Grochowski Hospital

Dry eye disease (DED) is a prevalent and increasingly recognized disorder of the ocular surface that poses a significant clinical and public health challenge worldwide. Its complex and heterogeneous nature reflects the interplay of tear film instability, inflammation, epithelial dysfunction, and neurosensory abnormalities. The evolving understanding of DED pathophysiology has led to substantial changes in diagnostic criteria and therapeutic paradigms, shifting from purely symptomatic management toward mechanism-based and individualized approaches. Ongoing advances in molecular biology, immunology, and biomedical technology continue to reshape the therapeutic landscape of DED. In light of the growing clinical burden and the evolving understanding of DED as a complex, multifactorial disorder of the ocular surface characterized by loss of tear film homeostasis, hyperosmolarity, inflammation, and neurosensory abnormalities—as defined by the Tear Film & Ocular Surface Society in the TFOS DEWS III report—the purpose of this study was to comprehensively review the current evidence regarding DED pathophysiology, risk factors, classification, diagnostic algorithms, and contemporary therapeutic strategies, with particular emphasis on mechanism-based and emerging treatments.

Migraine is a disabling neurological disorder frequently accompanied by sleep complaints, including insomnia symptoms and poor subjective sleep quality. Growing evidence supports a bidirectional relationship: disturbed sleep may precipitate migraine attacks and contribute to greater disease burden, while migraine-related symptoms may disrupt sleep continuity and impair next-day functioning. This structured literature review synthesizes contemporary evidence on the migraine–sleep association, including the prevalence of sleep disturbances in migraine, mechanistic links between sleep dysregulation and migraine, clinically relevant comorbid sleep disorders, and management implications. A structured search of PubMed/MEDLINE, Scopus, and Web of Science identified English-language peer-reviewed publications (2015–2025), including observational studies, systematic reviews, meta-analyses, and clinical guidance documents. Across study designs, poor sleep quality is consistently more common in people with migraine and is associated with higher migraine burden. Emerging longitudinal and genetic epidemiology findings are compatible with reciprocal influences between insomnia liability and migraine risk. Clinically, the reviewed evidence supports routine screening for sleep problems in migraine care, targeted evaluation and treatment of comorbid sleep disorders, and consideration of evidence-based insomnia interventions as part of integrated management.

Introduction: Whiplash injuries are one of the most prevalent consequences of traffic collisions and are associated with a wide range of conditions referred to as whiplash-associated disorders (WAD). These manifestations are most commonly associated with pain and limited mobility of the cervical spine. A growing number of research indicates that these injuries may also impair the function of the temporomandibular joints (TMJs), thereby contributing to the development of their subsequent disorders. The aim of the study: The objective of the study was to discuss the correlations and dependency between whiplash injury and temporomandibular joint function. Acquiring this knowledge enables specialists to make precise diagnoses and implement appropriate therapeutic procedures, thereby reducing the risk of misdiagnosis or misdiagnosis omissions. Materials and methods: The following literature review provides a comprehensive discussion of the association between whiplash injuries and temporomandibular joint function. In December 2025, an extensive search of prominent electronic databases (PubMed, Google Scholar) was undertaken in order to identify relevant published studies on this subject. Conclusions: Studies indicate that whiplash injury may impair TMJ function and contribute to the development of TMJ disorders. The mechanisms underlying this relationship may be functional or neurophysiological in nature, but remain under investigation.Symptoms may be transient or persist long-term for several years, underscoring the necessity for a holistic diagnosis and an interdisciplinary therapeutic approach in patients after whiplash injury.

Hypoparathyroidism (HypoPT) remains the last "classic" endocrine deficiency hormone disorder not routinely treated with hormone replacement. In November 2023, European Medicines Agency (EMA), and in August 2024, Food and Drug Administration (FDA) registered a new parathyroid hormone analogue: palopegteryparatide (TransCon PTH; YORVIPATH®) for the treatment of selected cases of hypoparathyroidism. As the Polish Society of Endocrinology Expert Panel, we recommend that parathyroid hormone (PTH) replacement therapy should be considered for HypoPT patients in whom conventional therapy is insufficient or poorly tolerated. PTH replacement therapy offers a more physiologic approach to treating HypoPT than conventional therapy. Palopegteriparatide can lead to eucalcemia, more effectively than conventional treatment, lowers serum phosphate and urinary calcium, and improves renal function and quality of life.

Background: Diabetic retinopathy (DR) remains a leading cause of vision loss worldwide, making early detection and effective screening essential for preventing irreversible complications. Traditional imaging methods, such as fundus photography and optical coherence tomography (OCT), identify established retinal lesions but often fail to capture subtle early microvascular changes. Objective: This review examines current retinal imaging techniques and evaluates the integration of artificial intelligence (AI) to enhance the detection of DR. Methods: The analysis focuses on studies investigating AI applications with fundus photography, OCT, and optical coherence tomography angiography (OCTA), highlighting their diagnostic performance and potential to improve screening programs. Results: OCTA enables high-resolution, non-invasive visualization of retinal and choroidal vasculature, allowing early detection of microaneurysms, capillary non-perfusion, and other biomarkers. AI integration improves diagnostic accuracy, sensitivity, and specificity, reducing the burden on clinicians. However, clinical adoption is limited by small, homogeneous datasets, lack of standardized imaging protocols, and limited explainability of AI algorithms. Conclusion: AI-enhanced retinal imaging shows significant promise for early detection and improved management of DR. Future efforts should focus on multicenter validation, data standardization, and development of explainable AI models to enable safe, effective, and equitable implementation in routine clinical practice.

Background: Polycystic ovary syndrome affects 8-13% of women of reproductive age and is one of the most common endocrine disorders. Although PCOS has traditionally been viewed as a reproductive and metabolic pathology, accumulated evidence demonstrates significant psychological and social consequences affecting women's quality of life. Aim: This literature review systematizes current scientific evidence on the psychological and social impact of PCOS on women's quality of life, with emphasis on body image concerns, mental health comorbidities, and fertility-related distress. Methods: We searched PubMed/MEDLINE, Embase, Web of Science, PsycINFO, and Cochrane Library databases for relevant literature. The review included systematic reviews, meta-analyses, cohort studies, and qualitative studies. No time restrictions were applied; we included both recent research and foundational publications from earlier years. Results: Women with PCOS show much higher body dissatisfaction than healthy women. Visible symptoms like excess hair growth and acne, combined with weight control problems, clash with cultural ideals of femininity and cause ongoing emotional distress. The prevalence of depressive and anxiety symptoms is elevated, with this association being multifactorial and involving both biological mechanisms (insulin resistance) and psychosocial factors. Eating disorders represent a particular area of vulnerability, with concerns about weight and body shape occupying a central role. Reproductive difficulties create a severe emotional burden, exacerbated by sociocultural contexts where motherhood is considered an essential part of female identity. Conclusion: PCOS has significant psychosocial consequences requiring a comprehensive approach to patient management. A medical model focused exclusively on physical symptoms is insufficient. Integration of mental health screening and a multidisciplinary approach are necessary for providing quality care to women with PCOS.

Duodenal tumors are rare neoplasms of the small intestine, often diagnosed at an advanced stage due to nonspecific clinical presentation and diagnostic challenges. We present the case of a 40-year-old patient hospitalized for vomiting, abdominal pain, and unintentional weight loss. During hospitalization, a duodenal mass was diagnosed, along with multiple liver metastases and associated gastrointestinal obstruction. This report discusses the epidemiology, pathogenesis, classification, clinical presentation, diagnostic methods, and therapeutic strategies for duodenal tumors, with particular emphasis on progressive intestinal obstruction and the need for appropriate nutritional interventions. This case highlights the importance of early diagnosis and an interdisciplinary approach in managing this rare disease.

Background and Clinical Significance: Wilson’s disease (WD) is an inherited, multisystem disorder of copper metabolism, resulting in pathological copper accumulation in various tissues (predominantly the liver and brain) and leading to secondary organ damage and corresponding clinical manifestations. Sleep disorders are frequent in neurodegenerative disorders, but remain underdiagnosed and poorly characterized in WD. Case presentation: We describe the case of a 51-year-old patient with WD presenting predominantly with neurological symptoms, who underwent routine video-polysomnography (v-PSG). The examination revealed shortened sleep latency, reduced rapid eye movement (REM) sleep latency, and sleep fragmentation—features of sleep architecture frequently observed in narcolepsy. These abnormalities worsened at follow-up despite the introduction of anti-copper treatment and concomitant neurological improvement. However, the patient did not report clinical symptoms of narcolepsy, and none were confirmed by the evaluating sleep specialist. Conclusions: This case highlights that sleep disorders (SDs) are common in patients with WD. Such patients may experience a wide range of SDs, and anti-copper treatment may improve sleep quality in addition to alleviating neurological symptoms. Narcolepsy is a rare but possible manifestation of SDs in WD. Therefore, whenever symptoms suggestive of sleep disturbances occur, WD patients should be referred to a sleep specialist, as accurate diagnosis and targeted treatment may profoundly improve quality of life, daily functioning, and long-term disease management.

Introduction: Primary immune thrombocytopenia (ITP) is the most common thrombocytopenic disorder in children. The aim of this study was to assess the epidemiology and current therapeutic practices in children with ITP in Poland. Material and methods: A survey was conducted in 19 pediatric hematology centers. The analysis covered the period of 2022–2023. The survey included 14 questions regarding the number of patients diagnosed and treated for ITP. The centers provided separate data for each year. Results: In the years 2022–2023, a new diagnosis of primary immune thrombocytopenia (nITP) was made in 814 patients. A subgroup of 130 children with persistent ITP (16%) and a total of 452 with chronic ITP were treated. nITP was treated with IVIG (627; 77%) or steroids (154; 19%). TPO agonist drugs were administered as follows: eltrombopag in 215 (26%) patients, romiplostim in 115 (14%) patients, and avatrombopag in 6 (0.7%) patients. Other conservative therapies were administered to 38 (4.6%) patients, including: mycophenolate mofetil (n = 16), rituximab (n = 9), azathioprine (n = 3), sirolimus (n = 2), vincristine (n = 1), vinblastine (n = 1), cyclophosphamide (n = 1), mercaptopurine (n = 1), chronic steroid therapy (n = 2), and dexamethasone + eltrombopag (n = 1). Surgical treatment was performed in 4 patients, including splenectomy (n = 3) and splenic artery embolization (n = 1). Discussion: A low level of adherence to the ASH 2019 recommendations regarding the use of steroids in nITP was noted. Oral TPO agonists were used twice as frequently compared to the subcutaneous form. Conclusions: In the years 2022–2023, ITP was diagnosed in an average of 407 children annually. Immunosuppressive treatment was applied in 4.6% and surgical treatment in 0.5% of children with ITP.