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Introduction and purpose: Gradual progression of cognitive and physical disability negatively affects personal, social and economic well-being of patients with multiple sclerosis. This particular group of people has a high risk of developing depressive disorders. This study reviews the prevalence, current diagnostic tools and evidence-based methods of treating depression in patients suffering from MS. Material and Methods: This paper reviews various types of research documents with a special focus on sources from the past 10 years. Works from the 1980s and 1990s were also cited to outline the progress made in exploring the given topic. Its main aim is to indicate that MS poses a risk of developing depression and to emphasize that this disorder may be mistakenly attributed to the primary disease. It highlights the need for raising awareness about the topic to ensure interdisciplinary care. Results: The study proved the connection between the prevalence of depression in MS. Characteristic somatic depressive symptoms such as chronic fatigue, sleep disturbances, can conclude either from MS or depression. Because of that prevalence of depression in MS patients is artificially altered. Conclusion: The prevalence of depression is significantly greater in patients with multiple sclerosis compared to the general population. Many somatic symptoms caused directly by neurodegenerative changes pose difficulties in differential diagnosis. Multidisciplinary treatment, including both psycho- and pharmacotherapy, remains the most effective therapeutic approach. Nevertheless, the development of new, accurate diagnostic methods is necessary in order to screen for depression in this group of patients.

Introduction and purpose: Obesity affects every age group and is associated with many negative health effects. Various diets are used to remove excess body weight. Recently, popular became two diets - intermittent fasting and ketogenic diet. Material and Method: This paper reviews various types of research documents published since 2018. Its main aim is to summarize the latest knowledge of ketogenic diet and intermittent fasting, including contraindications, side effects, impact on body weight and many diseases. It is also aimed to highlight the need for future research of the effects of both diets on various diseases and body weight reduction. Results: Both diets may be effective in weight loss and show other health benefits. Both ketogenic diet and intermittent fasting have proven to be effective in weight reduction. In the case of intermittent fasting the biggest impact on weight loss is calorie restriction. Ketogenic diet is effective as a result of calorie restriction, increased gluconeogenesis and loss of free water through increased diuresis. They can be used in the prevention and treatment of many diseases, including cardiovascular disorders, neurological disorders or potentially cancer. However, they cannot be administered by everyone and may cause dangerous side effects. Conclusion: Ketogenic diet and intermittent fasting are successful strategies for body weight reduction. Moreover, both of them may be used as an additional therapy for various diseases. However, patients should be under supervision.

One of the most prevalent digestive diseases worldwide, functional gastrointestinal dysfunction (FGID) places a substantial strain on healthcare resources and causes significant morbidity. A study using Rome IV diagnostic criteria estimates the prevalence of FGID is about 40% worldwide. Most people with FGID exhibit symptoms from the realm of psychopathology, most often anxiety and depression, making patients' quality of life lower compared to even those with chronic organic diseases. By elucidating the causes and consequences of qualitative and quantitative changes between the microbiota of a healthy person and the microbiota of a person with FDIG, incredible progress has been made in understanding the role of the gut microbiota in FGID. However, the exact cellular and molecular pathogens of FGID that are directed by the gut microbiota remain unknown, and learning more about them will result in non-empirical, but targeted therapies.

Introduction:Rosacea is a chronic, inflammatory disease, characterized by skin lesions or ocular symptoms. Skin lesions are located primarily on the central face. Thickening of the skin can occur in some people. There are four subtypes of rosacea and one variant. Rosacea significantly impairs the quality of life. The exact cause of rosacea is not yet fully understood, but it is thought to involve a combination of genetic, environmental, and lifestyle factors. Treatment starts with avoidance of triggering factors. Obesity leads to multiple negative health effects. It has been associated with some inflammatory dermatoses, such as psoriasis and atopic dermatitis.As obesity disrupt cutaneous vasculature and temperature regulation, it may be also associated with increased risk for rosacea and worse course of this disease. Aim of study:The purpose of the study was to review the literature on the influence of obesity and other metabolic disorders on development of rosacea. Matherials and methods:A systemic review was conducted using PubMed, ScienceDirect, Google Scholar databases. The search strategy was based on following terms: rosacea, BMI, obesity, overweight, metabolic changes, insulin resistance and rosacea Results and Conclusions:The complex relationship between obesity and other metabolic disorders and rosacea goes beyond obvious binary relationships. Chronic inflammation, genetic predisposition, common risk factors, and changes in metabolic and vascular function contribute to their complex interaction.Recognition and understanding of this relationship offers the potential for the development of new treatment strategies in the future that will prevent the occurrence of rosacea by modifying i.a. the risk factors we describe before they affect the patient's health and cause the disease described. Future research should continue to explore the underlying mechanisms and therapeutic interventions

Introduction: Diabetic foot is a serious condition affecting large percentage of long term diabetics .Proper diabetic foot treatment, education and prevention can greatly influence quality of life of many diabetics who are at risk of developing this condition. Aim of study: The purpose of the study was to review the latest literature on the most recent diabetic foot treatment, education and prevention. Matherials and methods: A systemic review was conducted using Google Scholar, PubMed and ScienceDirect databases and the search was limited to studies published between 2000 and 2023. The search strategy was based on following terms: diabetic foot, diabetic neuropathy, diabetic ulcer, diabetic foot treatment. Results: We found many different studies which show importance of gut microflora in various different ailments and diseases, we have also found many showing factors that influence intestinal microbiota composition. Conclusions: diabetic foot is a severe complication of diabetes that requires a multidisciplinary approach to treatment. Prevention is essential, and patients should be educated on the importance of foot care and blood sugar control.With proper treatment and management, diabetic foot can be prevented and effectively treated.

Diabetes is now one of the most common chronic diseases. Its incidence is increasing, and thus the number of people suffering from its health complications is increasing. In 2015, 3 million people in Poland suffered from diabetes, and it is estimated that this number will increase to 4 million by 2040. Acute complications of diabetes include i.a. hypoglycemic or lactate and hypermolar comas. Chronic complications include, for example, microangiopathies (retinopathies, nephropathy) as well as macroangiopathies and neuropathies. Neuropathy is the result of too much glycemia and can affect as many as 2/3 of diabetic patients. Everyday pain sometimes makes it impossible to perform the simplest activities, and an optimal treatment plan is difficult to develop. At the same time, it can be prevented with regular exercise, regular glycemic control and a proper diet. In this paper, we present a literature review on neuropathy and neuroarthropathy as a complication of diabetes and other diseases, with particular emphasis on painless fractures.

Introduction: Gut microbiome is composed of hundreds of different bacterial species.Possibly every type of bacteria can affect many different aspects of human healthGut bacterial composition varies immensely between healthy and sick people and there are many factors which can influence micriobiota balance in our intestines. Aim of study: The purpose of the study was to review the latest literature on the gut bacteria importance and to discover what factors can influence gut microbiome composition. Matherials and methods: A systemic review was conducted using Google Scholar, PubMed and ScienceDirect databases and the search was limited to studies published between 2000 and 2023. The search strategy was based on following terms: microbiome, gut bacteria, health and microbiome, gut microflora, human intestinal microbiota Results: We found many different studies which show importance of gut microflora in various different ailments and diseases, we have also found many showing factors that influence intestinal microbiota composition.Conclusions: Gut microbiota is very broad topic – it can affect many different aspects of human health, starting from lowering the risk of developing allergy or affecting weight loss to affecting risk of colorectal cancer development . It can be affected by many different factors – lots of them are still uknown and need further studies.

Introduction: Blood sugar level impairment, especially diabetes mellitus (DM) is a significant problem. DM leads to many serious complications. Patients suffering from cardiac failure (HF) and diabetes have a risk of hospitalization increased 1.5 times compared to the control group without DM. That is why it is very important to keep appropriate glycemic control. β-blockers, are considered to cause a blood glucose level impairment. The relationship between the use of β-blockers and the development of DM is one of the most interesting and controversial issues in diabetology. Despite many benefits, some doctors are reluctant to prescribe β-blockers because of perceived negative metabolic effects.Aim of study: The purpose of the study was to review the literature describing oral β-blockers, used in HF, influence on glucose metabolism and to discover the best β-blocker treatment for cardiac failured diabetics and prediabetics. Methods: A systemic review was conducted using PubMed, ScienceDirect, Google Scholar databases. The search strategy was based on the following terms: beta-blocker, blood glucose level, metoprolol, nebivolol, carvedilol, bisoprolol. Results: β-blockers differ in terms of their mechanism of action and their effects on glucose metabolism. Metoprolol is associated with a worsening of glucose and lipid control. Bisoprolol have a neutral impact on glucose metabolism. Vasodilating β-blockers may improve glycemic profile.Conclusions: All four β-blockers used in HF have similar blood pressure lowering effect but different metabolic effect. Metoprolol should not be used as a drug of choice in patients with impaired glucose metabolism. Bisoprolol, nebivolol or carvedilol may be recommended as a drug of choice in patients with cardiac failure and impaired carbohydrate metabolism. The choice between bisoprolol and vasodilating β-blockers in patients with glycemic disorders is still an unresolved issue.

Introduction: Regular physical activity benefits everyone, regardless of age, considering individual abilities and health conditions. Pregnancy is a special time for women as well as an appropriate time to reassess lifestyle choices and introduce better habits. Aim of the study: Summary of the current state of knowledge about exercise in pregnancy, recommended forms of physical activity and benefits for health and well-being. Methods and Materials: A review was conducted in PubMed, ScienceDirect and GoogleScholar including publications from the last 5 years. Literature was searched using the following terms: “physical activity”, “exercise”, “pregnancy”, “resistance exercise”, “aerobic exercise”. Results: The number of studies focused on benefits of prenatal exercise is escalating. It has been proven that physical activity can prevent gestational diabetes, help in blood glucose, and blood pressure control, improve the mental state of a mother, and contribute to the improvement of placental function. It can also affect a parturition and child postnatal development. At the same time, it turned out that many women do not have the appropriate knowledge and do not undertake the recommended activity during pregnancy. Conclusion: Interest in the topic of physical activity during pregnancy has increased significantly in recent years, yet further research is needed to dispel the existing doubts and to understand thoroughly the significance of physical activity during pregnancy on maternal and child health. Future educational interventions aimed at pregnant women in terms of safety and recommended forms of activity during pregnancy are necessary to update their knowledge and to help them implement recommendations.

Introduction: Depressive disorders are a significant problem. They lead to suffering, loss of interest and may contribute to suicide attempts. Despite the large number of available medications, 10-35% of patients fail to achieve remission. Therefore, for these ongoing researches are underway to thoroughly understand the pathophysiology of depression. Aim of study: The purpose of the study was to review the latest literature on the kynurenine pathway importance in depression, and to discover its links with theories relating to the pathogenesis of depression. Matherials and methods: A systemic review was conducted using PubMed, ScienceDirect, Google Scholar databases and it was limited to studies published between 2000 and 2023. The search strategy was based on following terms: kynurenine, depression, kynurenine pathway in depression, treatment resistant depression, tryptofan metabolites. Results: Animal studies confirm the importance of the kynurenine pathway in animal models of depression. Peripherally directed inflammatory stimuli in humans lead to peripheral activation of the kynurenine pathway. The regulation of the kynurenine pathway in the brain is specific to a particular region as well as to a given type of depression.Conclusions: Further studies of the kynurenine pathway targeting different regions of the brain are necessary. Conducting a simultaneous analysis of many central and peripheral tryptofan metabolites will be helpful to accurately determine their mutual impact in both compartments. Understanding changes in kynurenine pathway transmission in a particular type of depression may be helpful in developing new, more effective drugs.

The aim of our study is to present a case report of a patient who, due to advanced symmetrical peripheral diabetic polyneuropathy, was unaware of the fracture of the fifth finger of the left hand and even tried to restore it to its previous position. The 53-year-old patient with type 1 diabetes at the age of 9, who, due to non-compliance with medical recommendations and poor metabolic control (over the last 15 years, HbA1c has never fallen below 8.1%, reaching 11.1% in May 2017), developed complications such as: ischemic heart disease, diabetic retinopathy, nephropathy and peripheral neuropathy. In February 2019, in the morning, when unscrewing the fuel filler cap in the car, the patient suffered a finger fracture. He remained unaware of this fact all day due to the lack of any pain symptoms. It was only in the evening that he noticed the wrong placement of the fifth finger on his left hand. On the next day, there was a slight soreness with pressure, and the swelling deepened, which prompted him to visit the emergency room. An X-ray examination was performed there, which showed a fracture of the shaft of the proximal phalanx of the fifth finger of the left hand with angular setting of the fragments. The finger was immobilized in a plaster cast and the patient was referred for further check-up in a specialist outpatient clinic. Fortunately, the attempt to set the finger on his own did not cause any significant complications, and after removing the plaster cast, the patient regained the use of the broken finger. A recent electromyographic study confirmed the existence of a very advanced peripheral neuropathy. In summary, improperly treated, poorly controlled type 1 diabetes has serious consequences. It is very important that people suffering from it conduct regular self-monitoring of blood glucose levels and lead a healthy lifestyle.