The human gastrointestinal tract hosts a complex ecosystem known as the gut microbiota, which plays a crucial part in digestion and immune system function. Among the clinically recognized manifestations of dysbiosis in this system are Small Intestinal Bacterial Overgrowth (SIBO), Intestinal Methanogen Overgrowth (IMO), Small Intestinal Fungal Overgrowth (SIFO), and Large Intestinal Bacterial Overgrowth (LIBO). This study aims to investigate the complex pathophysiological mechanisms underlying these syndromes and their diagnostics and therapeutic options, focusing primarily on the roles of methane-producing archaea and fungal overgrowth. The methods employed in this study involve a comprehensive analysis and synthesis of peer-reviewed articles, systematic reviews, clinical trials, and meta-analyses. This review summarizes that methane production by Methanobrevibacter smithii was linked to altered fermentation, reduced microbial diversity, and slowed intestinal transit. Fungal species were associated with increased intestinal permeability, inflammation, and biofilm formation. Targeted interventions addressing microbial imbalances demonstrated potential therapeutic value. This review highlights the complex and multifactorial nature of gut dysbiosis, revealing its impact beyond the gastrointestinal tract. While emerging therapies targeting methanogens, fungi, and biofilms show promise, further research is essential to optimize their clinical application. The findings emphasize the need for interdisciplinary collaboration to refine diagnostic and therapeutic strategies.

Introduction: Hidradenitis suppurativa (HS, acne inversa) is a chronic, recurrent inflammatory dermatosis with an etiopathogenesis that remains not fully understood. Characteristic skin lesions—nodules, abscesses, sinus tracts, and scars—are most commonly located in skin fold areas, leading to a significant deterioration in patients’ quality of life, both physically and psychosocially. Despite advances in medical knowledge, the diagnosis of HS is often delayed, and treatment represents a major clinical challenge requiring individualized therapeutic approaches. This article provides a review of current literature on pharmacological treatment strategies for HS, including both topical and systemic therapies. Particular emphasis is placed on antibiotic therapy (e.g., tetracyclines, combination therapy with clindamycin and rifampicin, triple-drug regimens, ertapenem), as well as hormonal and immunomodulatory treatments. Furthermore, the growing role of biologic therapies, including TNF-α and interleukin inhibitors, and the use of emerging targeted agents under investigation are discussed. Attention is also drawn to the importance of androgen receptors and their potential role in the pathogenesis of HS, as reflected in the effectiveness of antiandrogen therapies (e.g., spironolactone or oral contraceptives containing a progestogenic component). The review includes data on the efficacy, safety, and limitations of various therapeutic methods based on clinical trials and systematic reviews. The need for further research on the skin microbiome and immune response mechanisms is highlighted, as it may serve as a basis for the development of new, more targeted therapeutic interventions. It is emphasized that HS treatment should be multidimensional and tailored to disease severity as well as coexisting metabolic and endocrine disorders. Materials and Methods: The article was written based on scientific papers available on PubMed and Google Scholar Key findings: Analysis of current evidence indicates that pharmacotherapy constitutes a fundamental component in the management of hidradenitis suppurativa (HS), with treatment outcomes strongly dependent on disease severity. Biological therapies, including adalimumab, secukinumab, and belimumab, have demonstrated significant clinical efficacy in moderate to severe HS, particularly in individuals unresponsive to conventional therapies, and represent a major advancement in disease management. Antibiotics remain widely used, providing symptomatic relief despite HS being a chronic inflammatory rather than an infectious condition. Topical clindamycin (1%) is effective in mild cases with superficial inflammatory lesions but shows limited efficacy in deep nodules and carries a risk of microbial resistance. Systemic antibiotic therapy, especially clindamycin combined with rifampicin, has achieved clinical remission in a substantial proportion of moderate HS cases, whereas severe disease may require intensified regimens, including metronidazole, rifampicin, moxifloxacin, or intravenous ertapenem; however, relapse rates following treatment discontinuation remain high. Anti-androgen therapies, such as spironolactone, finasteride, cyproterone acetate (CPA), and metformin, have demonstrated beneficial effects in women with hormonally driven flares or hyperandrogenic comorbidities. Novel topical and systemic anti-androgen agents (finasteride, flutamide, clascoterone, leuprolide) are currently under investigation, but high-quality randomized controlled trials are Conclusions: Hidradenitis suppurativa remains a significant therapeutic challenge, with current pharmacological strategies providing only partial and often temporary disease control. Biologic agents offer substantial clinical improvement in refractory moderate to severe HS, whereas antibiotics and anti-androgen therapies remain valuable options in mild to moderate disease, albeit with limitations such as high relapse rates and potential adverse effects, including antimicrobial resistance. The complex and incompletely understood pathophysiology of HS highlights the urgent need for further research into immunologic, microbial, and hormonal pathways to facilitate the development of targeted and personalized treatment approaches.

Introduction and objective: In recent years, the negative impact of chronic stress on health and proper functioning of the human body has been increasingly discussed. This phenomenon is a growing problem that affects an increasingly larger part of society. The body's response to stress is the release of cortisol – a glucocorticoid hormone produced in the adrenal cortex, commonly referred to as the "stress hormone." The aim of this article is to analyze the impact of elevated cortisol levels on human organs and systems, as well as to discuss possible preventive measures aimed at reducing chronic stress levels, based on current literature data. State of knowledge: Cortisol is a glucocorticoid hormone produced by the adrenal glands, which plays a crucial role in various physiological processes of the body. Its release is regulated by the hypothalamic-pituitary-adrenal (HPA) axis, a neuroendocrine system responsible for the body's response to stress and maintaining homeostasis. Chronic stress leads to disruptions in the proper regulation of cortisol secretion, which is associated with negative health consequences, such as metabolic disorders, obesity, progression of neurodegenerative diseases, increased risk of cardiovascular diseases, and weakened immune response. Research also indicates a link between elevated cortisol levels and the occurrence of mood disorders, including anxiety and depression. Materials and methodology: Materials and methodology: The review is based on a thorough analysis of materials obtained from scientific databases "PubMed" and "Google Scholar," which serve as verified sources of information. Conclusion: In order to reduce excessive cortisol secretion and its negative effects on the body, it is important to effectively counteract chronic stress. Achieving this goal requires implementing effective coping strategies and lifestyle modifications that can help reduce the frequency of stress in daily functioning.

Introduction and objective: Endocrine disorders affect the regulation of metabolic processes and are often associated with disturbances in glucose and hormonal homeostasis. In recent years, digital tools have increasingly contributed to the diagnosis and monitoring of metabolic diseases. Technological advancements have introduced continuous glucose monitoring (CGM) for patients with diabetes, as well as artificial intelligence (AI) algorithms to support the assessment of hormonal and imaging parameters in the diagnosis of PCOS. Despite these advances, studies on patients with diabetes using CGM who are simultaneously diagnosed with PCOS remain limited. AI-based diagnostic tools show promising accuracy in detecting PCOS characteristics through hormonal profiles and ultrasound imaging. The aim of this review is to summarize current evidence on CGM systems and AI in the evaluation and diagnosis of endocrine disorders, focusing on diabetes and PCOS. Methods: This narrative review analyzed literature from 2019–2025 and one earlier publication using PubMed and Google Scholar, focusing on CGM, AI, and diagnostic approaches in endocrine disorders. Results: CGM provides valuable insight into glucose variability and metabolic patterns in diabetes, but evidence for its use in patients with concurrent PCOS is limited. AI-based tools demonstrate high accuracy in identifying PCOS features, especially through hormonal profiling and ultrasound analysis. Conclusion: Digital technologies such as CGM and AI offer promising opportunities to improve the evaluation and management of endocrine disorders, particularly in women with PCOS. Larger, standardized studies are needed to validate clinical utility and support integration into routine care.

Introduction: Breast cancer represents the most frequently diagnosed malignancy among women globally, affecting approximately 2.12 million new cases annually according to the Global Burden of Disease 2021 analysis. While radical mastectomy remains the primary surgical treatment, it often results in significant chest wall defects and axillary distortion with profound negative impacts on body image, psychological well-being, and overall quality of life (QoL). Breast reconstruction has evolved into an integral component of modern oncological treatment, extending beyond aesthetic considerations to encompass comprehensive patient-reported outcomes and functional recovery. Contemporary healthcare increasingly embraces precision medicine principles, wherein breast reconstruction serves as a paradigmatic field requiring personalized treatment algorithms that balance oncological safety, aesthetic outcomes, and patient-specific variables. This comprehensive review synthesizes current evidence on precision medicine approaches in breast reconstruction, examining surgical innovations, postoperative rehabilitation strategies, and patient-centered outcome assessment. Materials and Methods: This review constitutes a thorough analysis of peer-reviewed literature obtained from the PubMed scientific database, synthesizing materials spanning from the Introduction through References of the manuscript. The analysis encompasses recent advances in surgical techniques, rehabilitation protocols, bioengineered technologies, and patient-reported outcome measures employed in breast reconstruction following mastectomy. Key Findings: Contemporary breast reconstruction integrates three interdependent pillars: advanced surgical techniques, targeted postoperative rehabilitation, and precise patient-centered outcome assessment via validated tools such as BREAST-Q. Modern surgical strategies include nipple-sparing mastectomy (NSM) with immediate reconstruction, prepectoral breast reconstruction utilizing acellular dermal matrices (ADM), and autologous free flap techniques (particularly DIEP flaps). Enhanced Recovery After Surgery (ERAS) protocols significantly reduce hospitalization duration to post-operative day 3 with equivalent complication rates compared to traditional protocols. Early mobilization and structured physical therapy demonstrably improve shoulder range of motion and functional outcomes. Patient-reported outcomes consistently demonstrate that autologous reconstruction produces superior satisfaction and health-related quality of life compared to implant-based approaches. Emerging tissue engineering technologies, including three-dimensional bioprinting, adipose-derived stem cells, and bioengineered scaffolds, represent promising future directions for functional breast reconstruction with reduced morbidity. Conclusions: Precision medicine in breast reconstruction requires integrated decision-making incorporating molecular data, clinical variables, and subjective patient experiences throughout all treatment phases. Optimal outcomes depend upon personalized surgical strategy selection, early and targeted rehabilitation, and standardized measurement of patient-reported outcomes. This multifaceted, precision-based approach ensures maximal functional and psychological benefits while minimizing procedural morbidity, ultimately delivering comprehensive quality of life improvements for breast cancer survivors.

Background: Frequent travel disrupts the circadian rhythm, often leading to disturbed melatonin production. This disruption contributes to sleep fragmentation, reduces sleep quality, and cumulative fatigue that many travelers experience as more than just temporary jet lag. Despite the growing spread of global travel, the long-term consequences of melatonin deficiency and chronic circadian misalignment remain underrecognized and insufficiently addressed. Aim: To review the available literature on how frequent travel leads to melatonin deficiency and sleep fragmentation and to highlight the need for better strategies to address this growing circadian health issue. Methods: A narrative review was conducted using 35 peer-reviewed articles identified through PubMed, Scopus, and Google Scholar. The studies were organized into six thematic categories: biological mechanisms of melatonin production, circadian rhythm disturbances and frequent long-distance travel (jet lag), sleep fragmentation – mechanisms and consequences, correlation between melatonin deficiency and sleep fragmentation, long-term health issues and current intervention strategies. Results: Melatonin deficiency and sleep fragmentation in frequent travelers, by disrupting the central circadian rhythm, are associated with a number of serious long-term health consequences, such as neurodegeneration and cognitive impairment, metabolic disorders and cardiovascular diseases, diabetes, obesity, mental health issues and increased risk of cancer. Further research is needed to develop better strategies for managing circadian rhythm disruption and reducing its long-term effects. Conclusions: The circadian rhythm dysfunction is closely connected to many future health problems. Addressing this growing issue requires greater awareness and more effective, evidence-based strategies to support circadian stability in those who travel regularly.