Sexual dimorphism significantly impacts the lacrimal gland’s structure, function, and ageing processes, playing an important role in dry eye disease (DED) pathophysiology. This multifactorial disorder, characterised by tear film instability, inflammation, and visual impairment, disproportionately affects women, especially after menopause. It highlights the interplay between sex steroid hormones, lacrimal gland function, and environmental factors. Systemic and local androgens are vital for maintaining lacrimal gland health and tear production, while the role of oestrogens remains less clear. Evidence suggests dose and context-dependent effects on inflammation and glandular function. Histopathological and molecular studies reveal significant sex differences in the lacrimal gland, with women exhibiting more pronounced age-related degenerative changes, including fibrosis and acinar atrophy, contributing to their increased susceptibility to DED. Despite these findings, the underlying mechanisms connecting sex steroid hormones, receptor expression, and local tissue regulation to these disparities remain poorly understood, highlighting the need for further research. This review synthesises the current knowledge of sex-specific differences in the lacrimal gland, emphasising the importance of integrating systemic and local biomarkers, histological data, and molecular insights into personalised therapeutic strategies. By tailoring treatments to patients’ unique hormonal and molecular profiles, personalised medicine has the potential to transform DED management, addressing unmet clinical needs and improving outcomes.

Introduction. Hip fractures in the elderly pose a major public health challenge, particularly due to the frequent presence of comorbidities which can pro- long the preoperative preparation and increase intra- operative and postoperative risks.Aim. This study aimed to assess whether the comorbidity burden changes preoperative preparation duration and evaluate its mediating effect through additional diagnostic tests and anesthesiological risk assessment.Methods. A retrospective observational study was conducted on 71 patients with hip fractures admitted to the University Hospital Sveti Duh over one year. Demographic data, ASA classification, comorbidity types, and the number of additional diagnostic procedures were analysed. Statistical methods included the Mann-Whitney U test, multiple linear regression, and Sobel’s test to evaluate mediation effects.Results. Urological, neurological, and endocrine comorbidities significantly prolonged preoperative preparation (p<0.05). The number of additional diagnostic tests was the strongest predictor of preparation duration (p<0.001) and mediated the relation- ship between comorbidity burden and preoperative delay. Higher ASA classification scores were linked to longer preoperative preparation times and more required tests.Conclusion. Comorbidities in hip fracture patients have prolonged the preoperative planning, with specific conditions leading to prolonged hospital stays and increased diagnostic demands. Optimising chronic disease management before trauma occurrence may help reduce preoperative delays and improve surgical outcomes.