Understanding the topography of facial skin thickness is crucial in plastic surgery and underpins the success of numerous reconstructive, oncological, transplant, volumetric, and aesthetic procedures. Objective: This study aims to assess facial skin thickness using high-frequency ultrasound, evaluate its correlation with age, anatomical location, and physical parameters, and create a comprehensive facial skin thickness map. Methods: High-frequency ultrasound (75 MHz, axial resolution 21 μm) was used to scan 38 anatomical sites on the faces of 45 patients aged 22–73 years from esthetic medicine clinics. Measurements were performed manually within the device software. Extensive statistical analysis was conducted to determine dominant thickness values, assess variations by location and age, and evaluate correlations between biometric variables (age, weight, height, BMI) and skin thickness at various facial sites. Based on these findings, a relative thickness index and detailed topographic map of facial skin were developed. Results: The thickest skin was observed in the lower third of the nose, particularly at the nasal apex (median: 1907 μm, IQR: 455.75 μm, p < 0.001), while the thinnest skin was on the upper eyelid (median: 573.50 μm, IQR: 128.75 μm, p < 0.001). Skin thickness was significantly influenced by anatomical location (p < 0.001, η² = 0.52), age (p < 0.001, η² < 0.01), and their interaction (p < 0.001, η² = 0.04), collectively accounting for approximately 57% of variance in skin thickness. Correlations between biometric parameters and skin thickness were generally weak, though a few strong correlations were found between specific facial sites. Conclusions: A detailed facial skin thickness map, including a relative thickness index, was developed.

Introduction and objective: Vitamin D is a group of steroidal compounds that play an important role in calcium and phosphate metabolism. It exists in two forms, as ergocalciferol and cholecalciferol. Its deficiency is widespread globally, including Poland, especially during the autumn-winter...

Bruxism, defined as a repetitive jaw-muscle activity characterized by clenching or grinding of teeth and/or by bracing or thrusting of the mandible, is a prevalent behavior affecting up to 22% of adults worldwide. While traditionally viewed as a disorder, current understanding recognizes bruxism as a behavior that may have both positive and negative consequences. Objective assessment methods for evaluating the effectiveness of interventions in symptomatic patients remain limited. This article presents the first longitudinal study using myotonometry to quantify changes in masseter muscle following botulinum toxin type A (BoNT-A) treatment in patients with symptoms of bruxism. In total, 57 patients were recruited and their masseter muscle tone, stiffness, elasticity, relaxation time, and creep parameters were measured. Measurements were performed at baseline, 3 weeks, and 3 months post-injection during both rest and maximum voluntary contraction. BoNT-A treatment produced significant improvements in all biomechanical parameters, with the greatest effects observed in patients with the highest baseline muscle values. The objective biomechanical changes correlated with the duration of BoNT-A’s therapeutic effects. These findings establish myotonometry as a valuable tool for objective assessment of masticatory muscle function and demonstrate that BoNT-A produces measurable, long-lasting biomechanical changes in masseter muscle parameters, supporting its possible clinical application in this challenging condition.

INTRODUCTION Depression is a common and serious mood disorder mainly manifested by sadness, anhedonia, lack of hope and interest in activities once enjoyed. According to WHO depression is a leading cause of disability and inability to work worldwide. Chronic disease is every condition lasting more than 1 year and requiring medical attention. The aim of this article is to show challenges of depression and chronic diseases coexistence. DISCUSSION Depression might be a factor causing difficulties in diagnosing chronic diseases as patients are less likely to cooperate. On the other it might lead to worse compliance and higher risk of chronic diseases’ development. Studies show depression coexisting with chronic illnesses is a valid problem for public health and aggravates the course and effects of treatment of those conditions. Treating an underlying disease is as important as treating depression itself as it might lead to reduction in symptoms of depression. Moreover doctors should choose drugs having regard to depression as well as lingering conditions. SUMMARY Depression still seems to be diminished and ignored in patients with chronic illnesses even though it is proved to have a destructive influence on the health of patients. It is of high importance to raise an awareness of doctors on that subject and its scale. There are plenty of treatment methods for depression in case of chronic diseases co-occurence which gives hope for improving a quality of life of patients and achieving better effects of therapy of an underlying disease.

Introduction Celiac disease is a quite common condition resulting from the interaction of genetic, immunological, and environmental factors, with the main environmental factor being exposure to gluten. Non-celiac gluten sensitivity (NCGS) affects individuals without celiac disease or wheat allergy and is characterized by intestinal and extraintestinal symptoms related to the consumption of grain products, without accompanying damage to the intestinal mucosa. Discussion Gluten is a grain protein that is resistant to digestive enzymes and accumulates in the intestines, leading to tissue damage and the release of tissue transglutaminase 2 (tTG2) enzyme, which increases gluten immunogenicity. The presence of HLA-DQ2 or HLA-DQ8 gene variants in the genome is a necessary condition for the development of the disease, but it does not always lead to celiac disease. The pathomechanism of non-celiac gluten sensitivity is not yet fully understood. Diagnosis of celiac disease involves serological tests, genetic tests, and histological examination. Conclusions The only effective treatment for celiac disease is a strict gluten-free diet, which involves eliminating wheat, rye, barley, and triticale from one's diet. Further research is necessary to search for effective therapies. The approach for NCGS involves introducing an appropriate diet - either low FODMAP or gluten-free.

Introduction Irritable bowel syndrome (IBS) is the most frequent functional disorder of the gastrointestinal tract. Main symptoms are recurring stomach ache connected with defecation, changes of frequency of defecation and/or stool’s consistency. Cause of IBS is still unknown unlike its pathomechanism. Continuous research allows doctors to understand and treat it better. Discussion Diagnosing IBS might be difficult even for the most experienced doctors due to its uncharacteristic symptoms. Therefore diagnosis should be made by using Rome IV Criteria. IBS is divided into 4 subtypes basing on clinical picture: IBS with predominant constipation, IBS with predominant diarrhea, IBS with mixed bowel habits and IBS unclassified. Classification is being performed with the use of Bristol Stool Chart. Choice of remedy should be made depending on the subtype of IBS. Pharmacological treatment is symptomatic and focuses on relieving pain, diarrhea, constipation and bloating. Drugs that can be used are: loperamide, rifaximin, antispasmodic (e.g. hyoscine), antidepressants or laxatives. Treatment should also contain nonpharmacological methods. Nonpharmacological techniques which are proved to help patients contain regular physical activity, body mass reduction, low-FODMAP diet, using probiotics, psychotherapy and supplementing soluble fibre. Conclusions IBS is a big issue for public health as it is lowering quality of life and is generating big indirect costs. Difficulties in diagnosing are increasing those costs. That’s why it is of high importance to find more effective therapy. Raising awareness among doctors is crucial as plenty of methods are available to treat the disease which allows to reduce symptoms and costs.