Dominika Bachurska

Introduction: Vacuum-Assisted Closure (VAC) is one of the modern-treatment methods for closing wounds using Integra® Wound Matrix, a matrix of 2 mm bovine collagen with a silicone layer, supporting collagen deposition and revascularisation. Case Report: He case is described of a patient who...

Background. Malignancy-associated hypercalcemia (HHM) is a frequent metabolic complication in advanced cancer, often leading to neurological deterioration, cardiovascular disturbances, reduced functional status, and shorter survival. In palliative care, timely diagnosis and management of HHM are essential to improve symptom control and patient comfort. Aim. To present a comprehensive, evidence-based review of current diagnostic and therapeutic approaches to hypercalcemia of malignancy, with a focus on palliative care settings. Material and methods. A narrative review was conducted using databases such as PubMed, MEDLINE, Google Scholar, and Europe PMC. Fifty-six articles published between 1994 and 2024 were selected based on clinical relevance and scientific quality. Results. Hypercalcemia in malignancy arises predominantly from PTHrP secretion, calcitriol overproduction, or local osteolysis. Diagnostic workup includes calcium profile, PTH/PTHrP levels, and imaging. Management involves intravenous hydration, bisphosphonates, denosumab, glucocorticosteroids, and—occasionally—calcitonin or hemodialysis. Timely treatment improves symptoms and may enable continuation of oncologic therapies. In palliative patients, hypercalcemia often necessitates a shift toward comfort-focused care and underscores the importance of interdisciplinary management. Conclusions. Malignancy-associated hypercalcemia significantly worsens prognosis and quality of life in advanced cancer. Individualized treatment—including rehydration, anti-resorptive agents, and symptom control—is essential. Effective calcium regulation alleviates suffering, facilitates supportive care, and should be integrated into comprehensive palliative strategies.

Alcohol use disorder (AUD) remains a significant global health challenge, characterized by compulsive alcohol intake, impaired control over consumption, and a high risk of relapse. Despite its widespread impact, pharmacological treatment options for AUD are limited and often insufficient. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), originally developed for the treatment of type 2 diabetes and obesity, have recently gained attention for their potential to modulate reward-related behaviors and neurobiological pathways implicated in addiction. Preclinical studies in rodent models have demonstrated that agents such as dulaglutide, semaglutide, and liraglutide can reduce alcohol intake, reverse neurochemical disruptions in key brain regions, and alleviate anxiety and cognitive impairments associated with chronic alcohol exposure. These findings are supported by emerging clinical evidence, including randomized controlled trials and large-scale cohort studies, which suggest that GLP- 1RAs—particularly semaglutide—may reduce alcohol consumption and alcohol-related hospitalizations, especially in individuals with coexisting metabolic conditions. Although further randomized trials are needed to establish causality and define optimal treatment populations, GLP-1RAs hold substantial promise as a novel pharmacological approach in the treatment of AUD.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the hepatic manifestation of systemic metabolic dysregulation, strongly linked to type 2 diabetes, cardiovascular diseases, liver-related complications, and different types of malignancies. Although MASLD is associated with obesity and insulin resistance, it is increasingly recognized that the liver engages in complex crosstalk with several endocrine pathways, including thyroid function, sex and steroid hormone regulation, and growth hormone signaling. The pathophysiology of MASLD is multifactorial and complex, as reflected by its clinical range—from simple steatosis to cirrhosis. MASLD now affects about one-quarter of the global population, with its prevalence rising due to sedentary lifestyles, chronic caloric excess, and endocrine disturbances contributing to disease progression. Given the escalating prevalence of MASLD and its frequent concurrence with various endocrinopathies, understanding this relationship is critical for refining diagnostic accuracy and optimizing therapeutic strategies. This review aims to synthesize contemporary insights into the complex interactions between MASLD and selected endocrine disorders, elucidate underlying pathophysiological mechanisms, and underscore novel treatment paradigms. As MASLD remains a significant clinical challenge worldwide, its intersection with endocrine dysfunctions represents a vital and promising domain for future research and clinical management.

Quantitative magnetic resonance imaging (MRI) volumetry has become a pivotal component in modern neurology, bridging the gap between detailed neuroimaging and clinical decision-making. By employing advanced imaging techniques like 3D T1-weighted, T2-weighted, and fluid-attenuated inversion recovery (FLAIR) sequences, MRI volu­metry enables clinicians to objectively quantify brain volume changes associated with neurological conditions such as Alzheimer’s disease, multiple sclerosis, epilepsy, and myotonic dystrophy. Automated segmentation tools, including FreeSurfer, NeuroQuant, volBrain, and AccuBrain, facilitate precise and reproducible analysis of structural brain changes, contributing significantly to early diagnosis, patient monitoring, and therapeutic planning. In Alzheimer’s disease, volumetric MRI enables the detection of early hippocampal and temporal lobe atrophy, providing a crucial biomarker for diagnosis and monitoring disease progression. Similarly, in multiple sclerosis, volumetric analyses quantify grey and white matter degeneration, reflecting motor and cognitive impairment severity. Moreover, quantitative MRI techniques precisely delineate structural abnormalities like hippocampal sclerosis and focal cortical dysplasia in epilepsy, crucial for accurate surgical intervention. Ongoing advances in artificial intelligence and machine learning are set to further enhance these volumetric approaches, addressing current limitations such as inter-observer variability and expanding their clinical applicability. This review outlines the existing landscape and future trajectory of quantitative MRI volumetry, underscoring its expanding role in clinical neurology and personalised medicine.

Introduction and purpose Air pollution, stemming from natural occurrences and human activities, significantly threatens global health, particularly impacting respiratory conditions like asthma. Air pollution substantially influences asthma exacerbation in athletes, a group particularly vulnerable due to their high physical activity levels and increased respiratory demands. Key pollutants, including particulate matter (PM), ground-level ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2), play critical roles in asthma development and exacerbation. The State of Knowledge Asthma, a chronic inflammatory disease influenced by genetic predisposition and environmental factors like air pollution, is characterized by airway hyperresponsiveness, obstruction, and chronic inflammation, leading to symptoms such as shortness of breath, coughing, wheezing, and chest tightness. Research highlights the link between air pollution exposure and asthma development, with PM2.5 exposure associated with increased asthma risk and pollutants exacerbating symptoms, especially in children. Athletes inhaling air pollutants during exercise face increased airway inflammation, mucus production, and bronchospasm, worsening asthma symptoms like wheezing and shortness of breath. Chronic exposure decreases lung function, increasing reliance on medication and limiting outdoor training on polluted days. Summary Effective asthma management amidst air pollution requires personal, community, and governmental measures. Patients should minimize exposure by wearing N95 masks and choosing low-traffic routes. Governments must monitor pollution, inform the public, and control emissions through alternative fuels and technologies. Adhering to WHO air quality guidelines could prevent many new asthma cases, emphasizing comprehensive air quality management's importance, especially among vulnerable populations like children.

Chronic suppurative otitis media (CSOM) remains a significant clinical challenge in otorhinolaryngology, characterized by prolonged inflammation of the middle ear and mastoid space, accompanied by a perforated tympanic membrane and persistent discharge for a minimum of two weeks. Despite its often viral origin, bacterial colonization is common, with frequent involvement of pathogens such as Pseudomonas aeruginosa, Staphylococcus aureus and Klebsiella pneumoniae. CSOM affects over 300 million individuals worldwide, primarily in low socio-economic communities, and is prevalent among children due to acute otitis media (AOM) or congenital disorders. In adults, it is often associated with conditions such as cholesteatoma or polyps. Approximately 60% of CSOM patients suffer from conductive hearing loss, which can impair speech development in children. This review discusses the etiological factors, associated complications, and treatment options for CSOM, emphasizing the importance of accurate diagnosis and comprehensive management, including potential surgical interventions. The persistent and recurrent nature of AOM, anatomical abnormalities, presence of polyps, primary ciliary dyskinesia, and cholesteatoma are highlighted as significant contributors to the development and perpetuation of CSOM. To complete discussion, there is a brief review of management in recovery after elaborated conditions with special regards to returning to physical activities.

Introducion and purpose Millions of people use contact lenses every day. Their primary and most common use is correcting refractive errors. Despite their beneficial purpose, contact lens use has many complications. It is estimated that 5 to 50% of patients may develop at least a single complication. The state of knowledge Contact lens-related complications are multifactorial. One of the main reasons for contact lens discontinuation is contact lens discomfort. Patients most often report dryness, burning, and irritated eyes. Other disorders can be briefly divided into conjunctival and corneal complications. The most common conjunctival and allergic complication of contact lens use is giant papillary conjunctivitis. Other significant conditions involving the conjunctiva can also be superior limbic keratoconjunctivitis or allergic or toxic conjunctivitis. Corneal complications, on the other hand, seemed to be much more severe. These include superficial punctate keratitis, peripheral corneal ulceration, and contact lens-related keratitis. Also, abrasion can occur due to improper eye hygiene or mechanical damage during lens replacement. It should also be remembered that prolonged use of lenses can lead to hypoxia and corneal edema. Summary This paper briefly outlines the possible complications of contact lens use. It is important to remember that despite their appropriate use, sometimes significant complications can occur. Noteworthy, corneal, or conjunctival complications require discontinuation of the lenses and appropriate treatment.

Introduction and purposeAndrogenetic alopecia (AGA) is one of the most common causes of baldness worldwide. It affects up to 80% of men by the age of 70 and up to 40% of postmenopausal women. In AGA etiology and pathogenesis, the three essential components play a key role - genetic inheritance, patient age and hormonal effects of androgens. In the following review, we have described the available FDA-approved and off-label treatments for AGA, along with their efficacy and potential side effects that should always be considered to prevent treatment discontinuation by the patients.The state of knowledgeThe pathogenesis of AGA is based on inherited dihydrotestosterone (DHT) sensitivity in the scalp skin, which leads to progressive hair loss. The literature documents the effectiveness of several treatments with different mechanisms of action in AGA therapy, but only topical minoxidil and oral finasteride gained FDA approval so far. Minoxidil acts by the blood vessels dilatation that increases the flow of oxygenated and growth factor-enriched blood to the hair follicles in the skin. 5-alpha reductase inhibitors, such as finasteride and dutasteride are another threapeutic option. Thy act by the inhibition of 5-alpha reductase, the enzyme which converts testosterone to DHT - the main causative agent of androgenetic alopecia. Recently, topical applications of minoxidil and finasterid, along with completely new emerging treatments for androgenetic alopecia are gaining popularity among doctors and patients. SummaryThis review describes current treatments for AGA, considering their efficacy, optimal doses, and the most common side effects. An important fact to emphasise is that androgenetic alopecia is based on a genetic predisposition, and treatment requires long-term use. For this reason, when choosing a medication, it is essential to cooperate with the patient and combine different therapeutic methods to achieve the desirable outcome while avoiding adverse reactions.

This narrative review examines current and emerging treatment strategies for diabetic macular edema (DME), a complication of diabetic retinopathy characterised by fluid accumulation in the macula, which can lead to vision impairment. The incidence of DME is particularly high in patients with long-standing diabetes and advanced retinopathy. The current treatment options for DME include anti-vascular endothelial growth factor (anti-VEGF) agents, corticosteroids, and laser therapies. Anti-VEGF agents, including bevacizumab, ranibizumab, aflibercept, and the more recently developed brolucizumab and faricimab, have been demonstrated to reduce macular thickness and improve visual acuity. Brolucizumab offers the advantage of fewer injections due to its longer duration of action, although it carries a higher risk of ocular inflammation compared to other anti-VEGF agents. The dual inhibition of the VEGF and angiopoietin-2 (Ang-2) pathways by faricimab may enhance vascular stability and reduce inflammation, potentially improving patient outcomes. Steroid therapies, including dexamethasone, fluocinolone acetonide, and triamcinolone acetonide, represent an alternative for patients who do not respond adequately to anti-VEGF treatment. Laser therapies, including focal, navigated, and subthreshold laser treatments, remain a crucial component in the management of DME, with the ability to seal leaking vessels and reduce fluid accumulation. In order to achieve the best outcomes for patients, it is essential to continue to advance these treatment modalities and adopt a personalised, multifaceted approach.