Chronic pain constitutes one of the most common chronic complaints that people experience. According to the International Association for the Study of Pain, chronic pain is defined as pain that persists or recurs longer than 3 months. Chronic pain has a significant impact on individuals’ well-being and psychosocial health and the economy of healthcare systems as well. Despite the availability of numerous therapeutic modalities, treatment of chronic pain can be challenging. Only about 30% of individuals with non-cancer chronic pain achieve improvement from standard pharmacological treatment. Therefore, numerous therapeutic approaches were proposed as a potential treatment for chronic pain including non-opioid pharmacological agents, nerve blocks, acupuncture, cannabidiol, stem cells, exosomes, and neurostimulation techniques. Although some neurostimulation methods such as spinal cord stimulation were successfully introduced into clinical practice as a therapy for chronic pain, the current evidence for brain stimulation efficacy in the treatment of chronic pain remains unclear. Hence, this narrative literature review aimed to give an up-to-date overview of brain stimulation methods, including deep brain stimulation, motor cortex stimulation, transcranial direct current stimulation, repetitive transcranial magnetic stimulation, cranial electrotherapy stimulation, and reduced impedance non-invasive cortical electrostimulation as a potential treatment for chronic pain.

Energy drinks (NE) are popular stimulants among adolescents and adults. They are commercial, advertised, widely available products that contain increased amounts of caffeine, and are designed to reduce feelings of fatigue in favor of increased mental and physical performance. In addition to caffeine, various ingredients such as vitamins, dyes or substances that impart a certain flavor are added to NEs. Many cases have been described of the harmful effects of NE used alone and in combination with alcohol on the human body: including on the digestive system, central nervous system, cardiovascular system or kidneys. We decided to analyze and compare with each other the composition of NEs from the most popular manufacturers available in most Polish grocery stores. We then briefly described the most important substances available in NE and reviewed the literature on their potential toxicity. It is reasonable for physicians and teachers to educate young people and their parents about the harmfulness of NE, especially when children are suspected of taking large amounts. Further observations and studies monitoring the harmfulness of NEs are needed, and the drinks themselves should be subject to special surveillance.

Meningiomas, being mostly benign tumors, are derived from the arachnoid cap cells, their etiopathogenesis is based on various factors. The etiology of sporadic meningiomas is not yet known. Many factors have been identified as possible causes of the development of intracranial meningiomas. These include head trauma, viral infections, deletion in the NF2 gene, the use of cell phones, and sex hormones. The review is based on a endocrine factors, playing a role in meningioma carcinogenesis. The carcinogenesis of meningioma appeals to be profoundly dependent from hormonal factors. Mayor ones, usually underlined in according to their prognostic significance, are female sex hormones. Due to this, meningiomas are twice as more likely to occur in female than in male patients. The other group of hormones appointed to play a role in meningioma carcinogenesis are adipokines in general – and leptin in particular. Leptin secretion correlates with BMI elevation, what may explain the confirmed linking between obesity and brain tumors. The scientific literature has documented the occurrence of meningioma in five patients with CAH, but the role of cortical axis and/or ACTH secretion impairments is still under consideration. Authors didn’t find any publication about the role of thyroid disorders in meningioma carcinogenesis. The carcinogenesis of meningioma appeals to be profoundly dependent from hormonal factors. The effects of female sex hormones and adipokines are under a significant consideration, and may be useful in severity prediction. Basic science research should be focused on ACTH secretion in meningioma and possible common genetic etiopathogenesis of meningioma and CAH.

Introduction and aim. Neutropenic enterocolitis is a severe disease that affects patients with immunodeficiency and is often related with the chemotherapy of the hematologic malignancies. Its pathophysiology is not fully understood. Neutropenic colitis may lead to sepsis, gastrointestinal bleeding and even perforations requiring surgical management. The therapy consists of antibiotic therapy, transfusions, hematopoietic growth factor treatment, usage of fluids and electrolytes, bowel rest and even surgical operations. The aim of this review is to consider the potential usage of probiotics in the prevention and treatment of neutropenic enterocolitis. Material and methods. References for that article were found through PubMed and Google Scholar, using terms: “neutropenic enterocolitis” and “probiotics”, or “gut microbiota” and “neutropenic enterocolitis”. The research was limited to abstracts and available full-text articles. Analysis of the literature. The most possible mechanism of neutropenic enterocolitis development appoints bacterial invasion with co-existing immunodeficiency. The probiotics appeal as beneficial agents in both prevention and treatment of neutropenic enterocolitis in according to their impact on gut immune barrier improvement. However older societies’ guidelines were cautious, the most modern ones appoint probiotics as a promising agent in neutropenic enterocolitis, what corresponds with results from current randomized clinical trials. Conclusion. As neutropenic enterocolitis is a severe disease we need to look for better or alternative therapies of that state. The probiotics seems to have beneficial effects in terms of prevention and treatment of neutropenic enterocolitis due to their impact on gut immune barrier. Benefits of such therapy are reflected in current societies’ guidelines which consider probiotics as a promising agent in neutropenic enterocolitis.

SGLT-2 inhibitors (flozins) are one of the new classes of anti-diabetic drugs, used from 2012. They are highly recommended in case of intolerance or contraindication of metformin, but in Poland they are used usually as third-line drug after metformin and sulfonylurea. They growing popularity is caused by their significance in cardiovascular risk reduction and preventive role in according to diabetes complications like chronic kidney disease, or diabetes-induced dementia. The aid of this article is to summarize the knowledge on the risk of psoriasis development in diabetic patients cured with flozins. In according to the newest studies, flozins may be considered as a pro-psoriatic factor, increasing the risk of this skin disease, especially in patients with diabetic kidney disease. But on the other hand, SGLT-2 inhibitors have significantly decreasing effect on cardiovascular risk, which is increased in psoriatic patients.

To evaluate the perceived educational impact and post-return implementation of the Far East Stroke Advanced Clinical and Observership Program at Sapporo Teishinkai Hospital in the contemporary endovascular era. We conducted an anonymous cross-sectional alumni survey of program participants. Outcomes included self-rated (1 to 5 Likert scale) vascular anatomy understanding, microsurgical skill, and confidence in managing vascular neurosurgery before versus after the program, and ratings of drawing-based learning. Operative exposure, structured educational elements, and post-return dissemination and practice changes were collected, including free-text responses. Before-versus-after comparisons used the Wilcoxon signed-rank test. Self-assessed ratings were significantly higher after the program across all primary outcomes. Vascular anatomy understanding, microsurgical skill, and confidence in managing vascular neurosurgery all increased significantly after participation, based on paired ordinal analysis using the Wilcoxon signed-rank test (all p < 0.001). Drawing exercises were rated highly, with a median score of 5. Most respondents reported subsequent knowledge transfer and changes in practice. Given the retrospective self-assessment design, these findings reflect perceived rather than objectively measured improvements. Participation in a high-volume, structured microsurgical observership/fellowship program was associated with substantial self-reported improvements in competence and confidence, along with frequent translation into practice and teaching after return. These findings should be interpreted in the context of subjective outcomes and potential sources of bias inherent to survey-based designs.