Background: Vaginal intraepithelial neoplasia (VaIN) is a rare but potentially precancerous condition strongly associated with human papillomavirus (HPV) infection. Despite increased detection rates due to HPV screening and colposcopy, diagnosis and management remain challenging. This study aimed to evaluate the epidemiological characteristics, risk factors, and outcomes of VaIN in patients referred to a tertiary academic center. Methods: We conducted a retrospective analysis of 48 patients who underwent colposcopy-directed vaginal biopsies between January 2019 and June 2024 at the Medical University of Warsaw. Data collected included patient demographics, HPV status, cytology, histopathology, and treatment outcomes. Patients were grouped based on the presence and grade of VaIN (VaIN 1 vs. VaIN 2/3). Statistical analyses were performed using SPSS software. Results: VaIN was diagnosed in 24 patients (50%), VaIN was confirmed in half of the cohort, VaIN 2 in 30%, and VaIN 3 in 18% of cases. HPV infection and prior cervical pathology were significantly associated with VaIN diagnosis (P = 0.03 and P = 0.05, respectively), and high-risk HPV infection correlated with higher-grade lesions (P = 0.04). Among VaIN 2+ cases, most patients required laser ablation or surgical excision, while VaIN 1 often regressed spontaneously. Regression occurred in 11 cases, and high-risk HPV infection was inversely associated with spontaneous regression (P = 0.04). Conclusions: This study confirms the central role of HPV, particularly high-risk subtypes, in VaIN pathogenesis. Conservative management may be appropriate for VaIN 1, while VaIN 2+ requires active intervention. HPV genotyping should be integrated into diagnostic workups, and long-term follow-up is essential due to the risks of persistence and recurrence.

Background: High-grade vaginal intraepithelial neoplasia (VaIN 2+) is a rare condition with limited evidence to guide optimal management. This study aimed to evaluate the efficacy of various treatment strategies and identify clinical risk factors associated with treatment failure. Methods: A systematic literature search in PubMed, Scopus, Web of Science, and Cochrane databases was performed following PRISMA guidelines. The meta-analysis included 15 retrospective studies including patients treated for VaIN 2+. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for treatment modalities (laser ablation, surgical excision, topical therapy) and clinical risk factors (prior hysterectomy, multifocality, immunosuppression, HPV16 infection and history of cervical intraepithelial neoplasia (CIN)). Results: Immunosuppression was significantly associated with a higher risk of treatment failure (RR = 2.01; 95% CI 1.12–3.60; p = 0.030). Topical therapies were found to have a significantly higher risk of treatment failure compared to laser ablation (RR = 1.92; 95% CI 1.34–2.92; p = 0.009). No statistically significant difference in recurrence risk was found between laser ablation and surgical excision, and between surgical excision and topical therapy. Factors such as prior hysterectomy, multifocality, and history of CIN did not show a statistically significant association with recurrence in the pooled models. Conclusions: Immunosuppression is a critical risk factor for VaIN 2+ recurrence, highlighting the need for individualized management and closer surveillance in this population. Surgical and ablative methods appear superior to topical agents in controlling high-grade disease. Given the retrospective nature of current data, standardized prospective studies are required to refine treatment algorithms.

Background:Hearing loss affects roughly 65% of adults aged 70 and older, vision impairment 20–30%, and dual sensory loss becomes more common with age. Meta-analyses show that these forms of sensory decline are associated with higher risks of hypertension, stroke, coronary heart disease, and cardiovascular mortality, even after adjustment for traditional cardiovascular risk factors. Shared vascular pathology explains part of these associations, but psychosocial and communication pathways may also contribute. Aim:To summarize evidence on psychosocial and communication-mediated mechanisms linking sensory decline to cardiovascular risk in older adults and to outline an integrated conceptual model. Material and Methods:A narrative review was conducted using targeted searches of PubMed and Google Scholar. Meta-analyses, cohort studies, and relevant qualitative and mechanistic literature were included. Findings were synthesized qualitatively. Results:Sensory impairment increases cognitive and communicative demands, which may heighten chronic stress and influence neuroendocrine and inflammatory pathways linked to cardiovascular disease. Reduced sensory input limits social participation and contributes to social isolation and loneliness, both established cardiovascular risk factors. In healthcare settings, communication barriers can impair symptom reporting, treatment adherence, and management of complex cardiovascular regimens. These pathways complement biological mechanisms and help explain persistent associations between sensory decline and cardiovascular outcomes. Conclusions:Psychosocial and communication mechanisms appear to be modifiable contributors to cardiovascular vulnerability in older adults with sensory impairment. Potential strategies include routine sensory screening, communication-accessible care, and interventions addressing isolation and stress. Randomized trials are needed to determine whether sensory interventions can reduce cardiovascular events.

Endometriosis is a chronic, estrogent-dependent, inflammatory disease affecting a plethora of women of reproductive age and is a major cause of pelvis pain and subfertility. Current treatments – surgery and hormonal supression are often only partly effective, lead to further fertility issues or have substantial adverse effects, creating an unmet need for a non-hormonal, disease modyfing therapy option (Carvalho, J. C., et al; 2021). Metformin, a biguanide used worldwide as a first-line insulin-sensitizing drug for type 2 diabetes, has emerged as a therapeutic option for endometriosis because of its pleiotropic anti-inflammatory, anti-proliferative, anti-angiogenic and metabolic effects. This paper analyses mechanistic, preclinical and early clinical evidence on metformin use in endometriosis, with particular attention to how the drug interacts with the known pathophysiology of the disease (Kimber-Trojnar, Ż., et al; 2022). Rather than an immediate replacement for standard hormonal therapies, metformin currently appears best positioned as a promising adjuvant or alternative for selected patients – particularly those with co-existing metabolic dysfunction pending high-quality clinical trials (Zhang, H., et al; 2023).

Background: Premature hair graying (PHG) is considered a distinct clinical entity, in which the presence of grey hairs on the scalp appears at a young age, generally before 20 years of age in individuals of European descent or slightly later, before 30 years of age in individuals of African ancestry. The etiology of premature hair graying remains multifactorial. Aim of the study: The objective of this narrative review was to summarize the potential contributors, which may play a role in graying of the hair at the young age. Material and methods: This comprehensive narrative literature review was conducted based on the scientific literature retrieved from the PubMed database. The analysis included original studies and case reports, which had been concentrated on the occurrence of PHG. Results: The available literature suggests correlations between premature canities and nutrient deficiencies in cobalamin, copper, folic acid, biotin, iron, calcium, zinc, cholecalciferol. The positive association with PHG indicate also high level of oxidative stress, long-term emotional stress, tobacco smoking, genetic disorders, autoimmune diseases or just be a side effect of some medications. Conclusions: The etiology of PHG is multifactorial. To date no effective therapeutic method capable of reversing premature hair graying has been established, highlighting the need for further research.

Background Stevens-Johnson syndrome and toxic epidermal necrolysis are rare but severe mucocutaneous hypersensitivity reactions. Ocular involvement is common and represents one of the major determinants of long-term morbidity. Acute ocular findings, including conjunctival hyperemia, pseudomembrane formation, and corneal epithelial loss, may progress to chronic complications such as severe dry eye, lid margin keratinization, symblepharon, limbal stem cell deficiency, and irreversible visual loss. Aims This narrative review aims to summarize current evidence on the epidemiology, pathophysiology, clinical spectrum, acute management, and long-term rehabilitation of ocular involvement in Stevens-Johnson syndrome and toxic epidermal necrolysis. Methods A narrative literature review was conducted to synthesize current data on ocular involvement in Stevens-Johnson syndrome and toxic epidermal necrolysis. The review focused on mechanisms of ocular surface injury, acute and chronic clinical manifestations, therapeutic strategies, and approaches to visual rehabilitation. Results Ocular damage in Stevens-Johnson syndrome and toxic epidermal necrolysis reflects the interaction between genetic susceptibility and a T cell mediated cytotoxic response involving Fas/FasL signaling, perforin/granzyme activity, and granulysin. Early manifestations may include conjunctival inflammation, pseudomembranes, epithelial defects, and corneal involvement. Without timely intervention, these changes may lead to chronic ocular surface disease, severe dry eye, symblepharon, lid margin keratinization, limbal stem cell deficiency, corneal scarring, and permanent visual impairment. Early discontinuation of the causative drug, prompt ophthalmological assessment, targeted topical therapy, and timely amniotic membrane transplantation are central components of acute management. Chronic care focuses on preservation and reconstruction of the ocular surface. Conclusions Ocular involvement in Stevens-Johnson syndrome and toxic epidermal necrolysis requires early recognition, multidisciplinary management, and long-term ophthalmological follow-up. Timely treatment during the acute phase is essential to reduce the risk of chronic ocular sequelae and irreversible visual loss.