HA (hyaluronic acid) fillers in aesthetic medicine - the most common complications

Introduction and purpose Hyaluronic acid (HA) is a polysaccharide consisting of the disaccharide units of glucuronic acid and N-acetylglucosamine. The age-related changes in the different anatomical layers of the face can be treated with hyaluronic acid fillers. Knowing the predictable aging changes of the face is crucial as this guides the optimum filler choice. HA is currently the most common used filler worldwide.  The aim of the study is to discuss the most common complications following aesthetic medicine treatments with the use of hyaluronic acid.   Description of the state of knowledge Filling soft tissues with hyaluronic acid is a popular procedure in the field of aesthetic medicine for patients who want non-invasive rejuvenation. Among the numerous fillers, those with hyaluronic acid (HA) have many advantages: HA is easy to use and its effect is reversible. HA fillers are considered safe, although there may be complications such as: allergic reactions, infections, granulomas, nodules, tyndall effect, ecchymosis and skin necrosis. Many complications with the HA filler are correctable, for example: too little formulation, over-correctionand, asymmetry. Hyaluronic acid fillers are examples of reversible dermal fillers as they can be removed with hyaluronidase.   Summary Avoiding complications is a top priority and must start with a thorough understanding of the anatomy followed by a precise injection technique. The ability to recognize complications and manage protocols will allow for their effective treatment

The use of botulinum toxin (BoNT) in urology - review

Introduction and purpose Botulinum neurotoxin (BoNT) prevents the release of acetylcholine into the synaptic cleft of the neuromuscular junction, which causes flaccid muscle paralysis. A non-obvious specialization that uses botulinum toxin is urology. The aim of this article is to present a literature review regarding the use of botulinum toxin in the treatment of urological diseases. Description of the state of knowledge In the overactive bladder syndrome, with resistance to oral medications, an alternative is botox injections into the bladder wall, which reduce the intensity of urgency and pollakiuria. Treatment of BPH with botulinum toxin injection may be an alternative to surgical and pharmacological treatment. Intra-articular botox injection causes smooth muscle relaxation and gland atrophy through prostate tissue apoptosis. Clinical studies show promising therapeutic effects of using Botox injections in the treatment of intramural cystitis. It reduces the feeling of bladder pain and the worsening of other symptoms. Panunzio et al. Presented a meta-analysis of prospective studies that showed a statistically significant improvement in pain perception after injection of botulinum toxin into the pelvic structures, compared with baseline values ​​for CPPS, in all cohorts evaluated. Summary Urology uses the entire spectrum of botox possibilities, from myocrelation in the bladder hyperresponsiveness syndrome, through neuromodulation and apoptosis induction in benign prostatic hyperplasia, ending with anti-inflammatory and analgesic properties in bladder pain syndrome and chronic pelvic pain syndrome

The role of the gut microbiota in pathogenesis and treatment of depression

Introduction and purpose Depression is the most common mental disorder, but the exact mechanisms underlying the pathophysiology of depression remain unknown. Abundant research evidence suggests that changes in the gut microbiota play a key role in the pathophysiology of depression through the brain-gut-microbiota axis. The aim of this study was to present the current state of knowledge on the role of gut microbiota in pathogenesis and treatment of depression and discuss its potential as a therapeutic target for depression A brief description of the state of knowledge The digestive tract and the processes which are set in it as well as the inhabitting microorganisms have a significant impact on our mental health and mood. The scientific research repeatidly confirm a strict relationship between the digestive and nervous systems. A microbiome-based approach is becoming increasingly prevalent in the understanding and treatment of neuropsychiatric disorders, especially depression. Antidepressants which are today the first-line therapy in the treatment of this disease are based inter alia on the antimicrobial and immunomodulatory mechanism of action. Conclusion  Immune cells which are settled in the intestines affect not only our physical health but also the mental one. Due to the relationship between depression and the gut microbiota, we have many treatment options that involve direct modification of the composition of the microbiome which include prebiotics, probiotics (psychobiotics) and faecal microbiome transplantation

Benefits of Withania somnifera (Ashwagandha) supplementation in obesity

Introduction and purpose: Ashwagandha (fam. Solanaceae) also known as Withania somnifera, is an herb commonly used in traditional Ayurvedic medicine. It is sometimes called Indian ginseng or winter cherry and it is used for its extensive health benefits for millennia as a Rasayana. Ashwagadha supplementation is playing an increasing role not only as an adaptogen, but is beneficial in the context of health in individuals struggling with obesity. This is a growing field of research and the aim of this brief review is to provide an update on the positive effects of Ashwagandha supplementation on the health of those dealing with obesity.  Description of the state of knowledge: Ashwagandha has a wide range of positive effects, most common are sedative, anti-stress, immunomodulatory and anti-cancer effects. The literature also draws attention to other results such as binding insulin sensitivity, increasing endurance, effects on adipogenesis and lipogenesis. Ashwagandha lowers blood cortisol levels, inhibits fat accumulation and the expression of genes involved into excessive fat tissue accumulation.  Summary: Regular intake of Ashwagandha is associated with health benefits in people struggling with obesity. As an adaptogen with adipogenic potential, Ashwagandha has great potential to participate in future adjunctive obesity therapy and the prevention of other similar and obesity-related diseases, but further research is needed in this area

Fractional microneedle radiofrequency - mechanism of action and assessment of safety, effectiveness in the treatment, and possible side effects based on a review of scientific literature

Introduction and purpose:  For all skin types, micro-needle radiofrequency (FMR) can be a safe and effective aesthetic medicine procedure for the treatment of various dermatological and aesthetic conditions. The aim of the study is to present the mechanism of action and assess safety, treatment efficacy, and possible side effects on the basis of a review of the scientific literature.  Description of the state of knowledge:  FMR uses micro-needles to penetrate the skin to a depth of up to 4.5 mm and deliver radiofrequency current in a fractional manner, producing the controlled fractions of micro-injuries in the dermis, inducing neocollagenesis, neoelastinogenesis, and angiogenesis. FMR has a wide range of positive effects such as skin rejuvenation, skin tightening, facial and body scar remodeling, and hair growth through transdermal collagen induction.  Summary:  Increasingly, patients are looking for minimally invasive methods of skin tightening and fat remodeling. In response, Aesthetic Medicine has proposed a combination of two techniques, micro-needling and radiofrequency. As more and more studies are showing the effectiveness and efficiency of this procedure, also emphasizing its safety, minimal risk of serious side effects, and ease of use, micro-needle radiofrequency is being proposed as an attractive answer to people's desires for a less invasive method of skin rejuvenation. However, further research in this area is needed to optimize the parameters of the treatment to achieve the best results

Hidradenitis suppurativa - current and promising non-surgical treatment

Introduction and purpose: Hidradenitis suppurativa (HS) also known as acne inversa is a chronic, inflammatory dermatosis with predilection to apocrine gland-rich regions. It is a multifactorial disease in which genetic and environmental factors play a key role. In this paper, we provide an overview of the current knowledge in most commonly used and emerging  treatment options of HS. A brief description of the state of knowledge: The primary defect in HS pathophysiology involves follicular hyperkeratosis with occlusion of the pilosebaceous apparatus, followed by follicular rupture and immune responses. It typically develops after puberty with deep-seated painful nodules, abscesses, sinus tracts and scars. Due to the permanently painful, odorous lesions, hidradenitis suppurativa is one of the most distressing dermatological diseases with a substantial impact on patients’ quality of life. Inflammation in patients with HS is not limited to the skin but is systemic. Patients with HS frequently have significant comorbidities like metabolic syndrome, type 2 diabetes mellitus, spondyloarthropathy, inflammatory bowel disease and depression. Treatment is challenging and consists of pharmacological and surgical techniques, which must often be combined for best results. Materials and methods: A search was conducted using PubMed and GoogleScholar data bases. Articles were searched in English using the following key words: “hidradenitis suppurativa”, “acne invera”, “treatement”, “management”, “biological treatement”. Summary: Therapeutic options have rapidly evolved in the last decade and include the use of topical therapies, systemic antibiotics and a wide range of  immunosuppressive medications such as anti-TNF-α biologics, but the number of therapies approved for HS is limited

Kombucha - fermented tea rich in nutrients and its impact on health - review

Introduction and purpose: Kombucha is a fermented beverage, usually made by fermenting sugared black or green tea with the symbiotic culture of bacteria and yeast (SCOBY). Kombucha has gained increasing popularity in recent years, mainly due to the fact that it has been associated with some health effects. The aim of the study is to review the articles available in the PubMed database in order to learn about the health benefits of Kombucha consumption.    State of knowledge: Kombucha is a source of phenolic compounds, vitamins and minerals, amino acids, enzymes, proteins and other compounds which influence biological activity. Scientific research on Kombucha has shown that it exhibits antioxidant, antibacterial, anti-inflammatory, anti-cancerogenic and antidiabetic properties. It also has a good influence on the digestive system. Kombucha consumption helps to lower cholesterol level, stimulates liver detoxification processes and also supports the proper functioning of the immune system. These properties depend on the various factors such as used products, concentration of bacteria and yeast, duration of fermentation or temperature.    Summary: Kombucha tea is known as a nutraceutical. It could be used as a dietary supplement. Most of the trials have been conducted on rats or mice. Kombucha has only been involved or tested in a few human trials. It is important to spread awareness among the population about this product and its impact on people’s health, conduct more research and standardise the production methods of this beverage

Art therapy as a primary and adjunct therapy in interventions for people living with serious illnesses - a review of the literature

Introduction and purpose Art-therapy is a therapeutic method which uses art as a tool to achieve benefits in physical and mental health. This kind of psychotherapy uses artistic media as a basic form of communication. As an additional form of treatment, combined with medication, it helps not only to explore a patient’s difficulties and problems but also to overcome them. Art-therapy is playing an increasing role in the context of health in individuals struggling with different diseases, especially with the mental ones. This is a growing field of research and the aim of this brief review is to provide an update on the positive effects of art-therapy and to list health problems in which it would be significant to use this kind of therapy. Materials and methods A search was conducted using PubMed and GoogleScholar data bases. Articles were searched in English using the following key words: “art therapy”, “psychodrama”, “dance movement therapy”, “music therapy”, “creative art therapy”. Description of the state of knowledge Art-therapy has a wide range of benefits in chronically ill patients. Most common are the awareness of the emotions and behaviors and helping to deal with them, helping to deal with the process of treatment. The literature also draws attention to other results such as increasing self- esteem and improving the quality of life. Summary Art-therapy is associated with health benefits in people struggling with different health problems. Art-therapy has great potential to participate in future basic and adjunctive therapy but further research is needed in this area

Varicose veins - diagnostic and treatment methods

Introduction and purpose: Varicose veins of the lower limbs are quite common and common disease. Their presence may be associated with the occurrence of a number of symptoms that negatively affect the quality and comfort of life, such as swelling, leg pain and cosmetic defect.The aim of the study is to review the available literature and articles available in the PubMed database in order to learn about the pathophysiology of varicose veins, methods of diagnosis and the most popular methods of their treatment. State of the knowledge: Varicose veins are described as fusiform dilatation of superficial veins with accompanying elongation and characteristic twisting. The main cause of their formation is insufficiency of the venous valve apparatus. Genetic and individual factors such as sex, age, and excessive body weight also have an impact. The diagnosis is based primarily on the physical examination of the patient and the Doppler ultrasound examination of the veins. Management options for varicose veins range from conservative management including pharmacotherapy to invasive and surgical methods, each of which has both advantages and disadvantages. Summary: Making a diagnosis of varicose veins usually does not cause many difficulties. There is no one-size-fits-all treatment method. When choosing it, many aspects should be taken into account, such as the patient's preferences, severity of disease symptoms, and the patient's general condition

Adverse effects in the management of breast cancer – recent studies

Introduction and purpose Breast cancer (BC) management includes local therapies surgery, radiotherapy and systemic – hormonotherapy, chemotherapy, targeted and immunotherapy. However, some adverse events of these treatment strategies limit their wide administration in BC therapy. The aim of the study was to present adverse effects in the management of BC, prevention and treatment of them. State of the knowledge Surgery of the breast leads to lymphedema, pain, and anatomical changes. The most characteristic adverse event of radiotherapy is radiation dermatitis which is more probable among obese, older patients, females, and smokers. Other side effects are pneumonia, cardiac and pulmonary injury. Chemotherapeutics lead to complications such as anthracyclines-induced cardiotoxicity. As a consequence of endocrine therapy, patients are affected by vasomotor, musculoskeletal, and vulvovaginal symptoms. Immune checkpoint inhibitors may cause immune-related adverse events (irAEs), which are usually mild. When severe irAEs occur, immunosuppressive drugs are used. Depending on stage, toxicities of the therapies can lead to interrupting the treatment of BC. Moreover, drug resistance is an important therapeutic obstacle in BC treatment.  Conclusion The application of a diversity of drugs in the treatment of breast cancer is associated with adverse effects which limit its efficacy. It is vital to develop novel, targeted therapeutic methods to optimize outcomes of patients. Given the adverse effects of breast cancer therapies and drug resistance, it is vital to develop novel, targeted therapeutic methods