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Introduction and purpose Diabetes is a disease resulting from impaired action or secretion of insulin. The number of patients currently amounts to approximately 422 million, and approximately 1.5 million deaths per year are directly attributed to this disease. Diabetes significantly reduces the quality of life and, if poorly controlled, can lead to serious complications. Mesenchymal stem cells are multipotent cells capable of differentiation. They have the ability to self-renew and have a modulating function. There are reports that they can be used in the treatment of this disease. The aim of the review was to present a new method of therapy and their possible effects. Material and methods The review was based on articles obtained from PubMed scientific database in the years 2015-2023, using the following keywords: diabetes mellitus, stem cells, diabetes complications. Results Implanted stem cells are able to transform into cells that produce and secrete insulin, and also enable better glycemic control. They can alleviate chronic inflammation and reduce fibrosis. Taking into account the complications that occur during long-term diabetes, the use of stem cells may be associated with improving the function of specific organs and tissues such as the kidneys, heart, eyes and nerves. Studies also report a positive effect of these cells on the healing process of wounds and ulcers. Conclusions Stem cells are a promising object of analysis. They can control glycemia and have a positive effect on the functioning of the kidneys, heart, eyes and nerves, and accelerate wound healing, but further, extensive research is needed to assess the effectiveness and safety of this therapy.

Introduction and purpose Contrast enhanced ultrasound (CEUS) is a modern diagnostic method that uses ultrasound waves in combination with intravenous administration of a contrast agent. It enables obtaining high resolution and assessing microcirculation in real time, thanks to which the researcher is able to analyze the enhancement and its features, which may help in diagnosing a specific pathology. Contrast agents, similar to CT and MRI, show specific phases of enhancement after administration - arterial, venous, delayed. Their additional advantage is safety, especially for patients with impaired kidney and thyroid function, and causing fewer allergic reactions. The aim of this review is to present the CEUS examination technique and the latest reports in the field of diagnosis of renal lesions. Material and methods This review was prepared based on the literature available from recent years in the PubMed and Google Scholar scientific databases using the keywords: ultrasonography, contrast enhanced ultrasonography, kidney, renal masses. Results Studies show that CEUS can be an effective method for imaging both cystic and solid lesions in the kidney. When using a contrast agent, the lesions show characteristic features that can guide the investigator to the diagnosis. Moreover, in comparative analyses, CEUS achieved comparable or better results than other diagnostic imaging methods. Conclusions CEUS is a modern and promising diagnostic method that can successfully compete with CT and MRI. Moreover, the metabolism and pharmacokinetics of contrast agents and their safety mean that CEUS can be used for the diagnosis of unclear pathologies in elderly patients, as well as for the control and supervision of changes that require frequent imaging. Keywords: ultrasonography, contrast enhanced ultrasonography, kidneys, renal masses

Introduction: Infertility is defined as the inability to conceive a child for at least 12 months of regular unprotected intercourse and may affect up to 15% of couples of reproductive age. Reduced semen quality may be caused by trauma, inflammation, or an inappropriate lifestyle. Research suggests that diet may be a factor in influencing sperm parameters. Material and methods: The literature of the PubMed scientific base was searched in 2015-2022 using the following keywords: semen, diet, infertility. Results: Analyzes of eating patterns showed that eating a diet high in red meat, high-fat dairy, sweet energy drinks, and snacks could negatively affect semen, and a pattern based on the consumption of fish, chicken, vegetables, fruits, legumes, and whole grains was associated with with an increased concentration of sperm. A high-fat diet (HFD) leads to obesity, endocrine disorders, dysbiosis of the intestinal microflora, and may be a factor that activates autophagy, which results in reduced sperm quality. A ketogenic diet can positively affect the semen of obese, infertile men. Studies analyzing the Mediterranean diet suggest that higher compliance rates are associated with a higher percentage of mobility as well as a reduced risk of low sperm concentration. The way you prepare your meals can also play a role as glycation end products are produced when grilling, baking and frying, which can damage sperm DNA. Conclusions: Diet may be an important factor influencing the quality of sperm in men, however, there is a need for further extensive, multi-center studies that will systematize this knowledge, which will enable the creation of specific nutritional recommendations for this group of people.

Introduction. The first case of SARS-CoV-2 infection was identified in December 2019 in Wuhan, China. The disease spread rapidly worldwide and the WHO declared a pandemic on March 11, 2020. Although coronavirus disease 2019 (COVID-19) has been associated primarily with respiratory disorders, more and more research is focusing on neurological manifestations and complications.Objective. The aim of the review is to systematize and update the knowledge and available research on neurological complications among COVID-19 patients.Review methods. A systematic search of PubMed and Google Scholar databases was conducted for studies. The following keywords combinations were used: COVID-19, SARS-CoV-2 infection, neurological complications, neurological manifestations, neuroinvasion, neurovirulence.Results. The disease in most patients is characterized by mild to medium fever, fatigue, dry cough, dyspnea, muscle pain and headache. ACE2, which is the receptor for SARS-COV-2, is ubiquitously expressed in a variety of human organs, including the brain. Following previous reports, these receptors are expressed in both glial cells and neurons. Many studies have reported neurological symptoms and complications among COVID-19 patients. The reported manifestations include: smell and taste disturbance, non-specific symptoms such as myalgia, headache and dizziness, acute cerebrovascular complications, encephalopathy, meningoencephalitis/encephalitis, seizure and complications of the peripheral nervous system.Conclusion. Healthcare professionals dealing with COVID-19, neuroscientists, and the general public should be aware of the neurological complications of COVID-19. Further studies are needed to assess the incidence of COVID-19 neurological complications in different populations and more analyzes are also required to understand the detailed mechanism of how the virus affects the nervous system.

Introduction: Caffeine is considered to be one of the most frequently used pharmacologically active substances in the world. Caffeine is a psychoactive and central nervous system stimuli that has the ability to increase energy, decrease fatigue, promote alertness and wakefulness. Potential role of caffeine's nociceptive properties shows that it may play a relevant role in pain modulation. Although caffeine at dietary levels is not a sufficient analgesic in its own, it has been included in many over-the-counter and prescription drugs. This review addresses caffeine's analgesic properties in pain management. Results: Caffeine shows relevant role in pain modulation through blocking adenosine receptors which are involved in nociception. Studies show that habitual dietary caffeine consumption results in decreased pain sensitivity.As an adjuvant to commonly used analgesics, caffeine provides an important increase in pain relief in various types of pain such as postoperative dental pain, headaches, or fibromyalgia.Conclusions: In conclusion, caffeine is associated with decreased pain sensitivity. Addition of caffeine to analgesics has resulted in their enhanced analgesic efficacy in pain treatment.

Introduction: Infertility affects millions of people of reproductive age worldwide. Male infertility may be caused by a number of different factors including problems in the ejection of semen, absence or low levels of sperm, or abnormal morphology and movement of the sperm. Environmental and lifestyle factors also have a meaningful impact on male reproductive system. Fertility care should include the prevention, diagnosis and treatment of the disorder. That is why numerous studies have explored the role of vitamin D in regulating the functioning of the reproductive system.Aim of study: Investigation of correlation between Vitamin D and male fertility.Results: Studies consistently show that Vitamin D deficiency has a negative influence on male fertility. Number of trials show that the mean value of Vitamin D serum levels tend to be significantly lower in infertile men compared to fertile men. Vitamin D insufficiency and deficiency has been noticed to be associated with poor semen quality (lower sperm concentrations, lower motility). It became evident that vitamin D exhibits positive correlation with the male fertility by maintaining the levels of sex hormones, down regulating oxidative stress and up regulating oxidative defence. Supplementation of Vitamin D may improve the quality and function of sperm by increasing its motility and concentration.Conclusions: Although Vitamin D supplementation cannot be considered for treatment of male infertility itself, physicians should take the vitamin serum levels under consideration while providing treatment for infertile male patients.

Introduction: Polycystic ovary syndrome (PCOS) is a hormonal disorder most common in women in reproductive age. The global incidence varies from 6% to 20% depending on the diagnostic criteria used, and is also the most common cause of infertility. This disease is related to insulin resistance and hyperinsulinemia. Berberine is a compound that affects the cardiovascular system and carbohydrate metabolism, which is why there are attempts to introduce it into the therapy of patients with PCOS. Material and methods: The literature was reviewed in the PubMed scientific base in the years 2012-2022 using the following keywords: berberine, polycystic ovary syndrome. Results: Research show that the use of berberine may have a positive effect on the waist circumference and waist-to-hip ratio, improve lipid parameters, lower the concentration of androgens, and reduce insulin resistance. In addition, a promising effect is the stabilization of the menstrual cycle and improvement of ovulation. There are reports that this drug may also restore the normal composition of the intestinal microflora disrupted in PCOS. Side effects are rare and mild, which confirms the safety of this substance. Conclusions: Polycystic ovary syndrome affects many women, leading to numerous and serious side effects, so it is important to develop an effective treatment with as few side effects as possible. Berberine is a promising prospect, but more studies are needed on larger groups of patients to confirm these reports and develop an effective treatment regimen. Keywords: berberine, polycystic ovary syndrome.

Introduction: Endometriosis is a common gynaecological disorder associated with pelvic pain and sub-fertility, affecting 7–15% of women of reproductive age. The disease is defined as the presence of endometrial-like tissue outside the uterine cavity, primarily on pelvic organs. The aetiology of endometriosis is still uncertain. The disease rarely causes mortality, however, it may have a significant impact on a patient's quality of life. Moreover, several studies have consistently shown that endometriosis is associated with a higher risk of some types of malignancies.Results: Endometriosis shares several molecular characteristics with invasive cancer, such as inflammation, tissue invasion, angiogenesis, dysfunction of immune cells and pro-survival features. Studies have shown that ovarian cancer, especially clear cell, endometrioid and serous, has been associated with endometriosis. Furthermore, the risk of cancer of the uterine cervix has shown to be decreased and the results on the risk of the cancers of uterine corpus or breast are inconsistent. Among non‐gynecological cancers, melanoma of the skin, non‐Hodgkin‐lymphoma, brain and thyroid cancers have also been associated with endometriosis.Conclusions: Research results indicate that women with endometriosis have an increased risk for some types of malignancies, therefore, they should be under strict gynecological control, even many years after menopause. Further research is needed to prove the real risk of different types of malignant tumors among women with endometriosis. In addition, it is necessary to establish periodic examination schedules among these patients in order to prevent certain types of malignancies.

Introduction: Sleep disorders are a big group of disturbances affecting many people in the world. They can appear as insomnia, interrupted sleep, worsened sleep quality or trouble falling asleep. Although they may not seem very dangerous, they lead to various unpleasant complications and even diseases. Cancer is said to be one of the possible sources of the problem.Results: Studies show relationship between cancer and sleep disruptions. They are frequent in lung, head and neck, gynecologic and breast neoplasms. Patients report higher scores of Pittsburgh Sleep Quality Index, insomnia severity scale and Epworth Sleepiness Scale meaning that they can be considered as poor sleepers. In addition, they often develop psychiatric disorders which are linked with higher risk of sleep problems.Conclusions: According to many research, cancer often comes with somnipathies. It should be taken into consideration when planning oncologic treatment and care to obtain the best effects of the therapy.

Introduction: The discovery of sodium-glucose co-transporter-2 inhibitors is attributed to phlorizin, which after oral administration caused the excretion of glucose in urine. Later studies showed that this effect was conditioned by SGLT-2 inhibition. However, this substance has not been used in the treatment of diabetes mellitus due to its non-selective action. Beeing also active against SGLT-1 transporters in alimentary tract, it causes osmotic diarrhea, dehydration and eventually malnutrition. Currently in Poland, gliflozins are used only in the treatment of diabetes mellitus, mainly type 2, especially with coexisting obesity and high cardio-vascular risk. However, as many human and animal studies show, the effect of SGLT2 inhibitors can be observed in many systems and organs.Results: The best known non-anti-diabetic action is the reduction of body fat and protection against fat accumulation following a high-calorie diet. These compounds reduce the production of endogenous fatty acids. Moreover, gliflozines lower the levels of cholesterol, triglycerides, uric acid and aminotransferases. They have a protective effect on the liver because they cause remission of nonalcoholic steatohepatitis (NASH), nonalcoholic fatty liver disease (NAFLD). They lower the cardiovascular risk and have an anti-inflammatory effect. Moreover, they inhibit vascular remodeling and improve hemodynamic conditions.Conclusions: According to many research, gliflozines have many collateral effects which can be used in the clinic as a treatment of diseases other than diabetes or coexisting with it. Obesity and cardiovascular diseases are among the most important health problems in the modern world. SGLT-2 inhibitors can prevent the above-mentioned diseases and reduce them.

Urine infections represent 40-50% of all infections in hospitalized patients. The most common uropathogens are E.coli, S.saprophitycus, and less commonly Enterobacteriaceae, such as Proteus mirabilis and Klebsiella pneumoniae. The spectrum of microorganisms isolated in hospital conditions may be wider. Raoultella planticola is a rare cause of human infections, so far only few cases of ZUM with this etiology have been described.A 56-years-old patient, with a history of cardiac disease, with exacerbation of chronic kidney disease, was admitted to the Department of Internal Medicine. The reason for admission was general deterioration. Many abnormalities in laboratory tests were detected. The doctors' attention was focused on the significant bacteriuria. Moreover, the patient reported dysuria symptoms. Material for urine microbiological culture was taken and empirical antibiotic therapy with ciprofloxacin started. The obtained result of urine culture allowed to identify the bacteria by R. planticola. As a result of the applied treatment, the patient's condition improved.An increasing number of infections with R. planticolla etiology is observed. The bacterium may lead to infections in many systems. The group of patients at risk of the disease includes people with renal dysfunction, who are immunosuppressed. Infections of R. planticolla etiology are usually characterized by good antibiotic response and positive prognosis.

Introduction: Acne vulgaris is one of the most common diseases in the world, which affects millions of people. Despite its objectively mild clinical severity, it is able to markedly change one’s appearance. Moreover it is said to be one of many factors that are responsible for mental health impairments. Results: Studies showed significant relation between acne and psychological disorders. Both depression and anxiety scores were higher in individuals with acne compared to healthy ones. Some studies reported an increased risk of suicide in this group as well. Research which included quality of life evaluation showed its impairment in larger part of respondents. Conclusions: Acne vulgaris is linked with an increased risk of serious psychiatric disorders. Therefore it is important to think about them when this condition is diagnosed.

Acne is one of the most widely spread dermatoses in the world mainly among adolescents and young adults. Because of its problematic symptoms it is very willingly treated with diverse available drugs. Despite its popularity, there is still lack of precise information about this disease. Even though risk factors like infections or hormonal changes are said to be well known, medicine is still not certain about some of them. Diet is one of the examples. It is supposed to play a huge role in acne genesis. Considering the ease of diet modifications it is crucial to understand its participation.

Ketogenic diet (KD) is a version of low-carbohydrate diet, that is rich in fat, but also contains enough protein and very low carbohydrates supply. This diet may be one of the treatment option for children with refractory epilepsy and studies show that it reduces seizures. KD may affect behavioural and cognitive functioning in children and adolescents with refractory epilepsy. The main weakness of KD are possible adverse side effects included drowsiness, constipation, weight loss, vomiting, gastroesophageal reflux, fever, hyperlipidaemia and elevated risk of kidney stones development.

Increase in the incidence of multidrug-resistant Gram-negative bacterial strains pose a significant threat to healthcare system worldwide. New antibiotics are necessary to combat particularly resitant pathogens. WHO’s global priority pathogens list was published in 2017 to promote research and development of new antibiotics, as part of WHO’s efforts to address growing global resistance to antimicrobial agents. Acinetobacter baumannii, Pseudomonas aeruginosa and carbapenem-resistant, third-generation cephalosporin-resistant Enterobacteriaceae were classified as highest priority pathogens requiring a new antibiotic treatment options. Cefiderocol is a novel parenteral siderophore cephalosporin that shows efficacy against listed Gram-negative bacteria. The results of the presented studies showed that cefiderocol has a strong antimicrobial effect against problematic strains that produce carbapenemases, such as KPC (K. pneumoniae carbapenemase) and B-class metallo-β-lactamases, including NDM-1 (New Delhi metallo-β-lactamase), as well as the ESBL-producing strains. In addition, it does not require the use of the β-lactamase inhibitor. The new agent demonstrates a favorable side effect profile. There is an urgent need to develop new antibiotics. Cefiderocol is a new antibiotic that has a potential to effectively combat particularly resistant bacteries such as carbapenem-resistant Acinetobacter baumannii, Pseudomonas aeruginosa, as well as carbapenem and 3rd generation cephalosporin-resistant Enterobacteriaceae.

Acne is one of the most widely spread dermatoses in the world mainly among adolescents and young adults. Because of its problematic symptoms it is very willingly treated with diverse available drugs. Despite its popularity, there is still lack of precise information about this disease. Even though risk factors like infections or hormonal changes are said to be well known, medicine is still not certain about some of them. Diet is one of the examples. It is supposed to play a huge role in acne genesis. Considering the ease of diet modifications it is crucial to understand its participation.

Ketogenic diet (KD) is a version of low-carbohydrate diet, that is rich in fat, but also contains enough protein and very low carbohydrates supply. This diet may be one of the treatment option for children with refractory epilepsy and studies show that it reduces seizures. KD may affect behavioural and cognitive functioning in children and adolescents with refractory epilepsy. The main weakness of KD are possible adverse side effects included drowsiness, constipation, weight loss, vomiting, gastroesophageal reflux, fever, hyperlipidaemia and elevated risk of kidney stones development.

Increase in the incidence of multidrug-resistant Gram-negative bacterial strains pose a significant threat to healthcare system worldwide. New antibiotics are necessary to combat particularly resitant pathogens. WHO’s global priority pathogens list was published in 2017 to promote research and development of new antibiotics, as part of WHO’s efforts to address growing global resistance to antimicrobial agents. Acinetobacter baumannii, Pseudomonas aeruginosa and carbapenem-resistant, third-generation cephalosporin-resistant Enterobacteriaceae were classified as highest priority pathogens requiring a new antibiotic treatment options. Cefiderocol is a novel parenteral siderophore cephalosporin that shows efficacy against listed Gram-negative bacteria. The results of the presented studies showed that cefiderocol has a strong antimicrobial effect against problematic strains that produce carbapenemases, such as KPC (K. pneumoniae carbapenemase) and B-class metallo-β-lactamases, including NDM-1 (New Delhi metallo-β-lactamase), as well as the ESBL-producing strains. In addition, it does not require the use of the β-lactamase inhibitor. The new agent demonstrates a favorable side effect profile. There is an urgent need to develop new antibiotics. Cefiderocol is a new antibiotic that has a potential to effectively combat particularly resistant bacteries such as carbapenem-resistant Acinetobacter baumannii, Pseudomonas aeruginosa, as well as carbapenem and 3rd generation cephalosporin-resistant Enterobacteriaceae.

Introduction: Neoplasms are the second most frequent cause of death in the pediatric population. In Poland, approximately 1100-1200 new cases of malignant neoplasms are diagnosed annually. Communication is an extremely important factor in pediatric oncology care. Hence, more and more research on its functions, significance, but also barriers and limitations is being developed. Material, methods, purpose: The literature published in the PubMed scientific database was searched using the following keywords: communication, pediatrics, oncology in 2016-2022. The aim of this review is to show the barriers, functions, and the importance of communication in pediatric oncology for the therapeutic process. Results: Communication in pediatric oncology was shown to perform the following functions: building relationships, exchanging information, enabling the family to self-manage, making decisions, managing uncertainty, responding to emotions, providing validation, and supporting hope. It was also noted that high-quality communication is associated with parental peace, increased recognition and confidence in healthcare professionals. Parents who receive understandable prognostic information have found less regret, as well as a desire to maximize time spent together with their child. Research shows communication barriers on many levels, such as: lack of comfort in difficult topics, time pressure, or the lack of a common mental model of the team and excessive demands. However, knowing these limitations is crucial to improving and overcoming these barriers. Conclusions: Communication in pediatric oncology plays many fundamental roles and constitutes an important aspect of the therapeutic process. Accordingly, it is important to emphasize the development and improvement of healthcare professionals' communication skills. Doctors can use knowledge of communication functions to better understand and fulfill parents' communication needs.