Agata Ogórek

Informations and purpose: Parabens are widely used preservatives found in cosmetics, pharmaceuticals, foods and household products. Increasing evidence shows that women of reproductive age, including pregnant women, are consistently exposed to these endocrine-disrupting chemicals, which may influence fetal and early-life development. Understanding exposure levels and potential health consequences is important for both public health and clinical practice. Methods: A systematic literature search was performed to identify studies evaluating paraben exposure during pregnancy and its effects on fetal and early childhood health. The literature search included studies published from 2019-2024 and contained searches of PubMed, Scopus, Science Direct and open access databases. Results: Parabens are widely detected in maternal and fetal matrices. Exposure to parabens in utero has been shown to result in changes to fetal size, metabolic and hormone-related factors and an increased risk of developing atopic and respiratory diseases in early childhood.Reported mechanisms involve endocrine disruption(specifically acting like estrogens and anti-androgens), oxidative stress, immune modulation and possible epigenetic effects. Conclusion: Current evidence indicates that parabens may influence child development through several biological pathways, with effects observable from fetal life into early childhood. Although causality remains to be fully established, reducing paraben exposure in pregnancy and early life—particularly from cosmetic and dermal sources—appears advisable. Public health measures promoting informed consumer choices may further mitigate exposure.

Introduction: Atrial fibrillation is the most common cardiac arrhythmia affecting approximately 700 thousand Polish people. In Poland, insufficient vitamin D levels are highly prevalent and concern around 90% of the population. Except the established, modifiable risk factors of AF, new risk factors such as vitamin D deficiency are being described. Some potential mechanisms involving vitamin D in atrial fibrillation pathogenesis include: cardiac remodelling via the vitamin D receptor, modulation of renin-angiotensin-aldosterone system, influence on parathyroid hormone concentration, changes in action potential duration and left atrium contractility, and activation of proinflammatory pathway by low vitamin D levels. Aim of the study: This review aims to analyze the potential relationship between vitamin D concentration and the risk of developing atrial fibrillation based on the current state of knowledge (as of 2025). Moreover, we tried to examine how vitamin D concentration could influence the efficacy of atrial fibrillation treatment methods such as cardioversion or ablation. Material and Methods: This review is based on literature from 2011 to 2024, searched in PubMed, Google Scholar, mp.pl and ClinicalTrials.gov that was describing the results of vitamin D deficiency on atrial fibrillation development and the treatment outcomes. Conclusions: Serum vitamin D concentration may have an impact on both atrial fibrillation onset and its treatment. It is possible that there are several groups of patients among whom the sufficient vitamin D level would be particularly beneficial. Further studies, especially those focusing on vitamin D supplementation, are needed to clarify the role of vitamin D in atrial fibrillation pathogenesis and treatment.

ATTR amyloidosis is a rare disease associated with abnormal folding of the transthyretin (TTR) protein, leading to the deposition of amyloid fibrils in the heart and nervous system. Treatment to date has focused primarily on alleviating symptoms such as heart failure and neuropathy. Currently available disease-modifying therapies include TTR stabilizers (tafamidis, acoramidis), which prevent TTR tetramer dissociation, and gene silencers (siRNA and ASO), which reduce TTR production and slow the progression of polyneuropathy. Modern experimental strategies, including CRISPR-Cas9 gene editing and anti-ATTR monoclonal antibodies, offer the potential for one-time treatment and removal of existing amyloid deposits. The choice of therapy should be tailored to the patient's phenotype, disease stage, and clinical capabilities, and ongoing research will better determine the long-term efficacy and safety of new drugs. The aim of this paper is to present contemporary therapeutic strategies in the treatment of transthyretin amyloidosis (ATTR), with particular emphasis on disease-modifying drugs such as TTR stabilizers, gene silencers, CRISPR-Cas9 gene editing therapies, and anti-ATTR monoclonal antibodies. The paper aims to evaluate the efficacy and safety of available therapies, discuss their clinical indications depending on the patient's phenotype (polyneuropathy, cardiomyopathy), and present directions for the development of new therapeutic strategies based on current clinical trials.

Background. Acne vulgaris is a chronic inflammatory skin condition that often leads to scarring and psychological distress. Oral isotretinoin is the most effective systemic medication for severe or treatment-resistant acne, but concerns about its adverse effects remain. Aim. This review summarizes the current state of knowledge on isotretinoin in acne therapy, highlighting safety issues and implications for everyday clinical practice. Material and methods. A narrative literature review was conducted using PubMed/MEDLINE for articles published between January 2016 and November 2025. Human studies and reviews on systemic isotretinoin for acne vulgaris treatment, along with selected articles providing relevant epidemiological and clinical context for acne, were included if they reported efficacy, remission, adverse effects, impact on tissue regeneration, or monitoring recommendations. Randomized trials, observational studies, systematic reviews, meta-analyses, and high-quality narrative reviews were eligible for inclusion. Non-acne indications, animal-only studies, and non-peer-reviewed publications were excluded. Results. Isotretinoin addresses all major pathogenic mechanisms of acne, leading to high clearance and long-term remissions. Mucocutaneous dryness is the most common adverse effect, but it is manageable with proper skincare. Laboratory abnormalities involve mild, reversible dyslipidemia and liver enzyme elevations. The most dangerous side effect is teratogenicity, which requires strict pregnancy-prevention programs. Studies have not confirmed an increased incidence of depression or inflammatory bowel disease; however, clinical monitoring remains essential. Musculoskeletal and ophthalmologic adverse effects are generally mild and dose-dependent. Conclusions. Structured risk management, regular clinical and laboratory checks, along with the lowest possible dose, enable safe and effective acne control through individualized isotretinoin treatment.

Introduction: Type 1 diabetes is a chronic autoimmune disease that leads to permanent lack of insulin. In recent years, advances in insulin formulations and delivery methods have improved the ability to mimic natural insulin secretion and support better diabetes management. Aim: The aim of this article is to review the most commonly used forms of insulin therapy and modern technologies supporting the treatment of type 1 diabetes, with attention to their effectiveness, safety, and impact on patients’ quality of life. Methods: A search of PubMed and ScienceDirect was performed for publications from January 2008 to June 2025. The review included clinical trials and review articles about insulin therapy in type 1 diabetes. Titles and abstracts were screened, full texts were analysed, and reference lists of key papers were checked. Results: Modern insulin therapy is based on insulin analogues with different action profiles and on delivery systems such as insulin pens, pumps, and hybrid closed-loop devices. New basal and prandial analogues help improve glycaemic control and reduce complications. Automated Insulin Delivery systems increase time in range and improve daily functioning. However, problems such as variability of insulin absorption, lipodystrophy, and high costs still remain. Conclusions: Although progress in insulin therapy has improved diabetes care, further research, better access to modern technologies, and further patient education is essential.

Introduction and purpose: Primary ciliary dyskinesia (PCD) is a rare genetic disorder of motile cilia affecting both respiratory and reproductive systems. Because ciliary motility is essential for sperm propulsion and gamete transport in the female reproductive tract, individuals with PCD frequently present with subfertility or infertility. The purpose of this review is to synthesize current knowledge on mechanisms, clinical presentation, diagnostic pathways, and management of fertility disorders in PCD. Description of the state of knowledge: Evidence from narrative reviews and recent cohort studies indicates that fertility impairment is more common in men than in women, with subfertility reported in up to 83% of men and 61% of women. A large cross-sectional study found infertility in 78% of men and 61% of women attempting conception and documented an increased rate of ectopic pregnancy (7.6% of pregnancies). In men, infertility is mainly due to immotile or severely dysmotile sperm resulting from axonemal defects, although many sperm remain viable; some genotypes also present with oligozoospermia, MMAF or sperm DNA damage. In women, impaired ciliary motility in the fallopian tubes and endometrium contributes to delayed embryo transport and increased ectopic pregnancy risk. Diagnosis relies on specialized PCD testing (nNO, HSVM, TEM, genetic analysis), combined with standard infertility evaluation. Assisted reproductive technologies—especially ICSI with vitality-based sperm selection—are highly effective for male PCD-related infertility, while IVF/ICSI provides favorable outcomes in women, although early pregnancy ultrasound is recommended. Summary: Fertility disorders are a significant but manageable aspect of primary ciliary dyskinesia. A substantial proportion of affected individuals can achieve pregnancy, often with the support of ART. Early recognition of PCD in infertile patients, multidisciplinary management, and attention to genotype–phenotype correlations improve counselling and treatment planning. Further prospective studies are needed to refine prognostic predictions and optimize reproductive care in PCD.

Introduction: Forest bathing (shinrin- yoku) is a Japanese practice, involving immersion in forested areas with engaging all five senses. Its potential preventive benefits have increasingly attracted interest within the international scientific community, since forest bathing appears to be a safe and low- cost complementary approach, while offering therapeutic value. This narrative review summarizes current evidence on the physiological and psychological benefits of forest therapy, with particular focus on its importance in the treatment of depression- a prevalent mental health disorder, that affects approximately 332 million people worldwide. Studies showed that forest bathing alleviates depressive symptoms, reduces stress, increases feelings of relaxation, happiness and overall mental well being, through several biological pathways, including serotonin modulation, oxytocin increase, cortisol reduction and increased parasympathetic activity. However, further high quality research is needed to clarify its clinical value and long term effects in the treatment of depression. Methodology: A narrative review of literature available in the PubMed database was undertaken, incorporating recent randomized controlled trials, cohort studies, and meta-analyses published in peer- reviewed journals. Articles were searched in English using key terms such as: forest bathing, shinrin- yoku, nature therapy, depression.

Premature graying of hair (PMGH) is a phenomenon resulting from the interaction of genetic, metabolic, and environmental factors, leading to melanocyte dysfunction in the hair follicle. This article discusses the key etiopathogenic mechanisms of PMGH, with particular emphasis on the roles of oxidative stress, micronutrient deficiencies, autoimmune processes, hormonal disorders, and metabolic alterations. Population data indicate that gender and ethnicity influence both the incidence and course of PMGH, while clinical observations suggest that it may serve as an early marker of endocrine, autoimmune, hematological, or cardiovascular disorders. Although the psychosocial burden varies, in many young individuals graying negatively affects their sense of attractiveness and overall mental well-being. Current therapeutic strategies include optimizing nutritional status, antioxidant supplementation, modulation of α-MSH pathways, as well as selected pharmacological treatments and phototherapy. Case reports confirm the possibility of partial or complete repigmentation. Despite a growing body of evidence, the pathogenesis of PMGH remains incompletely understood, highlighting the need for further research into the mechanisms underlying the reversibility of this process and the development of effective, targeted therapies.

Introduction: Endothelial function is crucial for maintaining vascular homeostasis by regulating vasomotor tone, inflammation, and immune responses. Impairment of endothelial function is an early indicator of cardiovascular disease (CVD). Given the increasing prevalence of CVD, identifying modifiable risk factors, including dietary patterns, is becoming increasingly important. Aim of the study: This review compares the effects of ketogenic and plant-based diets on endothelial function, highlighting molecular mechanisms and clinical implications. Methodology: Literature was searched in PubMed, Scopus, and Web of Science (June–September 2025) using the keywords endothelium, ketogenic diet, vegetarian diet, atherosclerosis, and oxidative stress. Studies published in English between 2010 and 2025 were analyzed. Results: Ketogenic diets, although effective for weight loss, can lead to dehydration, micronutrient deficiencies, and increased endothelial inflammation due to low antioxidant intake. In contrast, plant-based diets are rich in fiber and antioxidants and low in trans fats, supporting endothelial integrity and reducing inflammation, though they may lack adequate EPA and DHA.

Introduction: In the 21st century, media significantly influences mental health. The TikTok app allows easy creation of videos and its algorithm adapts content to users interests. Aim: The following paper aims to analyse the impact of TikTok on the mental health of young users in the context of mood, eating and addiction disorders. Materials and Methods: Due to the dominance of users aged 16-24 on the TikTok platform, the research focused on the impact of the app on adolescent and young adult mental health. A review of papers available in bibliographic databases such as PubMed, Google Scholar and Web of Science was conducted, using the keywords: "TikTok", "mental disorders", "mental health", "eating disorders", "social media". Description of knowledge: Using TikTok can have both positive and negative effects. Positive aspects include an increased sense of social connection, reduction of stress and anxiety, and promotion of mental health issues by professionals. However, the app also carries risks, such as addiction, FOMO, misinformation, cyberbullying, impact on sleep quality and exposure to harmful content, and most importantly, exacerbates symptoms of mood and eating disorders. In order to minimise the negative effects of TikTok use, education about the potential risks is necessary. Conclusion: TikTok has the potential to have a positive impact on mental health as long as users use it consciously and in moderation, and the platform, educators and parents take steps to minimise the negative effects of children and young people using the app.