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THE ROLE OF GUT MICROBIOTA IN THE PATHOGENESIS OF DEPRESSION - CURRENT STATE OF KNOWLEDGE
Get PDFIn recent years, there has been growing interest in the role of the gut microbiome in modulating brain function and its potential impact on mental disorders, including depression. The gut-brain axis, a complex communication network between the gastrointestinal tract and the central nervous system, is crucial for comprehending the relationship between gut microbiota and mental health. Communication along this pathway takes place through various pathways: neuronal, hormonal, and immunological. Multiple preclinical and clinical investigations demonstrate that alterations in the composition and diversity of gut microbiota can influence neuroinflammatory mechanisms, neurotransmitter metabolism, and hypothalamic-pituitary-adrenal (HPA) axis function, potentially facilitating the emergence of depressive symptoms. This article aims to examine contemporary findings about the mechanisms by which the gut microbiome affects mood and to evaluate potential treatment strategies, including psychobiotics, dietary modifications, and fecal microbiota transplantation. Comprehending the function of the microbiome in the etiology of depression could provide novel avenues for the diagnosis and treatment of affective disorders. Although the current state of knowledge does not yet allow the formulation of concrete conclusions and diagnostic and therapeutic recommendations, it certainly encourages further research
ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) IN ADULTS: AN OVERVIEW OF THE CURRENT STATE OF KNOWLEDGE, DIAGNOSTIC CHALLENGES, AND THERAPEUTIC STRATEGIES
Get PDFAttention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder most commonly diagnosed in childhood. In recent years, the approach to its diagnosis and understanding has undergone significant changes. ADHD is increasingly being diagnosed in adulthood, which is related to advances in diagnostics and growing awareness among specialists. The aim of this review is to present the current state of knowledge regarding the clinical picture, diagnostic methods, and therapeutic strategies used in the treatment of ADHD in adults. The most common comorbid disorders and difficulties resulting from late diagnosis of this condition will also be discussed. Attention was also drawn to the need for further research and the development of specialist education in the diagnosis of ADHD
ADVANCES IN MINIMALLY INVASIVE SURGERY FOR THE MANAGEMENT OF UPPER URINARY TRACT ANOMALIES IN CHILDREN
Get PDFBackground. Minimally invasive surgery (MIS) has significantly evolved in pediatric urology, offering alternatives to traditional open techniques by reducing postoperative morbidity, improving cosmetic outcomes, and accelerating recovery. Technological advancements, especially the miniaturization of instruments and the introduction of robotic systems, have expanded the indications and efficacy of MIS for upper urinary tract anomalies in children.
Aim. To review the current applications, outcomes, and future directions of minimally invasive techniques in the treatment of upper urinary tract anomalies in the pediatric population.
Material and Methods. This narrative review summarizes data from published literature regarding laparoscopic and robot-assisted procedures in pediatric urology. It analyzes indications, technical considerations, benefits, limitations, and comparative outcomes of MIS versus open surgery, focusing on procedures such as pyeloplasty, nephrectomy, ureteroureterostomy, and ureterocalicostomy.
Results. MIS approaches demonstrated reduced hospital stays, less blood loss, lower opioid use, and improved cosmetic results with comparable complication rates to open surgery. Robot-assisted procedures, particularly pyeloplasty, showed promising safety and efficacy—even in infants—and allowed for outpatient, stent-free interventions. Challenges remain in cost, equipment scaling for pediatric patients, and training requirements.
Conclusions. MIS, including robotic-assisted surgery, is becoming the gold standard for many upper urinary tract interventions in children. Continued technological advancement and surgical expertise are expected to further enhance outcomes, expand indications, and improve the quality of care in pediatric urology
THE ROLE OF NASAL FIBEROSCOPY IN OTORHYNOLARYNGOLOGICAL PRACTICE FOR THE EARLY DETECTION OF UPPER AIRWAY CANCERS
Get PDFIntroduction and Purpose: Nasopharyngeal fiberoscopy is a modern, minimally invasive diagnostic technique that allows for direct, dynamic, and high-resolution visualization of the upper respiratory tract, including the nasal cavity, nasopharynx, oropharynx, and larynx. By using a thin, flexible fiber-optic endoscope, clinicians are able to assess the mucosal surfaces in great detail, identify potential pathological changes, and collect targeted biopsy specimens in a safe and precise manner. Compared to traditional examination methods such as indirect laryngoscopy or mirror examination, fiberoscopy offers significantly improved diagnostic accuracy, greater patient comfort, and the advantage of being performed in outpatient settings without the need for hospitalization.
In the field of otolaryngology, early detection of malignancies of the upper aerodigestive tract—such as laryngeal, nasopharyngeal, nasal, and base-of-tongue cancers—remains one of the most important clinical challenges. Detecting neoplastic changes at an early stage dramatically increases the likelihood of effective treatment, reduces the extent of surgical intervention required, and improves long-term prognosis. Consequently, the development and implementation of accurate, accessible, and non-invasive diagnostic tools such as fiberoscopy are of particular importance—not only in clinical practice but also in population-based screening and prevention strategies targeting high-risk groups.
This article provides a comprehensive review of current literature concerning the application of nasal fiberoscopy in the early diagnosis of upper airway cancers. It discusses the clinical advantages and limitations of the method, details of the examination procedure, and its role in the differential diagnosis of non-specific symptoms such as chronic hoarseness, globus sensation, or unilateral otalgia. Special attention is given to the integration of fiberoscopy with advanced imaging techniques (e.g., Narrow Band Imaging, autofluorescence, CT, and MRI), as well as the implementation of artificial intelligence and machine learning in real-time diagnostic support systems. Selected clinical cases and PubMed-sourced studies are presented to illustrate the growing clinical relevance and diagnostic effectiveness of this technique. The article also outlines future directions for the development of fiberoscopy and highlights its potential to become a key pillar in personalized head and neck cancer diagnostics in the 21st century.
Materials and Methods: This narrative review was based on a comprehensive search of scientific literature in the PubMed, Web of Science, and Google Scholar databases using the following keywords: nasal fiberoscopy, upper airway cancers, early diagnosis, endoscopic screening, otorhinolaryngology, and laryngological fiberoscopy. The analysis included original research articles, review papers, meta-analyses, case reports, and clinical guidelines from scientific societies that addressed the use of nasal fiberoscopy in the diagnosis of upper airway malignancies.
The selected publications provided data on diagnostic effectiveness, screening potential, technical capabilities, and integration with imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), narrow band imaging (NBI), autofluorescence, and artificial intelligence–assisted analysis. The aim was to synthesize current knowledge regarding the clinical value and evolving role of nasal fiberoscopy in the early detection and evaluation of upper aerodigestive tract cancers within otorhinolaryngological practice.
Results: The literature analysis revealed that nasal fiberoscopy demonstrates high diagnostic sensitivity and specificity in detecting both precancerous and cancerous lesions within the upper aerodigestive tract. This technique allows for real-time, dynamic assessment of anatomical structures, as well as the performance of targeted biopsies under direct visualization, which significantly enhances diagnostic accuracy. Compared to static imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI), fiberoscopy offers superior evaluation of mucosal surfaces and phonatory function.
Numerous studies have confirmed that the use of fiberoscopy in patients presenting with non-specific symptoms - such as hoarseness, dysphagia, or epistaxis - led to early detection of laryngeal, nasopharyngeal, and base-of-tongue cancers. Furthermore, in high-risk populations, including tobacco users, individuals with occupational exposure to carcinogens, or those with a positive oncological family history, nasal fiberoscopy proved more effective in identifying subclinical lesions than clinical observation alone.
Several case reports describe instances where routine fiberoscopic examination enabled the identification of early-stage malignancies in asymptomatic patients, which was critical for initiating radical yet function-preserving treatment. These findings highlight the growing importance of nasal fiberoscopy as both a diagnostic and screening tool in contemporary otorhinolaryngological practice.
Conclusions: Nasal fiberoscopy is becoming an increasingly important tool in otorhinolaryngological diagnostics. Its advantages - real-time assessment of mucosal structures, the ability to perform targeted biopsies, wide availability in outpatient settings, and low cost—make it applicable both in differential diagnosis and in screening high-risk populations. The literature clearly indicates that nasal fiberoscopy holds significant value as a first-line diagnostic method for patients with suspected neoplastic changes in the upper aerodigestive tract.
Integration with modern imaging technologies and artificial intelligence systems may further enhance its diagnostic effectiveness. However, additional large-scale clinical studies are necessary to validate its efficacy and to develop standardized screening protocols. In light of the rising incidence of head and neck cancers and the increasing emphasis on early detection, nasal fiberoscopy has the potential to play a pivotal role in improving treatment outcomes and overall patient survival
PSYCHEDELICS IN PSYCHIATRY - OVERVIEW OF PSILOCYBIN RESEARCH
Get PDFIntroduction: Recently, there has been a significant increase in interest in the use of psychedelics for various psychiatric conditions. Psilocybin is receiving particular attention as a psychoactive substance with significant therapeutic potential. Recent research focuses on its possible benefits in the treatment of major depressive disorders (MDD) and anorexia nervosa (AN).
Purpose of the study: This study aims to investigate the therapeutic potential of psilocybin in treating MDD and AN by analyzing its mechanism of action, clinical trials results and further implications of PAT.
Materials and methods: An overview of 26 articles sourced from PubMed and open-access databases was conducted, with a focus on randomized controlled trials, neurobiological mechanisms and also exploratory research.
Conclusions: Psilocybin and PAT demonstrated significant antidepressant effects, enhancing neuroplasticity, connectivity and cognitive flexibility. While evidence in MDD is significantly more established, preliminary findings in AN are promising, but still require further controlled clinical trials. Psilocybin represents a novel approach to treatment of MDD and AN
THE ROLE OF PRECISION MEDICINE AND GENOMICS IN CARDIAC SURGERY
Get PDFBackground: Precision medicine, driven by advances in genomics, is reshaping the approach to diagnosis, risk assessment, and treatment planning in cardiac surgery. By analyzing genetic variation and molecular pathways, clinicians can move beyond standardized protocols toward individualized surgical care.
Methods: This review synthesizes recent literature on the integration of genomic technologies - such as whole genome sequencing, gene expression profiling, and pharmacogenomics - into the preoperative, intraoperative, and postoperative phases of cardiac surgery. Sources include peer-reviewed articles, clinical trial data, and translational research reports published over the past 20 years.
Results: Genomic profiling enables improved risk stratification, early detection of hereditary cardiovascular diseases, and identification of genetic biomarkers predictive of surgical outcomes. Pharmacogenomic insights allow optimization of perioperative drug therapy, reducing complications and enhancing recovery. Emerging applications include bioinformatics-driven surgical planning and integration of multi-omic data for real-time decision support. However, challenges remain regarding data interpretation, ethical considerations, and integration into clinical workflows.
Conclusion: Precision medicine and genomics hold significant promise for improving patient-specific outcomes in cardiac surgery. Their successful implementation will require robust clinical evidence, interdisciplinary collaboration, and infrastructure to manage and interpret complex genomic data. Ongoing research is likely to expand their role from risk prediction to fully individualized surgical strategies
EFFICACY AND SAFETY OF LOW-DOSE ORAL MINOXIDIL IN THE TREATMENT OF ANDROGENETIC ALOPECIA – A LITERATURE REVIEW
Get PDFIntroduction: Androgenetic alopecia (AGA) is a chronic progressive form of hair loss affecting a significant portion of the adult population. Although topical minoxidil has a proven efficacy, it is often associated with low adherence due to adverse effects and the inconvenience of use. Increasing attention is being paid to low-dose oral minoxidil (LDOM), which may represent a therapeutic alternative with a favorable safety profile.
Purpose of The Work: The aim of this study was to assess the efficacy and safety of low-dose oral minoxidil (≤5 mg/day) in the treatment of androgenetic alopecia based on current clinical trial data.
Material and Methods: A narrative literature review was conducted, including studies published in English between 2019 and 2024, concerning the efficacy and safety in patients with AGA. A total of 9 publications meeting the inclusion criteria were analyzed.
Results: The analyzed studies demonstrated that LDOM increases both the number and diameter of hair in patients – in both men and women. The best results were observed at doses of 1-5 mg/day, although even very low doses (0.25 mg/day) yielded measurable effects. Adverse events were generally mild – most commonly hypertrichosis and cardiovascular symptoms (e.g., tachycardia), with incidence increasing with dose. Serious complications were rare and occurred primarily in patients with pre-existing heart disease.
Conclusion: Low-dose oral minoxidil is an effective and well-tolerated treatment option for AGA. Further studies are needed to standarize dosing and assess the long-term safety of the therapy
ELECTROCONVULSIVE THERAPY AS A SECOND-LINE TREATMENT FOR BIPOLAR MANIA
Get PDFIntroduction and Objective: Bipolar disorder affects approximately 2-4% of the global population, with acute mania representing a significant clinical challenge. While pharmacological interventions remain first-line treatments, 20-30% of patients experience inadequate response or intolerable side effects. This review evaluates the efficacy, safety, and clinical implementation of electroconvulsive therapy (ECT) as a second-line intervention for treatment-resistant bipolar mania.
Material and Methods: A comprehensive analysis of contemporary literature was conducted, examining controlled trials, meta-analyses, systematic reviews, and clinical guidelines published between 1988 and 2024. The review focused on clinical response rates, comparative efficacy studies, adverse effect profiles, technical parameters, and integration with pharmacotherapy.
Results: Evidence consistently demonstrates high efficacy rates (80-90%) for ECT in treatment-resistant mania, with rapid symptom resolution often occurring within the first week of treatment. Modern ECT techniques have substantially mitigated historical concerns regarding cognitive side effects. Bilateral electrode placement traditionally yields faster response in acute mania, though high-dose right unilateral placement may offer comparable efficacy with reduced cognitive impact. Integration with appropriate pharmacotherapy enhances long-term outcomes. Special populations, including pregnant women, elderly patients, and those with medical comorbidities, may particularly benefit from ECT when properly administered with population-specific modifications.
Conclusions: ECT represents an effective, relatively safe, and rapid-acting intervention for treatment-resistant bipolar mania that should be considered earlier in treatment algorithms rather than as a last resort. Individualized approaches to electrode placement, stimulus dosing, and maintenance strategies optimize outcomes while minimizing adverse effects. Future research directions include parameter optimization, identification of predictive biomarkers, and development of cognitive remediation strategies
HPV AND ANAL CANCER: GLOBAL PATTERNS, KEY RISK FACTORS, AND ADVANCES IN PREVENTION
Get PDFIntroduction and Purpose: This article comprehensively analyzes human papillomavirus (HPV) in anal cancer, covering its epidemiology, etiology, risk factors, and role in anal squamous cell carcinoma.
Methods: A literature search of PubMed and Google Scholar (2020–2025) included observational studies, clinical trials, meta-analyses, and systematic reviews.
State of Knowledge: HPV is the main cause of anal squamous cell carcinoma (ASCC), whose incidence is rising in high-income countries and is highest in men who have sex with men (MSM), people with HIV, and those with multiple partners, immunosuppression, receptive anal intercourse, smoking, or co-infections. Over 80% of ASCC cases are linked to HPV16, with HPV-positive cancers showing better survival, yet despite the vaccine being nearly 100% effective if given before sexual debut, global uptake remains low.
Conclusion: Persistent infection with high-risk HPV, especially HPV16, is the main driver of anal carcinogenesis, paralleling cervical disease, and HPV-driven anal cancer is an increasing public health concern. To reduce the incidence and improve outcomes, expanded vaccination, targeted screening, and public awareness are essential. Future efforts should focus on enhancing prevention uptake, clarifying the significance of HPV16 sublineages, and evaluating co-infections and immunity to improve prevention and management
THE USE OF STEM CELLS IN THE TREATMENT OF NEURODEGENERATIVE DISEASES - CURRENT STATE OF RESEARCH AND CLINICAL PERSPECTIVES
Get PDFIntroduction and aim: Neurodegenerative diseases, including Alzheimer’s, Parkinson’s, multiple sclerosis and amyotrophic lateral sclerosis, remain highly challenging due to their progressive course and lack of disease-modifying therapies. Stem cell-based strategies are increasingly investigated for their potential in neuroregeneration, immunomodulation and functional recovery. This study aims to summarize current evidence on stem cell applications in neurodegenerative diseases based on recent systematic reviews and meta-analyses.
Material and methods: A structured literature search was performed in PubMed, Medline and Google Scholar using the terms “stem cells,” “neurodegenerative diseases,” “clinical trials,” “systematic review,” and “meta-analysis.” Eligible publications included English-language systematic reviews and human studies from 2015–2025. Over 30 relevant sources were analyzed by disease type and stem cell modality.
Results: Most studies report a favorable safety profile, particularly with mesenchymal (MSC), neural (NSC) and induced pluripotent stem cells (iPSC). Clinical trials in Parkinson’s disease demonstrated measurable motor improvements, while applications in multiple sclerosis and spinal cord injuries showed immunomodulatory and functional benefits. Evidence in Alzheimer’s disease and ALS remains limited and preliminary. Across conditions, heterogeneity of methods and small sample sizes reduce generalizability.
Conclusions: Stem cell therapy shows promise as an innovative approach in neurodegenerative disorders, though it remains experimental. Encouraging early outcomes highlight the need for large-scale, standardized and long-term trials to confirm efficacy, optimize protocols and ensure safety. Stem cells may become central to neuroregenerative medicine, but they are not yet ready for routine clinical use