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Adrenal insufficiency, also known as Addison’s disease, is an endocrine disorder in which the adrenal cortex fails to produce adequate amounts of vital hormones. The adrenal cortex secretes several steroid hormones — cortisol, aldosterone, and androgens. Cortisol production is regulated by the adrenocorticotropic hormone (ACTH), produced by the pituitary gland. Cortisol is a vital “stress hormone” that affects fat and carbohydrate metabolism, supports immune regulation, and helps the body respond to physical and emotional stress. Aldosterone maintains water and electrolyte balance, regulating blood pressure and sodium–potassium levels. There are three types of adrenal insufficiency: primary, secondary, and tertiary. Primary Adrenal Insufficiency In this form, the adrenal glands themselves are damaged. Main causes: 1. Autoimmune destruction, where antibodies attack the steroid-producing cells of the adrenal cortex. 2. Amyloidosis 3. Metastatic lesions 4. Hemorrhagic infarction of the adrenal glands 5. Infectious diseases such as tuberculosis, meningococcal infection, or cytomegalovirus. Secondary Adrenal Insufficiency This type results from pituitary gland dysfunction, which leads to reduced secretion of ACTH and, consequently, decreased adrenal activity and cortisol production. Main causes: 1. Tumors 2. Head injuries 3. Circulatory disturbances 4. Inflammatory conditions Main Symptoms of Adrenal Insufficiency 1. Muscle weakness 2. Brownish skin pigmentation 3. Low blood pressure 4. Bradycardia 5. Low sodium levels 6. Elevated potassium levels 7. Hypoglycemia 8. Eosinophilia 9. Fatigue 10. Nausea, vomiting, diarrhea 11. Abdominal pain 12. Dizziness 13. Drowsiness Diagnosis A detailed medical history is essential, including any past or current use of glucocorticoid medications (pills, injections, or creams). These drugs have anti-inflammatory properties and are often prescribed for chronic conditions, but they must be used according to a strict medical schedule. Abrupt dose reduction or sudden discontinuation may suppress ACTH production in the pituitary gland, leading to adrenal insufficiency. Laboratory and imaging tests: • Hormonal assays (cortisol and ACTH levels) • MRI of the brain and CT scan of the adrenal glands Treatment The cornerstone of treatment is hormone replacement therapy to compensate for the lack of adrenal hormones. During stress (surgery, infections, fever, trauma, or intense emotional or physical exertion), the body’s need for cortisol increases, so the medication dose must be temporarily raised. After recovery, the dose should return to the previous level. Conclusion Adrenal insufficiency is a serious endocrine disorder that requires timely diagnosis and carefully monitored hormone therapy. If the above symptoms occur, it is essential to consult an endocrinologist for proper evaluation and treatment.

Dry eye syndrome is one of the most common eye conditions, in which the surface of the eye loses its normal moisture. This happens when the tear film becomes unstable or when tear production is insufficient. As a result, the eyes “dry out,” causing irritation, fatigue, and a feeling of grittiness. According to ophthalmologists, almost one in five people experiences this condition, most often women over 40. Modern habits — long computer use, air conditioning, and contact lenses — make the problem even more widespread. Causes and development The tear film protects the cornea from drying and irritation. It consists of three layers — oily, watery, and mucous. When any of these layers are disrupted, moisture evaporates quickly and the eye surface becomes unprotected. Causes can be internal or external. Internal factors include hormonal changes (such as during menopause or pregnancy), chronic illnesses, and deficiency of vitamins A and E. External ones include dry air, wind, air conditioners, and infrequent blinking while using screens. Improperly fitted lenses or long-term use of some medications can worsen the problem. Symptoms The main symptoms are dryness, burning, redness, and a feeling of sand or a foreign body in the eyes. Sometimes excessive tearing occurs as a reaction to irritation. Vision may become blurry or fluctuate during the day. Symptoms often worsen by evening, after prolonged reading or computer work, or in dry environments. In severe cases, corneal inflammation and visual impairment may develop. Diagnosis An ophthalmologist can diagnose dry eye syndrome during an eye exam. The doctor evaluates the eyelids, cornea, and tear film. Common diagnostic tests include: • Schirmer’s test – measures tear production; • Norn’s test – checks how quickly the tear film evaporates; • Fluorescein test – identifies dry spots on the cornea. These tests are painless and take just a few minutes. Treatment and care The main goal of treatment is to restore normal eye moisture and relieve irritation. Most patients benefit from “artificial tears” — drops or gels that imitate natural tears and protect the cornea. Inflammation may require anti-inflammatory or regenerative medications. It’s also important to remove triggering factors: avoid dry or dusty environments, choose lenses carefully, and take breaks from screens. In rare severe cases, minor surgery can help retain natural moisture. Prevention To prevent dry eye syndrome: • blink more often when using a computer, • maintain indoor humidity, • drink enough water and eat foods rich in vitamin A and omega-3, • avoid using eye drops without a doctor’s advice. Even mild dry eye requires attention. Early treatment helps preserve eye health and visual clarity.

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system, in which the immune system mistakenly attacks the myelin sheath of nerve fibers in the brain, spinal cord, and optic nerves. Damage to myelin disrupts the transmission of nerve impulses and leads to numerous neurological symptoms. Etiology The exact causes of multiple sclerosis are unknown. It is believed that the development of the disease is promoted by a combination of factors such as: • genetic predisposition, • environmental factors (infections, vitamin D deficiency, stress, smoking). Pathogenesis Immune cells (lymphocytes) penetrate the blood–brain barrier and damage myelin. As a result, inflammation develops, and over time, destruction of the nerve fibers (axons) themselves may occur. Forms of Multiple Sclerosis • Relapsing-remitting (RRMS) — the most common form, characterized by alternating periods of relapses and remissions. • Secondary-progressive (SPMS) — initially presents as RRMS, then gradually transitions into a progressive form. • Primary-progressive (PPMS) — gradual worsening of symptoms without distinct remissions. • Progressive-relapsing (PRMS) — a rare form in which disease progression is accompanied by periodic relapses. Symptoms The clinical picture is diverse and depends on which parts of the nervous system are affected. Possible manifestations include: • weakness in the limbs, muscle spasticity, • numbness, tingling, sensation of “electric shocks” in the body, • urinary and bowel dysfunction, • visual disturbances (diplopia, blurred vision, blindness in one eye), • problems with coordination, balance, and gait, • chronic fatigue, dizziness, • cognitive impairments (memory, attention), • depression and emotional instability. Diagnosis The diagnosis is made based on a combination of findings: • MRI of the brain and spinal cord — detection of demyelinating lesions, • Evoked potentials — assessment of nerve impulse conduction speed, • Cerebrospinal fluid analysis — detection of oligoclonal antibodies, • Clinical presentation and history of relapses. Treatment The main goals of therapy are to reduce disease activity, slow progression, and alleviate symptoms. Disease-modifying therapy (DMT): • interferon-beta, • glatiramer acetate, • monoclonal antibodies (natalizumab, ocrelizumab, alemtuzumab), • oral medications (fingolimod, dimethyl fumarate, etc.). Management of relapses: high doses of corticosteroids (e.g., methylprednisolone). Symptomatic therapy: medications to relieve spasticity, pain, fatigue, and urinary problems. Rehabilitation: physiotherapy, therapeutic exercise, psychological support. Prognosis Multiple sclerosis is a chronic and currently incurable disease. However, modern medications can significantly slow disease progression and maintain quality of life for many years. Most patients, especially those who start treatment early, retain mobility for decades.

Relapsing polychondritis is a rare but serious disease in which the body's immune system mistakenly begins to attack its own cartilaginous tissue. Cartilage is the flexible material that forms our ears, nose, certain joints, the trachea, and even parts of the heart. When this tissue is damaged, inflammation, pain, and changes occur. The disease is called relapsing because it usually progresses with recurring episodes: there are times when the disease is active, and then it weakens or almost disappears. After this calm period, inflammations may appear again. What are the main signs? Most often, the disease first affects the cartilage of the ears. A characteristic feature is unilateral or bilateral damage to the outer ear. The ear becomes red, painful, and swollen, while the earlobe usually remains unaffected. Many patients describe that their ears burn or hurt even when touched. It may lead to the development of "soft ears" or a "cauliflower ear" appearance. The next common symptom is inflammation of the nasal cartilage. The nose may become red, painful, and over time deformed, creating the so-called "saddle nose" appearance. Another symptom is damage to the throat, trachea, and bronchi, which is also quite common. Unlike other symptoms, this one can be life-threatening by causing softening of the tracheal rings, known as chondromalacia. This can lead to critical narrowing of the trachea—stenosis—and result in suffocation. Patients may develop hoarseness, shortness of breath, ineffective dry cough, and pain in the front of the neck. The disease can also affect the joints. A characteristic feature is damage to the cartilaginous connections of the sternum, which causes chest pain. Peripheral joints may also be affected, leading to swelling and pain. Among the relatively rare symptoms are inflammatory eye diseases, up to blindness; skin manifestations such as various rashes, nodules, ulcers; hematopoietic system disorders leading to aplastic anemia; and genitourinary involvement, up to renal failure. These symptoms are much rarer than the main ones (ears, nose, and airways), but their occurrence can make the disease life-threatening. There are no specific laboratory or special tests for this disease; diagnosis is based on a combination of clinical signs and examinations. Laboratory tests show no specific markers. A complete blood test may reveal elevated inflammatory markers, anemia, or leukocytosis. Instrumental studies include CT and MRI to assess airway damage. Biopsy is sometimes used but is not always conclusive. Considering the difficulty of diagnosing this disease, unfortunately, patients often reach rheumatologists too late. They are treated by ENT specialists, pulmonologists, ophthalmologists, therapists, and are referred to rheumatologists at rather advanced stages of the disease. Therefore, close collaboration among narrow specialists is very important for the patient’s benefit. In the past, this disease had a fairly high mortality rate due to late diagnosis and ineffective treatment. Today, the development of medicine, especially in the field of autoimmune disease diagnosis and treatment, has led to much higher effectiveness in early diagnosis and treatment of this disease.

Visiting a cardiologist is important not only if you already have health problems, but also for preventive assessment of your heart health. There are several warning signs and risk factors that should not be ignored. Main reasons to see a cardiologist 1. Chest pain or tightness Especially if the pain radiates to the arms, neck, or back. 2. Shortness of breath or difficulty breathing Even after minor physical activity. 3. Rapid or irregular heartbeat Palpitations, shortness of breath, or pounding heartbeat. 4. High blood pressure If blood pressure is persistently high and medications do not help. 5. Family history of heart disease If close relatives had heart disease at a young age. 6. Diabetes Diabetes significantly increases the risk of heart disease. 7. High cholesterol (hypercholesterolemia) Elevated cholesterol levels in the blood. 8. Swelling of the legs and shortness of breath May indicate heart failure. Prevention and treatment The main goal of prevention is to avoid the development of heart disease and reduce risk factors. Treatment, however, is aimed at managing and addressing existing problems. Myocardial infarction (heart attack) A heart attack develops when blood flow in a part of the heart muscle decreases or stops completely, causing damage. The most common symptom is chest pain or discomfort, which may radiate to the shoulder, arm, scapula, neck, or jaw. Other possible symptoms include: • shortness of breath, • nausea, • severe weakness, • cold sweat, • feeling of fatigue. What to do If you experience these symptoms, seek medical help immediately. Self-medication is extremely dangerous and can lead to serious consequences.

Fungal skin infections are considered one of the most common skin diseases in the world, primarily caused by the fungi Trichophyton, Microsporum, and Epidermophyton. Prevalence According to research, about 20–25% of the world's population will experience a fungal skin infection at least once in their lifetime. Fungal infections can affect people of any age, but they are most common in children and athletes. They are characterized by high contagiousness and frequent recurrence. Fungal infections are also common among populations living in hot and humid climates. Clinical Manifestations The clinical picture of a fungal infection depends on the type of fungus, the area of infection, and the patient's immune system. The main manifestations include circular, pink-red patches with distinct outlines, where the center often remains white or normal skin color. Sometimes, there is itching, burning, scaling, or even the formation of small blisters, especially in the spaces between the toes or on the scalp. Diagnosis To diagnose a fungal infection, a skin scraping is performed to detect fungi. In some cases, a culture is performed to determine the type of fungus. Treatment The treatment for fungal skin infections depends on the area and severity of the infection. • Mild and moderate cases – topical antifungal agents are used first. • Severe or widespread cases – systemic antifungal drugs are used for 2–6 weeks, with the dosage being individualized. In some cases, the course of treatment may be extended to reduce the risk of recurrence. Prevention • Maintain personal hygiene rules and do not share personal items. • Take a shower after sweating. • Do not leave certain areas of your skin moist. • Do not walk barefoot in public restrooms, saunas, or locker rooms. • Wear clean, dry, cotton underwear. • Keep your nails short and clean. • Do not share sports equipment, towels, or other personal items with other people. • When working with soil, wear protective clothing such as gloves, boots, long pants, and long-sleeved shirts. • Note that pets can be a source of fungal infections, so it is necessary to monitor their hygiene and health status. Conclusion Fungal skin infections are common but treatable diseases. Successful treatment and prevention require a comprehensive treatment plan, including topical and systemic therapy, hygiene measures, and patient education. Awareness of fungal skin infections and timely treatment reduce sanitary issues and the spread of the disease in society. Furthermore, promoting a healthy lifestyle, including strengthening the body's defense mechanisms, plays an important role in preventing fungal infections.

Botulism is a rare but serious infectious disease caused by the bacterium Clostridium botulinum. The danger comes from the powerful toxin it produces. This poison blocks the function of the nervous system, leads to paralysis, and can be fatal if medical help is not provided in time. There are several main forms of the disease. The most common is the foodborne form, which develops after consuming contaminated food. Wound botulism occurs when bacterial spores enter a wound and multiply. Infant botulism affects children under one year old when spores begin to grow in the intestines. Less frequent variants include intestinal colonization in adults, iatrogenic botulism following medical procedures, and the extremely rare inhalational botulism. Symptoms and Causes The first symptoms are often linked to vision problems: double vision, blurred sight, and dilated pupils. Soon after, droopy eyelids, dry mouth, difficulty swallowing, and slurred speech may appear. As the toxin spreads, muscle weakness develops along with digestive and respiratory difficulties. The most dangerous complication is paralysis of the respiratory muscles. Symptoms depend on the type of botulism: • Foodborne botulism: abdominal pain, nausea, vomiting, bloating, constipation, visual disturbances, and general weakness. • Wound botulism: gradual onset (1–3 weeks), localized weakness near the wound, possible fever, and no early digestive symptoms. The root cause is always the same: multiplication of Clostridium botulinum and release of its toxin. For this to happen, certain conditions are required — low oxygen, insufficient acidity, lack of salt or sugar, improper food storage, or inadequate heat treatment. Homemade canned foods prepared without proper sterilization are a frequent source of infection. Complications The most life-threatening complication of botulism is respiratory failure, which can cause death without mechanical ventilation. Even after successful treatment, patients may suffer from long-lasting weakness and fatigue. Recovery of muscle strength can take weeks or months, sometimes complicated by pneumonia or nervous system disorders. Diagnosis Doctors usually suspect botulism based on clinical symptoms: sudden visual disturbances, difficulty speaking and swallowing, and muscle weakness. Information about recently consumed food or the presence of wounds is also crucial. Laboratory confirmation may include tests of blood, stool, or vomit. To exclude other conditions with similar signs, additional diagnostic methods are often used, such as: • Computed tomography (CT) or magnetic resonance imaging (MRI) • Lumbar puncture • Electromyography Treatment Therapy is focused on quickly neutralizing the toxin and supporting vital functions. Patients older than one year are treated with an antitoxin, which blocks the poison’s further action. In severe cases with respiratory paralysis, artificial ventilation is required. Infants are treated with a specific preparation — botulinum immune globulin (Baby BIG). In wound botulism, treatment also includes surgical cleaning of infected tissue and the use of antibiotics. Prognosis With timely diagnosis and proper treatment, most patients recover. Noticeable improvements usually appear within a few months, but full recovery may take up to a year. Rehabilitation and supportive care are often necessary throughout this period. Prevention Botulism is largely preventable if proper food handling and storage practices are followed, especially when preparing home-canned goods. Key preventive measures include: • Refrigerating food within 2 hours of cooking • Boiling food for at least 10 minutes to destroy toxins • Avoiding swollen or damaged canned goods • Sterilizing homemade preserves in an autoclave at 121°C for at least 30 minutes • Discarding foods with an unusual or foul odor To reduce the risk of wound botulism, wounds should be cleaned promptly, non-sterile needles should never be used, and illicit drug use must be avoided. Injections of botulinum toxin should only be performed by licensed healthcare providers.

Measles is a highly contagious viral disease that causes fever, cough, and a characteristic skin rash. The infection is transmitted by airborne droplets and can lead to severe complications, including pneumonia and inflammation of the brain. Furthermore, having had measles weakens the immune system, making a person more susceptible to other infections. Before mass vaccination, measles claimed millions of lives annually worldwide. The disease is also called ordinary measles, 10-day measles, or rubeola. It should be distinguished from rubella (German measles)—which is a completely different infection. Symptoms of Measles Signs of the disease develop gradually. First, a high temperature, cough, runny nose, and red eyes appear. After 2–3 days, characteristic white spots on a background of red dots—the so-called Koplik's spots—appear in the oral cavity. Then, a rash appears, typically on the 3rd–5th day of the illness. Key symptoms: • high temperature; • dry, "barking" cough; • red or inflamed eyes; • runny nose; • weakness, fatigue; • white spots with a red border in the mouth; • extensive skin rash; • sore throat and muscle aches; • headache; • sometimes—digestive disorders (vomiting, diarrhea, abdominal pain). The rash usually begins on the face, then spreads down the body: neck, chest, back, arms, legs. In light-skinned people, it looks red; in dark-skinned people, it may be purple or less noticeable. The spots can merge, but itching rarely occurs. Causes and Transmission Routes The causative agent of the disease is the measles virus (Morbillivirus). It spreads through the air when an infected person coughs, sneezes, talks, or breathes. Virus particles can remain in the air and on surfaces for up to two hours after the infected person leaves. Infection can occur: • by being close to a sick person; • through shaking hands, kissing, sharing food or drinks; • through objects and surfaces contaminated with viral particles; • from mother to child during pregnancy, childbirth, or breastfeeding. Measles is one of the most contagious diseases: if one sick person and 10 unvaccinated people are in a room, 9 of them will become infected. The risk of transmission remains from the onset of the first symptoms, for 4 days before the rash appears and for another 4 days after. Risk Factors Severe progression and complications are more likely to develop in: • children younger than 5 years and adults older than 20 years;• pregnant women; • people with a weakened immune system. Measles Complications The consequences of the infection can range from mild to life-threatening: • otitis (ear infection); • dehydration due to severe diarrhea; • bronchitis, laryngitis; • pneumonia; • vision loss; • encephalitis (brain swelling); • subacute sclerosing panencephalitis (SSPE) — a rare but fatal infection of the nervous system that occurs years later; • measles inclusion body encephalitis (MIBE), more common in people with immunodeficiency; • death. Infection during pregnancy increases the risk of premature birth and low birth weight for the child. Diagnosis A doctor may suspect measles based on the appearance of the rash and the patient's complaints. To confirm the diagnosis, the following are used: • blood test; • nose or throat swab; • urine test. Treatment There is no specific cure for measles. The illness lasts about 10–14 days if complications do not arise. In a hospital setting, patients may be prescribed Vitamin A, which reduces the likelihood of severe consequences. However, it should not be taken without medical supervision: an overdose is dangerous for the liver and other organs. To ease symptoms at home, it is recommended to: • drink plenty of fluids; • get bed rest; • take antipyretics and pain relievers (Paracetamol, Ibuprofen); • gargle with a saline solution. Seek immediate medical attention if there is: • difficulty breathing; • chest pain; • sensitivity to light; • severe headache or neck stiffness; • confusion; • severe vomiting or diarrhea. Prognosis Measles can cause a severe course: approximately 2 out of 5 people who become ill require hospitalization. Even after recovery, a person remains more vulnerable to other infections. Dangerous complications can develop months or even years after the illness. Prevention The best way to protect yourself is vaccination. Vaccinations are given in childhood, but they can also be administered to adults if necessary. Illness after vaccination is extremely rare, especially if both doses are administered. One dose provides less protection.