In this article, we discuss the topic of chronic thromboembolic pulmonary disease (CTEPD) and the growing role of balloon pulmonary angioplasty (BPA) in its treatment. We present the pathophysiology of CTEPD which arises from an incomplete resolution of thrombi in the pulmonary arteries and leads to stenosis and occlusion of the vessels. The article focuses mainly on the chronic thromboembolic pulmonary hypertension (CTEPH) subpopulation for which prognosis is very poor when left untreated. We describe a multimodal approach to treating CTEPH, including pulmonary endarterectomy (PEA), BPA, and pharmacological therapies. Additionally, the benefits of pharmacological pre-treatment before BPA and the technical aspects of the procedure itself are outlined. It is emphasized that BPA does not replace PEA but serves as a complementary treatment option for eligible patients. We summarized efficacy and treatment goals including an improvement in functional and biochemical parameters before and after BPA. Patients who received pre-treatment with riociguat prior to BPA exhibited a notable reduction in the occurrence of less severe complications. However, elderly patients are still perceived as an especially vulnerable group. It is shown that the prognosis of patients undergoing BPA is similar to PEA in the first years after the procedure but the long-term prognosis of BPA still remains unclear. The 2022 ESC/ERS guidelines highlight the significant role of BPA in the multimodal treatment of CTEPH, emphasizing its effectiveness and recommending its consideration as a therapeutic option for patients with CTEPD, both with and without pulmonary hypertension. This review summarizes the available evidence for BPA, patient selection, procedural details, and prognosis and discusses the potential future role of BPA in the management of CTEPH.

Background and Aim: Polycystic Ovary Syndrome (PCOS) affects 5–16% of women of reproductive age and is associated with significant reproductive, metabolic, and psychological consequences. Lifestyle modification, including diet and physical activity, is universally recommended as first-line therapy. However, most clinical studies and guidelines treat PCOS as a homogeneous condition, overlooking the heterogeneity defined by the Rotterdam phenotypes. This reduces the applicability of current recommendations. The novelty of this review lies in focusing on phenotype-specific responses to lifestyle interventions. The aim is to summarize available evidence on dietary approaches, physical activity, supplementation, and behavioral factors across PCOS phenotypes and to identify gaps for future research. Methods: A narrative review was performed using PubMed, Google Scholar, and ResearchGate. Eligible publications included randomized controlled trials, systematic reviews, meta-analyses, and international guidelines published after 2018. Search terms combined PCOS, phenotype, diet, physical activity, insulin resistance, hyperandrogenism, supplementation, smoking, and sleep. Results: Evidence indicates that aerobic exercise, high-intensity interval training, low-AGE and high-fiber hypocaloric diets, and selected supplements such as β-hydroxybutyrate and N-acetylcysteine improve metabolic and hormonal outcomes. These effects are most pronounced in classical phenotypes A and B, characterized by hyperandrogenism and insulin resistance. Non-hyperandrogenic phenotypes, such as D, show limited response to interventions targeting androgen excess. Behavioral factors, including smoking and sleep disturbances, aggravate metabolic dysfunctions and worsen outcomes in hyperandrogenic phenotypes. Conclusions: Lifestyle modification remains central to PCOS management, but its effectiveness is not uniform across phenotypes. Tailoring dietary, exercise, and adjunctive strategies to the endocrine and metabolic characteristics of each phenotype may improve outcomes. Future research should prioritize phenotype-stratified trials to provide evidence-based recommendations that reflect the heterogeneity of PCOS.

Background Diabetes mellitus is a chronic metabolic disease associated with ocular complications beyond classical diabetic retinopathy. Long-term diabetes may affect the retinal neurovascular unit, retinal microcirculation, visual function, cornea, ocular surface, lens, optic nerve, and glaucoma-related structures. Some of these abnormalities may occur before clinically visible diabetic retinopathy. Aims The aim of this narrative review was to summarize current evidence on long-term structural and functional ocular changes associated with type 1 and type 2 diabetes mellitus, with emphasis on retinal neurodegeneration, retinal microvascular impairment, functional visual deficits, and selected extraretinal ocular complications. Methods A narrative literature review was conducted using PubMed, Embase, Cochrane Library, and Google Scholar. English-language publications from 2008 to 2026 were considered, and the final search was conducted on April 15, 2026. Search terms included diabetes mellitus, diabetic retinopathy, retinal neurodegeneration, corneal neuropathy, cataract, glaucoma, ocular complications, retina, and visual function. Meta-analyses, systematic reviews, longitudinal prospective studies, cross-sectional studies, and expert opinion articles were included. A total of 230 articles were initially identified, 85 full-text articles were assessed, and 43 key studies were included. Results Long-term diabetes was associated with retinal neurovascular damage, retinal neurodegeneration, retinal microvascular impairment, functional visual abnormalities, and selected extraretinal ocular complications. OCT studies demonstrated thinning of the inner retinal layers, including changes in the ganglion cell complex and retinal nerve fiber layer. OCT angiography may detect reduced macular microvascular density and capillary dropout before classical ophthalmoscopic signs of diabetic retinopathy. ERG, pattern ERG, VEP, and microperimetry may reveal abnormalities in retinal response, neural conduction, and macular sensitivity. Beyond the retina, diabetes was associated with corneal neuropathy, diabetic keratopathy, ocular surface disease, impaired epithelial healing, accelerated cataract formation, optic nerve and functional visual pathway involvement, and increased glaucoma risk. Conclusions Long-term type 1 and type 2 diabetes mellitus is associated with ocular changes beyond classical diabetic retinopathy. Assessment focused only on clinically visible retinopathy may miss earlier structural, microvascular, and functional abnormalities. A multimodal and individualized diagnostic approach may be useful, depending on disease duration, metabolic control, ocular symptoms, clinical findings, and available resources. Further longitudinal studies with standardized outcome measures are needed to clarify early diagnostic markers, risk stratification, and monitoring strategies for diabetes-related ocular disease.

Background Obesity is a chronic disease associated with increased cardiometabolic risk and requires long term multidisciplinary management. Semaglutide, a glucagon like peptide 1 receptor agonist, has emerged as an effective pharmacological option for weight management. The aim of this narrative review is to analyze current clinical evidence on the efficacy, safety, and adverse event profile of semaglutide in adults with overweight or obesity. Methods A narrative review of publications indexed in PubMed, Scopus, Web of Science, Embase, Google Scholar, and ResearchGate was conducted. Eligible studies published between 2020 and 2026 included randomized controlled trials, cohort studies, systematic reviews, meta analyses, and international clinical guidelines. Only studies involving adult participants meeting established indications for pharmacological obesity treatment, defined as a body mass index of at least 30 kg per square meter or at least 27 kg per square meter with weight related comorbidities, were included. Results The review synthesizes evidence from the STEP 1 to 8 clinical trials evaluating once weekly subcutaneous semaglutide in diverse clinical and ethnic populations. Across all trials, semaglutide in combination with lifestyle modification was consistently associated with clinically meaningful weight reduction compared with placebo. Comparative data demonstrate greater weight loss with semaglutide than with liraglutide in adults without diabetes mellitus. Semaglutide was effective in Asian populations characterized by increased cardiometabolic risk at lower body mass index values and was associated with reductions in visceral adipose tissue. In individuals with type 2 diabetes mellitus, weight loss was less pronounced but remained clinically relevant. The most frequently reported adverse events were gastrointestinal in nature and were predominantly mild to moderate in severity, with low rates of serious adverse events and treatment discontinuation. Conclusions Current clinical evidence indicates that once weekly subcutaneous semaglutide, used as an adjunct to lifestyle intervention, is an effective and generally well tolerated pharmacological option for weight management in adults with overweight or obesity. Maintenance of weight reduction requires continued treatment, supporting the concept of obesity as a chronic condition requiring long term therapeutic strategies.

Background Gel manicure is widely used in professional and home settings. Concerns relate to chemical exposure from acrylate containing nail products, ultraviolet radiation emitted by nail curing lamps, occupational exposure among nail technicians, and potential microbiological implications. Aims To systematize published evidence on health effects associated with gel manicure use, with emphasis on allergic reactions, ultraviolet exposure related outcomes, occupational risks, and microbiological findings, and to identify gaps in the current evidence base. Methods A narrative review was conducted using PubMed, Google Scholar, and ResearchGate. Publications from January 2010 to March 2025 were considered. Only English language articles were included. Inclusion criteria comprised randomized controlled trials, cohort studies, case control studies, systematic reviews, meta analyses, and international or national guidelines reporting health effects or exposure characteristics related to gel manicure use. Exclusion criteria included single case reports, conference abstracts, non peer reviewed publications, animal studies, and articles lacking explicit data on gel manicure exposure or associated health outcomes. The initial search yielded 223 records, and 44 publications were retained for analysis. Results Nail curing devices predominantly emit UVA radiation with peak wavelengths between 365 and 405 nm, with substantial variability across lamp types and designs. Under typical usage conditions, cumulative ultraviolet exposure during manicure sessions remains below levels associated with clinically significant dermatologic damage or increased skin cancer risk. Allergic contact dermatitis related to acrylate and methacrylate containing products is the most frequently reported adverse outcome, particularly among nail technicians and younger users. Evidence on microbial retention and reduced hand hygiene effectiveness with gel or artificial nails is heterogeneous and context dependent. Conclusions Available evidence indicates that allergic sensitization to acrylate containing nail products represents the primary clinically relevant health risk of gel manicure, whereas ultraviolet radiation related carcinogenic risk appears minimal under typical use. Standardization of exposure assessment and further research on occupational and microbiological outcomes are needed.

Introduction Laryngectomy is a surgical intervention that involves the partial or complete excision of the larynx, which is the primary organ responsible for phonation and airway protection. The most common indications for laryngectomy are malignancies of the larynx or severe trauma resulting in extensive damage to the larynx. The surgical procedure can be performed as a partial laryngectomy, which involves the removal of a portion of the larynx, or as a total laryngectomy, which requires the complete removal of the larynx, including the vocal folds, hyoid bone, epiglottis, thyroid and cricoid cartilage, and several rings of tracheal cartilage. This surgical intervention results in the separation of the upper airway from the oral cavity, nasopharynx, and esophagus, requiring the establishment of an alternative means for respiration and speech production. The management of patients who undergo laryngectomy requires a multidisciplinary approach, including the involvement of speech therapist and psychologists, among other healthcare professionals, to optimize the rehabilitation process and improve patient outcomes. Case presentation A 66-year-old male patient with a 30-year history of cigarette smoking was admitted to the ear, nose, and throat (ENT) clinic for complaints of hoarseness and dysphagia that had been present for several months. On examination, the patient's throat was unchanged, and there was no purulent discharge from the nose. The patient was diagnosed with laryngeal carcinoma, stage T3N1M0. Conclusions Total laryngectomy is a highly effective treatment option for advanced stage laryngeal cancer, with 5-year survival rates ranging from 53% to 86%. Patients who undergo total laryngectomy and receive a voice prosthesis and voice rehabilitation with a speech therapist report better voice quality and overall quality of life, which can help to reduce the risk of depression and anxiety following surgery.