Lactase Deficiency and Lactose Intolerance: Current Understanding and Future Directions

Introduction and purpose: Lactose, the primary carbohydrate in milk, requires the enzyme lactase for digestion. Deficiency in lactase activity leads to lactose intolerance, causing gastrointestinal symptoms. Understanding the genetic and environmental factors influencing lactase expression and activity is crucial. Moreover, accurate diagnostic methods and effective treatments are needed to manage lactose intolerance. This review aims to explore the current knowledge on lactase deficiency, lactose intolerance, diagnostic methods, and treatment options. State of knowledge:  Lactase deficiency encompasses congenital, primary, and secondary forms, each with distinct etiologies. Although often used interchangeably, lactase deficiency and lactose intolerance differ. However, the association between lactase deficiency and lactose intolerance is complex, influenced by various factors including dietary habits, gut microbiota, and gastrointestinal motility. Diagnostic methods are limited, and treatment strategies primarily involve dietary modifications, lactase supplementation, and probiotics.  Conclusion: Lactose intolerance presents significant clinical challenges, often underrecognized and misdiagnosed. Despite diagnostic advancements further research is needed to refine diagnostic accuracy. Treatment focuses on dietary adjustments, enzyme supplementation, and probiotics. Balancing symptom relief with nutritional adequacy is essential. Future studies should explore the role of gut microbiome modulation in lactose intolerance management through clinical trials.&nbsp

Alternative medicine - a replacement or an adjunctive for conventional therapy of chronic pain

Introduction and purpose:  Many people worldwide suffer from chronic pain. It is a very inconvenient condition on its own, not only an accompanying symptom of other diseases. Conventional drug treatment may be insufficient in some cases or may even cause serious side effects in the long term. In response to this, we aim to demonstrate the diversity of alternative pain management techniques in this review and identify conditions where such techniques may be beneficial to patients. State of knowledge: This paper evaluates some of the most common alternative pain management methods (acupuncture, massage, chiropractic, mind body therapies, herbal medicine, music therapy)  and their application in specific cases of chronic pain.  We also describe the possible mechanisms of action involved in the effectiveness of these techniques, based on contemporary studies. Summary: In conclusion, there are conditions where alternative medicine may be beneficial for patients suffering from chronic pain. The studies taken into account showed the best effects for chronic musculoskeletal pain treated with methods such as acupuncture and massage. Mind-body therapies may reduce stress levels and symptoms of depression associated with chronic pain, consequently improving the quality of patients' lives. However, alternative methods should not yet be considered as replacements for conventional drug therapy. More studies are needed to evaluate whether alternative therapies will play a significant role in chronic pain management in the future

Supplementation of vitamin D in children with obesity and vitamin D deficiency - review of outcomes in terms of obesity parameters and comorbidities

In recent years, vitamin D deficiency and obesity in paediatric population have reached epidemic levels worldwide as crucial health concerns with far-reaching consequences. There has been a substantial growth in studies dedicated to these two public health issues over the last years. Numerous studies have confirmed that excess body weight has negative impact on vitamin D metabolism, leading to a higher risk of low levels of this essential vitamin, among individuals who are overweight or obese. Vitamin D deficiency may play a role in the development of obesity-related conditions as insulin resistance, type two diabetes, NAFLD and cardiovascular disease due to anti-inflammatory properties, impact on the endocrine system and metabolic functions of this vital nutrient. Vitamin D supplementation seems to be a beneficial addition to pharmacology and lifestyle changes during obesity treatment

Acne vulgaris and treatment with topical retinoids - adapalene and tretinoin

Introduction and purpose: Acne vulgaris is a disease that mainly affects young people and is associated with overactive sebaceous glands. The disease mainly affects the face but can also occur on the back. Depending on the clinical picture, we can distinguish different types of acne and make our treatment dependent on it. The aim of the study will be to compare the effects of topical retinoids on acne vulgaris. State of knowledge: Topical retinoids have a direct anti-inflammatory effect and prevent the formation of blackheads and microcomedones. Five retinoids are currently available for topical treatment of acne vulgaris. We distinguish three generations. The mechanism of action is not fully understood, but it is known that they react with the RAR and RXR receptors. In the review paper, we will compare the effects of adapalene with tretinoin. Conclusion: According to the indicated study results, there is no significant difference in the effect of treatment with adapalene or tretinoin. Adapalene showed less irritation during treatment than tretinoin. The most important thing during acne treatment is choosing the right concentration and formulation by the dermatologist so that the patient does not stop treatment

Lactase Deficiency and Lactose Intolerance: Current Understanding and Future Directions

Introduction and purpose: Lactose, the primary carbohydrate in milk, requires the enzyme lactase for digestion. Deficiency in lactase activity leads to lactose intolerance, causing gastrointestinal symptoms. Understanding the genetic and environmental factors influencing lactase expression and activity is crucial. Moreover, accurate diagnostic methods and effective treatments are needed to manage lactose intolerance. This review aims to explore the current knowledge on lactase deficiency, lactose intolerance, diagnostic methods, and treatment options. State of knowledge:  Lactase deficiency encompasses congenital, primary, and secondary forms, each with distinct etiologies. Although often used interchangeably, lactase deficiency and lactose intolerance differ. However, the association between lactase deficiency and lactose intolerance is complex, influenced by various factors including dietary habits, gut microbiota, and gastrointestinal motility. Diagnostic methods are limited, and treatment strategies primarily involve dietary modifications, lactase supplementation, and probiotics.  Conclusion: Lactose intolerance presents significant clinical challenges, often underrecognized and misdiagnosed. Despite diagnostic advancements further research is needed to refine diagnostic accuracy. Treatment focuses on dietary adjustments, enzyme supplementation, and probiotics. Balancing symptom relief with nutritional adequacy is essential. Future studies should explore the role of gut microbiome modulation in lactose intolerance management through clinical trials.