Introduction and purposeAndrogenetic alopecia (AGA) is one of the most common causes of baldness worldwide. It affects up to 80% of men by the age of 70 and up to 40% of postmenopausal women. In AGA etiology and pathogenesis, the three essential components play a key role - genetic inheritance, patient age and hormonal effects of androgens. In the following review, we have described the available FDA-approved and off-label treatments for AGA, along with their efficacy and potential side effects that should always be considered to prevent treatment discontinuation by the patients.The state of knowledgeThe pathogenesis of AGA is based on inherited dihydrotestosterone (DHT) sensitivity in the scalp skin, which leads to progressive hair loss. The literature documents the effectiveness of several treatments with different mechanisms of action in AGA therapy, but only topical minoxidil and oral finasteride gained FDA approval so far. Minoxidil acts by the blood vessels dilatation that increases the flow of oxygenated and growth factor-enriched blood to the hair follicles in the skin. 5-alpha reductase inhibitors, such as finasteride and dutasteride are another threapeutic option. Thy act by the inhibition of 5-alpha reductase, the enzyme which converts testosterone to DHT - the main causative agent of androgenetic alopecia. Recently, topical applications of minoxidil and finasterid, along with completely new emerging treatments for androgenetic alopecia are gaining popularity among doctors and patients. SummaryThis review describes current treatments for AGA, considering their efficacy, optimal doses, and the most common side effects. An important fact to emphasise is that androgenetic alopecia is based on a genetic predisposition, and treatment requires long-term use. For this reason, when choosing a medication, it is essential to cooperate with the patient and combine different therapeutic methods to achieve the desirable outcome while avoiding adverse reactions.

This narrative review examines current and emerging treatment strategies for diabetic macular edema (DME), a complication of diabetic retinopathy characterised by fluid accumulation in the macula, which can lead to vision impairment. The incidence of DME is particularly high in patients with long-standing diabetes and advanced retinopathy. The current treatment options for DME include anti-vascular endothelial growth factor (anti-VEGF) agents, corticosteroids, and laser therapies. Anti-VEGF agents, including bevacizumab, ranibizumab, aflibercept, and the more recently developed brolucizumab and faricimab, have been demonstrated to reduce macular thickness and improve visual acuity. Brolucizumab offers the advantage of fewer injections due to its longer duration of action, although it carries a higher risk of ocular inflammation compared to other anti-VEGF agents. The dual inhibition of the VEGF and angiopoietin-2 (Ang-2) pathways by faricimab may enhance vascular stability and reduce inflammation, potentially improving patient outcomes. Steroid therapies, including dexamethasone, fluocinolone acetonide, and triamcinolone acetonide, represent an alternative for patients who do not respond adequately to anti-VEGF treatment. Laser therapies, including focal, navigated, and subthreshold laser treatments, remain a crucial component in the management of DME, with the ability to seal leaking vessels and reduce fluid accumulation. In order to achieve the best outcomes for patients, it is essential to continue to advance these treatment modalities and adopt a personalised, multifaceted approach.

Cabozantinib, an oral inhibitor targeting MET, AXL, and VEGF receptors, has become a key component of a sequential treatment strategy for clear cell renal cell carcinoma (ccRCC). The purpose of this work is to show that effective management of adverse events (AEs) during cabozantinib treatment and achieving a balance between AEs and treatment efficacy is crucial to achieving therapeutic goals. In this retrospective study, involving seventy-one metastatic RCC (mRCC) patients receiving second or subsequent lines of cabozantinib at the Department of Genitourinary Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, we explored the impact of AEs on overall survival (OS) and progression-free survival (PFS). AEs were observed in 92% of patients. Hypothyroidism during treatment was significantly associated with prolonged OS and PFS (HR: 0.31; p < 0.001 and HR: 0.34; p < 0.001, respectively). The occurrence of hand–foot syndrome (HFS) was also linked to improved OS (HR: 0.46; p = 0.021). Patients experiencing multiple AEs demonstrated superior OS and PFS compared to those with one or no AEs (HR: 0.36; p < 0.001 and HR: 0.30; p < 0.001, respectively). Hypothyroidism and HFS serve as valuable predictive factors during cabozantinib treatment in ccRCC patients, indicating a more favorable prognosis.

Introduction and purpose Acne is one of the most common dermatological conditions, especially in adolescents. The etiology of acne is complex, and many factors influence the formation of lesions. Local inflammation, a proliferation of Propionibacterium acnes, hormonal influences with particular importance of androgens, hyperkeratinization, and excessive sebum production are essential in the pathogenesis. The factors stimulating these processes are complex and not always clear. Therefore, in our work, we focused on investigating the connection between a high-glycemic diet and the formation of acne lesions. The state of knowledge The link between diet and acne has been only mentioned in the literature for many years. However, the development of science has made it possible to understand the exact pathogenesis of acne and the relationship of acne lesions to specific dietary components. Of all the diet products, a high glycemic index diet stands out as the one with the most significant impact. Foods with a high glycemic index, i.e. those with a high amount of simple sugars, through an increase in the expression of factors such as insulin, IGF-1 cause excessive sebum production in the sebaceous glands and even an increase in inflammatory infiltration, which further exacerbates acne lesions. In the following review paper, we have looked at the metabolic pathways and hormonal changes that link the consumption of high glycemic index foods to the formation of acne lesions and described several original papers that unequivocally demonstrate the critical role of this diet on acne formation. Summary Based on the literature, we emphasize that in acne treatment, it is necessary not only to focus on medications but, above all, to look at the patient holistically, modifying the lifestyle with particular importance on modifying the patient's diet by lowering its glycemic index.

Background and Objectives: More than 430,000 new cases of renal cell carcinoma (RCC) were reported in 2020. Clear cell RCC, which occurs in 80% of cases, is often associated with mutations in the VHL gene, leading to dysregulation of hypoxia-induced transcription factors pathways and carcinogenesis. The purpose of this study is to examine the adverse events (AEs) of cabozantinib treatment and the relationship between individual patient factors and the frequency of their occurrence in detail. Materials and Methods: Seventy-one patients with metastatic RCC were treated with second or further lines of cabozantinib at the Department of Genitourinary Oncology, Maria Sklodowska-Curie National Research Institute of Oncology. Comprehensive data, including demographics, clinicopathological factors, and AEs, were collected from January 2017 to June 2021. This study evaluated the impact of various patient-related factors on the rate of adverse events and treatment tolerance using a Cox proportional hazards model. Results: Cabozantinib-induced AEs were significantly associated with body mass index (BMI), body surface area (BSA), IMDC prognostic score, and treatment line. Notably, patients receiving cabozantinib post-tyrosine kinase inhibitors reported fewer AEs. Dose reduction was unrelated to adverse event frequency, but patients requiring dose reduction were characterized with lower body mass and BSA but not BMI. Conclusions: The factors described make it possible to predict the incidence of AEs, which allows for faster detection and easier management, especially in the high-risk group. AEs should be reported in detail in real-world studies, as their occurrence has a significant impact on prognosis.

Introduction and purpose Air pollution, stemming from natural occurrences and human activities, significantly threatens global health, particularly impacting respiratory conditions like asthma. Air pollution substantially influences asthma exacerbation in athletes, a group particularly vulnerable due to their high physical activity levels and increased respiratory demands. Key pollutants, including particulate matter (PM), ground-level ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2), play critical roles in asthma development and exacerbation. The State of Knowledge Asthma, a chronic inflammatory disease influenced by genetic predisposition and environmental factors like air pollution, is characterized by airway hyperresponsiveness, obstruction, and chronic inflammation, leading to symptoms such as shortness of breath, coughing, wheezing, and chest tightness. Research highlights the link between air pollution exposure and asthma development, with PM2.5 exposure associated with increased asthma risk and pollutants exacerbating symptoms, especially in children. Athletes inhaling air pollutants during exercise face increased airway inflammation, mucus production, and bronchospasm, worsening asthma symptoms like wheezing and shortness of breath. Chronic exposure decreases lung function, increasing reliance on medication and limiting outdoor training on polluted days. Summary Effective asthma management amidst air pollution requires personal, community, and governmental measures. Patients should minimize exposure by wearing N95 masks and choosing low-traffic routes. Governments must monitor pollution, inform the public, and control emissions through alternative fuels and technologies. Adhering to WHO air quality guidelines could prevent many new asthma cases, emphasizing comprehensive air quality management's importance, especially among vulnerable populations like children.