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Proton pump inhibitors (PPIs) are widely used medications known for their effectiveness in reducing gastric acid production and their overall safety profile. Despite being valued for these properties, concerns have been raised regarding potential adverse effects associated with their long-term use. Various studies indicate a higher prevalence of small intestinal bacterial overgrowth (SIBO) in patients on prolonged PPI therapy, with symptoms ranging from bloating and diarrhea to malabsorption and nutrient deficiencies. Diagnosing SIBO primarily involves non-invasive breath tests that measure hydrogen and methane levels produced by bacterial fermentation after ingesting a carbohydrate substrate, such as lactulose or glucose. Direct aspiration and culture of small intestinal fluid offer a more definitive diagnosis but are invasive and less commonly performed. Treatment of SIBO focuses on reducing bacterial overgrowth by using antibiotics. This review aims to inform clinicians about the possible risks of PPI therapy and the importance of suspecting SIBO in patients with nonspecific gastrointestinal symptoms.

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by a disrupted skin barrier and immune dysregulation. The exact pathophysiology of atopic dermatitis despite extensive research remains complex. It includes genetic disorders, a defect in the epidermal barrier, an altered immune response, and disruption of the skin’s microbial balance. Recent advances in research have provided deeper insights into the molecular mechanisms including the role of filaggrin mutations, Th2 cytokine-mediated inflammation, and the skin microbiome. Understanding the intricate interplay between these components is crucial for developing targeted therapeutic strategies. Aim of the study: This review provides a comprehensive overview of the current knowledge on the pathophysiological mechanisms underlying AD, highlighting recent advances and areas for future research. Material and methods: Comprehensive literature searches were performed across the main electronic databases of PubMed and GoogleScholar using the keywords: “atopic dermatitis”, “eczema pathophysiology”, “skin barrier”. Conclusions: Atopic dermatitis (AD) is a complex, chronic inflammatory skin disease with a multifaceted pathophysiology involving genetic, immunological, and environmental factors. Recent advances in understanding the molecular mechanisms underlying AD have highlighted the importance of skin barrier dysfunction, immune system dysregulation, and microbial interactions in the disease's progression.

Type 1 diabetes mellitus (T1DM) is a chronic autoimmune condition characterized by the destruction of insulin-producing beta cells in the pancreas, necessitating lifelong insulin therapy. This study explores the impact of physical activity on glycemic control and overall health in individuals with T1DM. Despite its proven benefits, including improved cardiovascular health, lower HbA1c levels, and reduced insulin requirements, over 60% of T1DM patients do not engage in regular exercise. Different types of physical activities—such as aerobic, anaerobic, and high-intensity interval training (HIIT)—affect metabolic responses differently. Aerobic exercises and HIIT have shown significant improvements in health-related quality of life (HRQoL) and reduced incidence of severe complications, such as diabetic ketoacidosis. However, exercise-induced hypoglycemia remains a significant risk, especially if exercise follows recent severe hypoglycemic episodes. Proper management strategies include adjusting insulin doses, monitoring glucose levels, and carbohydrate intake. The study highlights the importance of tailored exercise plans and preventive measures to mitigate risks such as nocturnal hypoglycemia and elevated ketones. Ultimately, effective integration of physical activity into diabetes management can lead to enhanced overall health and quality of life for individuals with T1DM.

Allergic rhinitis (AR) is a common disease characterized by inflammation of the nasal mucosa caused by exposure to allergens such as pollen, house dust mites, animal dander, and molds. Symptoms include sneezing, nasal itching, watery discharge, and nasal congestion, often associated with conjunctivitis. AR can significantly reduce patients' quality of life, affecting their ability to perform daily activities and causing sleep disturbances and fatigue. Diagnosis of AR is based on a past medical history, assessment of clinical symptoms, and allergy tests, such as skin tests, and measure of specific class E (IgE) immunoglobulins in blood serum level. Treatment includes allergen avoidance, pharmacotherapy, and allergen immunotherapy. Antihistamines, intranasal glucocorticosteroids, cromones, and anti-leukotriene drugs are the basis of pharmacotherapy, helping to control symptoms and improve a patient's quality of life. Allergen immunotherapy, both subcutaneous and sublingual, is effective in modifying the course of the disease and reducing hypersensitivity to allergens. New therapeutic and diagnostic approaches, such as biomarkers and biologics, are under investigation and may offer more personalized and effective AR treatment in the future. A holistic approach to AR, including patient education and lifestyle modification, is crucial for long-term therapeutic success. The article aims to review current diagnostic and therapeutic methods used in AR.

Introduction: Type 1 diabetes is a disease requiring complex treatment: intensive functional insulin therapy with multiple subcutaneous insulin injections (Multiple daily doses of insulin- MDI) or continuous subcutaneous insulin infusion (CSII) with a personal insulin pump. Type 1 diabetes is a disease with many complications including cardiovascular diseases. A key element in good disease control is adequate patient education. This paper will focus on physical activity and its impact on the course of the disease. Aim of the study: To research the impact of physical activity on the course of type 1 diabetes. To reinforce medical professionals' knowledge of exercise management among patients with type 1 diabetes. State of Knowledge: Regular physical exercise is beneficial for diabetes control, at the same time reducing the need for insulin. It also reduces the risk of dangerous late cardiovascular complications. Meta-analyses have shown a significant effect of physical activity on the reduction of HbA1c, BMI, triglycerides and total cholesterol. Continuous glucose monitoring (CGM) systems are recommended for physically active people with type 1 diabetes. Optimal glycaemia at the start and during sport are: for aerobic exercise 126-180 mg/dl (7-10 mmol/l), for anaerobic exercise 90-180 mg/dl (5-10 mmol/l). The reduction in insulin dose depends on the type of exercise, the length of the exercise, the method of treatment, and the pre-exercise blood glucose level. Conclusion: Physical exercise improves the control of type 1 diabetes and therefore reduces the risk of complications of the disease including cardiovascular diseases. Type 1 diabetes is not a contraindication to both amateur and professional sport. However, many variables need to be considered. Every patient with type 1 diabetes must be properly trained before starting exercise.

ABSTRACT: Prolactinoma is a benign tumor of the pituitary gland that leads to the overproduction of prolactin. It is the most common type of pituitary adenoma, accounting for approximately 50% of all pituitary tumors. The clinical presentation of prolactinoma varies depending on the level of prolactin elevation and the size of the tumor. In women, common symptoms include galactorrhea, amenorrhea, and infertility. Men may present with hypogonadism, decreased libido, erectile dysfunction, and gynecomastia. Large prolactinomas, known as macroadenomas, can cause mass effects such as headaches, visual disturbances due to compression of the optic chiasm, and hypopituitarism due to pressure on surrounding pituitary tissue. Understanding the pathogenesis of prolactinoma is crucial for developing effective treatments and improving patient outcomes. The development of prolactinomas involves a complex interplay of genetic, hormonal, and cellular factors. Treatment of prolactinoma aims to normalize prolactin levels, reduce tumor size, and alleviate symptoms. The first-line therapy is dopamine agonists, such as cabergoline and bromocriptine, with surgery and radiotherapy reserved for refractory cases. Furthermore, chemotherapeutic agent - temozolomide may be a treatment of choice in aggressive or malignant prolactinomas. By understanding the underlying mechanisms and different treatment methods, healthcare providers can optimize the management and outcomes for patients with prolactinoma.

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) was previously known as non-alcoholic fatty liver disease (NAFLD). MASLD is one of the most important and leading causes of liver disease worldwide. This disease is a public health challenge in the 21st century. Aim of the study: This article aims to present the latest literature data on MASLD. The study is intended to show what consequences are associated with changing the name of the disease and this article is purposive to be a vademecum of knowledge for practicing physicians. Material and methods: Comprehensive literature searches were performed across the main electronic databases of PubMed and GoogleScholar using the keywords: "metabolic-dysfunction associated steatotic liver disease”, “MASLD”, “non-alcoholic fatty liver disease” and “NAFLD” Conclusions: Most patients do not report any symptoms. It is important to identify patients at increased risk of MASLD. A fundamental role in prevention and treatment is lifestyle changes. The pharmacological approach includes among others use of antidiabetic drugs and treatment of other associated states.