Visual Article Details Journal of Education, Health and Sport eISSN 2391-8306 is a Humanistic Journal with an international reach, published in line with top standards applicable in scientific journals. Each issue contains original and review papers, and case reports of different specialties associated with Multidisciplinary Education Sections: Physical Culture Sciences; Health Sciences; Medical Sciences; Pedagogy; Socio-Economic Geography and Spatial Management; Earth and Environmental Sciences; Cultural and Religious Sciences; Proceeding; Book of Abstracts, is a double anonymized scientific published by the University Center for Sports Research, Nicolaus Copernicus University in Toruń, Poland. Manuscripts Preparation. Journal of Education, Health and Sport. 2025; eISSN2391-8306. In order to facilitate publication, the authors are kindly requested to submit texts written according to the rules presented below. Template How to prepare an Article for the Journal of Education, Health and Sport.docx How to prepare an Article for the Journal of Education, Health and Sport.pdf Journal of Education, Health and Sport is: a Humanistic Journal with a Global International Reach. Our mission is to offer the worldwide scientific community a broad, fast and direct access to publish the latest results of the research areas that are developing rapidly and where there are changes with a high potential impact. All Articles submitted for publication will be peer-reviewed within 2-30 weeks. All accepted articles will be published online before appearing in the print journal within 2-30 weeks from acceptance. The journal has had 40 points in Minister of Science and Higher Education of Poland parametric evaluation. Annex to the announcement of the Minister of Science and Higher Education of 05.01.2024 No. 32318. Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical culture sciences / Nauki o kulturze fizycznej; Health sciences / Nauki o zdrowiu. Note: in the previous list from November 3, 2023: Sections: Physical Culture Sciences; Health Sciences; Medical Sciences; Pedagogy; Socio-Economic Geography and Spatial Management; Earth and Environmental Sciences; Cultural and Religious Sciences. Uwaga: na poprzednim wykazie z 3 listopada 2023 Dyscypliny: Nauki o Kulturze Fizycznej; Nauki o Zdrowiu; Nauki Medyczne; Geografia Społeczno-Ekonomiczna i Gospodarka Przestrzenna; Pedagogika; Nauki o Ziemi i Środowisku; Nauki o Kulturze i Religii. ERIH PLUS 2014-12-31 Journal of Education, Health and Sport formerly Journal of Health Sciences Approved 2015-06-29 Citations from Scopus 1141 documents found for Journal of Education, Health and Sport. 732 secondary documents found 732 Secondary documents Citations from Scopus for Journal of Education, Health and Sport. + from Scopus 1277 documents found for J Educ Health Sport. 773 secondary documents found 773 Citations from Scopus for J Educ Health Sport. 732+773=1505 Secondary documents Citations from Scopus for Journal of Education, Health and Sport. EBSCO Essentials <a href="https://essentials.ebsco.com/search/eds?query=%22Journal%20of%20Education%2C%20Health%20and%20Sport%22&limit=50&sort=date_asc" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://zasobygwp.pl/redirect?sig=e08af7423fdfd355d4fd245a2400ef7cac1289b549a11c57a7a7e1810a6b8449&url=aHR0cHM6Ly9lc3NlbnRpYWxzLmVic2NvLmNvbS9zZWFyY2gvZWRzP3F1ZXJ5PSUyMkpvdXJuYWwlMjBvZiUyMEVkdWNhdGlvbiUyQyUyMEhlYWx0aCUyMGFuZCUyMFNwb3J0JTIyJmxpbWl0PTUwJnNvcnQ9ZGF0ZV9hc2M=&platform=desktop&brand=wp">https://essentials.ebsco.com/search/eds?query=%22Journal%20of%20Education%2C%20Health%20and%20Sport%22&limit=50&sort=date_asc Frequency: First Semi-annually, Quarterly, Current is Monthly. Open access model. Accept Articles 43 %. Reject Articles 57 %. Days to First Editorial Decision 10-60. Days to Accept 15-210. Days to Reject 15-210. Formerly Journal of Health Sciences 2011-2014 Index Copernicus Archiwalne ISSN:1429-9623 eISSN: 2300-665X GICID:71.0000.1500.0665
Nicolaus Copernicus University, Toruń, Poland
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The Impact of sleep apnea on sleep quality - A literature review
Background: Obstructive sleep apnea (OSA) is a common yet underdiagnosed disorder characterized by recurrent upper airway obstruction, leading to intermittent hypoxemia and micro-arousals. These disturbances fragment sleep and disrupt normal architecture. OSA affects not only respiration but also both subjective and objective sleep quality, contributing to daytime sleepiness, cognitive impairment, mood disturbances, and reduced quality of life. Aim: To evaluate the impact of OSA on sleep quality through a synthesis of clinical, observational, and interventional studies, with emphasis on subjective and objective measures, disease severity, and treatment effects. Materials and Methods: A narrative literature review was conducted using PubMed and Google Scholar. Included studies comprised observational, polysomnographic, interventional (CPAP), and systematic reviews. Findings were analyzed qualitatively. Results: Approximately two-thirds of OSA patients report poor, non-restorative sleep. Polysomnography shows increased arousals, reduced sleep continuity, and impaired slow-wave and REM sleep. Greater disease severity, particularly higher apnea–hypopnea index and hypoxemia, is associated with worse sleep quality and daytime dysfunction. Subjective measures often indicate greater impairment than objective findings. Poor sleep quality correlates with fatigue, cognitive deficits, mood disorders, and decreased productivity. CPAP improves sleep parameters and perceived sleep quality, though residual symptoms may persist due to comorbidities such as insomnia. Conclusions: Sleep quality impairment is a core feature of OSA. Sleep fragmentation and hypoxemia are key mechanisms driving non-restorative sleep. Discrepancies between subjective and objective measures highlight the need for patient-reported outcomes. While CPAP is effective, individualized, multimodal approaches are needed to fully restore sleep quality.
Copyright (c) 2026 Aleksandra Pelczar, Wiktoria Oczkowska, Diana Morawska, Przemysław Dominik Drabik , Alex Malinowski, Klaudia Marchewka, Radosław Sochocki, Wiktoria Białek, Agata Sadowska, Kacper Bartosik https://creativecommons.org/licenses/by-nc-sa/4.0
Comparative analysis of the effects of inhalational and intravenous anesthetics on hemodynamic variability and cardiovascular complications in patients undergoing general anesthesia – a review of current evidence
Background. Patient hemodynamic stability during general anesthesia is a crucial factor, managing which helps avoid many complications, especially cardiovascular ones. Intravenous and inhaled anesthetics affect the human body differently, have different mechanisms of action, and have different durations of action. Due to the diversity of anesthetics, it is essential to match them appropriately to the patient's medical history and current clinical condition to reduce the risk of possible postoperative complications. Aim. The aim of this study was to analyze the inhalation and intravenous anesthetics used by anaesthesiologists and their impact on the hemodynamic stability of patients and, consequently, the risk of cardiovascular complications. Material and methods. This paper provides a literature review of inhaled and intravenous anesthetics used in clinical practice. Research papers available in PubMed, Google Scholar, and ScienceDirect were analyzed. The focus was on clinical trials, meta-analyses, and review articles. Conclusions. Intravenous and inhaled anesthetics differ in their action profile and impact on the circulatory system. Inhaled drugs provide greater hemodynamic stability, while intravenous drugs are characterized by a faster onset of action and a less predictable effect on the patient's vital signs. Due to the advantages of both groups of anesthetics, the selection of anesthesia should be individualized for each patient, taking into account their health status, comorbidities, and the risk of thromboembolic events.
Copyright (c) 2026 Sandra Drabik, Maja Gałuszka, Aleksandra Gałuszka, Kamila Krycia, Karolina Mazur, Karolina Różycka, Magdalena Mulawa, Emilia Piaszczyńska, Dominika Matacz, Adrianna Adamczyk https://creativecommons.org/licenses/by-nc-sa/4.0
Chronic Proton Pump Inhibitor Use in Physically Active Individuals: Implications for Micronutrient Status, Bone Health and Physical Performance
Proton pump inhibitors (PPIs) are widely used in the treatment of acid-related gastrointestinal disorders. Although generally safe in short-term therapy, increasing evidence suggests that long-term use may adversely affect micronutrient status and bone metabolism, which may be particularly relevant for physically active individuals. This review summarizes current evidence on the effects of chronic PPI use on micronutrient status and bone health, as well as its potential indirect impact on physical performance. A narrative review of peer-reviewed literature published between 2006 and 2025 was conducted, including systematic reviews, meta-analyses, and observational studies. The synthesis focused on PPI pharmacodynamics, micronutrient homeostasis (iron, vitamin B12, calcium, magnesium), musculoskeletal outcomes, and physical performance. Long-term PPI therapy leads to sustained gastric acid suppression, potentially impairing the absorption of key micronutrients. Evidence indicates associations with iron deficiency, altered vitamin B12 status, hypomagnesemia, and reduced calcium bioavailability. These disturbances may negatively affect oxygen transport, neuromuscular function, energy metabolism, and bone mineral density. Observational studies suggest a modest increase in fracture risk and possible impairment in physical performance, although findings remain inconsistent and influenced by confounding factors. Chronic PPI use may therefore contribute to subtle but clinically relevant disturbances in micronutrient status and bone health, potentially affecting physical performance. However, given the predominantly observational nature of the evidence, conclusions should be interpreted cautiously. Regular reassessment of long-term PPI therapy and monitoring of nutritional and skeletal health may be warranted. Further prospective studies are needed to clarify causal relationships.
Copyright (c) 2026 Joanna Tambor, Małgorzata Sędek, Daniel Zieliński, Aleksandra Szumowska, Julia Kopiczak https://creativecommons.org/licenses/by-nc-sa/4.0
The Most Frequently Recommended Urological Pelvic Floor Physiotherapy Techniques for Men Based on the Latest Scientific Research
Urological dysfunctions, such as post-prostatectomy urinary incontinence, chronic pelvic pain syndrome and overactive bladder, constitute a significant clinical problem in men. Pelvic floor muscle physiotherapy is currently the most recommended conservative and supportive treatment option. The aim of this study was to analyze the latest scientific reports on the effectiveness of the most commonly used urological physiotherapy techniques for the pelvic floor in men. Material and methods consisted of a literature review conducted in databases such as PubMed, Scopus, and Web of Science. Publications were published between 2018 and 2025. Only randomized controlled trials, meta-analyses, and guidelines from scientific societies were included in the analysis: American Urological Association, International Continence Society, European Association of Urology, Polish Urological Association, Polish Continence Society, Polish Physiotherapy Society, and Polish Urogynecological Society. Results: The most effective techniques include pelvic floor muscle training (PFMT) supported by EMG biofeedback and electrostimulation. Additional effectiveness has been demonstrated with ultrasound therapy and other physical treatments. Multimodal therapy combining pelvic floor training, breathing exercises, and core stabilization accelerates the recovery of sphincter function after prostatectomy. The study's conclusions indicate that urological physiotherapy based on pelvic floor muscle training with biofeedback and supported by electrostimulation and neuromodulation techniques may be the best standard of treatment for functional urological disorders in men. Individualized therapy and early initiation increase its effectiveness.
Copyright (c) 2026 Aleksandra Gałuszka, Maja Gałuszka, Karolina Różycka, Magdalena Mulawa, Karolina Mazur, Emilia Piaszczyńska, Dominika Matacz, Sandra Drabik, Kamila Krycia, Adrianna Adamczyk https://creativecommons.org/licenses/by-nc-sa/4.0
Klinefelter Syndrome – Etiology, Clinical Presentation and Modern Approaches to the Diagnosis and Treatment: A Literature Review
Introduction: Klinefelter syndrome is the most common chromosomal abnormality in males, characterized by the presence of an extra X chromosome, resulting in 47, XXY karyotype. Its prevalence is approximately 1 in 500 to 1 in 1,000 live-born males. The phenotypic expression is highly variable and includes hypogonadism, infertility, and an increased risk of metabolic complications and neurocognitive disorders. Purpose: The aim of this review is to provide a comprehensive synthesis of the current state of knowledge on Klinefelter syndrome, with particular emphasis on modern diagnostic and therapeutic approaches. Material and methods: This article is a narrative literature review and was conducted using international databases. Publications were selected based on their scientific value, relevance, and relation to the topic. Results: Current evidence indicates that patients benefit from an interdisciplinary approach, involving coordinated care among multiple specialists, including andrologists, endocrinologists, geneticists, psychologists, and experts in infertility treatment. Despite its relatively high prevalence, a significant proportion of affected individuals remain undiagnosed until adulthood, resulting in delayed initiation of therapeutic interventions. Conclusions: Klinefelter syndrome is a genetic condition with numerous somatic, reproductive, and psychosocial consequences. Early diagnosis, individualized therapeutic strategies, and multidisciplinary care significantly improve long-term prognosis and quality of life in patients. Future research should prioritize the refinement of diagnostic approaches, elucidation of the long-term effects of hormone therapy, and investigation of the molecular mechanisms underlying phenotypic variability.
Copyright (c) 2026 Katarzyna Kupczyk, Mikhail Kazachok, Szymon Paruszewski, Aleksandra Dybcio, Mikołaj Jońca, Natasza Kurys, Dorota Szydłowska, Adam Kubisa, Mateusz Miluski, Julia Kupczak https://creativecommons.org/licenses/by-nc-sa/4.0
Paradigm Shift in the Pathophysiology and Treatment of Insulin Resistance: From Epigenetic Determinants to the Continuous Glucose Monitoring (CGM) Revolution
Introduction and purpose. The classical approach to metabolic diseases traditionally positioned insulin resistance as the primary cause of evolving pathology. However, modern evidence-based medicine indicates a critical need to redefine this view, demonstrating that hyperinsulinemia is an early, independent damaging factor that may precede clinical dysglycemia by a full decade. The fundamental aim of this study is to thoroughly analyze scientific evidence regarding the multifaceted pathogenesis, novel diagnostics, and modern treatment paradigms of insulin resistance and hyperinsulinemia. A brief description of the state of knowledge. Based on a comprehensive review of 49 targeted publications, it was shown that insulin resistance pathophysiology involves complex DNA methylation mechanisms, aldosterone excess, and consequent changes in neural connectivity. Furthermore, genetic analyses definitively confirm the causal link between hyperinsulinemia and systemic complications like gout. A highly effective diagnostic tool is the widespread adoption of Continuous Glucose Monitoring (CGM) systems, which measure interstitial fluid glucose and enable rigorous analysis of Time in Range (TIR) and Time Above Range (TAR) in individuals without diagnosed diabetes. Therapeutically, pivotal recent trials demonstrate the high efficacy of multi-receptor incretin agonists (e.g., GLP-1, GIP, Glucagon) and SGLT2 inhibitors in radically improving insulin sensitivity and comprehensive cardiometabolic profiles. Summary. Monitoring subclinical glucose fluctuations with advanced CGM technologies is a highly useful prophylactic tool. Interventions based on targeted lifestyle modifications and modern multi-target pharmacotherapy successfully promote the regression of prediabetes, significantly reducing the risk of vascular complications. Ensuring up-to-date classifications is necessary for accurate differential diagnosis and early implementation of targeted interventions.
Copyright (c) 2026 Emilia Piaszczyńska, Magdalena Mulawa , Dominika Matacz , Karolina Mazur, Kamila Krycia , Aleksandra Gałuszka, Karolina Różycka , Sandra Drabik, Maja Gałuszka, Adrianna Adamczyk https://creativecommons.org/licenses/by-nc-sa/4.0
Complex Regional Pain Syndrome: Contemporary Diagnostic and Therapeutic Methods
Complex Regional Pain Syndrome (CRPS) is a chronic condition, most commonly affecting the limbs, characterized by pain disproportionate to the initial injury and various autonomic, sensory, vasomotor, and motor symptoms. CRPS significantly reduces patients' quality of life, and its complex pathophysiology—which involves inflammatory, neurogenic, and autoimmune processes—poses significant diagnostic and therapeutic challenges. This study aims to present and analyze contemporary diagnostic and therapeutic methods used in the management of CRPS, focusing on current scientific knowledge and future perspectives.
Copyright (c) 2026 Jan Wójtowicz, Damian Ujazda, Weronika Głąb, Oliwia Dominiak, Aleksandra Komoń, Artur Grobelny https://creativecommons.org/licenses/by-nc-sa/4.0
Small Intestinal Bacterial Overgrowth (SIBO): A Review of Diagnostics and Therapeutics
Introduction and purpose. Small intestinal bacterial overgrowth (SIBO) is defined as an abnormal presence of colon-type bacteria in the small intestine (≥105 CFU/ml). This condition causes excessive gas, bloating, and potentially malabsorption or vitamin deficiencies. The aim of this review is to summarize the current knowledge regarding SIBO's clinical manifestation, diagnostics, and treatment. A brief description of the state of knowledge. SIBO is associated with motor disorders, anatomical defects, and systemic diseases. Its symptoms are non-specific and overlap with irritable bowel syndrome. While jejunal aspiration with quantitative culture is the diagnostic gold standard, non-invasive breath tests measuring hydrogen, methane, and hydrogen sulfide are currently utilized to distinguish specific SIBO subtypes. Treatment relies on antibiotics for bacterial eradication, with rifaximin being the preferred antibiotic due to its efficacy and tolerability in patients. Such treatment is supplemented by short-term (4-6 weeks) dietary interventions, such as the low-FODMAP diet, to restore intestinal eubiosis by eliminating fermentable nutrients. Furthermore, probiotics have shown potential in supporting therapy as well as fecal microbiota transplantation, though scientific evidence remains limited. Summary. Managing SIBO is a complex challenge requiring objective diagnosis and targeted antibiotic eradication. Crucially, preventing recurrence strictly depends on treating the underlying predisposing disease. While temporary dietary restrictions assist in restoring eubiosis, as well as the usage of probiotic and FMT the current quality of scientific evidence is insufficient.
Copyright (c) 2026 Karolina Mazur, Kamila Krycia, Karolina Różycka, Magdalena Mulawa, Aleksandra Gałuszka, Emilia Piaszczyńska, Dominika Matacz, Sandra Drabik, Maja Gałuszka, Adrianna Adamczyk https://creativecommons.org/licenses/by-nc-sa/4.0
Suzetrigine in the Management of Pain Review of the First-in-class Na V1.8 Selective Inhibitor
Introduction. The 2025 FDA approval of suzetrigine (Journavx) ended a 25-year stagnation in analgesic development. This introduced a paradigm shift in pain management. As a first-in-class, highly selective NaV1.8 sodium channel inhibitor, suzetrigine addresses the urgent need for potent, non-opioid options for moderate-to-severe acute pain. It targets channels that are expressed almost exclusively in peripheral nociceptors. Thus, it decouples robust analgesia from systemic risks and addictive potential inherent to traditional opioid therapies. Aim of the study. This review evaluates the status of suzetrigine as of 2026, focusing on its molecular mechanism, clinical efficacy, and safety data from pivotal Phase 3 trials, as well as its broader impact on public health and healthcare economics. Materials and methods. A systematic literature review was conducted using PubMed (up to early 2026). Analysis included structural molecular studies, Phase 2/3 clinical trials (NAVIGATE-1 and -2), and budget impact models regarding the opioid crisis. Conclusions. Suzetrigine represents a significant breakthrough in pain medicine, boasting a 31,000-fold selectivity for NaV1.8, thereby safeguarding the cardiac and central nervous systems. Clinical data demonstrate efficacy comparable to opioid pain therapy, but without respiratory depression, sedation, or physical dependence. Non-opioid mechanisms create measurable, substantial savings by preventing opioid-related adverse events and addiction-related costs. Suzetrigine is seen as a desirable foundation for modern multimodal analgesia, effectively bridging the therapeutic gap between traditional non-opioids and addictive substances.
Copyright (c) 2026 Maciej Przybył, Knieszko Fahim, Jakub Franaszek, Nadia Herchi, Martyna Jabrzyk, Patrycja Jarczyńska, Wojciech Kijowski, Mateusz Klusek, Karolina Michalak https://creativecommons.org/licenses/by-nc-sa/4.0
CGRP as a Biochemical Biomarker in Migraine Diagnosis: A Systematic Review
Introduction. Migraine is one of the leading causes of disability worldwide, particularly among young women. Due to the key role of calcitonin gene-related peptide (CGRP) in the activation of the trigeminovascular pathway, this molecule has emerged as a major candidate for a biochemical marker that could facilitate precise diagnosis and classification of patients. Aim. The aim of this review is to systematize the most recent evidence regarding the potential of CGRP as a diagnostic biochemical biomarker of migraine. Methods. The study was conducted in accordance with PRISMA guidelines, with a systematic search of MEDLINE, Web of Science, and Embase databases for publications from the last six years. A total of 166 records were identified, of which 13 articles were included in the final analysis following rigorous selection. Results. Most of the analyzed studies confirm that CGRP levels are significantly elevated in patients with migraine, particularly during the ictal phase. This has been demonstrated in serum, plasma, saliva, and tear fluid. CGRP levels were found to correlate with pain intensity and the severity of clinical symptoms. Higher concentrations were observed in chronic migraine (CM) compared to episodic migraine (EM). However, findings regarding interictal levels remain inconsistent, with some studies showing no significant differences between patients and healthy controls. Conclusions. CG RP remains a promising, yet still imperfect, diagnostic biomarker. Its clinical utility is limited by considerable methodological heterogeneity and the influence of individual factors such as sex, age, and comorbidities.
Copyright (c) 2026 Karolina Różycka, Kamila Krycia, Magdalena Mulawa, Karolina Mazur, Aleksandra Gałuszka, Emilia Piaszczyńska, Dominika Matacz, Sandra Drabik, Maja Gałuszka, Adrianna Adamczyk https://creativecommons.org/licenses/by-nc-sa/4.0
Subclinical Hypothyroidism as an overlooked contributor to depression and mood disorders
Introduction and Purpose: Thyroid hormones regulate metabolism and brain function, including mood and cognition. Subclinical hypothyroidism (SCH), defined by elevated TSH with normal fT3 and fT4, often goes unnoticed due to vague symptoms. This review investigates the possible link between SCH and mood disorders, particularly depression, and outlines potential neurobiological mechanisms. Materials and Methods: A narrative review of the literature was conducted using clinical trials, meta-analyses, and epidemiological data. The focus was on studies assessing the psychiatric impact of SCH and the effects of levothyroxine (L-T4) treatment on depressive symptoms in these patients. State of Knowledge: Evidence suggests that individuals with SCH—especially women and older adults—may experience increased depressive symptoms, fatigue, and cognitive impairment. Proposed mechanisms include disrupted serotonin and dopamine pathways, reduced neurotrophic factors, and HPT axis dysregulation. While some studies report benefits from L-T4 therapy, others find no significant effect, indicating the need for personalized treatment decisions. Conclusion: SCH may contribute to mood disorders, though a causal relationship remains unconfirmed. Thyroid function assessment should be considered in patients with unexplained depression. Personalized therapy and interdisciplinary collaboration are key, and more large-scale research is needed.
Copyright (c) 2026 Aleksandra Cieplak https://creativecommons.org/licenses/by-nc-sa/4.0
Evaluating the Role of Insomnia in the Clinical Manifestation of Irritable Bowel Syndrome
Background. Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by abdominal pain and altered bowel habits, involving gut–brain axis dysregulation, psychosocial, and immune mechanisms. Insomnia and sleep disturbances are highly prevalent in IBS and may contribute to symptom burden, but their role remains unclear. Aim. To systematically review the role of insomnia in IBS, focusing on prevalence, symptom severity, mechanisms, and effects of sleep-targeted interventions. Methods. A comprehensive literature search (including PubMed) was conducted for studies published up to 2026. Observational studies, clinical trials, mechanistic studies, and reviews examining the relationship between insomnia and IBS were included. Data on study design, populations, sleep assessment, IBS criteria, and outcomes were extracted. Due to heterogeneity, a qualitative synthesis was performed. Results. Insomnia is more prevalent in IBS patients than controls (37–70%). Greater insomnia severity is associated with increased abdominal pain, bloating, bowel disturbances, and reduced quality of life. Longitudinal and genetic evidence suggests insomnia may be an independent risk factor for IBS onset and exacerbation. Proposed mechanisms include gut–brain axis dysregulation, visceral hypersensitivity, stress response alterations, and immune modulation. Subjective sleep disturbances appear particularly predictive of symptom severity. Behavioral interventions, such as cognitive-behavioral therapy for insomnia (CBT-I), show potential to improve both sleep and IBS symptoms, though current evidence is limited. Conclusions. Insomnia is a common and clinically relevant factor in IBS, acting as both a comorbidity and a modifier of disease severity. Integrating sleep assessment and management into IBS care may improve outcomes. Further large-scale and mechanistic studies are needed to clarify causality and optimize treatment strategies.
Copyright (c) 2026 Wiktoria Oczkowska, Diana Morawska, Przemysław Dominik Drabik, Alex Malinowski, Klaudia Marchewka, Radosław Sochocki, Wiktoria Białek, Agata Sadowska, Aleksandra Katarzyna Pelczar, Kacper Bartosik https://creativecommons.org/licenses/by-nc-sa/4.0
Chronic low-grade inflammation as a key mechanism in the development of civilization diseases - a narrative review
Background Chronic low-grade inflammation (CLGI) is a persistent activation of the immune system that typically does not produce any signs of acute inflammation, chronically affects metabolism, endothelial function, and homeostasis. Contemporary evidence suggests that CLGI constitutes a biological “common background” for many civilization diseases including visceral obesity and insulin resistance, type 2 diabetes, atherosclerosis and cardiovascular diseases, metabolically associated steatotic liver disease as well as selected neuropsychiatric and neurodegenerative disorders, cancers, and chronic respiratory and kidney diseases. This mechanism is further amplified by immune ageing (inflammaging) which may help explain the increasing burden of multimorbidity in the population. Aim The aim of this article is to present CLGI as a pathogenetic mechanism in the development of civilization diseases and to discuss: (1) the main axes (immunometabolism, the gut–microbiota–barrier axis, endothelial dysfunction, oxidative stress, and ageing-related processes), (2) clinically useful biomarkers, and (3) the prevention and treatment. Material and methods A narrative review of the literature was conducted. The scope included publications addressing CLGI and its associations with selected civilization diseases. Searches were performed in databases e.g., PubMed/MEDLINE using keywords such as including, among others, “low-grade inflammation”, “metainflammation/metaflammation”, “inflammaging”, “hs-CRP”, “NLRP3”, “gut microbiota”, “atherosclerosis”, “MASLD/NAFLD”, “CKD inflammation”, and “COPD systemic inflammation”. The selection was purposive and problem-oriented: meta-analyses, systematic reviews, large cohort studies, and randomized clinical trials were prioritized and findings were synthesized thematically (mechanisms → biomarkers → disease entities → modulation strategies). Results The literature synthesis indicates that CLGI is sustained by the overlap of metabolic and environmental stimuli. Key contributors include dysfunction of visceral adipose tissue, disturbances of the intestinal axis (dysbiosis, increased intestinal barrier permeability), persistent activation of innate immunity (including inflammasome pathways) and endothelial and microcirculatory dysfunction. Biomarkers such as hs-CRP are clinically practical. However, the interpretation requires consideration of confounders (infections, comorbidity burden, obesity, and exacerbations of chronic diseases). CLGI supports the development and progression of metabolic disorders, atherosclerosis, metabolically driven liver disease, selected brain–immune axis disorders, and it increases the risk of complications and multimorbidity in CKD and COPD. Conclusions CLGI constitutes a coherent, biologically plausible mechanism linking lifestyle factors and ageing to the development of civilization diseases. Clinically, strategies that reduce the stimuli driving CLGI such as reduction of visceral obesity, physical activity, dietary modification, sleep improvement and stress reduction and the identification of individuals with an elevated inflammatory-risk phenotype are of particular importance. In selected populations, interventions with documented anti-inflammatory effects may be considered as an adjunct to standard management.
Copyright (c) 2026 Malwina Kubuj-Pawliszyn, Natalia Gąsior, Piotr Dryżałowski, Emil Cymer, Michał Anasiewicz https://creativecommons.org/licenses/by-nc-sa/4.0
Health Complications Associated with Anabolic-Androgenic Steroid Use in Physically Active Men: A Literature Review
Aim. The aim of this study was to review the current scientific literature on the adverse effects of anabolic-androgenic steroids (AAS) use in physically active men and to highlight the need for further research in this field. Introduction. The use of anabolic-androgenic steroids among physically active individuals is an increasing public health concern and is associated with significant health risks. In recent years, the use of these substances has expanded beyond professional athletes to include recreationally active individuals. Methods. A literature review was conducted using the PubMed and Google Scholar databases. The search included studies published between 2017 and 2025 focusing on the health effects of AAS use in physically active men. Results. Analysis of the available literature indicates that supraphysiological doses of AAS are associated with numerous adverse effects. The most significant complications involve the cardiovascular system (including hypertension and atherosclerosis), the endocrine system (particularly suppression of endogenous testosterone production and infertility), and psychiatric health (including mood disorders and increased aggression). Additional complications affecting the liver, kidneys, and skin have also been reported. Discussion. The findings suggest that AAS use poses a serious health risk, particularly due to its multi-system effects and the potential for long-term complications. The increasing prevalence of AAS use among recreational athletes further emphasizes the need for greater clinical awareness and early identification of affected individuals. Conclusion. Increasing awareness of the health risks associated with AAS use among both patients and healthcare professionals is essential for effective prevention and management. Further research is needed to better understand the long-term consequences of AAS use.
Copyright (c) 2026 Urszula Kacprzak, Zofia Biernacka, Mikołaj Celmer, Julia Kossakowska, Mateusz Majchrzak, Marcin Ruszkowski https://creativecommons.org/licenses/by-nc-sa/4.0
Postpartum Depression: From Molecular Mechanisms to Clinical Management – A State-of-the-Art Review for the Obstetrician
Background. Postpartum depression (PPD) is a common childbirth complication, affecting an estimated 17.2% of women worldwide. Unlike the short-lived “baby blues,” PPD is a unique neurobiological illness defined by an inability to adapt synaptically to reproductive hormone withdrawal. It is the most common cause of maternal suicide, and the offspring of PPD mothers also suffer long-lasting cognitive and emotional impairments. Aim. Our objective was to review the pathophysiology of PPD (with special emphasis on the GABAergic and immuno-inflammatory hypotheses), screening procedures and to outline a “stepped-care” management algorithm, including new neuroactive steroids. Material and Methods. A systematic literature search was conducted using PubMed/MEDLINE, Embase, and Cochrane databases (Jan 2010 – Dec 2024). We prioritized meta-analyses, randomized controlled trials (RCTs), and guidelines from major obstetric societies (ACOG, RCOG). Results. There is evidence for current hypothesis of rapid withdrawal of allopregnanolone as trigger of the development of symptoms that do not initiate the adequate GABA-A receptor reorganization in vulnerable women. Other mechanisms include HPA axis dysregulation and inflammation-induced tryptophan depletion. The gold standard for screening remains the Edinburgh Postnatal Depression Scale (EPDS) Sensitivity: 86%). Pharmacologic treatment has significantly progressed: Sertraline remains the first-line SSRI due to safety in lactation, but the FDA approval of Zuranolone (2023) provides a mechanism-specific, rapid-acting therapeutic option addressing the underlying hormonal dysregulation. Conclusions. Obstetricians are the primary gatekeepers for maternal mental health. Preparation of obstetricians to identify women at higher risk and to treat with pharmacotherapy is an essential part of contemporary obstetric practice.
Copyright (c) 2026 Maja Wojcieszak, Anna Gęborys, Joanna Kania, Alicja Maziarczyk, Jakub Lambach, Kacper Kutnik, Weronika Woźnica, Julia Dąbrowska, Michał Białogłowski, Katarzyna Mazurek https://creativecommons.org/licenses/by-nc-sa/4.0
Creatine supplementation and renal function - myths and evidence - a narrative review
Background: Creatine is one of the most commonly used ergogenic supplements. However, many myths and misconceptions about creatine supplementation regarding renal function are still popular even among medical professionals. Aim: The aim of this study was to summarise the current knowledge regarding creatine supplementation and renal function, as well as to evaluate the most common myths associated with its use and to discuss creatine supplementation in patients with chronic kidney disease. Particular attention was paid to the five most common myths. Methods and materials: A review of the literature in Polish and English was conducted using the PubMed/MEDLINE and Google Scholar databases for the period from 1998 to March 2026. A total of 189 publications were analysed. Results: Current scientific evidence suggests that creatine supplementation does not cause kidney damage in healthy individuals when administering doses within recommended range. An increase in serum creatinine levels in individuals supplementing creatine does not necessarily indicate impaired kidney function, as it may result from increased creatine intake and its metabolic processes, rather than actual organ damage. Assessment of kidney function in individuals using creatine should not be based solely on serum creatinine levels; other indicators should also be considered. It has not been confirmed that creatine supplementation increases the risk of kidney stones or leads to permanent disturbances in water balance. Available studies indicate that long-term use of creatine is well tolerated and safe; however, high-quality studies covering diverse populations and long follow-up periods are still needed. Conclusions: Current scientific evidence does not support the notion that creatine supplementation, when used at recommended doses, causes renal dysfunction in healthy individuals. However, careful interpretation of renal markers and further studies in clinical populations are necessary.
Copyright (c) 2026 Izabela Grzyb, Jan Szewczyk, Alicja Smolińska, Maria Bołoz, Sylwia Haba, Ewa Dapkiewicz, Dawid Gąsowski https://creativecommons.org/licenses/by-nc-sa/4.0
Impact of smoking and alcohol consumption on the development and progression of valvular heart diseases – a review
Introduction and aim: Valvular heart diseases (VHD) represent a growing problem in aging societies. The impact of modifiable lifestyle factors, such as substance use, plays a very important role in their pathogenesis. The aim of this study is to summarize current knowledge on the impact of tobacco smoking and alcohol consumption on the development and progression of valvular heart diseases. Review methods: PubMed, Embase, and Google Scholar databases were searched. Keywords used included: valvular heart disease, aortic stenosis, smoking, alcohol, alcoholic cardiomyopathy. The analysis included publications from 2017-2025, while retaining selected older studies of fundamental importance for pathophysiology and anatomy. State of knowledge: Tobacco smoking strongly promotes calcific aortic valve disease (CAVD) by inducing oxidative stress and promoting chronic inflammation within the myocardium. This process leads to biomineralization and, consequently, aortic stenosis. The impact of alcohol on the valvular apparatus is secondary. Chronic ethanol abuse is toxic to cardiomyocytes – it leads to the development of so-called alcoholic cardiomyopathy. In its course, cardiac chamber dilation and stretching of the valve annuli occur, resulting in the development of symptomatic functional regurgitation. Summary: Tobacco smoking favors structural valve degeneration (stenosis), whereas alcohol damages the myocardium, promoting secondary defects. The elimination of these factors is of key importance in the prevention of VHD.
Copyright (c) 2026 Kacper Sawczuk, Sylwia Kozieł-Kwit, Filip Skowierzak, Mariusz Wręczycki, Klaudia Kozyra, Aleksandra Sado, Krzysztof Szada-Borzyszkowski, Wiktoria Rogowska, Aleksandra Simlat, Bartłomiej Lisik, Patrycja Victoria Czaj https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Cigarette Smoking on the Oral Mucosa
Introduction. Tobacco smoking is the most common addiction worldwide. It is estimated that there are currently around 1.2 billion people addicted to this product globally (Reibel, 2005). The situation in Poland is not more optimistic - approximately 27–28% of adult Poles declare this habit (TNS Polska, n.d.). Each year, tobacco is responsible for the deaths of over 7 million people worldwide (World Health Organization, n.d.). Tobacco smoke contains approximately 4,000 chemical compounds, many of which are carcinogenic substances (Piekoszowski & Florek, 2001; Rudzinski & Banach, 2008). Aim. The aim of this study is to present the harmful effects of tobacco smoke on the condition of the oral mucosa and to discuss the most common pathological changes associated with exposure to tobacco smoke. Material and methods. The research material consisted of scientific publications concerning the impact of cigarette smoking on the oral mucosa. The literature review was conducted based on the PubMed and Google Scholar databases. Publications in both Polish and English, published between 1987 and 2023, were included.
Copyright (c) 2026 Adrianna Adamczyk, Maja Gałuszka, Aleksandra Gałuszka, Kamila Krycia, Karolina Mazur, Karolina Różycka, Magdalena Mulawa, Emilia Piaszczyńska, Dominika Matacz, Sandra Drabik https://creativecommons.org/licenses/by-nc-sa/4.0
Exercise-Induced Brain-Derived Neurotrophic Factor as a Mediator of Antidepressant Effects: A Narrative Review
Depression represents a significant global public health problem, negatively affecting patients’ quality of life and social functioning. Despite the increasing availability of effective pharmacological and psychotherapeutic interventions, a substantial proportion of patients fail to achieve full symptom remission. [1] Recently, growing attention has been directed toward physical activity as a non-pharmacological approach supporting the treatment of depression. Multiple studies indicate that regular exercise may lead to a reduction in depressive symptoms and improvements in cognitive function. In addition, other non-pharmacological interventions, including probiotics [2], meditation, light therapy [3,4], and physical training, have been investigated for their potential antidepressant effects. One of the proposed mechanisms underlying the beneficial effects of physical activity, apart from its anti-inflammatory properties and stimulation of endorphin release, is the modulation of brain-derived neurotrophic factor (BDNF) expression. BDNF plays a crucial role in neuroplasticity, neurogenesis, and the regulation of synaptic function, particularly within the hippocampus, as well as in the spinal cord and peripheral nervous system. [5,6] The aim of this narrative review is to summarize and critically discuss current evidence on the effects of physical activity on BDNF levels and its role in antidepressant mechanisms, highlighting its potential clinical relevance in the management of depressive disorders.
Copyright (c) 2026 Izabella Głowacka, Marcin Ślot, Małgorzata Katra, Adrian Pal, Patryk Cegiełka, Krzysztof Cienkowski, Mikołaj Szczęsny, Karolina Żeżawska, Aleksandra Adamczyk, Maria Sicińska https://creativecommons.org/licenses/by-nc-sa/4.0
The role of early assessment of body posture in preventing musculoskeletal deformities and stomatognathic system dysfunctions
Body posture plays a significant role in the functioning of the musculoskeletal system and can also affect the stomatognathic system. Postural disturbances can lead to changes in the head and neck, contributing to dysfunction in this area. Research indicates a correlation between body posture and the functioning of the stomatognathic system, which includes structures responsible for chewing, articulation, emotional expression, and breathing. Early detection of postural abnormalities allows for the implementation of appropriate corrective measures aimed at limiting secondary compensatory changes. A significant aspect is the fact that these abnormalities are increasingly occurring in children and adolescents. The aim of this study was to assess the importance of early diagnosis of postural defects in preventing abnormalities in the functioning of the stomatognathic system. The latest scientific research was analyzed, with a detailed focus on those concerning the early diagnosis of postural defects and early diagnostic and therapeutic intervention. Studies from 1984 to 2025 were included. They indicate a correlation between poor posture and abnormalities in the stomatognathic system. The most common approach is posture analysis, which is performed in basic anatomical planes. Additional diagnostic tests include the Dual Scale Posture Test and the Adams Test, as well as anthropometric measurements. Posture assessment, diagnosis, and appropriate therapy require an integrated approach encompassing various clinical areas.
Copyright (c) 2026 Maja Gałuszka, Aleksandra Gałuszka, Kamila Krycia, Karolina Mazur, Karolina Różycka, Magdalena Mulawa, Emilia Piaszczyńska, Dominika Matacz, Sandra Drabik, Adrianna Adamczyk https://creativecommons.org/licenses/by-nc-sa/4.0
Regenerative Therapies for Articular Cartilage: Current Concepts, Clinical Outcomes, and Future Directions
Introduction and purpose. Articular cartilage injuries represent a significant clinical challenge due to the tissue’s limited intrinsic healing capacity, often progressing to osteoarthritis and chronic disability. Traditional treatments remain largely symptomatic, prompting extensive research into regenerative therapies aimed at restoring functional cartilage tissue. Description of the state of knowledge. We conducted a systematic analysis of recent literature (2020-2026) encompassing randomized controlled trials, systematic reviews, meta-analyses, and prospective cohort studies. Evidence was synthesized across multiple therapeutic modalities including mesenchymal stem cells (MSCs), autologous chondrocyte implantation (ACI/MACI), platelet-rich plasma (PRP), osteochondral transplantation, tissue engineering scaffolds, and emerging technologies such as 3D bioprinting, gene therapy, and exosome-based treatments. Matrix-associated autologous chondrocyte implantation (MACI) demonstrates significant long-term efficacy with large effect sizes (>0.8) in patient-reported outcomes at 2-15 years follow-up. Mesenchymal stem cells from various sources (bone marrow, adipose tissue, synovium, umbilical cord) show promise in clinical trials, with synovium-derived MSCs exhibiting particularly high chondrogenic potential. Comparative studies indicate that ACI/MACI and expanded MSC transplantation outperform microfracture for focal cartilage defects. Summary. Regenerative therapies have evolved significantly, with cell-based approaches demonstrating superior outcomes compared to traditional marrow stimulation techniques. However, challenges persist regarding optimal cell source, dosage, delivery methods, and long-term durability. Standardized protocols, large-scale randomized trials, and integration of emerging technologies are essential to advance the field toward personalized, effective cartilage regeneration strategies.
Copyright (c) 2026 Jan Domińczak, Adam Dobosz, Antoni Wojnowski, Sofia Czarnecka, Gabriela Łuczyńska, Joanna Banatkiewicz, Emilia Deka, Hanna Bojanowska, Karolina Babik, Oliwia Bartkowska https://creativecommons.org/licenses/by-nc-sa/4.0
The Association Between Sugar-Sweetened Beverage (SSB) Consumption and Gut Microbiota Composition and Related Metabolites in Adults: A Systematic Review
Background. Sugar-Sweetened Beverages (SSB) are a major source of dietary sugars worldwide. Emerging evidence suggests that dietary factors, including sugar intake, may influence the composition of the gut microbiota, which plays a crucial role in human physiology. However, the relationships between habitual SSB intake, gut microbiota composition, and related metabolites in adults remain insufficiently studied. Aim. This systematic review aimed to synthesize available evidence on the associations between SSB consumption, gut microbiota composition, and related metabolite profiles in adults, while identifying methodological differences and gaps in literature. Material and methods. A systematic search identified observational studies investigating SSB intake and gut microbiota or metabolite outcomes in healthy adult populations. Results. Higher SSB intake was consistently associated with alterations in gut microbial composition, including shifts in the Firmicutes: Bacteroidetes ratio. Changes included reductions in short-chain fatty acid producing species including Eubacterium eligens, Ruminococcus callidus, and several Clostridium species. Metabolomic analyses revealed changes in branched-chain amino acids, aromatic amino acids, glycerophospholipids and bile acids with distinct patterns observed for specific SSB types. Overall, 56 serum metabolites were significantly related to SSB intake and implicated in diabetes risk. SSB was also linked to higher visceral adiposity index, total and LDL-cholesterol. Added sugar intake was positively associated with the genus Lachnobacterium. Conclusions. Habitual SSB consumption may influence gut microbial composition and related metabolites in adults, contributing to metabolic dysregulation. The limited number of studies, methodological differences and observational nature of available evidence, highlight the need for interventional studies and the necessity of standardized methods.
Copyright (c) 2026 Kamila Kamińska, Matylda Będkowska-Kuśmierek, Anna Złotnik, Kinga Krzysztofik, Antoni Klamka, Paulina Kawalec, Kamil Bronikowski, Maksymilian Ryszkowski, Krystian Fornal, Natalia Będkowska-Kuśmierek https://creativecommons.org/licenses/by-nc-sa/4.0
Exercise as Medicine in Migraine: Clinical Outcomes, Mechanisms, and Long-Term Therapeutic Potential
Background. Migraine is a highly disabling neurological disorder affecting approximately 14.4% of the global population. Its pathophysiology involves the activation of the trigeminovascular neuroinflammatory cascade and central sensitization. While pharmacological treatments are standard, issues with tolerability and medication overuse necessitate effective non-pharmacological interventions. Aim. To synthesize current clinical evidence (2019–2025) regarding the impact of structured physical activity on migraine pathophysiology, clinical outcomes, and craniocervical dysfunction. Material and Methods. A systematic review was conducted via PubMed/MEDLINE, covering articles from January 2019 to March 2026. The analysis included clinical trials, meta-analyses, and systematic reviews focusing on adult populations with episodic or chronic migraine. Results. Moderate-intensity continuous training (MCT) remains the clinical gold standard, reducing migraine frequency by a mean of 0.6 days/month and attack duration by 20–27%. Combined aerobic and resistance training demonstrates the highest efficacy in reducing overall migraine burden. Exercise induces analgesia by stimulating the release of endogenous opioids and endocannabinoids, promoting anti-inflammatory modulation, and stabilizing cortical excitability. Addressing craniocervical impairments through the Flexion-Rotation Test and multimodal physiotherapy significantly reduces disability. Tele-rehabilitation and digital tools further enhance long-term adherence. Conclusions. Structured physical activity is a potent, low-risk intervention for migraine prophylaxis. A minimum therapeutic window of 10–12 weeks is required for significant clinical improvement. Furthermore, exercise acts synergistically with modern pharmacological agents, such as CGRP antagonists, to improve global sensorimotor function and quality of life.
Copyright (c) 2026 Julia Łyżwa, Aleksandra Strzępek, Aleksandra Majchrzyk, Agnieszka Chmurska, Agnieszka Janaszek, Karolina Frączek, Mateusz Smerdzyński, Natalia Kałwa, Kinga Kałuża, Michał Pater https://creativecommons.org/licenses/by-nc-sa/4.0
Metabolic Adaptation and Weight Regain Phenomenon After Cessation of GLP-1 Analogue Pharmacotherapy
Obesity is currently recognized as a chronic, relapsing and progressive disease, constituting one of the most serious public health challenges of the 21st century. The introduction of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as semaglutide and tirzepatide, has led to unprecedented therapeutic success, enabling weight reduction comparable to that achieved by bariatric surgery. However, despite their high efficacy, discontinuation of these agents is associated with rapid and clinically significant weight regain. The aim of this paper is to analyze the physiological mechanisms responsible for post-treatment weight regain following GLP-1 analogue withdrawal and to evaluate the effectiveness of selected strategies aimed at limiting this phenomenon, with particular emphasis on resistance training, nutritional interventions and pharmacological deprescribing models. Available clinical and experimental data indicate that weight regain is driven primarily by metabolic adaptation, including a disproportionate reduction in resting metabolic rate, loss of lean body mass and dysregulation of appetite-controlling hormones. Evidence from major clinical trials (STEP, SURMOUNT) confirms that up to two-thirds of the lost body weight may be regained within one year after cessation of therapy. The findings highlight the necessity of treating obesity pharmacotherapy as part of a long-term management strategy. Integration of pharmacological treatment with resistance training, high-protein dietary patterns and gradual dose reduction protocols appears essential for sustaining therapeutic effects and preventing the rebound phenomenon.
Copyright (c) 2026 Karolina Babik, Oliwia Bartkowska, Joanna Banatkiewicz, Emilia Deka, Jan Domińczak, Sofia Czarnecka, Gabriela Łuczyńska, Adam Dobosz, Antoni Wojnowski, Hanna Maria Bojanowska https://creativecommons.org/licenses/by-nc-sa/4.0
The role of procedures used in the treatment of androgenetic alopecia - a literature review
The aim of the thesis is a review and critical analysis of invasive methods for treating androgenetic alopecia (AGA), including platelet- rich plasma therapy (PRP), low-level laser therapy (LLLT), microneedling (MN), hair transplantation and mesotherapy. The paper analyzed the results of randomized clinical trials, observational studies, and meta-analyses published over the past twelve years, with particular emphasis on safety indicators and the durability of effects. The results of available studies indicate that invasive treatment methods can lead to a significant improvement in hair density and quality, especially when an appropriate selected combination therapy is used. However, the effectiveness of individual technique varies, and their application requires appropriate patient qualification and consideration of the risk of complications. In conclusion, invasive methods for the treatment of androgenetic alopecia represent a promising therapeutic approach; nevertheless, further high-quality clinical studies are necessary to optimize treatment protocols and evaluate long-term outcomes.
Copyright (c) 2026 Jagienka Perzyńska, Weronika Bagińska, Urszula Załuska, Kinga Krzyżowska, Jaśmina Podkościelna, Kamila Ryszkowska, Natalia Pawelec https://creativecommons.org/licenses/by-nc-sa/4.0
Testicular cancer: The Most Common Malignancy in Young Men – A Review of Current Knowledge on Diagnosis and Treatment
Background. Testicular cancer is a rare malignancy that primarily affects young men and requires early diagnosis. The diagnosis is based on clinical tests, imaging tests and measurement of tumor markers. Treatment consists mainly of surgery, and further therapeutic management is adapted to the tumor type and stage. Aim. The aim of this study was to review the literature on testicular cancer, including risk factors, prevention, diagnosis, and treatment. Method and Materials. The literature review was conducted based on publications retrieved from the PubMed, Google Scholar, and Web of Science databases, using the keywords: testicular cancer, epidemiology, diagnostics, cancer markers, and treatment. Results. Regular monitoring of risk factors, testicular self-examination and attention to symptoms increase the likelihood of early detection of testicular cancer by patients. Prompt initiation of appropriate therapy allows effective disease control and improves survival outcomes Conclusion. Testicular cancer requires special diagnostic vigilance, and early therapeutic intervention is crucial for effective treatment.
Copyright (c) 2026 Kamila Krycia, Karolina Mazur , Karolina Różycka , Magdalena Mulawa, Aleksandra Gałuszka, Emilia Piaszczyńska , Dominika Matacz , Sandra Drabik, Maja Gałuszka , Adrianna Adamczyk https://creativecommons.org/licenses/by-nc-sa/4.0
Effects of GLP-1 Receptor Agonists on Bone Metabolism and Fracture Risk in Type 2 Diabetes and Obesity: Mechanisms and Clinical Evidence — A Narrative Review
Introduction and purpose: Type 2 diabetes (T2D) is associated with increased fragility fracture risk despite preserved or elevated bone mineral density (BMD) ("diabetic bone paradox"). As glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used in T2D and obesity, this narrative review synthesizes evidence on their effects on bone turnover, BMD and fracture outcomes, contrasting diabetic and non-diabetic populations. Brief description of the state of knowledge: Preclinical data suggest GLP-1 RAs may promote osteoblastogenesis and reduce marrow adipogenesis (e.g., via Wnt/$\beta$-catenin and OPG/RANKL signalling). Clinically, effects appear context-dependent and strongly influenced by weight loss. In T2D, most trials report neutral or small favourable changes in BMD and bone turnover markers. Some meta-analyses report a possible reduction in fractures (notably with longer liraglutide exposure), but fracture events were often secondary/safety endpoints and were not adjudicated, limiting certainty. Summary (conclusions): Overall, current evidence to date suggests no major skeletal safety signal for GLP-1 RAs in T2D, while definitive fracture-prevention effects remain unproven. In obesity, baseline risk assessment and monitoring of bone health should be considered in high-risk individuals, and future studies should prioritize adjudicated fracture endpoints and longer follow-up.
Copyright (c) 2026 Hubert Bojanowski, Zuzanna Marczak, Maksymilian Sito, Filip Jurkowski, Łukasz Wójcik, Natalia Gawron, Aleksandra Dobracka, Kinga Zachar, Monika Jarowicz, Jędrzej Czmyr https://creativecommons.org/licenses/by-nc-sa/4.0
Dermatillomania as a Mental Health Issue Among Young Adults: A Narrative Review
Dermatillomania, also known as skin picking disorder, is a body-focused repetitive behavior associated with significant psychological and physical consequences, particularly among young adults. This narrative review aims to summarize current knowledge regarding its clinical characteristics, diagnostic approaches, prevalence, underlying triggers, and available treatment options, with a focus on its impact on mental health. A targeted literature search was conducted using PubMed and Google Scholar, including publications from 2015 to 2026. The findings indicate that dermatillomania is relatively common yet frequently underdiagnosed, with onset typically occurring during adolescence. The disorder is strongly associated with emotional dysregulation, stress, and anxiety, and often coexists with other psychiatric conditions such as depressive and anxiety disorders. It can lead to substantial impairment in daily functioning, reduced quality of life, and social withdrawal, largely due to feelings of shame and stigma. Diagnostic assessment relies on established clinical criteria supported by validated screening tools, although challenges in recognition persist. Therapeutic strategies emphasize a multidisciplinary approach. Psychotherapeutic interventions, particularly cognitive-behavioral therapy and habit reversal training, remain the cornerstone of treatment, while pharmacological options - such as selective serotonin reuptake inhibitors and N-acetylcysteine - may provide additional benefit. Despite available interventions, there is still no standardized treatment protocol. In conclusion, dermatillomania represents a significant but often overlooked mental health issue requiring greater clinical awareness, improved diagnostic strategies, and further research to optimize treatment outcomes.
Copyright (c) 2026 Aleksandra Grzywacz-Guza, Martyna Gruba, Patrycja Hatala, Berenika Kantor, Katarzyna Cencelewicz, Patrycja Bździuch, Aleksandra Lewczuk https://creativecommons.org/licenses/by-nc-sa/4.0
The The role of Hyperhomocysteinemia in the Pathogenesis of Ischemic Stroke: A Review of Current Clinical Research
Introduction. Hyperhomocysteinemia (HHcy) is often associated with the risk of stroke, which is one of the most common causes of death and disability in adults worldwide. The medical literature indicates a multidirectional effect of this amino acid on atherosclerotic and neurotoxic processes by inducing oxidative stress and promoting a prothrombotic state.The pathogenesis is further characterized by direct endothelial damage and epigenetic dysregulation. Together, these processes disrupt the structural and functional integrity of the cerebrovascular system, consequently leading to stroke. Aim of the study. The aim of this study is to evaluate the biochemical and clinical impact of HHcy on stroke development and to assess the validity of monitoring plasma Hcy levels in patients at risk for cerebrovascular disease. Materials and methods. The articles available in major medical databases such as Pubmed or Google Scholar are the basis of this research review. The study was conducted with the use of keywords like ‘HOMOCYSTEINE’, ‘HIPERHOMOCYSTEINEMIA’, ‘STROKE’, ‘ISCHEMIC STROKE’. Conclusions. Hcy is a key, modifiable risk factor for ischemic stroke that significantly worsens prognosis and leads to disability. According to the authors, the standards of neurological care should be revised to include routine monitoring of this amino acid and maintaining a level below 10 umol/L. Detecting stroke early and lowering Hcy levels in people at risk may become an important part of modern stroke prevention. However, further clinical studies are needed to confirm the long-term effect of these measures on case numbers.
Copyright (c) 2026 Nadia Herchi, Knieszko Fahim, Jakub Franaszek, Sara Herchi, Martyna Jabrzyk, Patrycja Jarczyńska, Wojciech Kijowski, Mateusz Klusek, Karolina Michalak, Maciej Przybył https://creativecommons.org/licenses/by-nc-sa/4.0
Synergy of Protein Intake and Strength Exercise in Overcoming Anabolic Resistance in Sarcopenia Management
Background. Sarcopenia is characterized by accelerated muscle loss, driven by chronic inflammation and anabolic resistance, which blunts mTORC1 pathway activation in aging skeletal muscle. Aim. This narrative review analyzes the efficacy and synergistic effects of targeted protein supplementation and resistance exercise in countering sarcopenia. Material and methods. A literature search of PubMed and Google Scholar was conducted to identify recent clinical guidelines and studies on protein supplementation, leucine thresholds, and mechanotransduction in older adults. Results. Overcoming anabolic resistance requires a high intracellular leucine threshold of 2.5–3.0 g per meal. Whey protein effectively provides this rapid spike. Furthermore, progressive resistance training independently upregulates mTORC1 via mechanotransduction. Combining these interventions with specific adjuvants like creatine robustly sustains an anabolic environment. Conclusions. Effective sarcopenia management requires shifting from passive treatments to active interventions combining mechanical loading with targeted nutritional triggers.
Copyright (c) 2026 Łukasz Wójcik, Jędrzej Czmyr, Hubert Tomasz Bojanowski, Zuzanna Marczak, Maksymilian Sito, Filip Jurkowski, Natalia Gawron, Aleksandra Dobracka, Kinga Zachar, Monika Jarowicz https://creativecommons.org/licenses/by-nc-sa/4.0
Pharmacological and Non-Pharmacological Interventions for the Treatment of Obesity: A Review of Guidelines and Clinical Trials (2020–2025)
Background. Obesity is a long-term, relapsing condition that necessitates lifelong treatment.The years 2020 through 2025 signify a paradigm shift in obesity medicine with the departure from behavior-centric models towards neurohormonal interventions, led by the approval of high-efficacy incretin-based therapies. Aim. To review current clinical practice guidelines and pivotal randomized controlled trials(RCTs)published between Jan 1, 2020 and Jan 1, 2025, regarding the efficacy, safety, and cardiovascular outcomes of pharmacological and non-pharmacological treatments. Material and Methods. A comprehensive search of the literature was conducted in PubMed/MEDLINE, Embase, and Cochrane Library databases covering the period from Jan 1, 2020 to Jan 1, 2025. The review focused on Phase 3 RCTs, meta-analyses, and consensus guidelines from major medical societies (ADA, EASO, AACE, ASMBS).Key search terms included obesity, GLP-1 receptor agonists, semaglutide, tirzepatide and lifestyle intervention. Result. Lifestyle treatment (Medical Nutrition Therapy and physical activity)continues to be the cornerstone of therapy but is associated with limited long-term effectiveness as monotherapy due to metabolic adaptation.In stark contrast, new pharmacologic therapies have transformed the standards of care. Semaglutide 2.4 mg(STEP trials)demonstrated a mean weight loss of 14.9%, while tirzepatide (SURMOUNT trials) achieved up to 20.9% mean weight loss, with more than 30% of patients achieving results comparable to bariatric surgery.The SELECT trial(2023)further demonstrated that GLP-1 receptor agonists decreased MACE by 20% in patients with obesity and established cardiovascular disease. Conclusion. Multimodal treatment is required for modern obesity care.Although lifestyle modification remains an essential component of metabolic care, next-generation pharmacotherapy is increasingly recommended for patients with a BMI ≥30 kg/m²(or ≥27 kg/m² with comorbidities)to address physiological set points.
Copyright (c) 2026 Anna Gęborys, Maja Wojcieszak, Julia Dąbrowska, Dominika Miazga, Alicja Maziarczyk, Jakub Lambach, Kacper Kutnik, Joanna Kania, Weronika Woźnica, Michał Białogłowski https://creativecommons.org/licenses/by-nc-sa/4.0
Current Treatment Strategies for Irritable Bowel Syndrome - A Literature Review
Background. Irritable bowel syndrome is one of the most common chronic gastrointestinal disorders. This disease is diagnosed worldwide, although it is much more common in developed countries. The main role in the development of the disease is attributed to dysfunction of the brain-gut axis and factors such as intestinal microbiota dysbiosis and prolonged exposure to stress. The symptoms significantly reduce the quality of life of patients, which is why it is so important to develop clear recommendations for better control of the condition. Aim. The aim of this study was to analyse and summarise current pharmacological and non-pharmacological strategies for treating irritable bowel syndrome. Materials and methods. A review of the literature available in the PubMed, Google Scholar and Cochrane databases was conducted. Articles published between 2012-2025 were considered. Publications of low methodological quality and those containing incomplete data were excluded. Results. According to research, the best dietary intervention is a low-FODMAP diet, but it should be followed under the supervision of an experienced dietitian. Probiotics should be considered as first-line medications. A growing number of publications point to the beneficial effects of psychotherapy, regular moderate-intensity physical activity, and healthy eating habits, especially regular consumption of small meals. The impact of quality sleep and stress management skills on prolonging IBS remission is also emphasized, but the scientific evidence is not yet strong enough. Conclusions. Changes in diet and eating habits have been shown to be important in reducing symptoms and prolonging remission. There are many pharmacological options available, but there are no clear guidelines due to the complex pathomechanism of the disease. Currently, probiotics are the most recommended treatment. Herbal therapies, psychotherapy, mindfulness techniques, physical activity should be considered as additional support.
Copyright (c) 2026 Sandra Michałek, Julia Rokosz, Katarzyna Sładek, Julianna Koczuk, Krzysztof Mazur, Alicja Trzepizur, Bartosz Wnorowski https://creativecommons.org/licenses/by-nc-sa/4.0
Tea Consumption and Iron Deficiency Risk in Physically Active Individuals: Mechanisms, Clinical Relevance and Dietary Strategies
Iron is essential for physical performance and overall functioning. In physically active individuals, iron balance may be compromised by exercise-induced iron losses, post-exercise increases in hepcidin, and dietary factors that reduce iron bioavailability, including tea polyphenols. The aim of this review was to analyze the relationship between tea consumption and the risk of iron deficiency in physically active individuals, with particular emphasis on the interaction between exercise, diet, and iron metabolism, as well as on practical nutritional implications for prevention and management. This paper was prepared as a narrative literature review. PubMed was used as the primary source of literature. Studies relevant to iron metabolism, iron deficiency, tea consumption, polyphenols, and physically active populations were included and synthesized qualitatively. The reviewed literature suggests that iron deficiency in physically active individuals is a multifactorial problem. In addition to exercise-induced iron losses, intense exercise may increase hepcidin concentrations, with peak values typically observed several hours after training, which may transiently reduce iron absorption. Tea polyphenols markedly inhibit non-heme iron absorption and may further impair iron balance, particularly in individuals relying predominantly on plant-based iron sources. The greatest risk appears to concern premenopausal women, endurance athletes, individuals following plant-based diets, and athletes with low energy availability. Tea consumption may represent a clinically relevant dietary factor contributing to difficulty in maintaining adequate iron stores in physically active individuals. Practical management should include individualized dietary counseling, attention to the timing of tea intake in relation to meals and iron supplementation, consideration of post-exercise changes in iron absorption, and targeted supplementation when clinically justified.
Copyright (c) 2026 Aleksandra Kurek, Aleksandra Głowacka, Dominika Domińczak, Sofiia Ivanchuk, Patryk Górecki, Anhelina Kaminskaya, Tetiana Savchak, Hubert Feretycki, Aladdin Salama, Shafea Abdulla https://creativecommons.org/licenses/by-nc-sa/4.0
The Evolving Landscape of Psoriasis Treatment: Current Biologics and Novel Targets
Introduction. Psoriasis is recognized as an auto- immune inflammatory disorder characterized by hyperproliferation of keratinocytes and infiltration of T- cells. Disease can occur at any age and may cause episodes of depression and psoriatic arthritis. Currently the researchers are trying to find the most valuable and specific targets in treatment. Purpose. The primary purpose of our review is to provide comperhensive update on the most valuable and possibly best new rapidly evolving scientific approaches in treatment of chronic disease such as psoriasis. Materials and Methods. We have reviewed PubMed data base in order to identify clinical trials, meta analyses and randomized controlled trials form the past 5 years. Results. The review confirms the IL-23/IL-17 axis as the primary pathogenic driver. While management utilizes effective topical, systemic, phototherapy, and advanced biological agents (TNF-alpha, IL-17, and IL-23/IL-12 inhibitors), the continued therapeutic challenge, particularly for refractory patients, drives the need for innovative treatments. The emergence of the first oral, selective allosteric TYK2 inhibitor (deucravacitinib) and ongoing research into targets like IL-21 and the microbiota highlight the rapidly evolving landscape of psoriasis therapy.
Copyright (c) 2026 Szymon Pacek, Martyna Muda, Paweł Kalinowski, Patryk Bachurski, Karol Paweł Wiśniewski, Maja Międlar, Elisabetta Pierzga, Bartosz Zaranski, Gabriela Chmiel, Paweł Witkowski https://creativecommons.org/licenses/by-nc-sa/4.0
Physical Activity and Lung Cancer Risk in the Context of Exposure to Air Pollution – A Review of Current Evidence
Introduction. Lung cancer remains one of the leading causes of cancer-related mortality worldwide. While tobacco smoking is the primary risk factor, increasing evidence highlights the role of environmental exposures, particularly air pollution, in lung carcinogenesis. At the same time, regular physical activity is widely recognised as an important protective factor against many chronic diseases, including certain types of cancer. However, physical activity performed in polluted environments may increase the inhalation of harmful pollutants due to elevated ventilation during exercise, which raises questions about the interaction between these two factors. Aim of the study. The aim of this narrative review was to analyse the available scientific evidence regarding the relationship between physical activity and lung cancer risk in the context of exposure to air pollution. Methods. A literature review was conducted using PubMed, Scopus and Web of Science databases. Publications addressing epidemiological evidence, biological mechanisms of lung carcinogenesis related to air pollution, and the physiological effects of physical activity were included. Studies analysing the interaction between physical activity and environmental exposure were also considered. Results. The available evidence indicates that regular physical activity is associated with a reduced risk of lung cancer. Potential mechanisms include reduction of chronic inflammation, improved immune surveillance and increased antioxidant capacity. However, physical activity also leads to increased minute ventilation, which may result in higher inhalation of air pollutants. Most studies suggest that under moderate pollution levels the overall health benefits of physical activity outweigh the potential risks related to increased exposure. In environments with high pollution levels, the protective effect of physical activity may be attenuated.
Copyright (c) 2026 Natalia Czapla, Wiktor Wisoky, Weronika Ziółkowska, Ewelina Strużyńska, Piotr Ignyś, Joanna Łopińska, Marta Majchrzycka, Martyna Graczyk, Natalia Graczyk, Mateusz Majchrzak https://creativecommons.org/licenses/by-nc-sa/4.0
Post-Traumatic Stress Disorder (PTSD) - Risk Factors, Treatment and Prevention - A Literature Review
Introduction and objective. Post-traumatic stress disorder is a mental disturbance that is a reaction to an extremely stressful event (trauma) that exceeds a person's ability to cope and adapt. Such events include acts of war, disasters, natural disasters, traffic accidents, being a victim of assault, rape, harassment, abduction, torture, imprisonment in a concentration camp, severe, difficult experiences after taking psychoactive substances, receiving a diagnosis of a life-threatening illness. Typical PTSD symptoms include anxiety, exhaustion, feelings of helplessness, recurring, violent involuntary memories of the traumatic event, flashbacks, hallucinations or nightmares related to the trauma, and avoidant behaviour in situations associated with the trauma. Treatment of PTSD, depending on the severity and persistence of symptoms, may include psychotherapy and pharmacotherapy. The aim of this study is to systematise information on this condition and raise awareness of this issue among healthcare professionals and patients.
Copyright (c) 2026 Jakub Skrzypek, Natalia Fidut, Kamila Zioło, Karol Szyprowski, Weronika Wrzosek, Weronika Zarzycka, Mateusz Zugaj, Maciej Kisielewski, Bartosz Okliński, Julia Wawerska https://creativecommons.org/licenses/by-nc-sa/4.0
Depression Following Athletic Retirement in Elite Athletes: A Review of Risk Factors, Neurobiological Mechanisms, and Preventive Strategies
Background. Depression is one of the most common mental disorders worldwide and a significant public health concern. In elite athletes, particular attention has been given to the transition period following career termination, which involves numerous biological, psychological, and social changes that may increase the risk of mood disorders. Aim. This review aims to present current knowledge on the epidemiology, risk factors, and neurobiological mechanisms of depression following athletic retirement, and to discuss preventive strategies and future research directions. Material and Methods. This is a narrative review based on an analysis of the available scientific literature on the mental health of elite athletes, with particular emphasis on the post-career period. Results. Available data indicate that depressive symptoms occur in approximately 15-30% of former athletes, particularly within the first years after career termination. Major risk factors include strong athletic identity, involuntary retirement, lack of alternative career pathways, chronic pain, and repetitive head injuries. Neurobiological mechanisms also play a significant role, including dysregulation of the HPA axis, neuroinflammatory processes, and alterations in neurotransmitter systems. Conclusions. Depression following sports career termination is a complex biopsychosocial issue. Effective prevention requires early, systemic, and interdisciplinary approaches that encompass both the active career period and the transition to post-sport life. Further research, particularly prospective studies, is necessary to better understand the underlying mechanisms and to develop effective support strategies.
Copyright (c) 2026 Martyna Iwanowska, Beata Flis, Alicja Cyrzan , Jakub Z. Zalewski, Adam Zysk, Mateusz Ząbek, Bartosz Fronczak, Adrian Goss, Małgorzata Styczyńska, Maciej Wojewódzki https://creativecommons.org/licenses/by-nc-sa/4.0