demonstrates that gut microorganisms influence emotional regulation, cognition, and stress responsiveness through complex neural, immune, and metabolic pathways. This review provides an extensive overview of current knowledge regarding the microbiota–gut–brain axis, with particular emphasis on depression and anxiety disorders. Mechanistic insights, human clinical trials, and therapeutic perspectives including probiotics, prebiotics, dietary modulation, and fecal microbiota transplantation are discussed. Despite promising findings, important methodological limitations remain, and further research is required to translate microbiota-based interventions into routine psychiatric practice
THE EYE AS AN INTERFACE: HOW XR, AI AND AUTOMATION CHANGED OPHTHALMIC PRACTICE (2015–2025)
No full textThis review examines the integration of emerging digital technologies in ophthalmology to address global vision impairment affecting over 2.2 billion people, with a focus on scalability, equity, and sustainability amid rising age-related pathologies like AMD, glaucoma, and DR.
Objectives: Synthesize evidence from 2015-2025 on xVR/AR, AI, teleophthalmology, robotics, and nanotechnology, evaluating clinical efficacy, economic viability, ethical implications, and environmental impact.
Methods: Systematic literature search across PubMed, Scopus, IEEE Xplore, and Web of Science using Boolean keywords for targeted technologies. Inclusion: peer-reviewed studies with quantitative outcomes (e.g., visual acuity, AUC, CO2 reductions); exclusion: pre-2015, non-English, non-clinically validated works. Data extraction emphasized study design, interventions, outcomes, biases, and ethics.
Key Findings: VR dichoptic therapy yields 1.8 logMAR improvements in amblyopia with 88% adherence, surpassing patching. AI achieves >90% sensitivity for DR screening, mitigated by generative models for bias. Teleophthalmology resolves 75% cases remotely, saving up to 176 kg CO2/patient. Robotics enable <20 µm precision in surgeries like automated cataract extraction. Nanotechnology enhances drug bioavailability (>5%); 3D bioprinting pioneers corneal implants.
Conclusions: These technologies foster precise, decentralized eye care, but require addressing biases, regulations, and access barriers for equitable global impact