Introduction: Madelung's disease (MD), also known as multiple symmetric lipomatosis, is a rare metabolic disorder characterized by the accumulation of unencapsulated adipose tissue, predominantly in the head, neck, and upper trunk. Non-surgical treatment options remain limited in effectiveness, making surgical excision the primary therapeutic approach. However, challenges such as intraoperative bleeding and postoperative recurrence necessitate ongoing refinement of surgical techniques. Methods: We conducted a retrospective case series involving six patients diagnosed with Madelung's disease and treated surgically between 2018 and 2024 at the Department of Plastic Surgery, University Clinical Hospital in Gdańsk. All patients underwent staged surgical excision of pathological adipose tissue following infiltration with Klein's solution to minimize bleeding. Demographic and clinical data, comorbidities, fat distribution patterns (Type I or II), and body mass index (BMI) were recorded. The primary outcome was recurrence in the operated regions over a one-year follow-up period; the secondary outcome was the occurrence of surgical complications. Results: The study included five male and one female patient, with a mean age of 57 years (range: 44–67). Risk factors included smoking ( n = 4), alcohol abuse ( n = 2), and metabolic or systemic comorbidities. The BMI ranged from 21 to 33. All patients underwent successful surgical resection, with no recurrence of adipose tissue in the treated areas during follow-up. Histopathological evaluation confirmed the presence of benign lipomas in all specimens. No major complications, such as excessive bleeding or postoperative infections, were observed. Discussion: Surgical excision with prior infiltration of Klein's solution appears to be a safe and effective treatment for Madelung's disease, offering low recurrence and complication rates. The use of staged procedures and careful intraoperative management is critical in addressing the disease's vascular and infiltrative nature. While these findings are promising, larger prospective studies are needed to validate the efficacy of this approach and to further optimize surgical strategies for this rare condition.

Objectives: Chronic Rhinosinusitis (CRS) is a common inflammatory disease impacting 5-12% of the population, leading to substantial morbidity and healthcare expenses. Bacterial biofilms on the sinonasal mucosa are a key factor in CRS's development, persistence, and resistance to treatment. This review explores their role in refractory CRS, focusing on structure, formation, impact on severity, and diagnostic/therapeutic approaches. Methods: We conducted a comprehensive literature review using PubMed, Scopus, and Web of Science, searching for keywords related to CRS, bacterial biofilms, antibiotic resistance, and therapies. We prioritized studies from the last decade examining biofilms' impact on CRS pathogenesis, resistance, and novel treatments. Key findings: Biofilms, organized microbial communities within an extracellular polymeric matrix, are significantly more resistant to antibiotics and host immune responses than free-floating bacteria. They form through stages: initial attachment, proliferation, and complex 3D structure development, with quorum sensing vital for maturation. Common CRS biofilm pathogens include Staphylococcus aureus, Pseudomonas aeruginosa, and Haemophilus influenzae. Biofilms correlate with more severe disease, poorer surgical outcomes, and higher recurrence. Diagnostics include electron microscopy, confocal laser scanning microscopy (CLSM), and molecular methods. Treatment involves surgical removal, topical antibiotics, and novel strategies like phage therapy, quorum sensing inhibitors, and micro-biome-based interventions. Conclusions: Biofilms are critical in refractory CRS, causing persistence, treatment resistance, and worse outcomes. A deep understanding of biofilm mechanisms is crucial for effective diagnostics and therapies. Future research should standardize diagnostics, clarify biofilm-host interactions, and conduct trials on new, personalized biofilm-targeting treatments.

Increasing exposure to blue light is a major problem in the modern lifestyle of individuals. The increasing use of digital devices and LED lighting is recognised as a major environmental factor affecting human health. While it has a positive effect on alertness during the day, excessive or late-night exposure disrupts the circadian rhythm by affecting the intrinsically photosensitive retinal ganglion cells (ipRGCs), which regulate melatonin secretion and the sleep-wake cycle. The main negative consequences of evening blue light exposure include: disrupted sleep architecture, particularly by reducing slow-wave and REM sleep, which are essential for recovery processes, impaired cognitive performance, increased daytime sleepiness and a higher risk of mood disorders, including depression and anxiety. Interventions and prevention strategies aimed at reducing evening blue light (through filters, night mode settings or glasses) and morning exposure to bright light have been shown to be beneficial for sleep quality, circadian phase regulation and mood stabilisation. Despite progress in this area, there are still significant research gaps, particularly in relation to individual differences in light sensitivity, long-term effects and the optimal timing and intensity of interventions. This review summarises the latest results of 33 studies and provides a structured overview of the current evidence on the short- and long-term effects of blue light on circadian rhythms, sleep and mental health. It highlights practical measures to minimise harmful exposure suggesting the directions for future research to promote circadian health and general well-being in the context of modern lifestyles.

Background and Objectives: Melanoma is an aggressive cutaneous malignancy with a high recurrence rate even after complete resection. Circulating tumour DNA (ctDNA) has emerged as a promising biomarker for detecting minimal residual disease (MRD), assessing tumour burden, and predicting recurrence. This study aims to evaluate the clinical utility of ctDNA analysis in determining completeness of melanoma resection and disease staging. Materials and Methods: A systematic review was conducted in accordance with PRISMA guidelines, searching PubMed and Web of Science for studies published between January 2017 and February 2025. Eligible studies assessed ctDNA before, during, or after melanoma resection to evaluate surgical completeness and staging. Studies without perioperative ctDNA assessment or which focused solely on immunotherapy efficacy were excluded. Results: Fourteen studies with 1077 patients met the inclusion criteria. Preoperative ctDNA detection correlated with advanced stage, greater tumour burden, and poorer survival. Postoperative ctDNA persistence was strongly associated with recurrence, often detectable months before clinical relapse. In most patients remaining disease-free, ctDNA cleared within weeks after surgery. ctDNA levels reflected metastatic spread, though sensitivity was lower for brain lesions. Across studies, undetectable postoperative ctDNA was consistently linked to longer recurrence-free survival. Conclusions: Perioperative ctDNA analysis shows promise as a prognostic biomarker for detecting residual disease and anticipating relapse in melanoma. However, heterogeneity in patient cohorts, study design, and ctDNA detection methods limits immediate clinical application. Large, standardized prospective trials are needed to validate ctDNA for perioperative management.

Background/Objectives: Skin cancer is the most common cancer worldwide, creating a significant burden on healthcare systems. According to the World Health Organization, 1.5 million new cases are reported annually, though the actual number is likely higher due to underreporting. The main risk factor is UV radiation, with additional contributors such as smoking, older age, and outdoor work. Basal cell carcinoma (70–80%) and squamous cell carcinoma are the most prevalent non-pigmented skin cancers. This study assessed the knowledge of patients undergoing surgical treatment for facial skin cancer regarding risk factors, prevention, treatment, and health-related behaviors. The goal was to guide educational strategies aimed at reducing disease incidence and improving outcomes. Methods: A cross-sectional study of 220 patients treated at the UCK Department of Plastic Surgery (April–August 2024) was conducted. Participants completed anonymous questionnaires on demographics, medical history, beliefs about lesions, and sun-protective behaviors. Clinical data included tumor location, size, histopathology, and excision completeness. Statistical significance was set at p < 0.05. Results: Patients were on average 71 years old; 61% had a secondary education. Sun protection habits varied by education and gender. SPF use was higher among those with higher education (79.55%) and among women (55.83%). SPF users had smaller lesion diameters (p < 0.001). However, 71% delayed seeking care for over a year, often due to misperceptions. Conclusions: There is a notable lack of awareness about skin cancer, especially prevention and early detection. Education and gender influence protective behaviors. Tailored educational initiatives may help reduce incidence and promote earlier diagnosis.

Objective: Psychiatric comorbidities, particularly anxiety and depressive disorders, are highly prevalent among patients with cardiovascular disease and represent significant contributors to adverse clinical outcomes and healthcare resource utilization. This investigation examined the association between evidence-based mental health interventions and subsequent healthcare utilization patterns in patients with heart failure (HF) and coronary artery disease. Methods: We evaluated the impact of psychiatric treatment modalities, including pharmacological therapy and psychotherapeutic interventions, on hospital readmission rates and emergency department (ED) utilization among cardiovascular patients with comorbid anxiety or depressive disorders. Key Findings: Mental health treatment demonstrated substantial protective effects against adverse healthcare utilization outcomes. Patients receiving combination therapy (both pharmacotherapy and psychotherapy) exhibited the most pronounced benefit, with a 75% reduction in hospital readmission risk and a 74% decrease in ED visits compared to untreated controls. Monotherapy approaches also yielded significant improvements: psychotherapy alone was associated with a 49% reduction in readmission risk and 53% decrease in ED utilization, while pharmacological intervention alone resulted in 58% and 49% risk reductions for readmissions and ED visits, respectively. These findings remained statistically significant across all treatment modalities examined. Conclusions: The implementation of appropriate mental health interventions, whether through pharmacological management, psychotherapeutic approaches, or combined treatment strategies, represents a critical component in the comprehensive care of cardiovascular patients with psychiatric comorbidities. These data provide compelling evidence that addressing psychological comorbidities is not merely adjunctive but essential for optimizing clinical outcomes, reducing healthcare burden, and improving the overall prognosis of patients with HF and coronary disease. Integration of psychiatric care into standard cardiovascular management protocols should be considered a clinical imperative.