Coenzyme Q10 – a literature review on supplementation in chronic disorders and the anti-aging process

Introduction: The continuous growth and aging of the population poses enormous challenges in maintaining the health of the entire world’s population, which is forecasted to exceed 9 billion by 2050. Diseases of the XXI century can be prevented by reducing risk factors and appropriate prophylaxis, which also includes supplementation. Aim: The aim of the study was to summarise data on the effects of coenzyme Q10 on the course of chronic diseases and the aging process. Materials and methods: PubMed and Google Scholar databases were searched. Most of the articles published after 2012 were reviewed. Brief description of the state of knowledge: Decreased levels of coenzyme Q10 and increased levels of oxidative stress have been found in the course of multiple chronic diseases. It seems logical that coenzyme Q10 supplementation improves mitochondrial function and provides antioxidant protection to organs and tissues affected by various pathophysiological conditions. In addition to significantly improving cardiovascular and neurological functions, coenzyme Q10 has also found a wide application in delaying skin aging processes. Conclusions: Coenzyme Q10 is the third most commonly used dietary supplement in the world. The efficacy of coenzyme Q10 in selected groups of patients has been confirmed in clinical trials. More research and clinical trials are needed with more participants undergoing longer-term supplementation to assess the benefits of coenzyme Q10.

Management of Bladder Cancer Patients with Clinical Evidence of Lymph Node Invasion (cN+)

The purpose of this review is to present the current knowledge about the diagnostic and treatment options for bladder cancer (BCa) patients with clinically positive lymph nodes (cN+). This review shows compaction of CT and MRI performance in preoperative prediction of lymph node invasion (LNI) in BCa patients, along with other diagnostic methods. Most scientific societies do not distinguish cN+ patients in their guidelines; recommendations concern muscle-invasive bladder cancer (MIBC) and differ between associations. The curative treatment that provides the best long-term survival in cN+ patients is a multimodal approach, with a combination of neoadjuvant chemotherapy (NAC) and radical cystectomy (RC) with extended pelvic lymph node dissection (ePLND). The role of adjuvant chemotherapy (AC) remains uncertain; however, emerging evidence indicates comparable outcomes to NAC. Therefore, in cN+ patients who have not received NAC, AC should be implemented. The response to ChT is a crucial prognostic factor for cN+ patients. Recent studies demonstrated the growing importance of immunotherapy, especially in ChT-ineligible patients. Moreover, immunotherapy can be suitable as adjuvant therapy in selected cases. In cN+ patients, the extended template of PLND should be utilized, with the total resected node count being less important than the template. This review is intended to draw special attention to cN+ BCa patients, as the oncological outcomes are significantly worse for this group.

Patients with Positive Lymph Nodes after Radical Prostatectomy and Pelvic Lymphadenectomy-Do We Know the Proper Way of Management?

Lymph node invasion in prostate cancer is a significant prognostic factor indicating worse prognosis. While it significantly affects both survival rates and recurrence, proper management remains a controversial and unsolved issue. The thorough evaluation of risk factors associated with nodal involvement, such as lymph node density or extracapsular extension, is crucial to establish the potential expansion of the disease and to substratify patients clinically. There are multiple strategies that may be employed for patients with positive lymph nodes. Nowadays, therapeutic methods are generally based on observation, radiotherapy, and androgen deprivation therapy. However, the current guidelines are incoherent in terms of the most effective management approach. Future management strategies are expected to make use of novel diagnostic tools and therapies, such as photodynamic therapy or diagnostic imaging with prostate-specific membrane antigen. Nevertheless, this heterogeneous group of men remains a great therapeutic concern, and both the clarification of the guidelines and the optimal substratification of patients are required.