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ADVANCES IN ENDOMETRIOSIS THERAPY: A REVIEW OF TARGETED THERAPIES, NANOPARTICLES AND STEM CELLS
Get PDFBackground: Endometriosis is an estrogen-dependent chronic inflammatory disease characterized by the presence of active endometrium outside the uterine cavity, most commonly in the pelvis. It affects an estimated 10-15% of women of childbearing age and is often associated with infertility, chronic pelvic pain, painful menstruation, and dyspareunia. Despite its high prevalence and significant impact on quality of life, the cause of endometriosis remains unclear, and the available treatment methods have many limitations.
Aim: This article aims to review current developments in endometriosis treatment, with a focus on new therapeutic strategies involving targeted therapies, nanoparticles and stem cells.
Methods: An analysis of the latest (2015-2025) literature from databases such as PubMed and Google Scholar was conducted to synthesize the available information. Search terms included combinations of “Endometriosis treatment,” “pathogenesis of Endometriosis,” “an update on Endometriosis,” “new therapeutics in Endometriosis,” and “immunotherapy in Endometriosis,” “stem cells and the Endometrium.”
Results: In recent years, there has been significant progress in developing targeted therapies that modulate specific signaling pathways, hormone receptors, inflammatory cytokines, and angiogenesis within endometrial lesions. Concurrently, the importance of nanotechnology in medicine, particularly in the context of precision drug delivery using nanoparticles, is growing. Additionally, regenerative therapies using stem cells are receiving increasing attention. These therapies offer the potential to repair damaged tissues and modulate the immune response.
Conclusion: Although preliminary studies are promising, the introduction of these innovative therapies requires further multi-center studies and evaluation of safety and cost. The integration of targeted therapies, nanotechnology and stem cells along with modern molecular diagnostics may soon revolutionize the treatment of endometriosis. This will pave the way for more effective and less invasive methods to improve patients' quality of life
RECENT ADVANCES IN THE MANAGEMENT OF PLANTAR FASCIITIS: A SYSTEMATIC REVIEW
Get PDFIntroduction and Purpose: Plantar fasciitis (PF) is one of the most common causes of heel pain in adults, with a lifetime incidence of about 10%. Diagnosis is primarily clinical, based on patient history and physical examination. This study aims to present and compare treatment modalities for PF, including conservative and surgical options.
Brief Description of the State of Knowledge: The plantar fascia is a dense connective tissue crucial for supporting the medial longitudinal arch and enabling efficient gait. PF most often affects individuals aged 45–65 and is frequently associated with elevated body mass index. A characteristic symptom is sharp heel pain upon rising in the morning, which improves with walking. Physical examination may include the Silfverskiöld test to assess gastrocnemius contracture. Imaging, such as radiography, ultrasonography, or MRI, can support diagnosis. Although PF often recurs, 85–90% of patients respond to conservative treatment. Historically, management relied on night splints, orthoses, NSAIDs, and corticosteroid injections. Current strategies emphasize stretching and strengthening exercises. Surgical treatment is reserved for refractory cases.
Materials and methods: In this article, we utilized scientific literature describing various treatment approaches for patients with PF. Particular attention was given to diagnostic strategies and the appropriate use of imaging modalities. Treatment efficacies were compared, and potential adverse effects were also discussed.
Conclusions: Multiple therapies for PF show similar efficacy. Conservative management should remain first-line, with surgery considered when nonoperative measures fail. Successful outcomes depend on individualized treatment, patient education, and adherence. Collaboration between orthopedic surgeons and physiotherapists plays a key role in optimizing care
COMPARATIVE EVALUATION OF SPORT-BASED EXERCISE MODALITIES FOR REDUCING ARTERIAL HYPERTENSION: A LITERATURE REVIEW
Get PDFBackground: Hypertension is the principal modifiable risk factor for cardiovascular disease worldwide and the leading preventable cause of mortality. Over the past 30 years prevalence has doubled to ≈1.3 billion people. Each 20-mmHg increase in systolic or 10-mmHg rise in diastolic blood pressure approximately doubles cardiovascular and stroke mortality; even modest BP reductions substantially lower cardiovascular events, reducing premature mortality globally.
Aim: The aim of this study was to provide a comprehensive review of different types of physical exercise and to compare their effectiveness in reducing arterial blood pressure.
Materials and Methods: Between May-July 2025 we searched PubMed, PMC and Google Scholar (MeSH and free-text). Human studies only; included RCTs, non-randomized, cohort, cross-sectional studies, systematic reviews and meta-analyses. Two reviewers screened; heterogeneity precluded meta-analysis; findings narratively synthesized per PRISMA.
Research results: Different exercise modalities-including aerobic, resistance, isometric, interval, and mind-body practices-consistently reduce blood pressure, with magnitude varying by modality, intensity and duration. Evidence suggests a dose-response for aerobic training and robust SBP reductions for isometric protocols, while resistance, interval and mind-body interventions provide moderate benefits. Heterogeneity in study designs, populations and quality limits direct comparisons and highlights the need for standardized, high-quality trials.
Conclusions: Various exercise types-including aerobic, resistance, isometric, interval, and mind-body practices-consistently reduce blood pressure. Isometric training strongly lowers systolic BP, aerobic exercise shows dose-response benefits up to 150 min/week, and other modalities offer moderate effects. Regular physical activity is a safe, effective nonpharmacological strategy, supporting integration into comprehensive hypertension management
THE CRITICAL ROLE OF EARLY DIAGNOSIS IN EHLERS-DANLOS SYNDROME: A COMPREHENSIVE REVIEW
Get PDFIntroduction and purpose: Ehlers- Danlos syndrome (EDS) is a group of genetic connective tissue disorders with 13 distinguished subtypes. Approximately, 1 in 5000 people receive a diagnosis; however, this number is likely underestimated due to frequent misdiagnosis and delayed identification. The aim of this literature review is to provide a comprehensive overview of EDS, with focus on diagnostic process, common comorbidities and consequences of delayed diagnosis.
State of knowledge: Among the 13 recognized EDS subtypes hypermobile EDS (hEDS), classical EDS (cEDS), and vascular EDS (vEDS) are the most prevalent. Most subtypes can be confirmed through genetic testing, however hEDS lacks a known genetic marker and is diagnosed solely on clinical criteria. This prolongs the diagnostic process-frequently exceeding a decade- leading to psychological distress and increased risk of complications in surgery or pregnancy. Comorbidities such as POTS, MCAS, and gastrointestinal dysmotility are prevalent and further complicate clinical management.
Conclusion: Early detection and accurate diagnosis are crucial for improving patient outcomes and quality of life. It reduces the risk of complications, enables tailored treatment plans and helps with psychological distress of medical uncertainty. Healthcare professionals must have higher awareness about EDS in order to provide integrated, comprehensive care
UNCONVENTIONAL WOUND-HEALING STRATEGIES: A NARRATIVE REVIEW OF THE LITERATURE, EMPHASIZING AESTHETIC MEDICINE MODALITIES
Get PDFBackground. In 2019, the United States devoted 1.45 billion in the same year, accounting for 5.6 % of the national healthcare budget. These figures underscore wound care as a critical, interdisciplinary challenge for healthcare systems worldwide.
Aim. Synthesize current approaches to wound management and to elucidate the adjunctive potential of aesthetic medicine techniques in promoting tissue regeneration.
Material and methods. Between April and June 2025, we conducted a comprehensive literature search of PubMed, PMC and Google Scholar using the following keywords: “aesthetic medicine,” “wound healing,” “chronic wounds,” “mesotherapy,” “laser therapy,” and “stem cells in aesthetic medicine.”.
Results. Mesotherapy enhanced burn closure in rat models (glutathione reduced residual wounds to 22.7 cm² versus 46.4 cm² controls). Laser therapies (CO₂, Er:YAG, fractional) improved hypertrophic scar remodeling and chronic wound re‐epithelialization, reduced inflammation, and increased collagen and angiogenesis. Microneedling and ASC-based mesotherapy accelerated hypertrophic and venous ulcer healing metrics.
Conclusions. The studies cited above have demonstrated that procedures employed in aesthetic medicine may offer significant benefits as an adjuvant therapy in the wound-healing process. In particular, emphasis has been placed on the use of high-energy sources—namely, lasers—which markedly enhance the healing of chronic wounds, especially in patients burdened by multiple comorbidities
SPECIAL CONSIDERATIONS IN THE DIAGNOSIS AND MANAGEMENT OF CHRONIC GRAFT-VERSUS-HOST DISEASE IN PEDIATRIC PATIENTS
Get PDFBackground: Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative therapy for a variety of pediatric hematologic and non-malignant disorders, yet chronic graft-versus-host disease (cGVHD) remains the primary cause of long-term non-relapse morbidity and mortality. The incidence of cGVHD in children has been increasing, a trend associated with the expanded use of peripheral blood stem cells and unrelated donors. Despite generally lower rates than adults, cGVHD remains a significant and growing clinical problem with profound long-term implications for pediatric survivors, who have a much greater life expectancy.
Objective: This review aims to provide a focused and much-needed overview of cGVHD in children. Specifically, it delineates the unique epidemiological, pathobiological, and clinical characteristics that distinguish the disease in this population, including immunological distinctions, diagnostic challenges, and special considerations for long-term effects. This report highlights the pressing questions in treatment and research, addressing the historical lack of specialized data and emphasizing the principle that "children are not small adults" in the context of this complex condition.
Methods: This review was conducted by systematically analyzing and synthesizing peer-reviewed articles, clinical guidelines, and consensus statements related to pediatric cGVHD. A comprehensive literature search was performed across databases including PubMed, Scopus, and Embase using a combination of keywords such as "pediatric," "chronic GvHD," "children," "hematopoietic stem cell transplantation," "management," "diagnosis," and "long-term effects."
Summary: The lower incidence and severity of cGVHD in children are attributable to distinct biological factors, including superior thymic function and a greater use of bone marrow or cord blood grafts. However, diagnostic challenges persist due to non-specific symptoms and the limitations of adult-derived criteria. The profound and age-specific impacts of the disease and its treatments on growth, neurocognitive development, and infectious risk underscore the disproportionate long-term burden on pediatric survivors. The review discusses therapeutic strategies that prioritize steroid-sparing regimens and the integration of novel targeted inhibitors and cellular therapies.
Conclusion: A paradigm shift is necessary, advocating for dedicated pediatric research, age-adapted diagnostic tools, and a multidisciplinary, holistic approach to long-term survivorship care to optimize the functional status and quality of life for children with cGVHD
CARDIAC ARRHYTHMIAS CAUSED BY HYDROXYZINE USE
Get PDFHydroxyzine, an H1 receptor antagonist, is a drug commonly used to treat anxiety, pruritus, urticaria or used during premedication before surgery. It was introduced to the market as early as the 1950s, but it was not until 2015 that a warning was issued regarding its potential to cause arrhythmias. This action is due to its effect on the transport of potassium ions through ion channels in myocardial cells, leading to a prolongation of the QT segment, which can contribute to torsade de pointes-type arrhythmias.
Numerous clinical cases of cardiac arrhythmias and QT prolongation following hydroxyzine use have been reported in the literature. This is most likely to occur in patients with comorbidities, genetic factors that prolong the QT segment, or those taking other drugs that can cause arrhythmias.
Meta-analyses of safety reports published by manufacturers of drugs containing hydroxyzine and non-clinical studies also provide information on the potential for cardiac torsade de pointes arrhythmias while taking hydroxyzine.
Therefore, it is extremely important to take a thorough patient history before initiating hydroxyzine treatment, to rule out risk factors for cardiac arrhythmias, and to assess the benefits and risks of the drug. This is particularly important in elderly patients and those suffering from multiple chronic diseases.
Extreme caution should also be exercised when administering hydroxyzine to patients in emergency conditions in a hospital emergency department setting or by emergency medical teams, when it may not be possible to establish an accurate history.
Despite the high efficacy of hydroxyzine in both reducing symptoms of anxiety, pruritus and premedication preoperatively, the potential risk of cardiac arrhythmias in certain groups of patients should always be considered and the benefit/risk ratio assessed when including treatment
STRIAE DISTENSAE: A LITERATURE REVIEW OF TREATMENT MODALITIES AND THEIR CLINICAL EFFICACY
Get PDFBackground. Striae distensae, or stretch marks, are common linear dermal scars resulting from collagen and elastin disruption. They frequently affect women during puberty and pregnancy, as well as individuals experiencing rapid weight gain or endocrine disorders, and can substantially impair quality of life.
Aim. This review aimed to synthesize current literature on the pathophysiology, risk factors, and therapeutic options for striae distensae, with a focus on aesthetic medicine techniques such as laser therapies and microneedling.
Materials and Methods. Between March and June 2025, PubMed, PMC, and Google Scholar were systematically searched using the keywords “aesthetic medicine,” “striae,” “stretch marks,” “laser therapy,” and “microneedling.” Studies reporting clinical efficacy, histological changes, and safety profiles were included.
Results. Topical agents (e.g., retinoids, Centella asiatica, and hyaluronic acid) produced modest improvements. Among aesthetic procedures, chemical peels, platelet rich plasma, microdermabrasion, carboxytherapy, and radiofrequency demonstrated variable success. Microneedling and fractional CO₂ laser treatments yielded the most pronounced results, especially in combination, achieving up to 60-70% improvement in early (striae rubrae) lesions. However, mature hypopigmented striae albae remained particularly resistant, with improvements typically below 30%. Adverse events-primarily transient erythema and post inflammatory hyperpigmentation-were more common in darker skin phototypes.
Conclusions. Complete elimination of stretch marks remains unachievable; nonetheless, combination based, individualized approaches can significantly enhance their appearance. There is a critical need for robust, large scale randomized trials employing standardized, objective assessments, long term follow up, and inclusion of diverse skin phototypes and patient reported outcomes to establish evidence based treatment protocols
LUNG ULTRASOUND AS A SUPPLEMENT TO ECHOCARDIOGRAPHY
Get PDFIntroduction: Ultrasonography is a technique used in virtually every field of medicine, across a wide range of fields. Echocardiography has dominated cardiology for years. Although it is a difficult technique requiring extensive knowledge and experience, it allows for obtaining a wealth of valuable diagnostic information. Furthermore, it is highly standardized, and its usefulness has been confirmed in numerous scientific studies over the years. A technique that continues to gain popularity and has great potential is lung ultrasound, which, thanks to its specificity, can complement a typical echocardiographic examination with valuable information.
Methods: This study is based on an analysis of the use of lung ultrasound and echocardiography in our clinical practice and a comparison of the results with a literature review.
Results: Among the potential applications of lung ultrasound in cardiology are undoubtedly the assessment of pulmonary edema, free pleural effusion, pneumothorax, and pulmonary embolism. In all of these conditions, it is not only a valuable diagnostic tool but also for non-invasive monitoring. It is also a valuable tool for monitoring patient hydration during intensive fluid therapy.
Conclusions: The advantages of lung ultrasound over echocardiography include a favorable learning curve, the lack of high equipment requirements for basic assessment, and its easier performance. The ability to supplement echocardiography with lung ultrasound will undoubtedly provide significant added value in the diagnosis and monitoring of patients hospitalized in a cardiology department or consulted on an outpatient basis
POSSIBILITIES OF PLEURAL LINE ULTRASOUND - ORIGINAL WORK
Get PDFIntroduction: Ultrasonography is an accurate and reproducible tool for assessing the pleura. It represents a critical point, as the chest wall can be assessed directly, while the underlying lungs are only assessed through specific artifacts.
Methods: The work is based on our many years of experience in pleural line ultrasound and is additionally compared with literature information. We reviewed our patient databases and analyzed the ultrasound examinations performed.
Results: Imaging the pleural line provides valuable information for diagnosing and monitoring various disease entities. Importantly, it can be successfully used in virtually any patient group, without the exposure to harmful radiation used in conventional radiology. It is also a key component of a broader examination, namely chest ultrasonography, and is a crucial element assessed in emergency ultrasound protocols.
Conclusions: Pleural line ultrasound is an important and safe diagnostic tool worth using in clinical practice. Its safety and highly detailed imaging are key considerations. It's worth comparing this method with other imaging techniques