Chronic kidney disease (CKD) is a very prevalent and insidious disease, particularly with initially poorly manifested symptoms that progressively culminate in the manifestation of an advanced stage of the condition. The gradual impairment of kidney function, particularly decreased filtration capacity, results in the retention of uremic toxins and affects numerous molecular mechanisms within the body. The dysbiotic intestinal microbiome plays a crucial role in the accumulation of protein-bound uremic toxins such as p-cresol (pC), indoxyl sulfate (IS), and p-cresyl sulfate (p-CS) through the ongoing fermentation process. The described phenomenon leads to an elevated level of oxidative stress and inflammation, subsequently resulting in tissue damage and complications, particularly an increase in cardiovascular risk, representing the predominant cause of mortality in chronic kidney disease (CKD). Therefore, exploring methods to reduce uremic toxins is currently a pivotal therapeutic strategy aimed at reducing the risk of organ damage in patients with chronic kidney disease (CKD). This review aims to summarize recent discoveries on modifying the composition of the intestinal microbiota through the introduction of special probiotic and synbiotic supplements for CKD therapy. The potential to connect the gut microbiota with CKD opens the possibility for further extensive research in this area, which could lead to the incorporation of synbiotics and probiotics into the fundamental treatment and prevention of CKD.

Background: Cubital tunnel syndrome (CuTS) is the second most common compressive neuropathy of the upper extremity, with an estimated prevalence of 1.8–5.9% in the general population. It represents a significant clinical and socio-economic problem, contributing to pain, functional impairment, and reduced work productivity. Aim: This narrative review aims to summarize current evidence on the pathophysiology, diagnostic approaches, and treatment strategies for CuTS, with particular emphasis on clinical outcomes and implications for healthcare systems. Methods: A narrative review was conducted using the PubMed database, including systematic reviews, meta-analyses, and clinical studies published between 2017 and 2026. Results: CuTS pathophysiology involves mechanical compression, traction, and ischemia of the ulnar nerve. Diagnosis is based on clinical examination supported by electrodiagnostic testing and ultrasound. Conservative treatment is effective in mild cases, while surgical techniques, including decompression and anterior transposition, show favorable outcomes. No single surgical method has demonstrated clear superiority. Treatment outcomes are influenced by disease severity and duration. From a healthcare perspective, delayed diagnosis is associated with increased costs and higher rates of surgical intervention. Conclusion: CuTS requires an individualized, evidence-based approach. Early diagnosis and optimized treatment strategies may improve clinical outcomes while reducing healthcare costs and socio-economic burden. Future approaches should focus on improving diagnostic pathways and access to cost-effective interventions.

Carotid artery stenosis causes 10% to 20% of all strokes. This review evaluates the evolving, complementary roles of carotid endarterectomy (CEA), transfemoral stenting (TFCAS), transcarotid revascularization (TCAR), and best medical therapy (BMT). Aggressive BMT forms the universal foundation of care, reserving intervention for symptomatic (≥50%) or high-risk asymptomatic (>70%) patients. CEA remains a durable gold standard where routine patch angioplasty minimizes perioperative stroke and thrombosis. While traditional TFCAS carries elevated stroke risks in patients over 70, modern dual-layer stents and proximal protection significantly mitigate microembolic complications. TCAR successfully bridges open and endovascular approaches; by utilizing direct access and neuroprotective flow reversal, it minimizes embolic and cranial nerve injuries while providing the highest probability of preventing long-term restenosis. Ultimately, modern management has transitioned from competing modalities into a highly individualized selection paradigm.

Aim. To synthesize evidence on the role of physical activity (PA) in preventing and managing gestational diabetes mellitus (GDM), covering physiology, observational data, trials, implementation barriers, and gaps. Materials and methods. Narrative review of studies on preconception and pregnancy PA for GDM prevention and on PA interventions for treatment/control. Outcomes: incident GDM, fasting/postprandial glucose, insulin use, gestational weight gain, hypertensive disorders, delivery mode, neonatal outcomes (LGA, macrosomia, hypoglycemia), and longer‑term offspring data. Dose–response and subgroup analyses by timing, intensity, supervision, and maternal BMI. Results. Preconception and early‑pregnancy PA are linked to lower GDM risk Protective estimates span ~21–46% overall. Dose–response: ≥15–21 MET h/week preconception; in pregnancy, 10/20/50 MET h/week ≈6/11/15% lower risk. Early, supervised light–moderate programs yield the largest prevention effects; one RCT reported up to 90% risk reduction at 150–180 min/week. A single moderate bout lowers postprandial glucose for 1–2 h; repeated aerobic/resistance training with dietary counseling improves fasting/postprandial glucose and may reduce insulin needs. Intensified lifestyle care reduces gestational weight gain and LGA. Evidence for hypertensive disorders, cesarean delivery, and long‑term outcomes is mixed. PA levels are low (MVPA ~11–14 min/day); barriers are clinical, symptomatic, cultural. Conclusions. Promote PA before and early in pregnancy (≥15–21 MET h/week preconception; up to ~50 MET h/week in the first trimester when feasible). Early, supervised light–moderate programs and regular aerobic or resistance exercise plus dietary counseling are effective. More RCTs should refine optimal modality, dose, timing, supervision, and long‑term outcomes.

Chimeric antigen receptor T-cell (CAR-T) therapy represents a major advancement in cancer immunotherapy, introducing a novel therapeutic approach based on the genetic modification of T lymphocytes to enhance tumor-specific cytotoxicity. This strategy has significantly transformed the treatment landscape, particularly in hematologic malignancies. The aim of this review is to summarize the current state of knowledge regarding CAR-T therapy, including its mechanisms of action, clinical applications, toxicity profile, limitations, and future directions of development. A narrative review of the literature was conducted based on selected publications indexed in biomedical databases, with particular emphasis on recent advances in both hematologic and solid tumors. CAR-T therapy has demonstrated high clinical efficacy in hematologic malignancies, especially B-cell cancers such as acute lymphoblastic leukemia and multiple myeloma, achieving substantial response rates in patients with relapsed or refractory disease. In contrast, its application in solid tumors remains limited due to challenges including antigen heterogeneity, an immunosuppressive tumor microenvironment, and reduced T-cell infiltration. The therapy is associated with characteristic toxicities, most notably cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, which require careful monitoring and management. Furthermore, its broader implementation is constrained by complex manufacturing processes, high costs, and limited accessibility. Ongoing research focuses on improving CAR-T cell persistence, overcoming T-cell exhaustion, optimizing antigen targeting, and developing novel strategies such as allogeneic products and combination therapies. In conclusion, CAR-T therapy constitutes a transformative modality in modern oncology, with established efficacy in hematologic malignancies and emerging potential in solid tumors, and its continued development is expected to further expand its clinical utility.

Background: Carpal tunnel syndrome (CTS) represents one of the most common peripheral nerve entrapment neuropathies affecting the upper limb, resulting from increased pressure within the carpal tunnel and compression of the median nerve. It is associated with numbness, pain, and hand weakness, leading to functional impairment and reduced quality of life. While conservative treatment is effective in early stages, surgical intervention remains the main option in advanced cases. Aim: The aim of this narrative review was to summarize current evidence on the diagnosis, treatment, and surgical outcomes of carpal tunnel syndrome, with particular emphasis on the effectiveness of surgical decompression and factors influencing recovery. Material and methods: A narrative review of the literature was conducted using PubMed and other peer-reviewed sources. Articles published in English between 2010 and 2026 were included, focusing on the surgical management of carpal tunnel syndrome. Results: Surgical division of the transverse carpal ligament leads to significant symptom improvement in most patients. Both open and endoscopic techniques reduce pain and improve hand function. Endoscopic approaches may allow faster recovery, whereas open procedures remain widely used and reliable. Surgical treatment is associated with sustained symptom relief and favorable long-term outcomes, particularly in moderate to severe cases. Postoperative rehabilitation and early mobilization support recovery. Conclusions: Surgical decompression is an effective treatment for patients with persistent or severe CTS, providing durable symptom relief and functional improvement. Patient selection, surgical technique, and postoperative rehabilitation are key factors influencing outcomes.