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Background: Obesity is an increasing problem in the modern world due to increased morbidity and due to its clinical consequences. It is a chronic disease that causes the development of numerous complications, such as cardiovascular diseases, type 2 diabetes or cancer. The problem of the excessive body weight is global and affects over 2 billion people around the world. Due to the increasing problem of obesity, pharmacotherapy is recommended in patients with BMI ≥30 kg/m2 or BMI ≥27 kg/m2 with accompanying risk factors. To fight obesity, however, we primarily use lifestyle modification methods, such as a rational and balanced diet based on reduced caloric content and a low-carbohydrate diet. Another aspect is the use of the optimal amount of exercise of moderate intensity. Only the combination of all these methods gives a real chance for long-term weight loss and maintenance. Scientific research on GLP-1 analogue drugs such as semaglutide and liraglutide brings us a lot of prospects. The mechanism of their action is based on mimicking the natural GLP-1 secreted in the body. Aim of the study: The following article as an analysis of the current medical knowledge on the effectiveness and safety of obesity treatment with GLP-1 agonists based on available publications. Methods and materials: Literature review based on PubMed data using the following key words: obesity; semaglutide; Glucagon-like peptide-1 (GLP-1) agonists State of knowledge: GLP-1 receptor agonists are incretin drugs. This class of drugs has been approved by the FDA for the treatment of type 2 diabetes. Results: Numerous studies have shown that chronic systemic delivery of GLP-1 agonists led to weight loss and helped to maintain a lower body weight. Reduction in food intake is reported as the main mechanism.

Background: Non-alcoholic fatty liver disease (NAFLD) is an increasing problem in the modern world due to increased morbidity and due to its clinical consequences. It is a chronic liver disease, histologically divided into non-alcoholic steatohepatitis (NAFL) with isolated steatosis to non-alcoholic steatohepatitis (NASH), which is characterized by hepatocyte injury, inflammation, and variable degrees of fibrosis that can progress to cirrhosis in a fraction of patients. Data on the prevalence of NAFLD vary depending on the population studied and the method used to establish the diagnosis, but the prevalence rate ranges from 6% to 35%, with a median of 20%. The prevalence of NASH in the European population is estimated at 5-6%, which makes NAFLD a new civilizational challenge. Aim of the study: The following article as an analysis of the current medical knowledge on the effectiveness and safety of NAFLD and NASH treatment with semaglutide based on available publications. Methods and materials: Literature review based on PubMed data using the following key words: NAFLD; NASH; semaglutide; Glucagon-like peptide-1 (GLP-1) analogues State of knowledge: GLP-1 receptor agonists are incretin drugs. This class of drugs has been approved by the FDA for the treatment of type 2 diabetes. Results: There is currently no approved therapy for NAFLD or nonalcoholic steatohepatitis (NASH). Beneficial effect of semaglutide on glycemia and weight loss makes them an attractive potential therapeutic form in NASH. However, there is a need for more clinical studies, on larger groups of people to recognize the effective form of semaglutide NAFLD therapy.

Introduction: The ketogenic diet, originally used in the treatment of epilepsy, has recently attracted increasing interest from scientists. There are more and more reports about the possible benefits of using KD. Aim of the study: The aim of the study is to present the assumptions of the ketogenic diet and the effects of its use in weight reduction, treatment of type 2 diabetes and the treatment of cancer and dementia. Description of the state of knowledge: Beneficial effects of the use of a ketogenic diet related to weight reduction and improvement of the lipid profile have been described. The ketogenic diet also allows to reduce the intake of antidiabetic drugs and reduce or discontinue insulin therapy. Animal studies also suggest benefits of using KD in the treatment of cancer. However, studies involving humans are lacking. There are also reports of the effect of KD on delaying the onset of dementia symptoms. Summary: Despite very promising scientific reports, there are no long-term studies on the impact of the ketogenic diet on cardiovascular risk. Therefore, it should be used after weighing the pros and cons.

• Introduction: Pompe disease (PD) is a rare metabolic disorder caused by a partial or complete deficiency of acid α-glucosidase (GAA) which leads to lysosomal accumulation of glycogen. Excessive amounts of glycogen accumulate mainly in the cells of the heart and skeletal muscles and cause dysfunction of these tissues. It is inherited in an autosomal recessive manner. The most common diagnostic methods include genetic tests and the measurement of enzyme activity in leukocytes or fibroblasts. A screening test is also available that tests the enzyme activity in dried blood spot (DBS). The treatment of PD is mostly based on synthetic GAA enzyme supply to the patients. The therapy reduces glycogen storage and improves muscle function, decreases heart size and prolongs the lives of those with infantile form of PD. In the adult onset of the disease treatment increases physical efficiency and reduces the progression of respiratory failure. • Aim of the study: Systematization of current knowledge about Pompe disease with particular emphasis on possible clinical presentations, diagnostics and therapeutic options. • Material and methods: Literature review based on PubMed data using the following keywords: Pompe disease, Glycogenosis type ii, glucosidase alpha • Summary : Pompe disease is a rare disease with many problems related to diagnosis and possible therapies. Its symptoms can be very misleading and cause a delay in diagnosis . It is critical to start the therapy as soon as possible to best manage the disease. The prognosis of PD is poor, especially in children under 12 months of age. Gene therapy research is currently underway and early results are very promising. There is still much to learn about dealing with this disease.

• Introduction: The assessment and treatment of pain in the pediatric population is a huge challenge for doctors and medical staff dealing with this group of patients. It is also one of the most important elements of pediatric care practice. There are many factors that contribute to the difficulty of assessing and managing pain in children, but the most important seems to be the lack of unified standards of care. In pain therapy, both pharmacotherapy and behavioral methods and psychological care are used. • Purpose of the work: The aim of this work is to systematize the current state of knowledge in the field of pain therapy in the pediatric population, focusing particular attention on pharmacotherapy • Materials and Evidence: We reviewed the literature available in the PubMed database using the following keywords: pediatric; pain therapy; analgesia • Summary: Pain therapy in the pediatric population, despite the fact that it is often underestimated and insufficiently managed, is crucial both in terms of avoiding health complications and in the overall therapeutic process. Despite the presence of many drugs for pain therapy on the market, many of them are not approved for use in this group of patients. Knowledge of their mechanisms of action and predicting the impact on metabolism in a pediatric patient compared to an adult is crucial for the management of both acute and chronic pain syndromes. Despite the current knowledge, there is still a need for broader research on the possibility of the drugs used, their impact on the therapy process and side effects in the youngest patients.

Introduction: Irritable bowel syndrome (IBS) is one of the most common diseases affecting people around the world. It is characterized by irregular bowel movements and abdominal pain. IBS significantly reduces the quality of life of patients. Despite such a frequent occurrence of this disease, its correct diagnosis and treatment still causes many problems for primary care physicians. Aim of the study: The aim of the study is to present the current state of knowledge on the pathophysiology, diagnostics and drugs used in irritable bowel syndrome. Description of the state of knowledge: Many factors may play a role in the pathogenesis of IBS. The most common are: genetic factors, intestinal motility disorders, visceral hypersensitivity, mental disorders, especially disorders of the brain-gut axis regulation, past intestinal infections, intestinal microbiota disorders and food intolerances. The Rome IV criteria are currently used in the diagnosis of IBS. Treatment of irritable bowel syndrome includes lifestyle modification and dietary management, pharmacotherapy and psychotherapy. Summary: Irritable bowel syndrome is a chronic disease, symptoms often recur and complete recovery is not possible.

Introduction and purpose: Erythropoietin (Epo) and its analogs used as performance-enhancing substance and are considered doping and are therefore forbidden in sports, however the scientific evidence behind doping is frequently weak. We aimed to determine the effects erythropoietin on maximal aerobic capacity(VO₂ max), endurence and to present direct detection methods. State of knowledge: Erythropoietin is a glycoprotein cytokine. During cellular hypoxia, Epo is secreted mainly by the kidneys, it stimulates bone marrow production of red blood cells. To compensate for normal red cell turnover, low levels of Epo are constantly secreted in sufficient quantities. In addition to anemia and chronic lung disease, cellular hypoxia can result in elevated levels of Epo. VO₂ max is the peak volume of oxygen that a person can consume during exercise. Essential for breathing, oxygen is inhaled by the lungs and converted into energy, which then fuels human cells and expels carbon dioxide in the exhaled breath. This allows the body to manage more efficiently aerobic workouts that involve a large amount of oxygen intake, such as running, swimming or other cardio exercises. Conclusions: Current data from PubMed indicate a significant relationship between Epo overuse and endurance in professional sports. That is one of the most important reasons to pay attention to the effects of EPO and new detection methods.

Introduction: Rheumatoid arthritis (RA) is a chronic autoimmune disease of unknown etiology that mainly affects the joints, but extra-articular symptoms may also occur. The global prevalence of RA is approximately 5 cases per 1,000 adults[1]. A better understanding of the pathophysiology of the disease in the treatment of RA has led to the development of more effective treatments. Current drugs include glucocorticoids (GCs) and synthetic and biological disease-modifying anti-rheumatic drugs (DMARDs). Apart from these, the most commonly used analgesics are non-steroidal anti-inflammatory drugs (NSAIDs). BLMPs work by targeting specific molecules involved in the inflammatory process, not just symptom relief. Purpose: To review the currently available PubMed data on biologics and exercise for RA and their mechanisms in the context of disease pathophysiology and future prospects. Brief description of the state of knowledge: BLMPs are a necessary alternative in patients who have not achieved the treatment goal for 6 months or have experienced side effects during treatment with conventional disease-modifying drugs. We also analyzed the effect of exercise on the course of RA. Conclusions: The introduction of bDMARDs has opened a new era in the treatment of diseases such as RA. However, due to the difficult access to this form of therapy, side effects, contraindications to currently used drugs, and increasingly well-known mechanisms, there is also a need to constantly search for new solutions. A growing body of evidence in recent years suggests that regular physical activity has a positive effect on various aspects of RA, including disease-related outcomes, mental well-being, and cardiovascular health. Also in this non-pharmacological field, further research is needed to fully understand the mechanisms behind these effects.

Central serous chorioretinopathy (CSCR) is a disease characterized by serous detachment of the neurosensory retina in the macular area, caused by increased choroidal vascular permeability. The disease is more common in young and middle-aged men (20-50 years old), it has been shown to be highly correlated with an increased level of stress in patients. Other risk factors for the central serous chorioretinopathy are: type A personality (ambitious, nervous and emotional people), use of steroids, Cushing’s syndrome, helicobacter pylori infection, gastroesophageal reflux, hypertension, sleep apnea. The disease leads to visual impairment: metamorphopsia, blurred vision, color vision impairment, impaired contrast and vision in the dark. CSCR diagnostics include funduscopic examination of the eye through the Volk lens revealing focus of circular retinal elevation, optical coherence tomography (OCT), which is a quick and non-invasive test that allows the diagnosis and monitoring of the disease. In the past, the diagnosis was based on fluorescein angiography, the dye spilling out fills the detachment space, revealing the leak center. In most cases the shunt stops spontaneously and spontaneous resorption of the subretinal fluid occurs without the need for treatment. The chronic form of CSCR ongoing more than 4 months requires initiation of therapeutic procedures. The first- line treatment is laser therapy. Micropulse laser therapy of the retina stimulates the pigment epithelium to produce anti-angiogenic factors and inhibit the inflammatory process, as a consequence, the resorption of the subretinal fluid occurs with minimal damage to the retina.

The correct structure of the tear film ensures the appropriate degree of hydration of the eye surface, and has a protective and nourishing function. Irregularities in the structure of one of the three layers of the tear film can contribute to dry eye syndrome. In recent studies, scientists have focused on dysfunction of the Meibomian gland and on deficiencies in the lipid layer of the tear film, which led to the evolution of preparation complementing the tear film. Dry eye syndrome is a multifactorial disease of the ocular surface. Symptoms vary from itching, burning, irritation, eye strain and eye inflammation to potential complications that include damage to the cornea, conjunctiva, and even loss of vision. Blurred vision is a component of the definition of DSO (apart from discomfort, tear film instability, changes in tear osmolarity, changes in neurosensory and specific inflammation on the surface of the eye). Changes in the thickness of the tear film translate into changes in the breaking power of the eye. It is believed that for every 0.1 mm change in tear film thickness, there is 0.5 D in the "+" or "-" direction. The result of aberration is the lack of a sharp, dotted image.Treatment is adjusted individually for each patient, based on the underlying disease mechanism. Recent studies have shown that dry eye is an inflammatory disease that shares many characteristics with autoimmune diseases. The main goal of this work is to present an outline of epidemiology, pathogenesis, risk factors and treatment methods.