Cardiovascular aging is a multifactorial and systemic process that contributes significantly to the global burden of cardiovascular disease, particularly in older populations. This review explores the molecular and cellular mechanisms underlying cardiovascular remodeling in age-related conditions such as hypertension, atrial fibrillation, atherosclerosis, and heart failure. Central to this process are chronic low-grade inflammation (inflammaging), oxidative stress, cellular senescence, and maladaptive extracellular matrix remodeling. These hallmarks of aging interact to impair endothelial function, promote fibrosis, and compromise cardiac and vascular integrity. Key molecular pathways—including the renin–angiotensin–aldosterone system, NF-κB, NLRP3 inflammasome, IL-6, and TGF-β signaling—contribute to the transdifferentiation of vascular cells, immune dysregulation, and progressive tissue stiffening. We also highlight the role of the senescence-associated secretory phenotype and mitochondrial dysfunction in perpetuating inflammatory and fibrotic cascades. Emerging molecular therapies offer promising strategies to reverse or halt maladaptive remodeling. These include senescence-targeting agents (senolytics), Nrf2 activators, RNA-based drugs, and ECM-modulating compounds such as MMP inhibitors. Additionally, statins and anti-inflammatory biologics (e.g., IL-1β inhibitors) exhibit pleiotropic effects that extend beyond traditional risk factor control. Understanding the molecular basis of remodeling is essential for guiding future research and improving outcomes in older adults at risk of CVD.

Acute pancreatitis (AP) is an inflammatory condition with varying severity, ranging from mild self-limiting episodes to life-threatening complications. The incidence, clinical presentation, and outcomes of AP differ significantly across age groups, with elderly patients demonstrating distinct challenges. Biliary pancreatitis is more prevalent in older adults, whereas alcohol-induced AP dominates in younger populations. Elderly patients frequently present with atypical or less pronounced abdominal symptoms, which may delay diagnosis. Comorbidities such as kidney failure, cardiovascular disease, diabetes mellitus and arterial hypertension are significantly more common in the elderly and are associated with increased risk of organ dysfunction, systemic complications such as organ failure, multiple organ dysfunction syndrome (MODS), and prolonged hospitalization. The higher incidence of intensive care unit admissions and mortality is noted in the elderly, particularly in those over 80 years, in particular. Evidence on age-related differences in local pancreatic complications is inconsistent, with a possible trend toward lower rates in older adults. Early identification and individualized treatment planning are essential. Abundant fluid administration should be limited in older patients due to frequent cardiac insufficiency but should be carefully monitored due to the present or threatening renal insufficiency. Pain control with opioids may cause severe CNS complications for elderly patients. In contrast, ERCP, when indicated, is usually well tolerated in older patients. Personalized management in elderly patients is strongly recommended.

Background: Infertility affects a substantial proportion of the global population, and assisted reproductive technologies (ART) do not guarantee success. Increasing evidence suggests that the vaginal and endometrial microbiomes play a critical role in female reproductive health, influencing implantation, pregnancy maintenance, and ART outcomes. Objective: This narrative review aims to synthesize current evidence on the composition of the vaginal and endometrial microbiota and to explore biological mechanisms linking microbial profiles with reproductive success in ART. Materials and Methods: A comprehensive narrative review of published literature was conducted, focusing on studies evaluating vaginal and endometrial microbiota composition, associated immunological and metabolic mechanisms, and reproductive outcomes in natural conception and ART cycles. Results: In healthy reproductive-age women, a Lactobacillus-dominant vaginal and endometrial microbiome is associated with enhanced immune tolerance, epithelial barrier integrity, and metabolic activity supporting endometrial receptivity. Lactobacilli regulate local immune responses via anti-inflammatory cytokine signaling, modulation of pattern recognition receptor pathways, and production of metabolites involved in prostaglandin synthesis, angiogenesis, and uterine contractility. In contrast, dysbiotic communities enriched in non-Lactobacillus taxa are linked to increased pro-inflammatory signaling, impaired decidualization, mucosal barrier disruption, and altered immune cell balance. Clinical studies consistently report higher implantation, clinical pregnancy, and live birth rates in women with Lactobacillus-dominant microbiota; however, methodological heterogeneity limits causal interpretation. Emerging microbiome-modulating interventions, including probiotics, antibiotics, and vaginal microbiota transplantation, show potential but remain experimental. Conclusions: A Lactobacillus-dominant reproductive tract microbiome appears strongly associated with improved ART outcomes. Standardized prospective and interventional studies are needed to establish clinically relevant microbial biomarkers and develop effective microbiome-targeted therapies.

Background. Infectious mononucleosis (IM), most commonly caused by the Epstein–Barr virus (EBV), affects primarily adolescents and young adults between 15 and 24 years of age, populations with high rates of sports participation. Although IM is usually self-limited, ,its symptoms most often include fever, pharyngitis, posterior cervical lymphadenopathy, fatigue, and malaise. Aim of study. This review aims to summarize the current evidence on the diagnosis, clinical management, and return to play (RTP) recommendations for athletes and paediatric athletes with IM. Materials and Methods. The review was based on a search of articles published in the PubMed database. Search terms included: infectious mononucleosis, Epstein-Barr virus, splenic rupture, splenomegaly, return to play and Monospot test Current state of knowledge. Prolonged fatigue and the risk of splenic rupture may significantly disrupt training and competition. The most relevant sports-related complication is splenic rupture, which is associated with splenomegaly and occurs most often early in the disease course. Conclusions. RTP decisions should be individualized based on symptom resolution, clinical findings, the type of sport (contact vs non-contact), and shared decision-making. The general consensus is to avoid contact sports and strenuous training for at least 3–4 weeks. Ultrasound may be helpful in selected cases, but its routine use is limited by the wide variability in baseline spleen size and the absence of validated thresholds for safe RTP.

Background: Genitourinary syndrome of menopause (GSM) affects approximately 50% of postmenopausal women and arises from estrogen deficiency, causing vaginal epithelial thinning, Lactobacillus depletion, and increased vaginal pH, which collectively elevate infection risk. Local estrogen therapy (LET) is standard but may be limited. Interest is growing in non-hormonal regenerative therapies, including CO₂ and Er:YAG lasers and PRP. Aim: This narrative review aims to evaluate the current evidence on the efficacy and safety of CO₂ and Er:YAG laser therapies, as well as platelet-rich plasma (PRP), in the management of GSM with a focus on clinical guidelines and expert recommendations. Methods: A narrative review of the literature was conducted, including clinical trials, systematic reviews, expert opinions, and international society guidelines. Outcomes of interest included symptom severity (VAS), Vaginal Health Index (VHI), Female Sexual Function Index (FSFI), vaginal pH, patient satisfaction, and reported adverse events. Results: CO₂ and Er:YAG laser therapies, as well as PRP, demonstrate promising efficacy in reducing symptoms of genitourinary syndrome of menopause, with improvements observed in clinical parameters (VHI, FSFI, VAS) and high patient satisfaction. The safety profile reported in available studies is favorable, with adverse events generally mild and transient. Conclusions: CO₂ and Er:YAG laser therapies and PRP represent promising non-hormonal approaches for GSM, particularly in women with contraindications to estrogen. Due to limited high-quality evidence, these modalities remain experimental, and their efficacy and protocols require confirmation in long-term, sham-controlled studies.

Acne vulgaris is a common chronic inflammatory disorder of the pilosebaceous unit affecting all age groups. Its causes are complex and multifactorial involving skin microbiome changes, sebaceous gland hyperactivity, follicular hyperkeratinization, immune-mediated inflammation, hormonal signaling, and genetic susceptibility. Recent research shows acne is an immune-driven disease with early inflammation. This review provides an overview of acne pathophysiology focusing on interactions between inflammation, microbial imbalance, sebaceous gland activity, hormones, and genetics. A literature search was done using PubMed, Scopus, Web of Science, and Google Scholar from 2000 to 2025. Studies were analyzed to summarize molecular, cellular, and immune mechanisms in acne. Acne is driven by early persistent inflammation, altered sebum, microbial imbalance, especially pathogenic Cutibacterium acnes, and immune activation via Th1 and Th17 pathways. Androgens and IGF-1 modulate sebaceous glands and inflammation. Genetic factors influence immune response and sebaceous function. These mechanisms create a self-perpetuating loop causing lesion development. Acne is a multifactorial inflammatory disease from microbial, sebaceous, hormonal, immune, and genetic interactions. Understanding these pathways supports targeted therapies to reduce inflammation and restore microbial balance. Keywords – acne vulgaris, pathophysiology, inflammation, Cutibacterium acnes, sebaceous glands, androgens, IGF-1