Background: In recent years, there has been a significant increase in the frequency of inflammatory diseases in women of reproductive age, likely due to changes in the microbiome, which prompted this study. Aim: To study the dynamics of the taxonomic profile of the microbiota and the state of local immunity of the skin, nasopharynx, vagina, and feces in women living in Ukraine during 2010-2025. Materials and Methods: A total of 136 women aged 20-39 years who underwent a preventive examination by a family doctor and were examined by a dermatologist, gynecologist, and otorhinolaryngologist were included in the study. In 2010-2011, 44 women were examined; in 2017-2018, 47; and in 2024-2025, 45. The microbial spectrum of the skin, oropharynx, vagina, and feces, including Gram-positive and Gram-negative bacteria, was analyzed using a VITEK 2 COMPACT bacteriological analyzer ("bioMérieux", France) with AES: Global CLSI-based + Phenotypic software. The humoral component of local immunity was assessed based on the level of secretory immunoglobulin A, which was determined using an enzyme-linked immunosorbent assay. Results: It has been established that significant changes have occurred in the human microbiome over the past 15 years. Thus, the total number of bacteria on the skin has increased, with a statistically significant increase observed in 2024-2025 compared to 2010-2011. This was particularly evident in the increased numbers of Staphylococcus aureus, Streptococcus pyogenes, fungi of the genus Candida, and Malassezia spp., accompanied by a decrease in Staphylococcus epidermidis and Staphylococcus hominis. In the oropharyngeal microbiome, a significant increase in opportunistic streptococci, opportunistic staphylococci, fungi of the genus Candida, and an integral indicator of the number of opportunistic flora was detected during this period. In vaginal secretions, the replacement of normal microflora (Lactobacillus spp.) with opportunistic microorganisms, both aerobic and anaerobic, was observed, while in feces, a decrease in normal flora and an increase in the numbers of staphylococci, non-fermenting Escherichia coli, and fungi of the genus Candida were observed. Changes in the microbiome were accompanied by a decrease in the concentration of secretory immunoglobulin A in biological media, which, in turn, deepened the disruption of the microbiome and led to a decrease in normal flora and an increase in opportunistic pathogens. Conclusion: In women of reproductive age, a deterioration in the state of microbiocenosis has been observed in recent years against a background of decreased local immunity, which is one of the important factors contributing to the increased frequency of inflammatory processes. Their microbial landscape is characterized by the replacement of normal microflora of the skin, nasopharynx, vagina, and intestine with conditionally pathogenic microorganisms. The results obtained, in our opinion, justify the need for timely implementation of individualized therapeutic and preventive measures in women, which may contribute to the restoration of the microbiome and reduce the frequency of relapses of inflammatory diseases.
Sodium-glucose cotransporter 2 (SGL T2) inhibitors were developed for type 2 diabetes mellitus but now have an established role in heart failure and chronic kidney disease, including in patients without diabetes. This narrative review critically integrates outcome trials, human mechanistic studies, proteom-ics, and contemporary guidelines. Dapagliflozin and empagliflozin improve trial-specific composite out-comes across a broad range of left ventricular ejection fractions and kidney function. These clinical benefits are more firmly established than the contribution of individual molecular pathways. Renal hemodynamic effects and stimulation of erythropoiesis have human experimental support, whereas direct myocardial sodi-um-hydrogen exchanger inhibition and metabolic re-programming remain incompletely resolved. EMPER-OR proteomic studies provide translational support for coordinated changes in autophagy, iron handling, and cellular stress responses, without establishing causal mediation. Sotagliflozin is considered separately be-cause it inhibits both SGLT1 and SGLT2; its pivotal trials enrolled patients with type 2 diabetes and do not directly establish efficacy in people without diabe-tes. We propose an evidence-to-indication framework that distinguishes demonstrated clinical efficacy, sup-portive human biology, and exploratory mechanisms. This synthesis positions gliflozins as complementary components of cardiovascular and kidney care, rather than as uniquely pleiotropic drugs or interchangeable agents for every indication. The 2026 European So-ciety of Cardiology guidelines and the 2024 KDIGO guideline are integrated with the original trial popu-lations. Limitations include selective literature cover-age, heterogeneous endpoints, and incomplete mech-anistic validation. Treatment selection should follow the patient's disease phenotype and the evidence for the individual agent.
Artificial intelligence (AI) is transforming surgical education through adaptive learning, simulation, computer vision, learning analytics, and decision support. This structured narrative review synthesizes AI applications across the surgical learning continuum, from undergraduate education and clinical clerkship through residency, fellowship, independent practice, and continuing professional development. A structured literature search of PubMed/MEDLINE, Scopus, and Google Scholar was conducted between May and June 2026, with evidence organized using the AI-assisted Surgical Learning Continuum. AI can support personalized learning, clinical reasoning, simulation, objective technical assessment, operative video analysis, automated feedback, performance analytics, and longitudinal competency tracking. Generative and multimodal AI may further enable interactive and adaptive learning. However, implementation is constrained by algorithmic bias, hallucinations and reliability concerns, data privacy, explainability, automation bias, faculty preparedness, and regulatory uncertainty. The evidence remains heterogeneous, and technical performance does not necessarily establish educational effectiveness or clinical reliability. AI should therefore augment rather than replace human educators, preserving mentorship, professional judgment, ethical reasoning, accountability, and patient-centered care. Future research should prioritize rigorous validation, meaningful educational outcomes, cost-effectiveness, and responsible implementation across diverse surgical training environments.
The article "Contemporary Biomarkers of Blood-Brain Barrier Injury and Neuroinflammation in Preterm Infants with Hypoxic-Ischemic Encephalopathy" was published in Sanamed, Vol. 21, Issue 1, DOI: 10.5937/ sanamed0-66353. The Editorial Board of Sanamed was informed by the Ethics Committee of the Clinical Center of the University of Sarajevo that the Committee had not received an application, research protocol, or accompanying documentation for the study described in the article in question; had not reviewed the study or granted approval for its conduct; and that the official records of the Clinical Center of the University of Sarajevo did not confirm that the study had been conducted at that institution. The Editorial Board was also informed that one of the authors had stated that the study involving 120 patients had not been conducted. The findings are considered unverifiable and cannot be regarded as a reliable account of research conducted at the Clinical Center of the University of Sarajevo, as claimed in the article. The retraction of the article has therefore been requested. Due to serious concerns about the reliability of the entire empirical and evidentiary basis underlying the article, the article is hereby retracted.
Salivary gland tumors are a rare and highly heterogeneous group of neoplasms with diverse histopathological features, biological behavior, and clinical outcomes. Most arise in the parotid gland, where benign lesions predominate, whereas tumors of the sublingual and minor salivary glands have a substantially higher probability of malignancy. Clinical presentation ranges from slowly enlarging painless masses to aggressive lesions associated with pain, facial nerve dysfunction, local invasion, and distant metastases. Diagnosis integrates clinical examination, imaging, fine-needle aspiration cytology, selected core needle biopsy, and histopathological evaluation supported by immunohistochemistry and molecular testing. Surgery remains the cornerstone of treatment, with postoperative radiotherapy used for adverse pathological features. Advances in molecular pathology have identified recurrent alterations that refine diagnosis and enable biomarker-directed treatment in selected advanced cancers. This review summarizes current concepts in epidemiology, classification, diagnosis, treatment, molecular pathology, and multidisciplinary management of salivary gland tumors.
