The intricate development and physiological dynamics of the mammary glands, orchestrated by a delicate interplay of hormones, are crucial for reproductive function and lactation. Beginning with intrauterine clusters evolving into mature glands, hormonal fluctuations throughout puberty and the menstrual cycle finely tune mammary tissue growth. Oestrogens stimulate the proliferation of epithelial cells, while progesterone orchestrates the formation of lactiferous glands. During pregnancy, oestrogen and progesterone induces hyperplasia of lobules and ducts, preparing the breast for lactation. Prolactin is vital for lactation and stimulates milk production during pregnancy and postpartum. As shown by ultrasonography, physiological changes during lactation reflect glandular tissue transformation for milk secretion. Clinical and physiological changes, including increased blood flow, contribute to mammary growth and firmness, complicating clinical examination. Ultrasonographic findings reveal variability in women’s glandular and fat tissue distribution, suggesting that milk production is not solely determined by anatomical factors. Though not directly linked to milk production, blood flow dynamics hint at a threshold for optimal lactation. Understanding these complex hormonal and physiological mechanisms is crucial for comprehending mammary development, function, and clinical assessment.

Vulvar lichen sclerosus (VLS) involves chronic inflammation, immune dysregulation, and abnormal extracellular matrix remodeling, involving extracellular matrix protein 1 (ECM1) and non-coding RNAs, particularly miR-155. Platelet-rich plasma (PRP) and adipose-derived mesenchymal stem cells (ADSCs) offer regenerative potential through the release of growth factors and cytokines that promote angiogenesis, fibroblast proliferation, collagen synthesis, and tissue repair, which could potentially compensate for the disordered matrix in VLS. This systematic review aimed to evaluate the current evidence on the efficacy and safety of PRP, ADSCs, and active substances administered through mesotherapy to adult women with VLS. A search of the PubMed, Scopus, and Web of Science databases identified 251 records, of which 13 studies met the inclusion criteria (RCTs and cohort studies involving women aged ≥ 18 years who were treated with PRP, ADSCs, or mesotherapy). The reviewed studies suggest that these therapies may improve clinical symptoms, quality of life, sexual function, and tissue quality. However, their application may be constrained by procedural invasiveness and potential immunologic risks. Moreover, the current evidence base is limited by small sample sizes, a lack of control groups, and short follow-up periods. Larger, well-designed randomized controlled trials with long-term follow-up are needed to confirm their therapeutic value and establish clear clinical guidelines.

One of the primary health issues bringing patients to hospital emergency rooms is pain. It is often treated inadequately. Doctors working in the emergency department have the option of using a number of drugs for analgesia. The three main groups include non-steroidal anti-inflammatory drugs, non-opioid analgesics and opioid analgesics. In order to properly exploit their potential, it is necessary to properly classify the pain, know the basic action of the available drugs, choose the right dose, and know how to combine drugs from different groups to achieve balanced analgesia. By acting in this way, the patient in the hospital emergency department will be properly provided with medication, and this will have a positive effect on his overall health.

Lichen sclerosus (LS) is a chronic inflammatory skin disorder with an incompletely understood molecular pathogenesis. This systematic review aimed to synthesize current evidence on key molecular mechanisms underlying the disease, with a particular focus on immune dysregulation, epigenetic modifications, and tissue remodeling. A structured literature search identified studies employing transcriptomic, epigenetic, and experimental approaches. The strongest evidence consistently supports a central role of immune activation, particularly T cell-mediated responses involving Th1- and Th17-related pathways, accompanied by increased expression of pro-inflammatory cytokines and activation of the NF-κB signaling pathway. Epigenetic and post-transcriptional mechanisms, including dysregulated microRNAs (notably miR-155-5p) and altered DNA methylation patterns, may sustain immune imbalance and fibroblast activation partly via modulation of the FOXO signaling pathway. In parallel, experimental and multi-omics studies highlight enhanced fibroblast activity and extracellular matrix remodeling, largely associated with the TGF-β signaling pathway, linking inflammation with progressive fibrosis. Emerging data also suggest interactions between immune signaling and metabolic alterations, although these findings remain preliminary. Overall, the available evidence indicates that LS may involve a complex interplay between immune, epigenetic, and fibrotic mechanisms. While several molecular pathways and candidate biomarkers have been identified, their clinical relevance requires further validation in larger, well-designed studies.

Introduction: Chronic coronary syndrome is predominantly related to the atherosclerotic obstruction of the coronary artery or arteries. However, this phenomenon is not the only causative factor in this disease. It is usually forgotten, that there is a possibility of ischemia of the cardiac muscle with no obstruction found in the main vessel. The trigger of such pathology might be underlying in the microcirculatory system and the inappropriate dilation or constriction of those small vessels, which results in insufficient blood supply to the cardiomyocytes, similarly to the typical obstructive coronary artery disease. In this article we are willing to show that such dysfunction poses a great danger to the health and life and therefore we should be able to properly diagnose and treat it. Purpose of the work: The aim of this review of up-to-date literature is to raise awareness among both doctors and patients about the phenomenon of coronary artery disease but with no significant obstruction in the vessels supplying the cardiac muscle. The common cause of such condition is coronary microvascular dysfunction, that leads to a disease called microvascular angina. Our purpose was to reveal, how dangerous to the health of the patients this could be and therefore how essential it is to provide a proper diagnose and management. In addition, we have noticed a need for a summary of what has already been discovered on this topic, available therapeutic methods and future perspectives.

In clinical practice among cardiac patients, symptoms of palpitations diagnosed as premature beats or episodes of atrial fibrillation (AF) are very frequently reported. One of the most common diseases in the field of gastroenterology is gastroesophageal reflux disease (GERD) . However, it may happen that the coincidence of the above-mentioned disease entities may predispose to the development of arrhythmias. In this article we describe the case of a 65-year-old man, without previously diagnosed diseases, in whom a clear association of arrhythmias with gastrointestinal complaints was observed. The presence of a burning sensation in the lower sternal region and typical symptoms resulting from esophagitis aggravated by triggers allows us to suspect esophageal reflux disease. Diagnostic tests performed for concomitant cardiac diseases did not reveal an organic cause of the arrhythmia. The recurrent course of symptoms observed in the present case and the analysis of the cause-effect course made us to diagnose gastrointestinal syndrome, also referred to as Romheld's Syndrome.