Primary membranous nephropathy is a leading cause of nephrotic syndrome in adults, characterized by immune complex deposition in the glomerular basement membrane. Predicting proteinuria remission is essential for guiding treatment decisions, optimizing immunosuppressive therapy, and improving renal outcomes. Traditional prognostic markers, such as anti-PLA2R antibody status and baseline proteinuria levels, offer valuable insights into disease progression. However, recent research has identified additional biomarkers that may enhance risk stratification and refine individualized treatment strategies. Serum-based markers, such as uric acid and inflammatory indices, may indicate systemic changes that impact disease progression. Urinary biomarkers, including microhematuria, α1-microglobulin, and CXCL13, have been proposed as potential predictors of disease activity and remission likelihood. Furthermore, histopathological features, such as glomerular basement membrane thickness, tubulointerstitial injury, and acute kidney injury, provide structural correlates that may inform prognosis. This review explores both established and emerging prognostic indicators across various biological domains. Understanding these predictors can aid in developing personalized therapeutic strategies, optimizing disease management, and improving patient outcomes in primary membranous nephropathy.

Introduction Athletes commonly use ergogenic substances, ranging from natural to pharmacological agents, aiming to enhance their performance. This review analyses their risks in terms of hepatotoxicity and liver health. Materials and Methods A thorough research was conducted using the following databases: Embase, PubMed, Cochrane Library, and Google Scholar, in accordance with PRISMA guidelines. The keyword choice was decided based on the subject of the review beforehand. The Stage of Knowledge The review subsumes anabolic-androgenic steroids (AAS), selective androgen receptor modulators (SARMs), creatine, caffeine and herbal supplements. Despite strict bans, AAS and SARMs are widely abused, also among youth. Many of them display serious adverse effects, including consecutive signs of liver damage culminating in drug-induced liver injury (DILI). Moreover, SARMs present severe testosterone suppression. Overall, the safety profile of exogenous creatine is good and non-hepatoxic. The reports of serious side effects remain anecdotal. Additionally, there is a rising number of reports on the therapeutic application of creatine, also in terms of the liver. Caffeine effectively enhances endurance and glycogen recovery. Green tea, rich in catechins, minimises exercise induced muscle-damage and, by lowering AST levels and reducing oxidative stress, actively protects the liver. Both maintain a favourable safety profile. Summary Ultimately, the impact of ergogenic substances on liver health ranges from highly toxic to safe, even beneficial, within a broad spectrum. This contrast highlights the critical need for athletes to consider the severe adverse effects of any illicit and harmful substances against those proven to be both safe and effective. It is all in terms of their own well-being and the trends that later spread among people they are being looked up to.

Background: Diabetic kidney disease (DKD) is one of the leading causes of chronic kidney disease and kidney failure worldwide. Although most patients with diabetes are diagnosed clinically on the basis of albuminuria, estimated glomerular filtration rate decline, and diabetic retinopathy, clinical parameters alone may not reliably distinguish biopsy-proven diabetic nephropathy (DN) from non-diabetic kidney disease (NDKD) or mixed lesions. The role of kidney biopsy in diabetic patients therefore remains selective rather than routine, but its diagnostic and prognostic value is increasingly relevant in precision nephrology. Methods: This narrative review summarizes clinicopathological evidence on kidney biopsy in patients with diabetes, with particular emphasis on the Renal Pathology Society classification of DN, the prognostic significance of glomerular, tubulointerstitial, and vascular lesions, indications for biopsy, and emerging digital and molecular approaches to renal tissue assessment. Results: Histopathological evaluation provides information that cannot be fully captured by routine clinical markers. While glomerular lesions remain central to the classification of DN, tubulointerstitial fibrosis and tubular atrophy are among the strongest predictors of kidney disease progression. Vascular lesions, particularly arteriolar hyalinosis, also carry renal and cardiovascular prognostic significance. Kidney biopsy is especially valuable in patients with atypical clinical features, including rapid decline in kidney function, acute-onset nephrotic-range proteinuria, active urinary sediment, short diabetes duration, absence of diabetic retinopathy, or suspicion of immune-mediated glomerular disease. In these settings, biopsy may identify NDKD or mixed DN/NDKD, with direct therapeutic implications, including the potential use of disease-specific or immunosuppressive treatment. Emerging technologies, including artificial intelligence-assisted digital pathology, spatial transcriptomics, multi-omics profiling, and biomarker-based “virtual biopsy” models, may further refine lesion quantification and risk stratification, although they currently complement rather than replace tissue-based diagnosis. Conclusions: Kidney biopsy remains a clinically important tool in selected patients with diabetes. Beyond confirming DN, it enables the detection of NDKD, improves prognostic stratification, and supports individualized therapeutic decision-making. A selective, indication-driven biopsy strategy should be regarded as an essential component of precision nephrology in DKD, particularly as histopathology becomes increasingly integrated with digital, molecular, and computational approaches.

Introduction The geriatric population is prone to micronutrient deficiencies, including vitamin C. It is found in plant food, and deficiencies can be treated with over-the-counter supplements. This work aims to expand knowledge about the beneficial effects of vitamin C on diseases in the elderly. Materials and Methods A thorough analysis has been conducted following PRISMA recommendations. The research data have been derived from scientific databases of Embase, PubMed, Cochrane Library and Google Scholar. Key word choice was based on their relevance to the review subject beforehand. The Stage of Knowledge Modern science has confirmed that vitamin C is essential for health. Through advanced technology, we clearly understand how it supports collagen synthesis, reduces oxidative stress, and helps maintain strong organs and blood vessels. These properties are important for keeping organs functioning properly as the body ages. However, modern medicine does not rely on biological theory alone. We now use Evidence-Based Medicine (EBM) to prove if a treatment works in real-world scenarios. Clinical trials are the most important tool we have because they separate theoretical benefits from proven results. Summary The wide range of effects of vitamin C, from supporting immunity and collagen synthesis to protecting the nervous system, is very important for maintaining the health of seniors. Thanks to its antioxidant properties, ascorbic acid delays the ageing process and supports cognitive function. Ensuring an adequate supply of this vitamin is an essential part of maintaining a good quality of life for the elderly. Regular intake of vitamin C should therefore be standard practice in the daily health care of seniors.

Introduction Exercise-induced bronchoconstriction (EIB) is a transient lower airway narrowing occurring during or post-vigorous physical activity. Unlike exercise-induced asthma (EIA), characterized by chronic inflammation, EIB affects both asthmatic and non-asthmatic individuals. It is the primary chronic condition in elite athletes, with prevalence reaching 70% in endurance disciplines. Untreated EIB impairs respiratory health, mental well-being, and sports performance. Materials and Methods A systematic literature search was conducted, based on the following databases: Embase, PubMed, Cochrane Library, and Google Scholar, in reference to PRISMA guidelines. The keyword choice was decided beforehand in relation to the subject of the review. The Stage of Knowledge EIB pathophysiology centers on the hyperosmolar theory. Intense hyperventilation causes evaporative water loss and airway cooling. This osmotic shift and rapid rewarming trigger mast cell degranulation, releasing inflammatory mediators like cysteinyl leukotrienes (CysLTs) that cause smooth muscle contraction. Environmental factors heavily exacerbate this: cold air, low humidity, pollution, toxins, causing the disruption of epithelial barriers Summary EIB is a major health burden for athletes. Accurate diagnosis is vital to differentiate isolated EIB from chronic asthma. Effective management uses pharmacological treatments, like CysLT receptor antagonists, alongside dietary interventions, including Vitamin C, Omega-3, and gut microbiota modulation. These interventions mitigate inflammation, prevent irreversible remodeling, and optimize athletic performance.

Background Overtraining syndrome (OTS) is a multifactorial clinical condition resulting from an imbalance between training load and recovery. It affects up to 64% of male and 60% of female athletes at least once during their career and carries significant consequences for physical performance, hormonal balance, immune function, and mental health. Despite its prevalence, OTS remains poorly defined and difficult to diagnose due to the absence of a single validated biomarker and substantial overlap with other conditions common in athletic populations. Aim To review the current evidence on the pathophysiology, diagnostic approaches, biomarkers, and prevention strategies related to overtraining syndrome, and to evaluate the utility of existing and emerging diagnostic frameworks. Material and methods A thorough analysis has been conducted following PRISMA recommendations. The research data have been derived from scientific databases of Embase, PubMed and Google Scholar. Key word choice was based on their relevance to the review subject beforehand. Results OTS arises from the interaction of metabolic, immunological, neuroendocrine, and autonomic dysregulation. The EROS study identified over 45 candidate biomarkers, yet none proved universally diagnostic. Multidomain assessment combining hormonal, immunological, and autonomic markers demonstrated superior diagnostic value over any single parameter. Prevention relies on integrated monitoring of training load, recovery, nutrition, sleep, and psychological well-being. Summary OTS diagnosis requires comprehensive clinical evaluation and systematic exclusion of alternative aetiologies. No pathognomonic marker exists; therefore, multiparametric frameworks remain the most reliable diagnostic approach. Early detection and prevention through multidimensional athlete monitoring constitute the most effective clinical strategy.