Arkadiusz Grunwald

Introduction. Acne vulgaris is a common dermatosis where hormonal factors, particularly androgens that increase sebum production, play a key role. This hormonal basis makes therapies with anti-androgenic effects, such as Combined Oral Contraceptives (COCs), a logical and effective treatment strategy. This review will describe the effectiveness and mechanisms of COCs in managing acne. Aim. The aim of this review is to describe the effectiveness and effects of COC use in the treatment of acne, taking into account acne as a secondary lesion in the course of the below-mentioned conditions. Material and methods. The medical literature was reviewed on October 19, 2024 using the PubMed, Scopus and Google Scholar browsers using the keywords: hormonal contraception, acne vulgaris. The time frame for searching the sample was from 2017 to the current date of the search. 15 articles were identified in the Google Scholar database, 12 in the PubMed database and 26 in the Scopus database. Results. COCs can be effective in treating acne vulgaris due to their antiandrogenic properties. Androgens are believed to stimulate the growth of sebaceous glands and increase sebum production, contributing to acne formation. COCs are also used to manage other endocrine disorders associated with elevated androgen levels, such as hirsutism and polycystic ovary syndrome. Conclusions. Acne vulgaris continues to be an important medical and social problem. This dermatosis affects not only young people, but also endocrinological patients or patients receiving permanent treatment. Knowledge of the mechanism of its formation and the role of hormones in its pathogenesis may allow it to determine the appropriate treatment algorithm.

It is well established that breastfeeding provides significant health benefits for both the mother and the infant. The World Health Organization recommends initiating breastfeeding within the first hour after birth and continuing exclusive breastfeeding for 6 months. Successful breastfeeding is influenced not only by the proper physiological preparation of the body and the action of pregnancy-related hormones but also by the mother’s overall health status. However, the role of maternal body composition and metabolic condition in breastfeeding success has received little attention. To better understand the impact of these factors on breastfeeding effectiveness, we reviewed the latest research on this topic, with particular emphasis on the role of hydration and lipid metabolism. Our narrative review indicates that the amount and distribution of water and adipose tissue are crucial for successful lactation and that various hormonal imbalances and metabolic disorders increase the risk of delayed breastfeeding initiation, shortened breastfeeding duration, or insufficient milk production. In light of our findings, measurement methods for assessing described parameters were also introduced. This article aims to review the effects of maternal body composition, hydration status, and metabolic and social factors on lactation and breastfeeding.

Unfortunately, ovarian cancer is still diagnosed most often only in an advanced stage and is also the most lethal gynecological cancer. Another problem is the fact that treated patients have a high risk of disease recurrence. Moreover, ovarian cancer is very diverse in terms of molecular, histological features and mutations. Many patients may also develop platinum resistance, resulting in poor response to subsequent lines of treatment. To improve the prognosis of patients with ovarian cancer, it is expected to make better existing and implement new, promising treatment methods. Targeted therapies seem very promising. Currently, bevacizumab - a VEGF inhibitor and therapy with olaparib - a polyADP-ribose polymerase inhibitor are approved. Other methods worth considering in the future include: folate receptor α, immune checkpoints or other immunotherapy methods. To improve the treatment of ovarian cancer, it is also important to ameliorate the determination of molecular features to describe and understand which group of patients will benefit most from a given treatment method. This is important because a larger group of patients treated for ovarian cancer can have a greater chance of surviving longer without recurrence.

The ketogenic diet (KD) is a high-fat, low-carbohydrate diet that mimics the physiological state of fasting. The potential therapeutic effects in many chronic conditions have led to the gaining popularity of the KD. The KD has been demonstrated to alleviate inflammation and oxidative stress, modulate the gut microbiota community, and improve metabolic health markers. The modification of these factors has been a potential therapeutic target in serious mental illness (SMI): bipolar disorder, major depressive disorder, and schizophrenia. The number of clinical trials assessing the effect of the KD on SMI is still limited. Preliminary research, predominantly case studies, suggests potential therapeutic effects, including weight gain reduction, improved carbohydrate and lipid metabolism, decrease in disease-related symptoms, increased energy and quality of life, and, in some cases, changes in pharmacotherapy (reduction in number or dosage of medication). However, these findings necessitate further investigation through larger-scale clinical trials. Initiation of the KD should occur in a hospital setting and with strict care of a physician and dietitian due to potential side effects of the diet and the possibility of exacerbating adverse effects of pharmacotherapy. An increasing number of ongoing studies examining the KD’s effect on mental disorders highlights its potential role in the adjunctive treatment of SMI.

Breast cancer is one of the most common cancers worldwide, at the same time being one of the most prevalent causes of women’s death. Many factors such as alcohol, weight fluctuations, or hormonal replacement therapy can potentially contribute to breast cancer development and progression. Another important factor in breast cancer onset includes micronutrient status. In this narrative review, we analyzed 23 micronutrients and their possible influence on breast cancer onset and progression. Further, the aim of this study was to investigate the impact of micronutrient status on the prevention of breast cancer and its possible influence on various therapeutic pathways. We researched meta-analyses, systemic and narrative reviews, retrospective studies, as well as original studies on human and animal models. The results of these studies indicate a possible correlation between the different levels of micronutrients and a decreased risk of breast cancer as well as a better survival rate. However, further studies are necessary to establish adequate doses of supplementation of the chosen micronutrients and the exact mechanisms of micronutrient impact on breast cancer therapy.

Vulvovaginal candidiasis (VVC) is a common condition associated with discomfort in affected women. Due to the presence of different forms of the disease, diverse treatment regimens are developed; the newest ones include oteseconazole and ibrexafungerp. Here, we focus on the most up-to-date recommendations regarding VVC treatment, as well as novel treatment options. Topical and oral azoles are the drugs of choice in uncomplicated mycosis. The efficacy of probiotics and substances such as TOL-463 and chlorhexidine is indicated as satisfactory; however, there are no relevant guidelines. Although the majority of researchers agree that the treatment of non-albicans VVC should be long-lasting, the recommendations are inconsistent. Another clinical problem is the treatment of VVC with azole intolerance or resistance, for which literature proposes the use of several drugs including oteseconazole, ibrexafungerp, and voriconazole. The treatment schedules for recurrent VVC include mainly fluconazole; however, alternative options such as immunotherapeutic vaccine (NDV-3A) or designed antimicrobial peptides (dAMPs) were also described. We also focused on VVC affecting pregnant women, which is a substantial challenge in clinical practice, also due to the heterogeneous relevant guidelines. Thus far, few precise recommendations are available in the literature. Future studies should focus on atypical VVC forms to elucidate the inconsistent findings.

Stress is a process that triggers various physiological, hormonal and psychological mechanisms in response to a threat, which significantly affects the health of an individual. The COVID-19 pandemic introduced a lot of social changes that required constant adaptation to unfavorable conditions. The aim of the study was to assess the impact of stress related to this pandemic on pregnant women, mothers of premature infants and their families, and on obstetric complications, particularly preterm birth. A comprehensive literature review was performed using electronic databases such as Pubmed, Science Direct and Google Scholar. Keywords such as: “prematurity”; “pregnancy”; “stress”; “COVID-19” and various combinations of the above were used. Maternal stress and anxiety increase the levels of corticotropin-releasing hormone (CRH) in the placenta, which in turn affects the incidence of preterm birth and many other related maternal and neonatal complications. In addition, it was found that SARS-CoV-2 infection may increase the risk of this phenomenon. The COVID-19 pandemic has adversely affected preterm birth rates and the mental health of mothers of preterm infants, exacerbating their negative experience of having a premature baby. More research is needed to demonstrate the long-term effects of COVID-19 stress on prematurity.

Pregnant women with obesity and diabetes are at increased risk of developing infections and other complications during pregnancy. Several mechanisms are involved in the immunological mechanisms that contribute to reduced immunity in these populations. Both obesity and diabetes are associated with chronic low-grade inflammation that can lead to an overactive immune response. Pregnant women with obesity and diabetes often have an increase in pro-inflammatory cytokines and adipokines, such as TNF-α, IL-6, IL-1β, leptin, and resistin, which are involved in the inflammatory response. Insulin resistance can also affect the functioning of immune cells. Furthermore, both conditions alter the composition of the gut microbiome, which produces a variety of biomolecules, including short-chain fatty acids, lipopolysaccharides, and other metabolites. These substances may contribute to immune dysfunction. In addition to increasing the risk of infections, obesity and diabetes can also affect the efficacy of vaccinations in pregnant women. Pregnant women with obesity and diabetes are at increased risk of developing severe illness and complications from COVID-19, but COVID-19 vaccination may help protect them and their fetuses from infection and its associated risks. Since both obesity and diabetes classify a pregnancy as high risk, it is important to elucidate the impact of these diseases on immunity and vaccination during pregnancy. Research examining the efficacy of the COVID-19 vaccine in a high-risk pregnant population should be of particular value to obstetricians whose patients are hesitant to vaccinate during pregnancy. Further research is needed to better understand these mechanisms and to develop effective interventions to improve immune function in these populations.

Introduction: Telogen effluvium is a non-scarring hair loss that can occur after COVID-19 infection. It usually occurs after about 3 months, causes diffused hair loss and lasts up to 6 months. The purpose of this narrative review is to collect and summarize the effects of potential methods to promote hair regrowth in patients after COVID-19 infection. Material and method: The article reviews available in PubMed and ResearchGate databases, studies on telogen effluvium and SARS-CoV-2. Due to the limited literature, articles on telogenetic hair loss progressing independently of COVID-19 were also included in the review. Results: Hair loss after COVID-19 infection occurs in almost 30% of patients. This is likely related to pro-inflammatory cytokines released during infection and the pro-thrombotic effect of the virus. Telogen effluvium is the most common type of alopecia occurring after COIVD-19 infection - about 86% of all cases. It affects women more often than men. It seems that its severity may correlate with the severity of the infection. Other than female gender and a history of chronic disease, it is unlikely to find any other contributing factors. Effective treatments seem to include the use of oral supplements such as vitamin D, polyunsaturated fatty acids and zinc. In addition, topical application of minoxidil and high-platelet plasma treatments have shown good outcomes. Conclusions: Given the fairly common occurrence of hair loss after COVID-19 infection, it seems reasonable to seek the most effective strategies for its treatment. At present, it appears that the best results are obtained by combining different treatment approaches.

During the autumn season, it is common for mushroom pickers to eat poisonous mushrooms. This is due to many reasons, including the ignorance of pickers. The most common is the misidentification of inedible species as edible mushrooms. The result is poisoning, which in many cases requires hospitalization. This paper presents a case report of toadstool poisoning by a 62-year-old female patient. In addition, other relevant publications on intoxication, diagnostic methods and treatment are reviewed. The purpose of this paper is to present the management and treatment of a case of toadstool poisoning. The effects of mushroom poisoning can range from mild disorders, mainly gastrointestinal to organ failure and even death. Significant elevations of liver enzymes and prothrombin time are important in laboratory tests in cases of intoxication. Treatment most often involves specific antidotes, such as Sylimarin, Acetylcysteine. The diagnosis in most cases is made on the basis of the clinical picture and a thorough interview with the patient, and the diagnosis is established by detecting toxins in a urine test. The prognosis is better if patients with toadstool poisoning are admitted to the hospital early. It is worth noting that gastrointestinal syndromes can also result from eating raw or inadequately cooked mushrooms, and by eating them excessively or too often. Proper diagnosis and treatment of mushroom poisoning can save lives. It is very important to raise public awareness of mushroom poisoning, as well as early detection of potential signs of intoxication. Cooperation with the poison center and mycologists is very important, especially in high-risk cases.