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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Shockwave therapy for coronary calcification: the evolving role of intravascular lithotripsy in coronary interventions
Severely calcified coronary lesions represent a significant challenge during percutaneous coronary interventions (PCI), often limiting optimal stent deployment and increasing the risk of procedural complications. Intravascular lithotripsy (IVL) is an emerging technology designed to modify calcified plaques through the application of acoustic shockwaves, offering a safer and more controlled alternative to traditional atherectomy. Aim of the Study: This study aims to provide a comprehensive overview of the intravascular lithotripsy (IVL) technique, its mechanism of action, indications, and contraindications. Additionally, it evaluates the procedural efficacy, safety profile, and clinical outcomes of IVL based on current clinical trial data and real-world experience. Material and Methods: A narrative review was conducted, incorporating findings from major clinical trials (Disrupt CAD I–IV) and observational registries, with a focus on procedural success, complication rates, and major adverse cardiac events (MACE). The review includes comparative analysis of IVL outcomes in de novo lesions, in-stent restenosis (ISR), chronic total occlusions (CTO), and complex anatomical scenarios. Conclusions: IVL is a highly effective and safe modality for the modification of calcified coronary lesions. It consistently demonstrates procedural success rates exceeding 90%, with a low incidence of complications such as perforation or dissection. Clinical efficacy is sustained in both short- and long-term follow-up, with low MACE rates observed across studies. IVL is particularly valuable in cases resistant to conventional techniques. However, limitations related to cost, access, and certain patient populations necessitate further randomized studies to establish its role as a standard of care.
Copyright (c) 2026 Piotr Jóźwiak, Adam Rybak, Maria Wysieńska, Weronika Biaduń-Mućko, Kinga Rogowska-Borettini, Aleksandra Romanowska, Paweł Arkadiusz Malmur https://creativecommons.org/licenses/by-nc-sa/4.0
When the Kidney Looks Like Thyroid: Thyroidization of the Kidney as a Histological Pattern and Its Potential Clinical Correlation - A Scoping Review
Background: kidney thyroidization is a histological pattern - atrophic renal tubules filled with eosinophilic, colloid-like casts resembling thyroid follicles. Regarded as a nonspecific marker of chronicity in renal disease, yet its biological significance, clinical correlations, and prognostic value remain poorly defined. Aim: to synthesize the existing literature on renal thyroidization. Material and methods: a scoping review of the available literature describing thyroidization of the kidney in human renal pathology was done. 2 databases were screened - PubMed & Scopus. Eligible sources included original studies, case series, case reports, and reviews addressing histological features, mechanisms & clinical contexts of thyroidization. Support information extracted from relevant textbooks recognized as authoritative on the renal pathology field. Results: the literature associates thyroidization with chronic tubulointerstitial damage, mostly in chronic kidney disease of diverse etiologies. The pattern reflects tubular atrophy with proteinaceous casts, interstitial fibrosis and chronic inflammation. Clinical correlations are rarely assessed; the presence of thyroidization is usually interpreted as a marker of long-standing injury. Reports suggesting links with disease duration, recurrent infection, or poor renal outcome remain largely descriptive. Conclusions: thyroidization of the kidney is a reproducible and distinctive histological pattern that functions primarily as a morphological signpost of chronicity. Its potential value as a semi-quantitative marker of disease duration, prior injury burden, or prognosis has not been studied. Future work integrating digital pathology, quantitative morphometry, and clinicopathological correlation may clarify whether thyroidization carries information beyond that conveyed by established chronicity indices.
Copyright (c) 2026 Mieszko Czaplinski, Maria Król, Natalia Marta Bruska, Andrii Bilyk, Paweł Pustuła, Mikołaj Patalong, Bartłomiej Błaszkowski, Przemysław Kołodziej, Katarzyna Więckowska, Adam Wolski https://creativecommons.org/licenses/by-nc-sa/4.0
Dextrose as an effective agent in the treatment of entrapment neuropathies by Hydrodissection
Background. Entrapment neuropathies are a diverse group of peripheral nerve disorders caused by the compression and irritation of nerves at structurally narrow areas. More recently, interest has grown in the novel minimally invasive ultrasound-guided method in the treatment of entrapment neuropathies: nerve hydrodissection. This emerging procedure involves the injection of various substances around the nerve to separate it from surrounding tissues in order to allow for decompression and healing. Among injectable agents, 5% dextrose in water (DW) has gathered much interest because of its favorable properties. Aim. The objective of this study was to describe potential mechanisms of action, efficacy and safety of 5% dextrose in water in the management of entrapment neuropathies via hydrodissection based on recently published studies. Materials and methods. This study is a narrative review. Articles related to nerve hydrodissection with 5% dextrose in water published from 2020 (past 5 years) were included. Results. Hydrodissection by 5% dextrose in water significantly improves both symptoms and functions in various neuropathies. The application of 5% dextrose and water solution appears to have been explored extensively as a treatment for carpal tunnel syndrome. Compared to other treatments, including corticosteroids and local anesthetics, this solution shows a more sustained response and a good safety profile, with no adverse reactions reported. However, the true mechanism of action of 5% dextrose and water remains unclear. Proposed mechanisms include modulation of TRPV1 receptors, thereby playing a role in the attenuation of neuropathic pain. Conclusions. Hydrodissection using 5% dextrose and water solution can be considered an effective modality of therapy for entrapment neuropathies, with its efficacy best proved in the treatment of carpal tunnel syndrome.
Copyright (c) 2026 Szymon Stupnicki, Wiktoria Marzec, Michał Napierała, Natalia Skrzypska, Olga Wojtczak, Justyna Wróblewska, Jakub Tarczykowski, Kacper Zagaja https://creativecommons.org/licenses/by-nc-sa/4.0
Vitamins D and E as radiotherapy adjuncts - literature review of preclinical and clinical evidence
Introduction: Radiotherapy (RT) is the fundamental method in cancer treatment, yet tumor resistance and normal tissue toxicity limit its efficacy. Vitamins D and E may modulate RT outcomes through radiosensitization, antioxidant effects, and immune regulation. Methods and Materials: We reviewed preclinical and clinical studies from PubMed, ScienceDirect, ResearchGate, and Google Scholar using keywords like “radiotherapy”, ”radiation”, “vitamin D”, “vitamin E” and “radiosensitivity”. Results: Vitamin D enhances RT response via VDR-mediated DNA damage and reduces toxicity (e.g., mucositis), though hypercalcemia risk requires monitoring. Vitamin E (especially tocotrienols) alleviates mucositis and fibrosis, but excessive doses may compromise RT efficacy by neutralizing tumor-killing ROS. Conclusions: Vitamins D and E show therapeutic potential in RT but require precise dosing and timing to avoid interference with treatment. Personalized strategies and robust clinical trials are needed to establish evidence-based guidelines for their adjuvant use.
Copyright (c) 2026 Ada Wiśniowska, Maksymilian Wiśniowski, Kacper Buczek, Aleksandra Kozłowska https://creativecommons.org/licenses/by-nc-sa/4.0
When should you suspect if your patient is an Anabolic-Androgenic Steroid User? Evidence-Based literature review of usage patterns changes and clinical implications for medical practice (2005-2025)
Background: Anabolic-androgenic steroid (AAS) use has evolved into a significant public health concern affecting diverse populations beyond elite athletics. Objective: To examine evidence-based changes in AAS usage patterns including demographics, motivations, and health consequences from 2005-2025 using systematic reviews and peer-reviewed research. Methods: Literature review of peer-reviewed studies and systematic reviews from PubMed and National Health Institute Library focusing on AAS epidemiology, demographic changes, and health consequences published between 2005-2025. Results: Global lifetime prevalence of AAS use is estimated at 6-29%. Female participation is estimated to be constantly growing. Evidence indicates expansion beyond traditional athletic populations with significant cardiovascular, psychiatric, and reproductive health consequences. Conclusions: AAS use represents a widespread public health concern requiring enhanced clinical awareness and evidence-based management approaches among medical practitioners.
Copyright (c) 2026 Adrianna Pielech, Patrycja Dadyńska, Marek Wilczyński, Paweł Kwiecień, Michał Kwiecień, Julianna Zielska https://creativecommons.org/licenses/by-nc-sa/4.0
The influence of diet and oral supplementation on female infertility
Infertility is an increasing concern among young couples attempting to conceive. Despite advances in medical treatments, including ovarian stimulation, intrauterine insemination, and in vitro fertilization, the prevalence of infertility remains high, suggesting that multiple factors may interfere with reproductive success. Recent research has highlighted the important role of dietary patterns and oral supplementation in fertility, influencing metabolic health, inflammation, ovulation, and oocyte quality. Modifiable risk factors such as stress, obesity, and unhealthy diet have been associated with reduced pregnancy success. Given their potential impact, further investigation into diet and lifestyle interventions is essential to improve reproductive outcomes.
Copyright (c) 2026 Maciej Krężel, Olga Krężel, Marcelina Rybińska, Artur Szafraniec, Zuzanna Kalinowska https://creativecommons.org/licenses/by-nc-sa/4.0
Non-pharmacological strategies in the management of arterial hypertension in the elderly: A review of dietary, probiotic, and physical activity interventions
Background: Arterial hypertension is one of the leading causes of cardiovascular diseases worldwide. While pharmacological therapy plays a central role in management, non-pharmacological interventions are often the first-line approach, particularly in older adults. Aim: This article aims to review current evidence on the effectiveness of non-pharmacological interventions for managing arterial hypertension in older adults, focusing on diet, probiotic supplementation, and physical activity. Material and Methods: Data were obtained from publicly available scientific sources, including PubMed, BioMed Central, Google Scholar, and ResearchGate Results: The literature confirms the effectiveness of the DASH diet in lowering blood pressure and improving metabolic parameters, including insulin sensitivity and lipid profile. Reducing sodium and alcohol intake may delay or partially replace the need for pharmacological treatment. Probiotic supplementation exhibits antihypertensive effects by modulating gut microbiota and reducing inflammation, with minimal side effects. Regular physical activity, particularly aerobic exercise, contributes to significant reductions in blood pressure and improves functional capacity in older adults. The success of non-pharmacological interventions requires individual tailoring to each patient’s needs. Conclusions: A comprehensive approach combining the DASH diet, sodium and alcohol restriction, probiotic supplementation, and regular physical activity forms the cornerstone of effective non-pharmacological management of arterial hypertension in older adults. These strategies can reduce the need for pharmacotherapy, minimize drug-related adverse effects, and improve cardiovascular outcomes.
Copyright (c) 2026 Dawid Cyls, Radosław Sciepuro, Martyna Toczek, Paulina Ryszka , Damian Broda, Aleksandra Płusa, Daria Komissarova, Izabela Ciesielska, Łukasz Głąb, Paulina Janczylik https://creativecommons.org/licenses/by-nc-sa/4.0
The use of platelet-rich plasma in the healing of chronic and hard-to-heal wounds – a systematic review
INTRODUCTION: Chronic wounds are a significant clinical problem, burdening healthcare systems and affecting the quality of patients' life. The healing of chronic wounds is impaired at multiple levels, which makes traditional treatment methods often insufficient. Platelet-rich plasma is an autologous blood-derived preparation containing a high concentration of platelets and growth factors that can modulate regenerative processes in damaged tissues. OBJECTIVE: The objective of this review is to evaluate the efficacy and safety of using PRP in treatments of chronic and hard-to-heal wounds based on current clinical data. MATERIALS AND METHODS: A systematic search of the PubMed, Scopus, and Web of Science databases was conducted to identify clinical studies. Randomized controlled trials, cohort studies, case series, and systematic reviews published up to December 2025 were analyzed. Inclusion criteria included studies involving adult patients with chronic wounds, diabetic ulcers, pressure ulcers, venous ulcers, and hard-to-heal postoperative wounds. The following parameters were evaluated: wound healing time, rate of complete wound closure, reduction of wound surface area, pain intensity and the occurrence of adverse effects. KEY RESULTS: The analysis, covering 29 randomized clinical trials involving 2,198 chronic wounds, showed that the use of platelet-rich plasma significantly increased the chances of complete wound closure compared to standard treatment, with an odds ratio of 5.32 (95 percent CI: 3.37 to 8.40). Furthermore, PRP therapy was associated with a reduction in wound healing time by an average of 25 to 35 percent and a significant reduction in wound surface area. CONCLUSIONS: Platelet-rich plasma constitutes an effective and safe method supporting the treatment of chronic and hard-to-heal wounds. Its use can lead to the acceleration of the healing process, an increase in the rate of complete wound closure, and an improvement in the patients' quality of life.
Copyright (c) 2026 Paulina Pawłowska, Szymon Piosik, Aleksandra Skorupa, Łukasz Piasecki, Natalia Dudziak, Marek Kochański https://creativecommons.org/licenses/by-nc-sa/4.0
Nutritional Support in Acute Respiratory Distress Syndrome (ARDS): A Comprehensive Literature Review On Clinical Strategies and Patient Outcomes
Introduction and purpose: Acute respiratory distress syndrome (ARDS) is a life-threatening condition and is a frequent reason for admitting patients to the Intensive Care Units. The treatment of ARDS remains an important task for physicians worldwide. Nutritional therapy is a significant part of managing critically ill patients. The aim of this study is to gather and present knowledge regarding nutrition support for patients diagnosed with ARDS. A brief description of the state of knowledge: Acute Respiratory Distress Syndrome (ARDS) is a severe inflammatory lung condition associated with high morbidity and mortality. While respiratory support remains the cornerstone of treatment, nutritional therapy has emerged as a critical component of care. Patients with ARDS experience increased metabolic demands and catabolism, necessitating individualized nutritional strategies to preserve muscle mass, support immune function, and improve clinical outcomes. Although enteral nutrition is preferred, parenteral routes are often required due to feeding intolerance or contraindications. Emerging evidence also supports the use of immune-modulating nutrients, such as omega-3 fatty acids and antioxidants, though clinical recommendations remain cautious pending further research. Refeeding syndrome remains a serious and potentially life-threatening complication necessitating careful monitoring and gradual reintroduction of nutrients. Conclusions: Nutritional support is a vital component in the management of ARDS, with significant implications for patient recovery and outcomes. Individualized strategies that address energy and protein needs, minimize the risk of refeeding syndrome, and consider both enteral and parenteral routes are essential. While immune-modulating nutrition holds promise, further high-quality studies are needed to establish its routine use. Integrating nutrition into ARDS care pathways may enhance treatment effectiveness and improve prognosis.
Copyright (c) 2026 Magdalena Jakubowicz-Pawlak, Natalia Kuchenbeker, Adriana Dojs, Julia Mierzwińska-Mucha, Katarzyna Siekaniec https://creativecommons.org/licenses/by-nc-sa/4.0
When Campylobacter jejuni affects the heart - myocarditis in male patients
Introduction: Campylobacter jejuni is a bacteria that is one of the most common causes of bacterial foodborne illness worldwide. The bacteria is typically transmitted through consumption of undercooked poultry, contaminated water, or unpasteurized dairy products. In addition to gastrointestinal symptoms such as diarrhea, abdominal cramps or fever, C. jejuni has been associated with post-infection sequelae, including rare cases of myocarditis. Although uncommon, myocarditis can result in arrhythmias, heart failure or even death, requiring prompt medical attention. Methods: This review consists of the latest papers, including cases, systematic reviews and cohorts. The analysis focuses on summarizing the C. jejuni infection-related myocarditis in male patients, in particular determining the time of onset of gastrointestinal and cardiovascular symptoms, and the results of additional tests leading to the diagnosis of myocarditis. Results: Among the 46 reported male patients with Campylobacter jejuni-associated myocarditis or myopericarditis, left ventricular systolic dysfunction was documented in 17 cases (39.5%). The time interval between the onset of gastrointestinal symptoms and the onset of chest pain was available for 43 patients, with a mean delay of 3,84 days (median 3 days; range 0-14 days), indicating a short but clearly discernible latency between enteric infection and myocardial involvement. Overall, only one of the 46 patients (2.2%) died, whereas all others survived to hospital discharge, indicating a generally favourable short-term prognosis despite the relatively high proportion of cases with impaired ventricular function. Conclusions: Proper food handling, cooking poultry to appropriate temperatures, and good hygiene practices are essential for prevention of C. jejuni infections. Quick and precise diagnosis of myocarditis prevents severe complications of the disease.
Copyright (c) 2026 Michalina Janiszewska, Maciej Sobkowiak, Paulina Sobkowiak, Justyna Jusiak, Janusz Łuczak, Justyna Dżumaga, Jeremi Łuczak, Maria Łazik, Roksana Dybowska, Marta Walaszek https://creativecommons.org/licenses/by-nc-sa/4.0
Exercise-based Rehabilitation in Chronic Heart Failure - A Narrative Review
Chronic heart failure is a widespread clinical condition associated with reduced exercise tolerance, impaired quality of life, and increased morbidity and mortality. Exercise-based cardiac rehabilitation represents an essential component of non-pharmacological management in patients with chronic heart failure; however, optimal training strategies and delivery models remain under discussion. This narrative review summarizes current evidence regarding the safety, efficacy, and feasibility of exercise-based rehabilitation across different heart failure phenotypes. The analysis includes conventional centre-based programs, home-based rehabilitation, telerehabilitation, and novel exercise modalities. Available evidence indicates that structured exercise training improves functional capacity, exercise tolerance, and health-related quality of life, regardless of rehabilitation setting. Combined aerobic and resistance training, as well as high-intensity interval training, appear to provide greater functional benefits than moderate continuous exercise, particularly under supervised conditions. Functional assessment using cardiopulmonary exercise testing remains the reference standard, while the six-minute walk test offers a practical alternative in routine clinical practice. Individualized, patient-centred rehabilitation strategies are crucial for optimizing outcomes and supporting long-term engagement in physical activity among patients with chronic heart failure.
Copyright (c) 2026 Patrycja Mateja, Katarzyna Fabiś, Mateusz Zbylut, Sylwia Buczek, Weronika Mstowska, Kamila Milewska, Karolina Bury, Hanna Naliuka, Katarzyna Młynarczyk, Ewa Byjoś https://creativecommons.org/licenses/by-nc-sa/4.0
The Management of chronic wounds: a current review for internal medicine physicians
Background: Chronic wounds are a growing clinical problem in older patients especially those with multimorbidity. Their healing is impaired by constant inflammation, skin cell dysfunction and bacterial biofilm presence. Aim: The aim of this review article is to present the current management of chronic wounds in internal medicine practice. Methodology: The study was conducted as a narrative review. A structured literature search was carried out using the following electronic databases: PubMed,Scopus, Web of Science, and Google Scholar. The search included publications released mainly between 2017 and 2025, in order to reflect current clinical practice and guideline recommendations. Results: The reviewed literature and articles confirm that internal medicine doctors play a key role in the chronic wound treatment. Firstly, they should concentrate on the etiology of the wound. Comorbidities are also worth considering. The TIME strategy is a structured framework for dealing with wounds. Selected additional therapies are mentioned including negative pressure wound therapy and larval therapy which are used to improve debridement and reduction of bacterial biofilm. All of these actions contribute to reducing the risk of complications, hospitalizations and amputations. Conclusion: Chronic wounds are still a complex and heterogeneous clinical problem. It requires an individualized diagnostic and therapeutic approach based on etiology. The internist actions are essential in early patient assessment, management of comorbidities and coordination of multidisciplinary care. In some cases advanced therapies such as negative pressure wound therapy or larval therapy need to be performed in order to achieve a better outcome.
Copyright (c) 2026 Sylwia Czesława Buczek, Ewa Byjoś, Katarzyna Fabiś, Mateusz Zbylut, Patrycja Mateja, Weronika Mstowska, Kamila Milewska, Karolina Bury, Katarzyna Młynarczyk, Hanna Naliuka https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Gut Microbiota-Targeted Interventions in the Treatment of Depression
Aim: This review summarizes current evidence on the role of gut microbiota modulation using probiotics, prebiotics, and synbiotics in the treatment of depression, with particular emphasis on clinical studies and mechanisms of the gut–brain axis. Introduction: Depression is a prevalent mood disorder affecting more than 280 million people worldwide and is often resistant to standard pharmacological and psychotherapeutic treatments. Growing evidence from animal and human studies indicates that gut microbiota influences brain function and emotional regulation. Dysbiosis may contribute to neuroinflammation, altered neurotransmitter activity, and dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, thereby worsening depressive symptoms. Methods: A review of meta-analyses and randomized controlled trials published between 2016 and 2024 was conducted. Studies included adults with depression or comorbid depression and anxiety who received probiotics, prebiotics, or synbiotics. Depression severity was assessed using validated clinical scales. Results: Probiotic supplementation, particularly multi-strain formulations containing Lactobacillus and Bifidobacterium, was associated with significant reductions in depressive symptoms. Proposed mechanisms include modulation of gut microbiota composition, decreased pro-inflammatory cytokines (IL-1, IL-6), regulation of the HPA axis, effects on neurotransmitter metabolism (serotonin, dopamine, GABA), production of short-chain fatty acids, and vagus nerve activation. Synbiotics may enhance these effects, whereas prebiotics alone showed inconsistent outcomes. Conclusion: Probiotics and synbiotics appear to be safe and promising adjuncts to standard depression treatment. Targeting the gut–brain axis may represent a future direction for personalized psychiatric interventions.
Copyright (c) 2026 Justyna Jusiak, Michalina Janiszewska, Maria Łazik, Janusz Łuczak, Paulina Sobkowiak, Maciej Sobkowiak, Justyna Dżumaga, Jeremi Łuczak, Roksana Dybowska, Marta Walaszek https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Choline (B4) in Muscle and Heart Health and Its Function - A Narrative Review
Background: Choline is an essential micronutrient critical for neurotransmitter synthesis, lipid metabolism, and cellular function. Evidence demonstrates its vital importance for skeletal muscle and cardiac function. Objective: This narrative review analyzes choline's role in muscle and cardiac health, the biochemical mechanisms supporting muscle contraction and cardiac function, and practical implications for athletes and cardiovascular patients. Methods: Systematic search of PubMed, Scopus, and Web of Science (2026) using keywords: choline, muscle health, acetylcholine, cardiac function, muscle contraction, cardiomyopathy and supplementation. Priority given to randomized controlled trials, mechanistic studies, and systematic reviews. Results: Choline serves as a precursor to acetylcholine (ACh), the primary neurotransmitter for neuromuscular transmission and muscle contraction initiation [1–4]. Deficiency is associated with reduced strength and impaired nerve-muscle signaling [1,2,5–8]. Chronic deficiency decreases phosphatidylcholine synthesis, impairing muscle membrane integrity [9–11]. In cardiac health, choline and betaine lower homocysteine levels, a cardiovascular risk factor [12–14], and demonstrate cardioprotective effects through oxidative stress reduction and enhanced parasympathetic function [15–17]. Adequate intake (550 mg/day men; 425 mg/day women) is obtained through meat, seafood, eggs, legumes, and cruciferous vegetables [18–20]. Choline supplementation may improve endurance performance during intense exercise exceeding 2 hours [21,22]. Conclusions: Choline is essential for muscle health as an acetylcholine precursor and membrane lipid component, supporting contraction and protein synthesis. For cardiac health, choline reduces disease risk by lowering homocysteine and reducing oxidative stress. Adequate choline is vital for athletic performance and may support cardiac function in cardiovascular disease patients.
Copyright (c) 2026 Tamara Korohod, Martyna Pietrzak-Chmiel , Paulina Ramaneckaite, Agnieszka Binkiewicz, Maciej Ślesik https://creativecommons.org/licenses/by-nc-sa/4.0
Bone and joint infections: clinical forms, risk factors, prevention, etiology, diagnosis and treatment
Bone and joint infections pose many threats to human life and health. The scope of knowledge and skills to deal with this problem has improved significantly in recent years. The chosen direction should be continued so that we can prevent and treat bone and joint infections with the highest possible effectiveness.
Copyright (c) 2026 Paweł Arkadiusz Malmur, Aleksandra Romanowska, Weronika Biaduń-Mućko, Kinga Rogowska-Borettini, Aleksandra Padkowska, Jakub Maciej Pieniążek, Klaudia Arciszewska, Mateusz Dobosz https://creativecommons.org/licenses/by-nc-sa/4.0
Effectiveness of Different Intranasal Corticosteroid Delivery Methods in the Management of Chronic Rhinosinusitis with Nasal Polyps: A Comparative Review of Sprays, High-volume Irrigations, Exhalation Delivery Systems and Steroid-Eluting Stents.
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory condition of the nose and paranasal sinuses persisting for 12 weeks or more. It is associated with substantial symptom burden and reduced quality of life. While intranasal corticosteroids (INCS) continue to be the baseline of treatment, their clinical efficacy is often hindered by suboptimal delivery. In order to improve patients' quality of life and decrease topical corticosteroid usage, special attention is paid to the role of health education in both the prevention and therapy of the condition. Aim: This study aims to systematically compare the effectiveness and clinical outcomes of four major intranasal corticosteroid (INCS) delivery methods - conventional sprays, high-volume rinses, exhalation delivery systems, and steroid-eluting stents - in the management of CRSwNP. Material and methods of research: This study is a brief review of the available literature mainly in the PubMed database and a comparison of the effectiveness of different intranasal corticosteroid delivery methods, with a focus on their therapeutic approach. Particular focus is given to adapting delivery method to patient’s condition and medical history. Specifically, the review evaluates patient-relevant outcomes, including disease-specific quality of life, symptom control, polyp size reduction, and the need for surgical intervention. By addressing these objectives, this study seeks to provide clinicians with concise guide for selecting the most appropriate delivery method tailored to individual patient and clinical context. Results: Across RCTs and systematic reviews, all topical corticosteroid strategies outperform placebo. Methods that enhance sinonasal deposition (high-volume irrigations and EDS) demonstrate larger and more consistent effects on polyp size and patient-reported outcomes than conventional sprays, particularly in post-surgical anatomy.
Copyright (c) 2026 Zuzanna Kowalska, Maciej Bulwa, Małgorzata Filak, Katarzyna Cetera-Szmajduch , Anna Byra, Marta Kowalczyk, Jan Frey, Alicja Białas, Krzysztof Miazga https://creativecommons.org/licenses/by-nc-sa/4.0
Current strategies in the management of melasma: pathogenesis, risk factors and comprehensive treatment approaches
Melasma is an acquired pigmentary disorder characterized by symmetric hyperpigmented macules and patches on sun‑exposed facial areas. Its multifactorial pathogenesis includes melanocyte hyperactivity, dermal melanophages, vascular and inflammatory components, oxidative stress and hormonal drivers. Because of its chronic, relapsing nature and high risk of recurrence, melasma management requires individualized, multimodal approaches combining strict photoprotection, topical agents, systemic medications when indicated, and procedure‑based therapies for refractory or mixed cases. This review summarizes current knowledge of pathomechanisms and precipitating factors, evaluates therapeutic options (topical, systemic and procedural), compares modalities, and proposes practical algorithms for management and maintenance.
Copyright (c) 2026 Marta Walaszek, Justyna Jusiak, Jeremi Luczak, Maciej Sobkowiak, Paulina Sobkowiak, Janusz Łuczak, Justyna Dżumaga, Michalina Janiszewska, Maria Łazik, Roksana Dybowska https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Physical Activity in the Prevention and Treatment of Depressive Disorders
Background: Depressive disorders are among the leading contributors to global disability, affecting millions worldwide and imposing a major burden on public health systems. While pharmacotherapy and psychotherapy remain primary treatment modalities, physical activity (PA) has emerged as a promising strategy for both prevention and treatment of depression. Methods: This narrative review synthesizes evidence from high-quality meta-analyses, systematic reviews, prospective cohorts, randomized trials, and mechanistic research published between 2000 and 2025. Studies were selected based on relevance to PA’s preventive or therapeutic effects on depression and its underlying mechanisms. Results: Robust evidence indicates that higher levels of PA reduce the risk of incident depression by approximately 15–30% across populations [1–4]. Longitudinal studies demonstrate temporal and dose–response associations, fulfilling several Bradford Hill criteria. Exercise interventions produce moderate-to-large therapeutic effects in adults [5–7], significant improvements in adolescents and young adults [8], and additional benefits across perinatal, elderly, and medically comorbid groups [9–12]. Mechanistic research highlights neurobiological pathways, anti-inflammatory responses, autonomic improvements, enhanced cognitive function, and psychosocial resilience [13–18]. Conclusion: PA is a safe, feasible, and clinically meaningful intervention for preventing depressive disorders and improving outcomes among individuals with depression. Integrating structured exercise and lifestyle PA counselling within mental health and primary-care settings may enhance recovery, reduce cardiometabolic risk, and improve long-term prognosis.
Copyright (c) 2026 Katarzyna Młynarczyk, Sylwia Buczek, Karolina Bury; Ewa Byjoś; Katarzyna Fabiś, Patrycja Mateja, Kamila Milewska, Weronika Mstowska, Hanna Naliuka, Mateusz Zbylut https://creativecommons.org/licenses/by-nc-sa/4.0
Impact of Creatine Supplementation on Muscle and Bone Strength in Older Adults: A Narrative Review
Introduction and purpose: Age-related declines in skeletal muscle mass and strength, together with bone loss, reduce physical performance and increase frailty and fall risk in older adults. Creatine supplementation has been proposed as a supportive and potentially preventive strategy due to its role in cellular energy buffering and its capacity to augment exercise training adaptations. This narrative review summarizes current evidence on the effects of creatine supplementation on muscle strength and function and on bone-related outcomes in older adults. Review methods: A narrative review of the literature was conducted using PubMed and Google Scholar. Peer-reviewed studies published between 2000 and 2025 examining creatine supplementation and muscle- or bone-related outcomes in adults were included. Brief description of the state of knowledge: Evidence from randomized trials and meta-analyses indicates that creatine supplementation combined with progressive resistance training increases lean mass and improves dynamic strength and functional performance in older adults more consistently than resistance training alone. Mechanistically, benefits are biologically plausible through increased intramuscular creatine/phosphocreatine availability, improved high-intensity exercise capacity, and downstream anabolic signaling that supports training responsiveness. In contrast, effects on areal bone mineral density measured by DXA are generally neutral in long-term trials and pooled analyses. Summary (conclusions): Creatine is a well-studied supplement that, when paired with resistance training, reliably enhances lean mass and muscle strength in older adults. Current evidence does not support creatine as an effective stand-alone strategy to increase areal BMD, but potential benefits warrant further adequately powered, long-duration trials, particularly in sarcopenic and osteopenic populations.
Copyright (c) 2026 Paweł Michalak, Konrad Borowski, Oskar Pastuszek, Maja Radziwon, Emilia Bolesta-Okuniewska, Aleksandra Marchwińska-Pancer, Katarzyna Kopeć, Julia Ceryn, Anna Wicher https://creativecommons.org/licenses/by-nc-sa/4.0
Breastfeeding and postpartum depression mechanisms and care
Objective: To synthesize evidence on the association between breastfeeding and postpartum depression, emphasizing bidirectionality, proposed mechanisms, key modifiers (self-efficacy, stress and social support), and integrated intervention strategies. Methods: Narrative review of the peer-reviewed literature provided by the author, prioritizing meta-analyses, systematic reviews, randomized trials, and large observational or qualitative studies. Results: Across settings, postpartum depressive symptoms are associated with reduced breastfeeding initiation, exclusivity, and duration. Early cessation and negative breastfeeding experiences are also associated with higher depressive symptom burden in some populations. Self-efficacy and social support consistently correlate with both mood and feeding outcomes, and stress appears to amplify risk. Interventions spanning pregnancy through the postpartum period and combining lactation support with psychosocial care show the most consistent promise. Conclusions: Because breastfeeding and postpartum depression influence one another and share modifiable determinants, clinical pathways should integrate screening, individualized feeding support, and stepped mental health care.
How Does the Use of Dating Apps Relate to Physical Health Behaviors and Mental Health? A Narrative Review
Dating applications have becom e a central component of contemporary romantic and s ocial interactions, particular ly among adolescents, young ad ults, and emerging adults. While the se platforms offer opportuniti es for social connection, accu mulating evidence suggests tha t dating app use may be associ ated with a range of mental health outco mes and physical health–relate d behaviors. Research in this area remains fragmented, with findings dispersed across psychological, behavioral, and public health disciplines. Aim. The aim of this narrative revi ew is to synthesize and critic ally analyze existing research on the relationship between datin g app use, mental health outco mes, and physical health behaviors. Material and methods. A narrative review of peer- reviewed literature was conduc ted using articles provided by the author. The included studies encompass ed cross-sectional, longitudin al, diary-based, and review designs examining d ating app use in relation to m ental health indicators. Results. The reviewed literature indica tes that dating app use is ass ociated with diverse mental he alth outcomes, including depre ssive symptoms, anxiety, lonel iness, body dissatisfaction, and self-esteem fluctuations. Additionally, dating app engagement has been linked to several physical health behavi ors, such as risky sexual prac tices, sexually transmitted in fection risk, alcohol and subs tance use, sleep disturbances, and unhealthy weight-control b ehaviors. Conclusions. Dating app use appears to be meaningfully related to bot h mental health and physical h ealth behaviors, although the direction and strength of thes e associations vary across pop ulations and study designs. Fu rther longitudinal and theory- driven research is needed to c larify causal mechanisms and to inform health education, pr evention, and public health interventions.
Copyright (c) 2026 Justyna Dżumaga, Michalina Janiszewska, Maciej Sobkowiak, Paulina Sobkowiak, Justyna Jusiak, Janusz Łuczak, Jeremi Łuczak, Maria Łazik, Roksana Dybowska, Marta Walaszek https://creativecommons.org/licenses/by-nc-sa/4.0
Psychosomatic Disorders and the Physician-Patient Relationship - A Review
Introduction and Aim: Psychosomatic disorders present a significant challenge in medicine, where somatic symptoms are closely connected to psychological and social factors. Family physicians play a central role in recognizing and managing these patients, whose complex needs often lead to repeated consultations and increased healthcare utilization. This review aims to analyze the physician-patient relationship in the care of patients with psychosomatic disorders and its impact on diagnosis and treatment. Materials and Methods: The study is a literature review including scientific articles, monographs and textbooks in family medicine, psychosomatics and clinical psychology. Literature was searched in PubMed, Scopus, Web of Science and Google Scholar. Publications were selected based on relevance, scientific value and focus on physician-patient interaction, communication, patient personality traits and the role of Balint groups. State of Knowledge: Psychosomatic disorders manifest in cardiovascular diseases, peptic ulcers, eating disorders, skin diseases and sleep disorders with psychological factors influencing symptom development and course. Effective care relies on a biopsychosocial approach, empathetic communication and physician awareness of relational dynamics. Participation in Balint groups enhances empathy, improves patient communication and reduces physician burnout. Conclusions: The physician-patient relationship is a key therapeutic tool in psychosomatic care. Holistic treatment addressing both somatic and psychological needs, combined with effective communication and physician self-awareness, improves patient outcomes and fosters long-term therapeutic engagement.
Copyright (c) 2026 Michał Włodarczyk, Maria Skommer https://creativecommons.org/licenses/by-nc-sa/4.0
Contagious molluscum in swimmers with atopic dermatitis: transmission risk, clinical challenges and impact on sports participation - a narrative review
Background. Molluscum contagiosum (MC) is a common cutaneous poxvirus infection transmitted primarily through direct skin-to-skin contact and autoinoculation, with indirect spread via fomites considered plausible in shared environments. Swimmers may face heightened exposure to communal facilities and equipment, while atopic dermatitis (AD) can amplify susceptibility and disease burden through skin-barrier dysfunction and itch-driven dissemination. These factors can create clinical uncertainty about transmission risk, complicate management, and contribute to unnecessary restriction from training and competition. Material and methods. A narrative review was conducted using targeted searches of PubMed/MEDLINE and Google Scholar, supplemented by screening of reference lists and verification through official journal/publisher records. Search terms combined MC with AD-related constructs (eczema, filaggrin/barrier dysfunction) and aquatic/sport contexts (swimming, pools, athletes, transmission, fomites, return-to-play), and were expanded to include contemporary therapeutics relevant to clearance timelines. Results. The evidence base supports contact and autoinoculation as the dominant transmission pathways for MC, while direct evidence for chlorinated pool water as a primary vehicle remains limited; the swimmer setting is more plausibly “facility-associated” through shared surfaces, changing areas, and personal items. AD consistently emerges as a risk amplifier and phenotype modifier, with barrier dysfunction and pruritus promoting wider lesion dissemination and eczematization that can obscure diagnosis and complicate treatment tolerability. Therapeutic advances supported by randomized trials, including provider-applied cantharidin 0.7% formulations and topical nitric oxide–releasing berdazimer gel, offer practical options to reduce lesion burden and support time-sensitive participation planning.
Copyright (c) 2026 Oksana Zinko, Aleksandra Zimnoch-Włodarczyk, Maciej Łapiński, Michał Napierała, Kinga Ciecierska, Krystyna Wasilkowska, Sylwia Łatkowska, Laura Więcek, Kinga Ściurka https://creativecommons.org/licenses/by-nc-sa/4.0
Dietary Patterns and Supplementation in Depression and Anxiety: A Comprehensive Literature Review
Introduction and purpose: Depression and anxiety frequently co-occur and cause substantial functional burden. Nutrition - especially diet quality and supplementation - has been studied as a modifiable factor. This comprehensive literature review summarised evidence on dietary patterns and selected supplements in relation to depressive and anxiety symptoms. Material and methods: A narrative synthesis was performed using 32 articles (systematic reviews/meta-analyses, randomised trials, observational and mechanistic papers). The scope covered diet quality and dietary patterns, whole-of-diet interventions, gut–brain axis concepts, and supplementation with omega-3 fatty acids, B vitamins, magnesium, vitamin D, zinc, and probiotics. Results: Prospective evidence generally linked higher diet quality with lower depression risk. Whole-diet intervention trials showed mixed results, with several studies reporting improvements in depressive outcomes; anxiety outcomes were less consistent. Mechanistic literature supports plausibility through inflammation/oxidative pathways, serotonergic neurotransmission, and diet–microbiota interactions. Among supplements, evidence is most developed for omega-3 fatty acids (dose-response signals for anxiety) and magnesium (benefits in trials and meta-analysis), while findings for vitamin D, B vitamins, zinc and probiotics vary across studies. Conclusions: Diet quality improvement and selected supplements may offer adjunctive benefits for some individuals, but effects are heterogeneous and should not be overgeneralised. Nutritional strategies should be integrated with evidence-based mental health care, with timely clinical assessment and standard treatments used when indicated.
Copyright (c) 2026 Marta Kowalska, Zofia Kosztyła-Czech, Tomasz Wiśniewski, Michał Dworak, Mateusz Matyja, Wiktoria Ciszewska, Anna Mazur, Julia Brodziak https://creativecommons.org/licenses/by-nc-sa/4.0
Effects of Exercise on Inflammatory Biomarkers in Rheumatoid Arthritis
Background Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by persistent synovial inflammation leading to joint destruction, disability, and increased cardiovascular risk. Exercise is increasingly recognized as a non-pharmacological therapy that may modulate inflammation and improve clinical outcomes in RA. Aim The aim of this review was to evaluate the effects of different exercise modalities on inflammatory biomarkers in individuals with RA. Material and methods A narrative review was conducted using studies published in peer-reviewed journals, identified through databases such as PubMed. Randomized controlled trials, clinical interventions, and systematic reviews assessing the impact of aerobic, resistance, and combined training on inflammatory markers in adults with RA were included. Data were extracted on exercise protocols, biomarker outcomes, and methodological quality. Results: Exercise interventions in RA show variable effects on inflammatory biomarkers. Aerobic training consistently reduces CRP and TNF-α, while effects on IL-6 and ESR are less consistent. Resistance training primarily lowers ESR and CRP, with transient changes in interleukins. Combined aerobic and resistance programs demonstrate the broadest anti-inflammatory impact, reducing CRP and IL-6, modulating regulatory T and B cells, and improving disease activity and quality of life. Short-term, moderate-intensity, and home-based interventions are safe and effective, whereas low-intensity exercise shows limited biomarker changes. Conclusions: Regular exercise is safe and beneficial for patients with RA, reducing disease activity, improving physical function, and modulating inflammatory biomarkers, particularly CRP and IL-6. Combined aerobic and resistance training offers the broadest anti-inflammatory and clinical benefits. Further research is needed to determine the most effective interventions for targeted modulation of inflammation.
Copyright (c) 2026 Julia Dusiel, Anna Wałachowska, Alicja Tabian, Paulina Kozłowska, Jakub Smęt, Aleksandra Beata Chojnacka, Jacek Borawski, Julia Burdon-Sajnóg, Zofia Szymona-Kuciewicz, Klaudia Katarzyna Bartela https://creativecommons.org/licenses/by-nc-sa/4.0
Rosacea and Anxiety Disorders - Psychosocial Impact, Quality of Life and Integrated Management
Introduction and purpose: Rosacea is a chronic inflammatory facial skin disease that may be associated with significant psychosocial burden. Studies indicate that affected individuals may experience anxiety, reduced self-esteem and lower quality of life compared with the general population. This review aims to summarize current evidence on the epidemiology, pathophysiology, psychosocial impact and integrated management of rosacea with coexisting anxiety disorders. Materials and methods: A literature review was performed using PubMed and Google Scholar, focusing on English-language publications. Priority was given to systematic reviews, meta-analyses, randomized controlled trials and observational studies. State of knowledge: Rosacea is a common chronic inflammatory skin disease in adults, more frequently reported in women and individuals with fair skin. Its etiopathogenesis is thought to involve immune dysregulation, neurovascular abnormalities and skin-brain axis dysfunction. Facial manifestations are associated with an increased risk of social anxiety, internalized stigma and reduced quality of life. Studies indicate that patients with rosacea may have an over twofold increased risk of anxiety disorders compared with the general population. Evidence suggests that dermatological treatment, combined with cognitive-behavioral therapy and stress management, can improve skin symptoms and psychological well-being. Conclusions: The bidirectional link between rosacea and anxiety disorders highlights the need for holistic management. Combining dermatological treatment with mental health assessment and psychological support may improve quality of life, reduce psychosocial burden and help interrupt the cycle of stress and disease exacerbation.
Copyright (c) 2026 Angelika Radziszewska-Trojniak, Michał Włodarczyk https://creativecommons.org/licenses/by-nc-sa/4.0
Pain and Pathological Fractures as Primary Causes of Mobility Impairment in Multiple Myeloma
Background: Multiple myeloma (MM) is a malignant plasma cell disorder frequently complicated by skeletal involvement, affecting up to 80% of patients. Osteolytic lesions, pathological fractures, spinal instability, and chronic pain lead to functional impairment, neurological complications, and reduced quality of life. Bone disease in MM results from an imbalance between bone resorption and formation caused by dysregulation of the RANK/RANKL/OPG pathway. Aim: To review current literature on bone disease in multiple myeloma with emphasis on functional impairment, rehabilitation, and the role of orthopedic equipment in patient care. Material and methods: A narrative review was conducted using PubMed, Scopus, Google Scholar, and Polish medical databases. Articles published in English or Polish concerning adult MM patients with skeletal complications were included and analyzed qualitatively. Results: The literature shows that bone pain and pathological fractures, particularly in the spine, pelvis, ribs, and long bones, are major causes of disability and limited mobility. Pharmacological treatment, radiotherapy, and minimally invasive procedures such as vertebroplasty and kyphoplasty reduce pain and improve stability. Rehabilitation improves muscle strength, balance, and mobility. Orthopedic devices, including spinal orthoses, walkers, and crutches, increase safety and support daily activities. Conclusion: Skeletal complications remain a significant source of disability in patients with multiple myeloma. A multidisciplinary approach combining pharmacological treatment, interventional procedures, rehabilitation, and orthopedic support is essential to improve functional capacity and quality of life.
Copyright (c) 2026 Ewa Byjoś, Sylwia Buczek, Mateusz Zbylut, Weronika Mstowska, Kamila Milewska, Karolina Bury, Hanna Naliuka, Katarzyna Młynarczyk, Katarzyna Fabiś, Patrycja Mateja https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Physical Activity in the Prevention and Management of Various Cancers
Background: Cancers remain a leading cause of mortality in a modern society, and their incidence is growing each year. The disease and its related therapies cause considerable side effects, functional deterioration, and reduce quality of life (QoL), all of which correlate with less favourable outcomes. Physical activity (PA) represents a cost-effective and non-invasive adjunct to the traditional therapy regimes, which can alleviate these negative effects and improve clinical outcomes Aim: The narrative review summarises current evidence about the role of PA in oncology. It provides a solid background in biochemical mechanisms involved in the modulation of cancer biology and evaluates its clinical significance by assessing psychological, physiological, cognitive, QoL and mortality rates Methods: We conducted a narrative review of the available literature on the role of physical activity in modulating physiological and functional parameters, as well as mortality, in cancer patients. We considered original studies, reviews, systematic reviews and meta-analyses. Results: Evidence indicates that PA is an effective tool in both the prevention and management of cancers. Patients who engage in PA have improved metabolic, immune and oxidative stress parameters, which provide clinical outcomes such as improved QoL, cognitive, psychological and physiological performance. This consequently leads to a better prevention of cancers and provides benefits in terms of overall survival Conclusions: PA is an effective strategy for enhancing clinical outcomes in the cancer population and should be considered as an additional approach integrated into clinical guidelines.
Copyright (c) 2026 Roman Cemaga, Patryk Hebda, Mieszko Czapliński, Ewa Szplit, Mikołaj Patalong, Paweł Pustuła, Katarzyna Więckowska, Bartłomiej Błaszkowski, Adam Wolski, Mateusz Kubicki https://creativecommons.org/licenses/by-nc-sa/4.0
Treatment of post-dural puncture headache: current strategies and literature review
Introduction and purpose Post-dural puncture headache (PDPH) is an iatrogenic complication of lumbar puncture and neuraxial procedures, characterized by an orthostatic headache that typically develops within 48–72 hours following dural puncture. The pathophysiology of PDPH is primarily associated with cerebrospinal fluid leakage, leading to decreased intracranial pressure, traction of pain-sensitive intracranial structures, and secondary cerebral vasodilation. The incidence of PDPH depends on patient-related factors as well as technical aspects of the procedure, with the highest risk observed in young women, particularly in the obstetric population. Diagnosis is based on the characteristic clinical presentation in temporal association with a recent neuraxial intervention. Management includes conservative and pharmacological approaches; however, in refractory cases, the epidural blood patch remains the most effective therapeutic intervention. Material and methods The literature available in Pubmed and Google Scholar databases was conducted using the key words. Results The literature review indicates that post-dural puncture headache remains a common complication following dural puncture procedures. Conservative management, including bed rest, hydration, caffeine administration, and analgesics, is often effective in mild cases. In patients with persistent or severe symptoms, interventional methods—most notably the epidural blood patch—demonstrate high efficacy and rapid symptom relief. Conclusions Post-dural puncture headache is a clinically significant condition that may substantially affect patient comfort and recovery. Current evidence supports a stepwise approach to treatment, beginning with conservative measures and progressing to interventional therapies when necessary. The epidural blood patch remains the gold standard for refractory cases.
Copyright (c) 2026 Oliwia Osiak, Maja Pękala, Katarzyna Niedziółka, Jakub Ignatowicz, Maria Ochwat, Kinga Marczuk, Klaudia Nowak, Lidia Radomyska https://creativecommons.org/licenses/by-nc-sa/4.0
Ankle Sprain: A Common but Often Overlooked Injury – A Review of Causes, Treatment, and Rehabilitation
Introduction: Ankle sprains are a common injury affecting millions of people worldwide. While many cases are mild, they can lead to chronic joint instability, functional limitations and an increased risk of recurrence. Sprains most commonly involve the lateral ligaments of the joint, particularly ATFL, and in more complex cases, may also affect other structures, resulting in the high treatment costs. Aim: The aim of this article is to present modern methods of diagnosis, treatment and rehabilitation of ankle sprains, including innovative therapies and technologies that support recovery. Methods: A search of PubMed, Web of Science and Google Scholar was conducted. Included were randomized controlled trials, systematic review and meta-analyses of ankle sprain treatment and rehabilitation strategies. Results: An ankle sprain, if not treated properly, can lead to chronic instability, functional limitations and the risk of recurrence. Early diagnosis, intervention are crucial. Modern therapeutic methods such as micro-needle knives, electroacupuncture and rehabilitation robots offer promising treatment options. Integration of traditional methods with innovative technologies can speed up rehabilitation, improve joint stability and reduce the risk of recurrence. Conclusion: An ankle sprain, despite its initially mild nature,can lead to long term functional consequences. Early diagnosis and appropriate therapeutic intervention are crucial to minimise the risk of chronic instability and other complications. Modern diagnostic technologies and biological therapies are promising treatment options, accelerating the rehabilitation process and improving functional outcomes. However, these innovative methods require further research and verification of the reliability of the results obtained, as they are still in the early stages of development.
Copyright (c) 2026 Agnieszka Morawa, Karolina Osińska, Marcin Schulz, Michał Kulczak, Dawid Studziński, Anna Kołcz https://creativecommons.org/licenses/by-nc-sa/4.0
Dynapenia syndrome in geriatrics – clinical characteristics, distinction from sarcopenia, and contemporary therapeutic approaches
Introduction Dynapenia is an age-related loss of muscle strength despite preserved muscle mass, leading to functional decline, loss of independence, falls, and higher mortality. Its development is influenced by neuromuscular, endocrine, and metabolic changes, compounded by chronic inflammation, low activity, and inadequate nutrition. Results Resistance training is the most effective strategy to mitigate strength loss, enhancing neuromuscular function and physical performance. Aerobic exercise improves endurance and mobility. Adequate protein intake (1.0–1.2 g/kg) and supplementation with vitamin D, creatine, leucine, and omega-3 fatty acids support training adaptations. Early detection via handgrip strength allows timely interventions. Discussion Combining targeted exercise with optimal nutrition and supplementation maintains strength and independence in older adults. Interventions should be individualized based on health and functional status. Emerging molecular and gene-based therapies are experimental but may complement lifestyle approaches. Conclusion Dynapenia is not inevitable with aging. Early recognition, regular training, and proper nutrition can slow strength loss, reduce fall risk, and improve well-being. Materials and methods A review of scientific articles from PubMed, Google Scholar, and Dove Press Medical focused on dynapenia, muscle aging, and physical and nutritional interventions in older adults.
Copyright (c) 2026 Paulina Malon, Karol Śliwa, Anita Pieńkowska, Aleksandra Trojańska, Nel Geworkian, Natalia Hariasz, Martyna Pietz, Anita Szymańska https://creativecommons.org/licenses/by-nc-sa/4.0
Hypercalcemia of Malignancy: Diagnostic and Therapeutic Challenges
Background. Malignancy-associated hypercalcemia (HHM) is a frequent metabolic complication in advanced cancer, often leading to neurological deterioration, cardiovascular disturbances, reduced functional status, and shorter survival. In palliative care, timely diagnosis and management of HHM are essential to improve symptom control and patient comfort. Aim. To present a comprehensive, evidence-based review of current diagnostic and therapeutic approaches to hypercalcemia of malignancy, with a focus on palliative care settings. Material and methods. A narrative review was conducted using databases such as PubMed, MEDLINE, Google Scholar, and Europe PMC. Fifty-six articles published between 1994 and 2024 were selected based on clinical relevance and scientific quality. Results. Hypercalcemia in malignancy arises predominantly from PTHrP secretion, calcitriol overproduction, or local osteolysis. Diagnostic workup includes calcium profile, PTH/PTHrP levels, and imaging. Management involves intravenous hydration, bisphosphonates, denosumab, glucocorticosteroids, and—occasionally—calcitonin or hemodialysis. Timely treatment improves symptoms and may enable continuation of oncologic therapies. In palliative patients, hypercalcemia often necessitates a shift toward comfort-focused care and underscores the importance of interdisciplinary management. Conclusions. Malignancy-associated hypercalcemia significantly worsens prognosis and quality of life in advanced cancer. Individualized treatment—including rehydration, anti-resorptive agents, and symptom control—is essential. Effective calcium regulation alleviates suffering, facilitates supportive care, and should be integrated into comprehensive palliative strategies.
Copyright (c) 2026 Dominika Bachurska, Zuzanna Czach, Magdalena Ignarska, Justyna Ignarska, Oliwia Grygorczuk https://creativecommons.org/licenses/by-nc-sa/4.0
Semaglutide-Induced Weight Loss: Consequences for Muscle Mass and Functional Outcomes
Introduction: Semaglutide (Ozempic) is a long-acting GLP-1 receptor agonist used in the treatment of type 2 diabetes and obesity. Its potent effects on appetite suppression, delayed gastric emptying, and weight reduction are well documented. Increasing scientific attention has focused on its potential influence on lean body mass and skeletal muscle, as emerging evidence suggests that semaglutide-induced weight loss may include clinically relevant reductions in muscle mass. Understanding the extent and significance of these changes is essential for safe long-term therapy. Material and Methods of Research: A literature review was conducted using PubMed, Google Scholar, and Scopus. Clinical trials, observational studies, meta-analyses, and relevant preclinical research published in English between 2018 and 2024 were analyzed. Results:Evidence indicates that semaglutide-induced weight loss consistently leads to reductions in lean mass, typically comprising 20–40% of total weight lost. Mechanisms include caloric deficit, reduced protein intake, appetite suppression, and changes in anabolic signalin. Several studies demonstrated preserved muscle strength or stabilization of lean mass when therapy was combined with adequate protein intake and resistance training. Preclinical findings suggest that part of the lean mass reduction is reversible after treatment discontinuation. Conclusion: Semaglutide affects muscle mass primarily indirectly through appetite suppression and significant weight reduction. While lean mass loss is common, functional muscle decline is not inevitable and may be mitigated through dietary optimization and structured physical activity. Regular monitoring of body composition should be considered during semaglutide therapy.
Copyright (c) 2026 Barbara Reizer, Zofia Botto, Klaudia Krystek, Patrycja Felisiak, Dominika Kowalczyk, Zofia Śliwa, Dominik Andrzej Ślazyk https://creativecommons.org/licenses/by-nc-sa/4.0
Effects of Physical Activity on Female and Male Fertility: A Literature Review
Introduction: Infertility affects an estimated 60–80 million couples globally and represents a growing public health concern. Its etiology is multifactorial, with modifiable lifestyle and environmental factors playing a significant role. Among these, physical activity is increasingly recognized as a relevant contributor, although its precise impact on reproductive outcomes remains unclear. Promoting balanced, evidence-based strategies—including appropriate physical activity during the periconceptional period—should be considered a shared responsibility in preconception care. Objective: This review aims to synthesize current evidence on the role of physical activity in fertility, highlighting its relevance to both sexes. It discusses exercise types that support reproductive potential, contrasts them with potentially harmful modalities, and explores underlying physiological and cellular mechanisms. Conclusion: Couples planning pregnancy should appropriately adjust their lifestyle by engaging in moderate and regular physical activity suited to their individual capacity, while avoiding high-intensity or strenuous exercise. Infertility arises from both female and male factors, with each contributing to roughly half of all cases. High-intensity physical activity may impair fertility by contributing to menstrual cycle disturbances in women and reduced sperm quality in men. Both sexes have been shown to exhibit dysregulation of the hypothalamic–pituitary–gonadal axis under such conditions. Despite the abundance of literature on the subject, there is still a lack of conclusive evidence identifying the most beneficial type of physical activity for couples trying to conceive. Future research should focus on designing highly standardized studies that will serve as a foundation for clear and evidence-based lifestyle recommendations supporting reproductive health.
Copyright (c) 2026 Natalia Syncerz, Katarzyna Czajka, Katarzyna Zadrożna, Piotr Dryżałowski, Sara Steć, Bartłomiej Wójcik, Julia Borodacz, Martyna Czampiel, Michał Nawracaj, Julia Bort https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of physical activity and screen time on mental, physical and social health in children and adolescents: a narrative review
Background: Digital technologies have become deeply embedded in the everyday lives of children and adolescents, while physical activity levels are declining in many countries. These parallel trends raise concerns about their impact on mental, physical and social health. Aim: The aim of this narrative review is to summarize current knowledge on the relationships between physical activity, different forms of screen use (including social media and problematic smartphone use) and health outcomes in youth. Results: Evidence from reviews and large observational studies indicates that high total screen time is associated with more depressive and anxiety symptoms, reduced wellbeing, sleep disturbances, obesity and school difficulties. Intensive social media use and problematic smartphone use show particularly strong links with depression, anxiety, loneliness and functional impairment, and may display addiction-like features. In contrast, regular physical activity is consistently related to better mental health, higher life satisfaction and healthier sleep patterns, and may partly buffer the negative effects of excessive screen exposure. Sleep, loneliness and family context appear as important mediators and moderators of these associations. Conclusions: Excessive screen time and problematic smartphone use represent modifiable risk factors for youth health, whereas physical activity is a central protective factor that supports healthy development. Prevention strategies should therefore focus on promoting regular movement, setting limits on evening and night-time screen use, supporting healthy sleep hygiene and encouraging balanced, purposeful use of digital media in families, schools and health care settings.
Copyright (c) 2026 Dawid Stępień, Natalia Nawrocka, Alicja Hojda, Filip Bednarek, Izabela Małajewicz, Olga Plinta, Małgorzata Pietrzyk, Hanna Rodak, Karolina Oskroba https://creativecommons.org/licenses/by-nc-sa/4.0
EVALI: Current Understanding of Its Pathophysiology, Diagnosis, and Management
Background: E-cigarette, or Vaping, product use-Associated Lung Injury (EVALI) emerged in 2019 as a novel clinical syndrome, posing a significant public health challenge linked to the inhalation of aerosols from e-cigarette or vaping products, particularly those containing tetrahydrocannabinol (THC) and vitamin E acetate (VEA). Aim: This narrative review synthesizes the current understanding of EVALI's pathophysiology, diagnostic approach, and management principles, drawing upon evidence published from 2017 to 2024. Material and Methods: We conducted a comprehensive narrative synthesis of literature from 2017–2024, focusing on etiological studies, clinical case series, public health reports, and reviews detailing the mechanisms, clinical presentation, diagnostic criteria, and therapeutic outcomes of EVALI. Results: The pathophysiology involves a complex interplay of direct chemical pneumonitis, surfactant dysfunction, and acute lung injury patterns triggered primarily by VEA. Clinical presentation includes respiratory, gastrointestinal, and constitutional symptoms. Diagnosis relies on a meticulous history of vaping, consistent radiological findings (typically bilateral ground-glass opacities on CT), and exclusion of infection. Management is primarily supportive, with systemic glucocorticoids showing efficacy in reducing inflammation and improving outcomes in moderate to severe cases. Conclusions: EVALI represents a severe form of inhalational lung injury directly attributable to toxic substances like VEA in vaping aerosols. While the peak incidence has subsided, it underscores the ongoing risks of unregulated vaping products and highlights critical gaps regarding long-term sequelae. Continued surveillance, public health education, and further research are imperative.
Copyright (c) 2026 Bartłomiej Maciej Wrochna, Anna Olborska, Agnieszka Brzozowska, Gabriela Stondzik, Ada Niezgoda, Anna Izabela Garbacz, Paweł Kosiorek, Agnieszka Radziwonka, Tomasz Julian Majszyk, Jacek Głuski, Patrycja Anna Borowiecka, Aleksandra Węglarz https://creativecommons.org/licenses/by-nc-sa/4.0
Rehabilitation Strategies and Pain Management in Athletes with Musculoskeletal Injuries - a review
INTRODUCTION AND PURPOSE Musculoskeletal injuries, including ligament ruptures, sprains, partial tears, muscle damage, and fractures, are among the most common injuries observed in athletes. Properly conducted rehabilitation is based on early and appropriate patient mobilization following trauma, aiming to restore mobility and strength of the affected musculoskeletal structures during convalescence. Effective management of post-traumatic pain remains a crucial component of therapy, as pain reduction facilitates early mobilization and return to pre-injury functional status. The aim of this study was to review rehabilitation approaches used after various musculoskeletal injuries sustained during sports activity. MATERIALS AND METHODS Literature contained in PubMed and BioMed Central databases was searched using keywords such as rehabilitation, sport, musculoskeletal injuries, physical activity, pain management, exercise, therapy. Referenced sources in selected publications and thematic textbooks were also utilized. CONCLUSIONS Musculoskeletal injuries may result in significant functional limitations; however, their negative consequences can be effectively minimized through the timely initiation of structured rehabilitation. Exercises should be introduced gradually and adjusted to the injury stage to avoid excessive load on healing tissues. Adequate pain management is essential to support early mobilization and optimize recovery outcomes in athletes.
Copyright (c) 2026 Katarzyna Chowaniec-Rybka, Monika Bujak, Jędrzej Sztajura, Anna Szot https://creativecommons.org/licenses/by-nc-sa/4.0