Heat shock proteins (HSPs) are highly conserved molecular chaperones that play a key role in maintaining protein homeostasis, or proteostasis, especially under stressful environmental conditions such as hyperthermia, hypoxia, or the presence of reactive oxygen species. In pancreatic cancer, the expression of many HSP isoforms is dysregulated, contributing to the activation of mechanisms that promote tumor development, including proliferation, invasion, angiogenesis, treatment resistance, and cancer cachexia syndrome. HSPs are significant diagnostic and prognostic biomarkers. Some of them, such as HSP27, HSP70, and HSP90, have been shown to correlate with treatment response and patient survival. Others, including HSPA2 and HSPB6, may indicate an increased risk of disease recurrence. These proteins also represent promising therapeutic targets. Preclinical and clinical studies suggest that inhibiting HSP activity and associated signaling pathways may inhibit tumor growth and increase treatment efficacy. These therapeutic effects include inducing apoptosis, autophagy, and ferroptosis, as well as sensitizing cancer cells to chemotherapy and immunotherapy. This article summarizes the current knowledge about the role of HSPs in pancreatic cancer biology, their significance as biomarkers, and their potential therapeutic applications in treating pancreatic ductal adenocarcinoma (PDAC). Most studies conducted so far have been preclinical, and due to the promising results, further clinical investigation is warranted.

Heat shock proteins (HSPs) are highly conserved molecular chaperones that play a key role in maintaining protein homeostasis, or proteostasis, especially under stressful envi-ronmental conditions such as hyperthermia, hypoxia, or the presence of reactive oxygen species. In pancreatic cancer, the expression of many HSP isoforms is dysregulated, con-tributing to the activation of mechanisms that promote tumor development, including proliferation, invasion, angiogenesis, treatment resistance, and cancer cachexia syndrome. HSPs are significant diagnostic and prognostic biomarkers. Some of them, such as HSP27, HSP70, and HSP90, have been shown to correlate with treatment response and patient survival. Others, including HSPA2 and HSPB6, may indicate an increased risk of disease recurrence. These proteins also represent promising therapeutic targets. Preclinical and clinical studies suggest that inhibiting HSP activity and associated signaling pathways may inhibit tumor growth and increase treatment efficacy. These therapeutic effects include inducing apoptosis, autophagy, and ferroptosis, as well as sensitizing cancer cells to chemotherapy and immunotherapy. This article summarizes the current knowledge about the role of HSPs in pancreatic cancer biology, their significance as biomarkers, and their potential therapeutic applications in treating pancreatic ductal adenocarcinoma (PDAC). Most studies conducted so far have been preclinical, and due to the promising results, further clinical investigation is warranted.

Pancreatic neuroendocrine neoplasms (pNENs) are rare tumors with significant biological diversity. Despite significant improvements in diagnostics and a growing range of available therapies, long-term disease control remains difficult in advanced cases. The tumor microenvironment, which in pNENs adopts a predominantly immunosuppressive profile and promotes tumor development, is attracting increasing attention. A complex network of interactions dominates the tumor tissue, including M2 macrophages, regulatory T cells, and numerous pathways that inhibit effector lymphocyte activity. M2 macrophages, through the secretion of anti-inflammatory cytokines and exosome-mediated signaling, support angiogenesis while simultaneously attenuating the cytotoxic response. Simultaneously, receptors and ligands associated with immune checkpoints are overexpressed. In addition to classic molecules such as PD-1/PD-L1 and CTLA-4, the role of B7x and CD276 is increasingly being emphasized, as their presence correlates with rapid disease progression and poor prognosis. To date, attempts to use checkpoint inhibitors as monotherapy have yielded modest clinical benefits. However, approaches based on combination strategies—both in the form of dual immune blockade and in combination with chemotherapy or angiogenesis-targeted therapy—have shown significantly greater activity. Therapies using tyrosine kinase inhibitors, such as sunitinib and newer drugs (lenvatinib, surufatinib, cabozantinib), may partially normalize the tumor’s disrupted vascular architecture and thus increase its susceptibility to immunological interventions. In the coming years, it will be crucial not only to overcome the immunosuppressive nature of the TME but also to identify predictive biomarkers that will allow for more precise patient selection. This approach may open the way to more effective, personalized therapies for pNENs.

Jaskra pierwotna zamkniętego kąta (primary angle-closure glaucoma – PACG) dotyka ponad 17 milionów ludzi na świecie. Płytka komora przednia i krótka długość osiowa gałki ocznej zwiększają ryzyko zamknięcia kąta przesączania, a w rezultacie rozwoju neuropatii jaskrowej. Rozwój PACG jest także związany z predyspozycją genetyczną. Do poradni okulistycznej zgłosiła się 48-letnia pacjentka. Siostra pacjentki została dwukrotnie poddana witrektomii centralnej odbarczającej z powodu zaawansowanej PACG. Pacjentce zlecono badania dodatkowe: tonometrię, optyczną koherentną tomografię przedniego odcinka oka (anterior segment optical coherence tomography – AS-OCT), gonioskopię i perymetrię statyczną. Pacjentka została zakwalifikowana do profilaktycznej laserowej irydotomii obwodowej (laser peripheral iridotomy – LPI) obu oczu. W badaniach AS-OCT i gonioskopii stwierdzono zamknięty kąt przesączania w oku prawym (oculus dexter – OD), szczelinowaty w oku lewym (oculus sinister – OS) i spłyconą komorę przednią w obu oczach. Ciśnienie wewnątrzgałkowe (intraocular pressure – IOP) wynosiło 20 mmHg w OD i 15 mmHg w OS. Stwierdzono obwodowy ubytek względny pola widzenia w OD. Tonometria kontrolna po 14 miesiącach od wykonania LPI wykazała, że IOP OD wynosi 27 mmHg. Zalecono tymolol 0,5%. Mimo to po 3 miesiącach IOP OD wynosiło 22 mmHg. Pacjentkę zakwalifikowano do powtórnego zabiegu LPI OD. W badaniu kontrolnym IOP OD wynosiło 21 mmHg. Ostrość wzroku wynosiła 1,0 w obu oczach. LPI jest metodą pierwszego rzutu w leczeniu PACG. Mimo wysokiej skuteczności zabieg nie gwarantuje długotrwałego efektu. W razie nawrotu należy rozważyć kwalifikację do zabiegu przeciwjaskrowego.

Background: Background: Continuous glucose monitoring (CGM) has fundamentally transformed the management of type 1 diabetes (T1D) in pediatric populations by providing frequent interstitial glucose measurements and temporal trends. However, clinical efficacy and patient acceptability remain heterogeneous across studies regarding age, technology generation, and treatment regimens. Aim: This systematic review aimed to evaluate the clinical efficacy, glycemic outcomes, and patient acceptability of CGM systems in pediatric patients with T1D, focusing on changes in HbA1c, CGM-derived metrics, hypoglycemia reduction, and quality of life. Methods: Conducted in accordance with PRISMA guidelines, a systematic literature search across multiple databases identified prospective interventional and observational studies evaluating CGM use in children and adolescents aged <18 years diagnosed with T1D. Twenty-nine studies meeting the inclusion criteria were analyzed. Results: CGM use demonstrated meaningful improvements in glycemic metrics, particularly increasing Time in Range (TIR), reducing Time Below Range (TBR) and Time Above Range (TAR), decreasing glycemic variability, and enhancing the detection of asymptomatic and nocturnal hypoglycemia. While HbA1c reductions varied—being most pronounced in participants with higher baseline values—the greatest metabolic and glycemic benefits were consistently observed with regular, sustained sensor use and when CGM was integrated into automated insulin delivery (AID) systems. Patient and caregiver satisfaction was generally high, though practical challenges such as local skin reactions, adhesive failures, sensor discomfort, and alarm burden were documented. Conclusions: CGM is a valuable component of pediatric T1D management, providing essential glycemic insights beyond HbA1c alone. Its clinical effectiveness relies heavily on consistent sensor adherence, appropriate education, family engagement, and the integration of technology into daily therapeutic decisions.

Background: Pediatric medical procedures cause pain, anxiety, and distress, making non-pharmacological distraction strategies like immersive virtual reality (IVR) increasingly important. However, heterogeneity exists regarding hardware, immersion levels, clinical workflows, and implementation feasibility. Aim: To evaluate the technological characteristics, clinical effectiveness, feasibility, acceptability, and tolerability of IVR interventions delivered during pediatric procedures. Methods: A systematic review was conducted following PRISMA and PICOS criteria. Prospective interventional studies evaluating IVR (via headsets) in pediatric patients (<18 years) undergoing medical, diagnostic, surgical, or dental procedures were included. From 344 identified records, 327 unique articles were screened independently on the Rayyan platform, with consensus reached through discussion. Assessed outcomes included pain, anxiety, distress, cooperation, feasibility, acceptability, and adverse events. Results: Included studies showed high technological heterogeneity (smartphone-based to standalone headsets) and content variation (passive viewing to interactive games). IVR effectively reduced pain, anxiety, and distress across various procedures (e.g., venipuncture, vaccinations, dental care), though efficacy compared to active controls or 2D screens varied. Feasibility was high, with strong acceptability and satisfaction among children, parents, and healthcare staff. Adverse events were rare, mild, and self-limiting, primarily involving slight cybersickness (dizziness, mild nausea). Conclusions: Immersive virtual reality is a safe, highly acceptable, and effective non-pharmacological tool for reducing procedural pain and anxiety in children. Successful clinical implementation depends on age-appropriate ergonomics, procedure-compatible interactivity, proper infection control, and integration into routine workflows.