Visual Article Details Quality in Sport eISSN 2450-3118 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 Quality in Sport.docx How to prepare an Article for the Quality in Sport.pdf Creating an Account. Submitting an Article. Quality in 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 20 points in Ministry of Higher Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Higher Education and Science of 05.01.2024. No. 32553. Has a Journal's Unique Identifier: 201398. Scientific disciplines assigned: Economics and finance (Field of social sciences); Management and Quality Sciences (Field of social sciences). Punkty Ministerialne z 2019 - aktualny rok 20 punktów. Załącznik do komunikatu Ministra Szkolnictwa Wyższego i Nauki z dnia 05.01.2024 r. Lp. 32553. Posiada Unikatowy Identyfikator Czasopisma: 201398. Przypisane dyscypliny naukowe: Ekonomia i finanse (Dziedzina nauk społecznych); Nauki o zarządzaniu i jakości (Dziedzina nauk społecznych). The aim of the journal is to establish the platform for scientific discussion and to disseminate the research findings on sport, tourism management and event management, sport in various aspects, including social, humanistic, health and medical aspects. The scope of the papers published in the Quality in Sport covers the issues of: sport in various aspects, including social, humanistic, health and medical aspects; implementation of scientific research results into the practice of sports life, recreational, social, medical, health, managerial, media and economic; cooperation with the sports, recreational, cultural and social environment, media, managerial, medical, health and economic; supporting in organizing conferences, congresses and scientific symposia; management in sports and tourism organization; quality of sports event; satisfaction of participants of sports events and fans; management of sports facilities. 759 Citations from Scopus for Quality in Sport. 136 Secondary documents Citations from Scopus for Quality in Sport. + 70 Citations from Scopus for Qual Sport. 42 Secondary documents Citations from Scopus for Qual Sport. 136+42=178 Secondary documents Citations from Scopus for Quality in Sport. Frequency: First Semi-annually, Quarterly, Current is Monthly. Open access model. Quality in Sport only prints the papers which have not been published earlier. The journal is published in an on-line version. The on-line version is a reference one. Acceptance Rate 35% Rejection Rate 65% Quality in Sport EISSN 2450-3118 The manuscripts must be submitted via the online article system, represented on the journal website. The journal offers access to the contents in the open access system on the principles of non-exclusive license Creative Commons (CC BY-ND 3.0).
University Center for Sports Research, Nicolaus Copernicus University, Torun, Poland
Exercise-induced Rhabdomyolysis in a Young Adult after an Intensive Resistance-circuit Workout
Exercise-induced rhabdomyolysis is a potentially serious complication of high-intensity physical activity, increasingly observed in young adults, particularly in the context of high-intensity training, abrupt return to exercise after a longer break, and the widespread use of multi-ingredient pre-workout supplements. Early symptoms are often dismissed as “bad muscle soreness”, which may delay diagnosis and treatment and, in consequence, promote the development of acute kidney injury. The aim of this paper is to present a case of exercise-induced rhabdomyolysis in a young, previously healthy man after a resistance-circuit training session performed following a prolonged period of inactivity, and to discuss current knowledge on the etiology, clinical presentation, diagnostics, treatment and prevention of exercise-induced rhabdomyolysis in young adults. We describe the clinical course, laboratory findings and management, and then relate them to available data, with particular emphasis on environmental factors, dehydration and the use of pre-workout preparations. The case illustrates that early recognition based on simple tests – creatine kinase activity, assessment of kidney function and urinalysis – and prompt initiation of intensive fluid therapy often make it possible to avoid renal replacement therapy. From the perspective of sports medicine and primary care, education of young adults, gradual introduction of training loads, and cautious, informed use of supplements – especially in hot environments and with limited fluid intake – are crucial.
Copyright (c) 2026 Michał Karol, Kamila Koseska, Jan Borowicz, Bartosz Górecki, Kinga Kloch, Patryk Romaniuk, Mariia-Khrystyna Lohin, Aleksandra Strawińska, Małgorzata Bednarczyk https://creativecommons.org/licenses/by-nc-sa/4.0
High Altitude Diseases: Epidemiology, Pathophysiology, Diagnosis, Prevention and Treatment
High altitude diseases—encompassing acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE)—represent a spectrum of potentially life-threatening conditions affecting individuals ascending above 2,500 meters. AMS affects 20–75% of unacclimatized travelers, while HAPE and HACE demonstrate lower incidence (0.1–15.5% and 0.5–1.5%, respectively) but substantially higher mortality without intervention. Rapid ascent exceeding 500 m/day and genetic susceptibility to hypoxic responses emerge as critical modifiable risk factors. Pathophysiological mechanisms involve hypobaric hypoxia-induced cytotoxic edema and cerebral vasodilation in AMS/HACE, mediated by hypoxia-inducible factors and blood-brain barrier disruption, while exaggerated pulmonary artery pressure elevation and capillary stress failure characterize HAPE. Diagnosis relies on clinical criteria including the Lake Louise Score for AMS, radiographic evidence for HAPE, and neurological signs with advanced imaging for HACE. Prevention strategies prioritize graded ascent (≤300 m/day above 3,000 m) and pre-acclimatization; when rapid ascent is unavoidable, acetazolamide prophylaxis (125–250 mg twice daily) reduces AMS risk by approximately 50%. Treatment algorithms emphasize immediate descent asthe gold standard, supplemented by supplemental oxygen and pharmacotherapy tailored to illness severity: acetazolamide for AMS, dexamethasone for cerebral edema, and nifedipine for pulmonary hypertension A multidisciplinary approach integrating physiological understanding with pragmatic prevention strategies, early recognition through standardized diagnostic tools, and prompt evidence-based intervention optimizes outcomes and reduces morbidity and mortality in high-altitude environments.
Copyright (c) 2026 Szymon Kosek, Justyna Klonowska, Radosław Walkowski, Weronika Wasiniewska , Marcin Barański, Tomasz Kandefer, Maria Izabela Sroka https://creativecommons.org/licenses/by-nc-sa/4.0
Vagus Nerve Stimulation in Neurology and Beyond: A Comprehensive Review of Clinical Use, Mechanisms, Innovations and Future Directions
Background: Vagus nerve stimulation (VNS) has evolved from a treatment for drug-resistant epilepsy (DRE) into a broader neuromodulatory platform with expanding applications in neurology, psychiatry, immunology, and cardiology. Technological advances, particularly in non-invasive and adaptive modalities, have renewed interest in its therapeutic potential. Aim: To provide a comprehensive review of the clinical applications, mechanisms of action, safety profile, and emerging technological innovations in VNS, with emphasis on non-invasive techniques, adaptive stimulation, candidate biomarkers, and associated ethical considerations. Material and Methods: This narrative review synthesizes findings from peer-reviewed studies, clinical trials, and experimental reports identified through targeted searches in PubMed, Google Scholar, and related databases. Results: VNS demonstrates consistent efficacy in reducing seizure frequency in epilepsy and improving outcomes in treatment-resistant depression (TRD), inflammatory conditions, and cardiovascular disorders. Mechanistically, it modulates brainstem–cortical circuits, autonomic tone, and neuroimmune signaling pathways. Side effects are typically mild and transient. Non-invasive and closed-loop systems show promise in enhancing individualization and tolerability, although challenges remain in terms of standardization, long-term data, and equitable access. Conclusions: VNS represents a safe, increasingly personalized intervention with broad therapeutic scope. Future research should prioritize biomarker validation, optimization of stimulation paradigms, and integration with artificial intelligence (AI) and digital health tools, ensuring ethical and scalable implementation across diverse clinical populations.
Copyright (c) 2026 Michał Janiszewski, Marcin Komorowski, Joanna Piecek, Marta Omiecińska, Natalia Surosz, Aleksandra Graczyk, Michał Grochowalski, Jakub Szydło, Dominika Ziętara, Kacper Kmieć https://creativecommons.org/licenses/by-nc-sa/4.0
Effects of Regular Physical Activity on Metabolic, Cardiovascular and Cancer Outcomes: A Review of Current Evidence
Introduction. Physical activity is a key determinant of population health and plays a central role in preventing and managing chronic diseases, including obesity, cardiovascular diseases, type 2 diabetes and certain cancers. Despite strong evidence, global inactivity remains high, contributing to rising metabolic and cardiovascular burdens. Materials and Methods. This review synthesizes evidence from systematic reviews, meta-analyses, randomized controlled trials, and international guidelines , focusing on physical activity, exercise physiology, obesity, cardiovascular diseases, diabetes, and cancer prevention. Results. Regular physical activity improves health across major chronic diseases. In obesity, 150–300 minutes of aerobic activity per week plus resistance training reduces body fat, especially visceral adiposity. For cardiovascular diseases, recommended activity levels lower incidence by 14–22% and mortality by 28–40%. In type 2 diabetes, structured exercise ≥8 weeks reduces HbA1c by 0.4–1.0% and improves insulin sensitivity independently of weight loss. Moderate-to-vigorous activity decreases the risk of colorectal, breast, and endometrial cancers, with probable benefits for kidney, bladder, and gastric cancers. Discussion. Benefits of physical activity are mediated via cardiovascular, metabolic, anti-inflammatory, and immune pathways and occur across all ages, independent of weight loss. Barriers such as lack of time, low motivation, and limited access to safe environments highlight the need for systemic interventions, including public health policies, environmental planning, and community programs Conclusions. Regular physical activity is essential for preventing and managing chronic diseases. Even moderate exercise delivers significant cardiovascular, metabolic, and oncologic benefits, while higher volumes and mixed modalities enhance protection.
Copyright (c) 2026 Daniel Załęski, Michał Krankiewicz , Martyna Berdzińska , Justyna Jusiak, Paulina Halik https://creativecommons.org/licenses/by-nc-sa/4.0
Emerging Directions in CAR-T Cell Therapy: Solid Tumors
Background. CAR-T therapy represents a breakthrough in immuno-oncology, enabling tumor elimination independently of the MHC system. This strategy has achieved spectacular clinical success in hematology (ALL, DLBCL), primarily by targeting CD19 and BCMA antigens. However, adapting this technology to solid tumors, which account for approximately 90% of cancer cases, remains a challenge. Given the rising incidence in an aging population, overcoming the barriers limiting CAR-T efficacy in this group has become a critical research priority. Aim. The aim of the study was to summarize the current state of knowledge, challenges and emerging strategies for the use of CAR-T therapy in the treatment of solid tumors, based on the latest literature reports. Materials and methods. A literature review was conducted using PubMed, Google Scholar, and Web of Science databases, focusing primarily on articles published between 2023 and 2025, alongside relevant historical context. The search utilized the following keywords: CAR-T cells, immunotherapy, tumor microenvironment, breast cancer, lung cancer, and solid tumor. The analysis included only English-language publications. Results. The analysis tracks CAR evolution from 1st to 5th generation, emphasizing costimulation and TRUCK systems. In solid tumors (e.g., TNBC, NSCLC), efficacy is hindered by the immunosuppressive microenvironment (TME), antigen heterogeneity, and physical barriers. Key strategies to overcome these include combination with checkpoint inhibitors, CRISPR/Cas9 editing, Dual-CAR systems, and cytokine induction. Conclusions. CAR-T technology extends beyond hematology, showing promising potential in solid tumors, autoimmune diseases, and neurodegenerative disorders. New modification strategies overcome microenvironmental barriers in solid tumors, while CAR-T and CAR-Tregs effectively restore immune homeostasis in autoimmunity. This therapy is evolving into a versatile platform with broad translational significance.
Copyright (c) 2026 Michał Magiera, Miłosz Sikora, Piotr Czwałga, Patrycja Koprowska https://creativecommons.org/licenses/by-nc-sa/4.0
Effects of physical activity in patients with systemic lupus erythematosus: a narrative review
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterised by heterogeneous clinical involvement and persistent symptom burden despite advances in pharmacological therapy. Fatigue, mood disturbances, reduced physical functioning and heightened cardiometabolic risk remain prevalent and only partially amenable to medication alone. Growing interest has therefore focused on the role of physical activity as a complementary strategy in SLE management. This narrative review synthesises evidence from interventional and observational studies exploring associations between physical activity, structured exercise and key clinical outcomes in adults with SLE. Individuals with SLE consistently demonstrate reduced habitual activity, lower fitness and increased sedentary time compared with the general population. Across multiple trials, aerobic, resistance and combined exercise programmes were safe in clinically stable disease and did not increase activity or flare rates. Exercise interventions improved functional capacity, fatigue and selected psychological outcomes, whereas observational studies additionally link higher activity levels to better mood, sleep and cognitive functioning. Physical activity and fitness also correlate with more favourable cardiometabolic profiles, including lower arterial stiffness and reduced markers of subclinical atherosclerosis. Mechanistic data suggest that exercise may attenuate inflammatory signalling and modulate immune pathways relevant to SLE. Overall, physical activity represents a safe and valuable adjunct to standard therapy, offering benefits across functional, symptomatic and cardiometabolic domains. Further high-quality trials are required to optimise exercise prescriptions and evaluate long-term effects in diverse SLE populations.
Copyright (c) 2026 Wojciech Kaczorowski, Krystyna Wilkowska, Maciej Michałowski, Maria Sudomir, Karol Knysak, Alicja Maj, Mateusz Szczerba, Aleksandra Hejnosz, Michał Jastrzębski, Maja Piątek https://creativecommons.org/licenses/by-nc-sa/4.0
Lifestyle Factors and Non-Pharmacological Interventions in Mild Cognitive Impairment: Implications for Cognitive Health
Background. Mild Cognitive Impairment (MCI) is a heterogeneous clinical syndrome associated with an increased risk of progression to dementia, although individual trajectories vary substantially. Growing evidence indicates that modifiable vascular-metabolic, lifestyle, nutritional, and psychosocial factors influence cognitive outcomes in MCI, and that non-pharmacological interventions (NPIs) may support cognitive performance. Aim. To synthesize current evidence on modifiable risk factors associated with progression from MCI to dementia and to evaluate the effectiveness of NPIs targeting cognitive outcomes in patients with MCI. Material and methods. This structured narrative review was based on a targeted search of the PubMed database. Systematic reviews, meta-analyses, longitudinal cohort studies, and randomized controlled trials examining modifiable risk factors and NPIs in MCI were included. Twenty-eight peer-reviewed articles met predefined eligibility criteria and were synthesized narratively. Results. Cardiometabolic conditions, physical inactivity, depressive symptoms, and suboptimal dietary patterns were consistently associated with increased risk of cognitive decline in MCI. Biomarker-informed studies suggest that modifiable factors remain relevant even in patients with underlying Alzheimer’s disease (AD) pathology. Randomized trials and systematic reviews indicate that structured exercise, cognitive training, dietary interventions, and multidomain lifestyle programs are associated with improved cognitive performance, with evidence of dose–response effects. Conclusions. An integrated clinical approach combining assessment of modifiable risk factors with targeted NPIs may support cognitive outcomes in patients with MCI and represents a relevant strategy for early preventive care.
Copyright (c) 2026 Natalia Marianna Kubiś, Bartosz Palacz, Maria Magdalena Teper , Wiktor Perz , Aleksander Polus , Julia Anna Wrona , Anna Gluzicka , Liwia Olczyk , Jędrzej Piotrowski , Anhelina Korolchuk https://creativecommons.org/licenses/by-nc-sa/4.0
Sauna, the Cardiovascular System and Autonomic Regulation: Implications for Post-exercise Recovery
Introduction: Sauna bathing, traditionally associated with relaxation in Nordic countries, is increasingly regarded as a tool supporting cardiovascular prevention and post-exercise recovery. As its use becomes more widespread, questions arise about the safety of this form of heat exposure, the mechanisms by which it affects the cardiovascular system and autonomic regulation, and how it can be integrated into training programmes for athletes and physically active individuals. Aim: The aim of this narrative review is to organize current knowledge on the acute and chronic effects of sauna bathing on haemodynamic parameters, sympathetic–parasympathetic balance and post-exercise recovery, with particular emphasis on potential benefits, risks, contraindications and practical aspects of dosing the thermal stimulus. State of knowledge: Available studies indicate that a single sauna session induces predictable circulatory changes – peripheral vasodilation, an increase in heart rate and cardiac output with a moderate reduction in arterial blood pressure, and transient hypovolaemia. Regular sauna bathing has been associated in long-term observations with a more favourable cardiovascular profile, improvement in selected indices of sinus rhythm variability, better subjective well-being and improved exercise tolerance. In athletic populations, sauna may support the perception of recovery, promote muscle relaxation and facilitate glycogen resynthesis, provided that it is used with adequate attention to hydration and appropriate dosing of heat stress. Conclusions: Sauna appears to be a valuable and relatively simple adjunct to cardiovascular prevention strategies and recovery programmes, but it does not replace physical activity or causal treatment. Further interventional studies are needed to refine optimal protocols of sauna bathing in the general population and in elite sport, and to better define groups in whom the benefits outweigh the risks.
How obesity impacts the skin microbiome - Literature review
Background. Obesity is becoming an increasingly serious problem in society and affects an entire human body including skin. It potentially affects barrier integrity, immune responses and susceptibility to dermatoses. Aim. This review aims to examine how obesity changes the composition and function of the skin microbiome and what are the possible consequences. Material and methods. A research was performed in the PubMed and Google Scholar based on peer-reviewed studies published between 2017 – 2025 and focusing on phrases “skin microbiome”, “obesity”, and “skin diseases”. Results. Available studies indicate reduced microbial diversity, increased colonisation by opportunistic pathogens and overgrowth of yeasts on the skin of obese patients. Mechanical factors such as friction, sweating and elevated skin-fold temperature promote dysbiosis and inflammation. These changes are associated with dermatoses such as atopic dermatitis, intertrigo, folliculitis, seborrhoeic dermatitis and hidradenitis suppurativa. Treatment strategies include weight reduction, targeted skincare, antimicrobial treatment and new microbiome-modulating therapies. Conclusions. Obesity significantly influences the skin microbiome, contributing to a higher risk of infections and inflammatory dermatoses. Although the understanding of these mechanisms is improving, further research, particularly involving metagenomics and metabolomics is needed to develop more precise preventive and therapeutic approaches.
Copyright (c) 2026 Marta Opalińska-Kubowicz, Kinga Popieralska, Zuzanna Musialska, Yuliia Protsenko, Marta Kowalska, Magdalena Barczewska, Dominika Bieszczad, Anna Marczak, Olga Stadnicka, Marzena Swojnóg, Adam Mazurek https://creativecommons.org/licenses/by-nc-sa/4.0
Barotraumatic Orbital Emphysema in Divers: Comprehensive Review with Case Series
Aim. The aim of this paper is to outline the pathophysiological mechanisms underlying orbital emphysema in the context of barotrauma, which may occur in divers, to discuss the associated symptoms, diagnostic evaluation, and management, and to present the clinical cases described in the literature. Material and methods. The research methods applied included a systematic review of the PubMed, ResearchGate and Cyfrowa Biblioteka Medyczna UJCM databases, as well as other relevant sources, using the keywords: “orbital emphysema”, “diver”, “dive”, “scuba diving”, “eye barotrauma”, “paranasal sinuses anatomy”, “orbit anatomy”. Summary. Orbital emphysema refers to the presence of air within the orbital cavity, most often resulting from fractures of the orbital walls or barotrauma. Its clinical presentation varies from mild eyelid swelling and crepitus to more severe manifestations such as proptosis, restricted ocular mobility, or elevated intraorbital pressure. Management is conservative in most cases, with spontaneous resolution occurring over several days to weeks; however, urgent decompression may be required if orbital compartment syndrome develops. Among divers, only mild forms of orbital emphysema have been reported to date. Preventive measures include proper pressure equalization during diving, avoidance of forceful Valsalva maneuvers, and refraining from diving during episodes of sinus infection. Conclusions. Barotrauma-related risk increases when pressure equalization is impaired, the osteomeatal complex is obstructed, or minor facial injuries create pathways for air to enter the orbit during pressure changes. This review outlines the main features of orbital emphysema and its clinical manifestations in divers. Given the limited number of published cases, the condition is insufficiently described and requires further investigation.
Copyright (c) 2026 Alicja Kodura, Joanna Paluchowska, Milena Mordarska, Jan Łozowski, Alicja Piwowarczyk, Julia Białas, Natalia Gołąbek, Przemysław Piątek, Artur Merc, Łukasz Szymański https://creativecommons.org/licenses/by-nc-sa/4.0
Urban-Rural Disparities in Bronchial Asthma: A Review of Environmental Determinants and Epidemiological Insights
Introduction and aim of the study. Bronchial asthma, as defined by the Global Initiative for Asthma (GINA, 2024), is a heterogeneous disease characterized by chronic inflammation of the airways. This study aims to investigate the impact of environmental factors, including air quality and early-life exposure to microbiota, on the prevalence and development of asthma in urban and rural populations. Brief overview of the current state of knowledge. Asthma currently affects approximately 300 million people worldwide, with its prevalence increasing, especially in industrialized countries. Exposure of children to diverse microbiota, typical of farming environments, is associated with a lower risk of developing asthma and atopic diseases, which supports the hygiene hypothesis. In contrast, air pollution in urban agglomerations-especially particulate matter (PM2.5, PM10), nitrogen oxides, and polycyclic aromatic hydrocarbons-represents a significant risk factor. The pathomechanism of asthma involves complex immune responses in which chronic inflammation and bronchial hyperresponsiveness are modulated by environmental factors. Epidemiological studies indicate a higher prevalence of asthma in cities, which is associated with reduced immune stimulation by diverse microflora and increased exposure to pollutants. Conclusion. Available data confirm the complex role of environmental factors in the etiology of asthma. Preventive strategies should include reducing air pollution, especially in urban areas, and promoting safe contact of children with natural microbiota. Further research integrating epidemiology, immunology, and environmental protection is essential to develop effective strategies for asthma prevention and treatment.
Copyright (c) 2026 Wiktoria Cecuła, Kamil Ciechomski, Joanna Rypel-Bośka, Natalia Siuta , Elżbieta Siuda, Aleksandra Stupecka, Marcin Migiel, Izabela Brynczka, Klaudia Goleniewska, Jakub Miaśnikiewicz https://creativecommons.org/licenses/by-nc-sa/4.0
Integration of Aesthetic Medicine into Modern Dental Practice
Introduction: Modern aesthetic dentistry increasingly integrates techniques from aesthetic medicine to improve the appearance and function of the oral cavity. Growing patient expectations concerning not only health but also the aesthetics of teeth and perioral tissues have led to the development of interdisciplinary treatment methods. Materials and Methods: This article reviews current techniques used in aesthetic medicine, such as botulinum toxin, tissue fillers, and mesotherapy, and their adaptation in dental practice. The use of platelet-rich plasma (PRP) for aesthetic treatment of the face and perioral structures is also discussed. Results and Discussion: Aesthetic dentistry now includes procedures that enhance both teeth and facial soft tissue aesthetics. Botulinum toxin is used to treat gummy smile, bruxism, and muscular asymmetry. Dermal fillers help in contouring facial structures and enhancing lip volume. Mesotherapy and PRP support tissue regeneration and skin quality, also aiding healing after dental procedures.
Copyright (c) 2026 Julia Rafałowska, Małgorzata Sajda, Maria Sikora, Gabriela Sikora, Beata Wnuk, Katarzyna Śledź, Jakub Piórkowski, Julia Grygołowicz, Sara Salloum, Klaudyna Zalewska, Karolina Zalisz, Maciej Zając, Oskar Ptak https://creativecommons.org/licenses/by-nc-sa/4.0
Physical Activity and Lower Urinary Tract Function: Pathophysiological Mechanisms, Clinical Evidence, and Practical Implications – A Narrative Review
Lower urinary tract function (LUTF) depends on complex interactions between the detrusor muscle, urethral sphincters, pelvic floor musculature, and central and peripheral neural control. Disruption of these mechanisms may lead to lower urinary tract symptoms (LUTS), including urinary incontinence, urgency, frequency, nocturia, and voiding dysfunction, which substantially impair quality of life and participation in physical activity. Physical activity is a modifiable lifestyle factor that may exert both beneficial and adverse effects on urinary tract function. Moderate, well-structured exercise enhances pelvic floor muscle strength, neuromuscular coordination, metabolic health, and autonomic regulation, whereas excessive or high-impact training may exceed pelvic floor adaptive capacity and increase susceptibility to LUTS. This narrative review synthesizes contemporary evidence (2020–2025) regarding epidemiology, pathophysiological mechanisms, sport-specific risk profiles, and clinical outcomes related to physical activity and LUTF, and discusses practical implications for screening, prevention, and clinical management in physically active populations.
Copyright (c) 2026 Mikołaj Jankowski , Klaudia Bogdan, Urszula Janicka, Natalia Ciepluch, Szymon Słomiński, Wiktoria Toczek, Magdalena Olszówka, Sonia Dziugieł https://creativecommons.org/licenses/by-nc-sa/4.0
Background. Candida auris is an emerging, multidrug-resistant fungal pathogen of significant public health concern. Noted for its environmental persistence and high transmissibility, it poses a substantial threat in healthcare settings, particularly in intensive care units, driving the need for specific infection control protocols. Aim. The aim of this study was a comparative analysis of environmental disinfection methods used in the prevention and control of Candida auris in various countries and healthcare facilities. Material and methods. This review analyzed literature from 2016-2025, sourced from databases such as PubMed, alongside public health guidelines and epidemiological reports. A comparative analysis of the selected data was conducted. Results. Disinfection strategies against C. auris primarily recommend chlorine- and hydrogen peroxide-based agents, with UV-C and vaporized hydrogen peroxide (VHP) noted as supplementary measures. A comparative analysis revealed significant international divergence, particularly regarding quaternary ammonium compounds (QACs), which are largely restricted except in specific contexts like India. Overall efficacy is highly variable and dependent on disinfectant selection, workflow, staff training, and the consistency of protocol implementation. Conclusions. Chlorine- and peroxide-based disinfectants are most effective against C. auris, while QACs are discouraged despite their localized use. To counter variability in international guidelines, a unified regulatory framework is recommended. Key recommendations include standardizing procedures, enhancing staff training, and maintaining strict surveillance. Further research, including hospital case studies, is needed due to insufficient current data.
Copyright (c) 2026 Marta Krzyzaniak, Izabela Brynczka, Klaudia Martyna Patrzykąt, Zofia Gorzoch- Burduk, Julia Puzio, Paula Marcinkowska, Michał Jezierski, Kinga Popielarska, Ewelina Nowicka, Kamila Wróblewska https://creativecommons.org/licenses/by-nc-sa/4.0
CRISPR therapy - revolution in medicine or ethical danger
CRISPR, or rather rarely used full name – Clustered Regularly Interspaced Short Palindromic Repeats. Studying this family of DNA sequences has led to the creation of CRISPR-Cas9 technology for genome editing. This technology has been with us for quite some time and is undeniably considered one of the most significant breakthroughs in modern genetics. It provides a powerful weapon for editing genomes with unprecedented precision, which can be used for advancing biotechnological inventions, finding and deploying new treatments and for overall progress in medicine. Recently, spikes of progress have been seen, which unquestionably have sparked many ethical and moral discussions about this technology. This paper examines the revolutionary potential of CRISPR therapy in medicine, alongside the ethical and moral implications that arise from its application. The potential of the therapy has been placed in a specialised context – how the implementation of CRISPR-Cas9 could impact sportsmen and -women, especially those battling such hard genetic diseases as Paralympians in different disciplines do every day. By analysing the scientific advancements, potential applications, and ethical dilemmas, a comprehensive understanding of CRISPR’s impact on contemporary medicine and contemporary sports is developed.
Copyright (c) 2026 Adrianna Mielżyńska, Mikołaj Pograniczny, Marcelina Nalepka, Jakub Pochopień, Adrianna Pacołta, Jędrzej Golec, Aleksandra Nowicka https://creativecommons.org/licenses/by-nc-sa/4.0
GLP-1 Agonists and Dual Agonists in Obesity Treatment: Benefits, Risks, and Clinical Challenges in Geriatric Patients
Introduction. The global prevalence of obesity has increased markedly in recent decades, becoming a major contributor to metabolic syndrome (MetS), cardiovascular disease, and mortality. This trend increasingly affects older adults, in whom obesity often coexists with sarcopenia, frailty, and multimorbidity. Novel pharmacological therapies, particularly glucagon-like peptide-1 (GLP-1) receptor agonists and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, have demonstrated unprecedented efficacy in weight reduction, yet data in geriatric populations remain limited. Materials and Methods. A systematic literature search of PubMed, Embase, and Scopus was conducted for studies published between 2020 and 2025. Results. Both semaglutide and tirzepatide produced substantial and sustained weight loss, with mean reductions ranging from approximately 15% to over 20%, and significant improvements in glycemic control, lipid profile, and blood pressure. Tirzepatide consistently achieved greater weight reduction than semaglutide. Limited subgroup and post hoc analyses suggest that older adults experience meaningful metabolic benefits, although higher rates of gastrointestinal adverse events and treatment discontinuation have been reported. Discussion. In older patients, pharmacologically induced weight loss may be accompanied by disproportionate loss of lean body mass, increasing the risk of sarcopenia, frailty, and functional decline. Without appropriate nutritional and exercise interventions, these risks may attenuate the cardiometabolic benefits of treatment. Conclusions. GLP-1 and dual GLP-1/GIP receptor agonists are highly effective therapies for obesity, including in older adults, but require individualized risk–benefit assessment. Integration with nutritional support and resistance training is essential.
Copyright (c) 2026 Lidia Wydeheft , Justyna Jusiak , Paulina Halik, Paulina Malon, Kornelia Kędziora-Kornatowska https://creativecommons.org/licenses/by-nc-sa/4.0
Proton Pump Inhibitors - Clinical Use and Long-Term Safety in Adults
Background. Proton pump inhibitors (PPIs) are widely prescribed for gastrointestinal disorders. Their potent and persistent inhibition of gastric acid ensures efficacy but has raised concerns about adverse effects during long-term therapy. Aim. To summarize current evidence on the indications and clinical benefits of proton pump inhibitors in adults, and to review major long-term adverse effects and drug–drug interactions to guide safer treatment strategies. Material and methods. A narrative literature review was conducted using PubMed/MEDLINE for articles published between January 2016 and November 2025. Peer-reviewed human studies and major reviews on adults receiving oral PPIs were included if they addressed utilization, indications, duration of therapy, long-term adverse effects, drug-drug interactions, or deprescribing strategies. Pediatric studies, purely animal research, and non-peer-reviewed articles were excluded. Results. PPIs remain first-line treatment in gastroesophageal reflux disease, peptic ulcer disease, Helicobacter pylori eradication, and selected hypersecretory conditions. However, many patients receive these medications chronically without a clear ongoing indication or regular reassessment. Long-term PPI therapy can be linked to nutrient and electrolyte disturbances, increased fracture risk, renal complications, infections, and clinically relevant interactions with drugs such as clopidogrel and methotrexate. Cardiovascular and neurological risk signals remain inconclusive. Conclusions. PPIs should not be withheld from patients with justified indications, but must be prescribed thoughtfully. Clinicians need to use the lowest effective dose for the shortest necessary duration, regularly review indications, and educate patients to limit unnecessary chronic exposure while preserving the substantial benefits of PPI therapy.
Copyright (c) 2026 Klaudia Martyna Patrzykąt, Anna Maria Zakrzewska, Aleksander Midera, Julia Aleksandra Leśniak, Michał Borowski, Klaudia Elżbieta Niwińska, Julia Agnieszka Michalak, Zofia Czaplińska-Paszek, Natalia Maria Leśniak, Kinga Popielarska https://creativecommons.org/licenses/by-nc-sa/4.0
Immunotherapy targeting glicolipid antigen (GD2) expressed on neuroblastoma tumour cells. Review of literature
Neuroblastoma is the most common extracranial solid tumor of childhood and accounts for approximately 15% of pediatric cancer-related mortality. Despite advances in multimodal therapy, outcomes for patients with high-risk disease remain unsatisfactory, with long-term survival rates below 50%. Disialoganglioside GD2, highly expressed on neuroblastoma cells, has become a key therapeutic target enabling the development of monoclonal antibodies such as dinutuximab beta and naxitamab. Anti-GD2 antibodies exert antitumor activity through complement activation, antibody-dependent cellular cytotoxicity, and antibody-dependent phagocytosis, mechanisms that can be further enhanced by cytokines including IL-2 and GM-CSF. Clinical studies demonstrate that immunotherapy incorporating anti-GD2 antibodies significantly improves event-free and overall survival compared with standard isotretinoin maintenance, although treatment is frequently limited by severe neuropathic pain and other adverse reactions. Recent findings highlight the potential of copper chelation as an adjuvant strategy. Additionally, naxitamab-based chemoimmunotherapy shows promising activity in patients with refractory or minimal residual disease. This review summarizes the current landscape of GD2-directed immunotherapy, supportive approaches such as ketamine-based analgesia, and emerging synergistic strategies, including copper chelation, that may further optimize therapeutic outcomes in high-risk neuroblastoma.
Copyright (c) 2026 Konrad Gawin, Anita Ignasiak, Wiktoria Zawiślak, Kacper Rychlica, Michał Cisowski, Maria Dąbrowska, Jolanta Cholewińska-Rychlica , Paulina Madura, Daria Mrozik-Gałecka https://creativecommons.org/licenses/by-nc-sa/4.0
The Association Between Chronic Obstructive Pulmonary Disease and Depression and Other Mental Disorders: A Literature Review
Chronic obstructive pulmonary disease (COPD) already represents a growing global health challenge, whose implications and consequences extend beyond the respiratory system, encompassing various mental disorders, including depression, anxiety disorders, cognitive impairment, and sleep disturbances. This literature review, covering publications from recent years, analyzes the multifactorial mechanisms linking COPD with mental health disorders—beginning with chronic inflammation, hypoxia, oxidative stress, and increasing functional limitations. The presented data indicate that depression affects even more than one-third of COPD patients, intensifying somatic symptoms of the underlying disease, increasing the risk of exacerbations, hospitalizations, and mortality, and reducing treatment adherence and the effectiveness of rehabilitation. Similarly, anxiety disorders, cognitive impairment, and sleep disturbances, which often coexist with COPD, influence the perception of dyspnea, the ability to self-manage therapy, and overall patient functioning. This paper highlights the importance of early diagnosis of mental disorders using validated screening tools, as well as the need for a holistic model of care combining pharmacological interventions with non-pharmacological approaches based on pulmonary rehabilitation, cognitive-behavioral therapy, and psychosocial support. Integration of pulmonological and psychiatric perspectives is essential both for improving patients’ quality of life and optimizing prognosis. The findings point to an urgent need for further research on the mechanisms underlying comorbidities and the effectiveness of integrated treatment models.
Copyright (c) 2026 Filip Bednarek, Olga Plinta, Alicja Hojda, Natalia Nawrocka, Hanna Rodak, Izabela Małajewicz, Małgorzata Pietrzyk, Dawid Stępień, Karolina Oskroba https://creativecommons.org/licenses/by-nc-sa/4.0
Background: To the development of rosace contribute factors such as genetic, environmental, and neurovascular causes.. The ocular form affects an estimated prevalence of 10-46% of patients. Symptoms may include redness and tearing of the eyes, foreign body sensation, burning, dryness, itching, photophobia, blurred vision, eyelid margin telangiectasia, and periorbital erythema. Purpose: Ocular rosacea is a long lasting condition that causes persistent inflammation of the eyes and eyelids. The aim of this paper is to organize information on the etiopathogenesis, diagnosis and treatment of this disease. Methods: Comprehensive review of the literature available on PubMed, Google Scholar, Scopus database by searching the keywords “rosacea”, “ocular rosacea”, “ ocular rosacea treatment”, “keratitis”, “dry eye syndroms” Results: Diagnosis requires vigilance because the disease is often confused with other ophthalmological conditions. There are no specific treatment guidelines for ocular rosacea. Managment options depend on the stage of the disease, ranging from conservative treatment based on proper eyelid hygiene and avoidance of triggers in the mildest cases to long-term systemic antibiotic therapy in patients with advanced disease. Conclusions: Ocular rosacea is a disease that is not yet fully understood. Expanding research on this manifestation of rosacea is essential to develop standards for diagnosis and treatment. Collaboration between physicians from multiple specialties in patient care is essential to ensure rapid diagnosis and comprehensive treatment.
Copyright (c) 2026 Aleksandra Bielak, Maria Spychalska, Zofia Bogiel, Aleksandra Foryś, Monika Kałwak, Daria Kuczwalska, Antonina Machała, Daria Trocka https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Drinking Water Fluoride on the Risk of Hypothyroidism Development: A Review of the Latest Research
Introduction and purpose: Thyroid diseases are common endocrine disorders, with hypothyroidism being the most frequently diagnosed condition of the gland. Water fluoridation is an effective strategy for preventing dental caries, as confirmed by epidemiological studies. Despite the reported benefits, there are concerns about the risk of thyroid dysfunction with high fluoride exposure. The aim of this paper is to review the latest research on the impact of fluoride in drinking water on the risk of developing hypothyroidism. Materials and methods: A literature search was conducted using the medical databases PubMed and Google Scholar. Articles were retrieved in English, employing the keywords: “hipothyroidism”, “thyroid function”, “water fluoridation”, “fluoride”, “iodine”. State of Knowledge: Hypothyroidism affects approximately 4% of Europeans, with an annual incidence of 226 cases per 100,000 people. Drinking water is the main source of chronic fluoride exposure, and over 500 million people live in areas of endemic fluorosis. Numerous studies indicate a clear correlation between fluoride concentration in water and TSH levels, suggesting that excessive fluoride exposure increases the risk of hypothyroidism, which can have serious health implications, especially for pregnant women. Summary: Recent studies confirm the correlation between fluoride exposure and the development of hypothyroidism, emphasizing the need to monitor the impact of fluoride on health.
Copyright (c) 2026 Nicola Stencel, Jakub Szczot, Konrad Krupa, Karolina Skulimowska, Katarzyna Trela, Aleksander Tuteja, Laura Więcko, Liwia Olczyk, Klaudia Burzykowska, Kamila Gęborys https://creativecommons.org/licenses/by-nc-sa/4.0
Vascular bed infections (BSI) are a significant clinical problem. They are characterized by a high mortality rate, which is both a diagnostic and therapeutic challenge. The aim of the study is to discuss in detail the etiology, epidemiology and classification of bloodstream infections, as well as their impact on inpatients and outpatients. Vascular bed infections can be classified as nosocomial or community-derived, and the incidence varies depending on the age group and the patient's contact with the medical community. In particular, older patients and immunocompromised patients are at higher risk of developing BSI, which is associated with a higher risk of severe complications such as sepsis and septic shock. Blood cultures are primarily used in diagnostics, but new technologies such as MALDI-TOF can speed up the process. Treatment is based on early initiation of antibiotic therapy, which should be adapted to the sensitivity of the pathogens and the source of infection. The paper also highlights the importance of monitoring bacterial resistance and adapting therapies to the changing epidemiological profile. The conclusions of the study are aimed at increasing the effectiveness of diagnosis and treatment of vascular bed infections, which is crucial in improving patients' health outcomes.
Copyright (c) 2026 Kinga Rogowska-Borettini, Paweł Arkadiusz Malmur, Weronika Biaduń-Mućko, Aleksandra Romanowska, Maria Wysieńska, Piotr Jóźwiak, Adam Rybak https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Omega-3 Fatty Acids in the Pathophysiology and Treatment of Migraine: An Updated Review of Clinical Evidence, Mechanistic Pathways and Nutritional Recommendations
Migraine is a complex neurological disorder in which neuroinflammatory processes, altered neuronal excitability, mitochondrial dysfunction, and changes within the immunological microenvironment play key roles in its pathophysiology. Omega-3 fatty acids, particularly EPA and DHA, exhibit potent anti-inflammatory, pro-resolving, and neuroprotective effects. This article provides a narrative review of the literature describing the mechanisms of action of omega-3 fatty acids and their clinical efficacy in studies related to migraine. Background: Migraine is one of the most diagnosed neurological disorders and significantly impacts patients’ quality of life. Current understanding highlights its neuro-immunological nature, involving complex interactions between neurons, glial cells, and inflammatory mediators. In recent years, increasing attention has been directed toward nutritional factors that may modulate the course of the disorder, including omega-3 fatty acids. Aim: The aim of this article is to provide an expanded narrative review of the mechanisms of action of omega-3 fatty acids and to evaluate their clinical effectiveness in the context of migraine prevention and treatment. Material and Methods: This review has a narrative character. The literature was searched in the PubMed, Scopus, and Web of Science databases for the years 2000- 2025, using keywords related to migraine and omega-3 fatty acids (including migraine, omega-3 fatty acids, EPA, DHA, resolvins, CGRP). Experimental studies, clinical trials, and reviews addressing the role of EPA and DHA in the pathophysiology and treatment of migraine were included. Publications of low methodological quality or lacking complete data were excluded. The aim of this review was to provide a synthetic summary of current knowledge rather than to conduct a systematic review. Results: The reviewed evidence indicates that omega-3 fatty acids, particularly EPA and DHA, influence several biological pathways relevant to migraine pathophysiology. Mechanistic studies consistently demonstrate their ability to modulate pro-inflammatory lipid mediators, enhance the production of pro-resolving molecules, stabilize neuronal membranes, improve mitochondrial efficiency, and reduce CGRP-related neurovascular activation. Clinical trials show heterogeneous but generally favourable outcomes, with the most pronounced benefits observed in interventions that include increased EPA intake combined with dietary reduction of omega-6 fatty acids and treatment durations of at least 12 weeks. Adjunctive therapies involving omega-3 fatty acids, such as combinations with valproate or metabolic cofactors, also suggest potential synergistic effects. Evidence in paediatric populations remains limited and inconsistent. Conclusions: Omega-3 fatty acids represent a promising adjunctive strategy in migraine management, supported by mechanistic plausibility and growing clinical evidence. Their therapeutic potential appears strongly context-dependent, particularly on dietary omega-6 intake and treatment duration. EPA-rich formulations may offer enhanced anti-inflammatory and migraine-preventive effects, while DHA contributes to neuroprotection and neuronal stability. Although current findings are encouraging, larger and methodologically rigorous clinical trials are needed to establish optimal dosing, treatment protocols, and biomarkers that could guide personalized omega-3-based interventions in migraine care.
Copyright (c) 2026 Karolina Wojciechowska, Izabela Zajkowska, Patrycja Zabrocka, Julia Martowska, Ewelina Choroszewska, Julia Baran, Wiktor Warych https://creativecommons.org/licenses/by-nc-sa/4.0
Sex-specific Differences in Myocardial Infarction – Literature Review
Background: Acute coronary syndromes in the course of ischemic heart disease remain the dominant cause of death in both female and male populations. In recent years, there has been increasing interest in gender-based differences in disease symptoms and outcomes. Taking the data into consideration and implementing it in a day to day practice might prove beneficial to patients and reduce the sex-specific disparities. Aim: The aim of this study is to gather recent information on the topic of sex-based differences in myocardial infarction and ischemic heart disease. We wanted to bring awareness to the issue and help clinicians understand what approach is best for patients prognosis. Material and methods: A review of studies including meta-analyses, clinical trials, cohort studies and systematic reviews was done with the use of various databases. The review focused on studies from last 10 years with individual older papers all mentioning the variations in women and men concerning ischemic heart disease and myocardial infarction. Results: Larger studies with better female representation seem to highlight the problem of women frequently carrying the burden of different risk profile, pathophysiology behind the disease, delayed presentation and less promising outcomes. However some studies in opposition show less significant differences in men and women regarding symptoms and mortality in myocardial infarction. Conclusions: The problem of sex differences in acute coronary syndromes should not be disregarded nor treated lightly since it has impact on both female morbidity and mortality. Part of research might still be inconclusive but that should only encourage researchers to delve deeper into it. Women seem to benefit from more personalized approach in both diagnostic procedures as well as treatment options.
Copyright (c) 2026 Natalia Janik, Julia Lenart, Zuzanna Wadowska, Julia Janowiak, Martyna Sobiś, Anna Górowska, Anna Bogacka, Nina Kiersznowska, Małgorzata Buchman, Barbara Miłek https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Septoplasty on Physical Performance and Quality of Life in Active Individuals – A Literature Review
Background. Appropriate upper airway patency is an essential component of exercise physiology. The nose is not only responsible for conditioning inhaled air but is also the primary source of nitric oxide (NO), which aids gas exchange in the lungs. Nasal septal deviation (NSD) disrupts flow aerodynamics, increases airway resistance, and forces a premature transition to the less efficient oral airway, depriving the physically active individual of metabolic benefits and limiting exercise potential. Aim. The purpose of this study is to summarize the existing literature on the effect of nasal septal deviation on performance parameters and to determine how effective surgical correction (septoplasty) is in relation to performance, hemodynamic, and recovery parameters among physically active individuals. Results. The literature review reveals that septoplasty offers several physiological advantages. During exercise, the process increases the economy of effort and delayed fatigue, as it decreases metabolic cost by increasing time to exhaustion without necessarily increasing absolute VO2max. In the hemodynamic area, nasal patency significantly unburdens the heart by lowering pulmonary artery pressure (mPAP) and improving left ventricular function. In addition, the procedure normalizes sleep quality and heart rate variability (HRV) parameters, which is the basis of a successful recovery after exercise. Conclusions. Septoplasty is an effective treatment that promotes exercise capacity in athletes. This process has a profound influence on minimizing the metabolic cost of breathing, improving cardiovascular function and the quality of biological recovery, eliminating the physiological and functional gap between patients with NSD and the healthy population.
Copyright (c) 2026 Klaudia Brzoza, Filip Matusiak https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Modern Technologies in Managing Glycemia During Physical Activity in Patients with Type 1 Diabetes – A Literature Review
Introduction. Regular physical activity is a fundamental component of therapy for type 1 diabetes (T1D), offering multidimensional benefits: from improved insulin sensitivity and weight control to reduced cardiovascular risk and enhanced psychological well-being. Despite these proven advantages, the fear of hypoglycemia remains the primary barrier preventing patients from engaging in regular exercise. Aim. The aim of this study is to provide a comprehensive review of current literature regarding the use of modern diabetes technologies - specifically Continuous Glucose Monitoring (CGM/FGM) systems and Advanced Hybrid Closed Loop (AHCL) insulin delivery systems - in the context of various forms of physical activity. Methods. A systematic search of the literature was conducted using PubMed, Google Scholar and Web of Science databases. The review prioritized clinical trials, meta-analyses, and consensus guidelines published between 2007 and 2024, with a special focus on the rapid technological advancements observed in the 2020–2024. Results. The analysis indicates that modern technologies have revolutionized the approach to exercise in T1D. CGM systems allow for proactive trend-based decision-making, while AHCL systems effectively mitigate hypoglycemia risk through automated insulin suspension. However, the efficacy of these tools is dependent on the type of exercise (aerobic vs. anaerobic) and requires specific patient education regarding "exercise modes" and nutritional strategies. Conclusion. While modern technology significantly reduces the cognitive burden of diabetes management during sports, it does not eliminate physiological challenges entirely. Future research should focus on dual-hormone systems and algorithms dedicated to high-intensity interval sports.
Copyright (c) 2026 Emilia Bolesta-Okuniewska, Konrad Borowski, Julia Ceryn, Katarzyna Kopeć, Aleksandra Marchwińska-Pancer, Paweł Michalak, Oskar Pastuszek, Maja Radziwon https://creativecommons.org/licenses/by-nc-sa/4.0
Plant-Based Diet - Modulation of the Gut Microbiome and Metabolic Consequences
Plant-based diets have gained prominence due to their environmental benefits and protective effects against metabolic disorders, including obesity, type 2 diabetes, and cardiovascular disease. The gut microbiome acts as a key metabolic organ mediating the interaction between diet and host physiology, primarily through microbiota-accessible carbohydrates (MACs) and polyphenols found abundantly in plant foods. A comprehensive literature review demonstrates that plant-based diets promote favourable shifts in microbiota composition, increasing beneficial bacteria populations such as Lachnospiraceae, Ruminococcaceae, and Bifidobacterium spp., while reducing pathobionts including Enterobacteriaceae and Bilophila wadsworthia. These compositional changes enhance production of short-chain fatty acids, particularly butyrate, which strengthen intestinal barrier function and activate signalling pathways regulating satiety hormones (GLP-1, PYY) and glucose homeostasis. Plant-derived tryptophan metabolites and urolithin A further support intestinal integrity through aryl hydrocarbon receptor and Nrf2 pathway activation. The resulting microbiome alterations correlate with improved postprandial glycemic response, reduced cholesterol levels, decreased inflammatory markers, and lower risk of non-alcoholic fatty liver disease. However, the protective effects depend critically on consuming whole foods rich in fiber and polyphenols rather than processed plant-based alternatives. Long-term randomized controlled trials and personalized approaches considering individual microbiome variation are necessary to fully elucidate these mechanisms and optimize dietary recommendations across diverse populations.
Copyright (c) 2026 Bartosz Wróbel, Lena Wójcik, Michał Filipski, Justyna Klonowska, Szymon Kosek https://creativecommons.org/licenses/by-nc-sa/4.0
The new ophthalmic formulation of bilastine: current state of knowledge
Background: Allergic conjunctivitis is a common ocular condition characterized by itching, redness and tearing, which significantly affect patient comfort and daily functioning. Recently, a preservative-free ophthalmic formulation designed for once-daily administration has been developed, containing the second-generation antihistamine bilastine at a concentration of 0.6%. Aim: The aim of this review was to summarize the current state of knowledge on the new ophthalmic formulation of bilastine, evaluate the available clinical evidence on its efficacy and safety and identify major research gaps and directions for future investigation. Materials and methods: A literature review was performed using PubMed, Google Scholar, ResearchGate, Embase, Scopus and Web of Science, applying the keywords: bilastine, ophthalmic, ocular, eye, conjunctivitis, eye drops, ophthalmic solution and formulation. Results: Phase II and phase III studies demonstrated a rapid onset of action and sustained symptom control for up to 16 hours following single-dose administration. Bilastine was shown to be noninferior to ketotifen in relieving ocular pruritus. An 8-week placebo-controlled study confirmed clinically meaningful improvements in patient-reported symptoms, a favorable safety profile and good tolerability. Experimental pharmacokinetic studies demonstrated high concentrations in the conjunctival tissue with minimal systemic exposure, supporting a once-daily dosing regimen. Conclusions: The 0.6% ophthalmic bilastine formulation represents an effective and well-tolerated treatment option for allergic conjunctivitis, offering the advantages of rapid onset of action, prolonged efficacy lasting up to 16 hours and a preservative-free formulation. However, scientific data remain limited regarding the safety of long-term use beyond 8 weeks, its use in pediatric populations and direct comparative studies with other commercially available ophthalmic second-generation antihistamines.
Copyright (c) 2026 Jan Łozowski, Milena Mordarska, Alicja Piwowarczyk, Joanna Paluchowska, Natalia Gołąbek, Alicja Kodura, Przemysław Piątek, Julia Białas, Łukasz Szymański, Artur Merc https://creativecommons.org/licenses/by-nc-sa/4.0
Obesity as a Multidisciplinary Challenge
Purpose. Obesity is a chronic metabolic disease that has reached epidemic proportions worldwide, affecting individuals across all ages, genders, and socioeconomic backgrounds. Its growing prevalence presents a significant public health issue due to the various complications it leads to, such as metabolic disorders, cardiovascular diseases, and psychological or social problems. The aim of this article is to analyze the effectiveness of current therapeutic approaches to obesity, with particular focus on dietary interventions, pharmacotherapy, psychotherapy, and surgical treatment. Materials and Methods. This article is based on a literature review of obesity treatment methods. Data from clinical trials, meta-analyses, and clinical guidelines were selected through searches in databases such as PubMed and Google Scholar. Keywords are “obesity”, “diet”, “anti-obesity drugs”, “pharmacotherapy”, “psychotherapy” and “bariatric surgery.” Priority was given to studies published between 2020 and 2025. Findings. This review provides an overview of current obesity treatment strategies. While dietary changes are the key element of treatment, combining them with pharmacotherapy and psychological support enhances effectiveness and leads to better long-term outcomes. Surgical intervention is reserved for severe cases after other methods have been explored. Each approach is assessed for its effectiveness, safety, and role within a comprehensive treatment plan.
Copyright (c) 2026 Aleksandra Mazur, Krzysztof Sajewicz, Julia Dulęba, Paulina Strzałkowska , Filip Kin, Joanna Koszałko , Monika Kaźmierczak, Maciej Hobot, Julia Kalisiak, Nel Geworkian https://creativecommons.org/licenses/by-nc-sa/4.0
The Evolution of Anatomical Classification Systems for Sinonasal Malignancies
Background. Malignant tumors of the nasal cavity and paranasal sinuses present unique diagnostic challenges. Due to their concealed location and nonspecific symptoms, over 70% of cases are diagnosed at an advanced stage, leading to high mortality. While modern oncology utilizes precise imaging (CT, MRI), earlier approaches relied on physical examination and topographical classifications. Understanding this evolution remains crucial for contemporary rhinosurgery. Aim. This study analyzes historical concepts to understand how pioneers perceived anatomical barriers and tumor spread. It further links these perspectives to tumor biology and the evolution of modern strategies, including skull base surgery. Materials and methods. This study synthesizes historical and contemporary data to trace the evolution of anatomical classifications. A search of PubMed, Google Scholar, and Web of Science databases was performed, focusing primarily on English-language articles relevant to sinonasal tumor surgery and imaging. Results. Early classifications (Sebileau, 1906; Öhngren, 1933) relied on geometric planes for prognosis. The advent of CT/MRI and the TNM system (1977) shifted the paradigm from theoretical geometry to anatomical barriers, while Harrison (1976) proved the feasibility of skull base resection. Consequently, surgery evolved from rigid "en bloc" resections to "compartment theory" and endoscopic techniques based on wall infiltration. Future trends point towards multidimensional models integrating radiomics and molecular profiling, extending beyond anatomy to biological signatures. Conclusions. The evolution of classification systems, from historical topographic lines to modern radiomic algorithms, reflects the progression from macroscopic assessment to digital precision. Despite the paradigm shift toward a functional approach, the precise delineation of tumor boundaries remains a critical challenge for optimizing surgical efficacy and minimizing complications
Copyright (c) 2026 Michał Magiera, Miłosz Sikora, Piotr Czwałga https://creativecommons.org/licenses/by-nc-sa/4.0
Improvement of lipid profile after 6 months of self-initiated, multicomponent physical activity in a previously inactive 62-year-old patient: a case report
Background: Hypercholesterolemia has become one of the main, modifiable risk factors to develop atherosclerotic cardiovascular diseases.Diet modification and lipid‑lowering pharmacotherapy are standard of care, but some patients decline these options. Regular physical activity can improve lipid profile and blood pressure without any medications and diet . Aim: To evaluate the effect of regular, multicomponent physical activity, without concurrent dietary change or pharmacotherapy on lipid profile, blood pressure and body mass in a previously inactive 62‑year‑old man. Material and methods: A 62‑year‑old male patient with elevated total cholesterol (TC) and LDL‑cholesterol (LDL‑C) , previously sedentary, declined diet modification and lipid‑lowering medications. In April 2025 he initiated a multicomponent program: running ( 5 km, three times per week), swimming (twice per week), and resistance training (twice per Results: Over 6 months, TC decreased from 217 to 174 mg/dL (−19.8%; 5.61 to 4.50 mmol/L), LDL‑C from 147 to 116 mg/dL (−21.1%; 3.81 to 3.00 mmol/L), and HDL‑C increased from 49 to 54 mg/dL (+10.2%; 1.27 to 1.40 mmol/L). Non‑HDL cholesterol declined from 168 to 120 mg/dL (−28.6%; 4.35 to 3.10 mmol/L). Blood pressure decreased from 135/85 to 122/80 mmHg, and body mass from 85 to 83 kg (−2.4%). Conclusions: In this previously inactive adult, 6 months of systematic, multicomponent physical activity without dietary or pharmacologic changes was associated with clinically meaningful improvements in LDL‑C, non‑HDL cholesterol, HDL‑C, blood pressure and body mass. The case supports multicomponent exercise as a practical, non‑pharmacologic intervention in primary prevention for patients declining standard lipid‑lowering strategies.
Copyright (c) 2026 Konrad Puchalski, Natalia Radwańska , Izabela Polakowska, Bartłomiej Labut , Katarzyna Popielec-Jakubiec, Miraslau Kabak , Agata Bęben, Zuzanna Glowacka , Wojciech Neumann https://creativecommons.org/licenses/by-nc-sa/4.0
Hypochlorous acid in ophthalmology: a narrative review
Background: Hypochlorous acid (HOCl) is a naturally occurring molecule that plays a key role in host defence, exhibiting broad-spectrum antimicrobial activity against bacteria, viruses and fungi while maintaining an excellent safety profile for human tissues. Its utility has been demonstrated in numerous studies in wound care, perioperative antisepsis and more recently in nasopharyngeal sprays and inhalation applications. Aim: The purpose of this study was to provide an overview of the current and potential uses of hypochlorous acid in ophthalmic practice. Materials and methods: A comprehensive narrative review of the literature was conducted using the PubMed, Web of Science, ResearchGate, Google Scholar, Scopus and Embase databases. The search strategy was based on the following combination of key terms: (“hypochlorous acid” OR HOCl) AND (ophthalmology OR keratitis OR “ocular surgery” OR “meibomian gland dysfunction” OR “dry eye” OR blepharitis OR ocular OR “ocular surface” OR “eye infections” OR conjunctivitis). Results: HOCl demonstrated broad antimicrobial activity in several studies, with meaningful reductions in bacterial load, rapid in vitro fungicidal effects and improvement in clinical parameters of blepharitis, dry eye disease and meibomian gland dysfunction. Antiseptic efficacy relative to povidone-iodine varied, with some studies showing inferior perioperative performance. Across all reports, HOCl was well tolerated, with no serious adverse events and consistently better patient comfort than povidone-iodine. Conclusions: Hypochlorous acid is a safe, well-tolerated antiseptic with potential benefits in eyelid hygiene, dry eye disease, blepharitis and as an adjunct in ocular infections. While its antimicrobial efficacy is promising, it is inconsistent compared with povidone-iodine and it should currently be viewed as a complementary rather than a replacement agent. Further standardized clinical studies are needed to clarify its optimal role.
Copyright (c) 2026 Milena Mordarska, Jan Łozowski, Natalia Gołąbek, Łukasz Szymański, Artur Merc, Przemysław Piątek, Alicja Kodura, Alicja Piwowarczyk, Joanna Paluchowska, Julia Białas https://creativecommons.org/licenses/by-nc-sa/4.0
Education, Physical Activity, and Reproductive Health in Women: Understanding the Impact of the Vaginal Microbiome
Background. The vaginal microbiome is essential for women’s reproductive health, affecting fertility, implantation, pregnancy outcomes, and vulnerability to gynecological conditions. It is increasingly recognized within the broader context of women’s health literacy and lifestyle, including physical activity, which may influence microbial balance. Aim. To summarize current evidence on the composition and clinical importance of the vaginal microbiome while integrating insights from public health, health education, and sports science. Material and methods. A review of open access studies published between 2021 and 2025 identified 23 eligible articles. Additional literature on women’s health education and physical activity was included to highlight interdisciplinary links. Results. Lactobacillus-dominant communities, especially those enriched with Lactobacillus crispatus, support mucosal stability and favorable reproductive outcomes. Dysbiosis, characterized by low Lactobacillus levels and high microbial diversity (CST IV), is linked to bacterial vaginosis, subfertility, implantation failure, and preterm birth. Education and lifestyle-focused interventions may help mitigate dysbiosis, while early evidence suggests physical activity supports systemic regulation relevant to microbial stability. Conclusions. The vaginal microbiome significantly influences reproductive and overall health. Integrating microbiome knowledge into health education and lifestyle promotion may improve preventive strategies and clinical outcomes.
Copyright (c) 2026 Emilia Borychowska, Michalina Czudowska, Magdalena Zawadzka, Dominika Marszałek, Klaudia Kurzątkowska, Aleksandra Natalia Bystros, Marta Drozdowska, Aleksandra Ocimek, Karolina Gwóźdź, Zofia Aneta Mierzejewska https://creativecommons.org/licenses/by-nc-sa/4.0
Mental Health of Youth Athletes After Sport Career Termination: A Systematic Review
Background. Mental health challenges in youth athletes following career termination represent a significant but understudied public health concern. Despite increasing recognition of mental health issues in sports, limited comprehensive evidence exists regarding psychosocial experiences and effective interventions for former youth athletes transitioning out of competitive sport. Aim. To systematically review and synthesize qualitative and quantitative evidence on mental health outcomes and coping mechanisms in youth athletes following sport career termination, identify research gaps, and provide recommendations for clinical practice. Material and methods. A comprehensive systematic literature review was conducted following PRISMA 2020 guidelines. Electronic databases were searched for English-language peer-reviewed articles. Thirteen studies met inclusion criteria (11 qualitative, 2 quantitative). Quality assessment was performed using appropriate tools. Results. The synthesis reveals predominantly qualitative evidence highlighting "social death" and identity foreclosure as primary psychological distress mechanisms. Quantitative data suggest significant psychological distress in the acute post-selection phase and links between high athletic identity and anxiety. However, contrary to deficit narratives, long-term qualitative data indicate high wellness levels and post-traumatic growth facilitated by communal coping and body recalibration. Only two specific interventions (online support groups and Bodies in Motion) were identified. Conclusions. While transition out of sport poses significant risks for psychiatric symptoms driven by identity loss and institutional silence, it offers growth opportunities when supported by holistic interventions. Urgent priorities include developing evidence-based programs addressing somatic "relearning" and leveraging mentorship networks to mitigate isolation.
Copyright (c) 2026 Karol Knysak, Alicja Maj, Maja Piątek, Michał Jastrzębski, Aleksandra Hejnosz, Mateusz Szczerba, Krystyna Wilkowska, Wojciech Kaczorowski , Maciej Karol Michałowski, Maria Sudomir, Julia Strumińska https://creativecommons.org/licenses/by-nc-sa/4.0
When Intimacy Hurts: Dyspareunia in Genitourinary Syndrome of Menopause - A Review of Treatment Options
Dyspareunia, defined as pain during or immediately after sexual intercourse, is one of the most common and troublesome symptoms of Genitourinary syndrome of menopause (GSM), affecting a significant number of perimenopausal and postmenopausal women. This paper aims to review and systematize knowledge on pharmacological and non-pharmacological methods of treating this condition, the main cause of which is atrophy of the vulvar and vaginal tissues resulting from estrogen deficiency. An analysis of the available literature indicates that local estrogen therapy remains the gold standard for alleviating symptoms, as it effectively restores the elasticity and lubrication of the epithelium. As alternative therapeutic options, particularly important for patients with contraindications to estrogens, the use of prasterone (DHEA) and oral ospemifene (SERM) is discussed. The paper also presents the role of non-hormonal methods, such as commonly used lubricants and moisturizers as first-line therapy, and hyaluronic acid injections. Attention was also paid to modern laser therapy, which, despite its promising regenerative effects, has not yet been fully approved by scientific societies due to the lack of long-term safety data. The conclusions of the paper emphasise the need for individualised therapy, taking into account the patient's medical history and preferences, which is key to improving the quality of sexual life for women during menopause.
Copyright (c) 2026 Julia Dąbrowska, Michał Białogłowski, Katarzyna Mazurek, Anna Gęborys, Maja Wojcieszak, Julia Matuszewska, Weronika Woźnica, Alicja Maziarczyk, Jakub Lambach, Dominika Miazga https://creativecommons.org/licenses/by-nc-sa/4.0
The impact of obesity on clinical outcomes in acute pancreatitis: a systematic review
Background: Obesity may influence the severity of acute pancreatitis (AP) by intensifying inflammatory and metabolic disturbances. However, evidence is inconsistent due to differences in patient characteristics and AP causes. Clarification is needed to determine if obesity reliably predicts severe AP and complications. Aim:To evaluate the association between obesity, disease severity, complications, and clinical outcomes in AP. Methods: We conducted a systematic review of observational studies following PRISMA guidelines. We searched databases for studies on adult AP patients assessing obesity or BMI in relation to disease severity, organ failure, local complications, ICU admission, or mortality. We excluded studies on visceral adiposity indices only, pediatric cohorts, non-original publications, and non-RCT/non-observational designs. Results: Eleven studies met the inclusion criteria. Most reported that obesity is linked with increased AP severity and higher rates of systemic or local complications, such as organ failure, necrosis, and greater healthcare utilization. Large database studies confirmed increased complication rates in obese patients. However, findings regarding mortality were inconsistent: some studies noted higher mortality in overweight individuals, others showed no difference. Studies using BMI as a continuous variable found a consistent association between higher BMI and increased AP severity. Conclusions: Obesity appears to be associated with more severe AP and selected complications, but its link to mortality remains unclear. BMI alone shows limited predictive value and should be interpreted alongside other clinical data. Further research is required to standardize the incorporation of obesity into early AP risk assessment.
Copyright (c) 2026 Zofia Kosztyła-Czech, Marta Kowalska, Anna Mazur, Julia Brodziak, Katarzyna Fojcik, Wiktoria Ciszewska, Tomasz Wiśniewski, Michał Dworak, Wiktor Werenkowicz, Mateusz Matyja https://creativecommons.org/licenses/by-nc-sa/4.0
The role of the gut microbiota in childhood obesity
The gut microbiota has emerged as an important factor influencing metabolic health of people. Recent research indicates that children with obesity present distinct microbial compositions compared with their normal-weight peers, suggesting a potential role of intestinal microorganisms in the development adiposity. This paper discusses current findings on how dietary patterns, perinatal exposures and inherited microbial traits shape the gut microbiome in childhood. Particular attention is given to taxa associated with metabolic alterations, as well as to microbial metabolites that may influence energy balance and inflammation. Studies linking the gut microbiota to anthropometric measures and early markers of cardiovascular dysfunction highlight its potential value as a diagnostic tool. Understanding these complex host–microbe interactions may contribute to the development of targeted microbiota-based interventions and personalized therapeutic strategies aimed at preventing or treating childhood obesity.
Copyright (c) 2026 Kamila Bała, Natalia Staszko https://creativecommons.org/licenses/by-nc-sa/4.0
Targeting Schizophrenia: A Review of Pharmacological and Psychosocial Innovations
Background. Paranoid schizophrenia is the most common subtype of schizophrenia, characterized by both positive symptoms, such as hallucinations and delusions, and negative symptoms like reduced motivation and social withdrawal. While pharmacological advances have improved symptom control, challenges remain in treating negative symptoms and ensuring long-term adherence and recovery. Aim of the study. This review analyzes recent literature (2020–2025) on pharmacological and psychosocial treatment strategies for paranoid schizophrenia, with attention to effectiveness, tolerability, and integration. Materials and methods. PubMed and Google Scholar were searched for meta-analyses, RCTs, and guidelines published in the last 5 years using terms like “paranoid schizophrenia”, “antipsychotics”, “long-acting injectables”, “CBT”, “treatment”. Current stage of knowledge. Modern antipsychotics, particularly SGAs and LAIs, reduce relapse risk and enhance adherence. Cariprazine and newer agents like Cobenfy show promise in treating negative and treatment-resistant cases. Integration with psychosocial strategies—especially CBT and family interventions—enhances functional recovery, though results for negative symptoms remain mixed. Novel treatments target glutamatergic and cholinergic systems beyond traditional dopaminergic focus. Conclusions. A multimodal approach is essential. Future treatment should emphasize personalized strategies, early intervention, targeting of non-dopaminergic pathways, and better access to integrated care, particularly for patients with persistent negative or cognitive symptoms.
Copyright (c) 2026 Urszula Janicka, Klaudia Bogdan, Mikołaj Jankowski, Natalia Ciepluch, Szymon Słomiński, Wiktoria Toczek, Magdalena Olszówka, Sonia Dziugieł https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Estrogen Levels on the Development of Breast Cancer in Postmenopausal Women with Diagnosed Obesity or Overweight
Breast cancer is one of the most commonly diagnosed malignancies in women. Its development is largely influenced by hormonal factors. Estrogens, as key female sex hormones, play a crucial role in the proliferation of mammary gland cells, which may contribute to the initiation and progression of tumorigenesis. In postmenopausal women, estrogens are primarily derived from the conversion of androgens in adipose tissue, leading to hormonal changes that impact breast cancer risk. This study aims to examine the influence of estrogen levels on breast cancer development in postmenopausal women with overweight and obesity, as well as to elucidate the underlying biological mechanisms of this association. The molecular actions of estrogens and their effects on estrogen receptor (ER) expression in the context of breast cancer will be discussed. Additionally, the role of obesity as a risk factor for breast cancer in postmenopausal women will be presented. This article seeks to enhance the understanding of the role of obesity in oncogenesis among women whose physiological estrogen levels should correspond to their age-appropriate hormonal balance.
Copyright (c) 2026 Jakub Pochopień, Mikołaj Pograniczny, Adrianna Mielżyńska, Adrianna Pacołta, Marcelina Nalepka https://creativecommons.org/licenses/by-nc-sa/4.0
Animal-Assisted Interventions in Pediatric and Geriatric Care: A Review of Benefits, Mechanisms, and Limitations
Background. The role of animals in modern medicine extends beyond experimental models to include the therapeutic potential of the human-animal relationship. Animal-Assisted Interventions (AAI), including Therapy (AAT), Education (AAE), and Activities (AAA), constitute an effective tool for improving patients' psychophysical well-being. These methods, utilizing appropriately trained animals (most commonly dogs) or their robotic counterparts, are applied in supporting cognitive and social functions as well as motivating activity. Aim. The aim of this review was to present the benefits of AAI in both children and adolescents, as well as in elderly patients with age-related physical, mental, and neurological disorders. Material and methods. This paper constitutes a review of recent literature, based on an analysis of data retrieved from PubMed, Google Scholar, and Web of Science databases. Only English-language publications were analyzed. Results. Analysis of studies confirms the multidimensional impact of AAI on health. In the physical sphere, contact with an animal enforces movement and sensory stimulation, improving balance and cardiovascular parameters. Regarding the psychological aspect, AAI regulates hormonal balance (oxytocin/cortisol), reducing symptoms of depression and anxiety in seniors, as well as pain and hospitalization stress in children. Although robotics offer an allergen-free alternative, interaction with a living animal, yields more lasting social effects. However, the use of AAT carries epidemiological risks and challenges regarding animal welfare, requiring strict safety procedures. Conclusions. AAI constitutes an effective, non-pharmacological support method in geriatrics and pediatrics, characterized by a unique, multidimensional nature. While the development of robotics (Pet-Robot Intervention, PRI) opens new perspectives, the success of interventions with living animals requires absolute adherence to strict safety and ethical standards.
Copyright (c) 2026 Michał Magiera, Piotr Czwałga, Miłosz Sikora, Patrycja Koprowska https://creativecommons.org/licenses/by-nc-sa/4.0
Pain Assessment in Palliative Medicine: Review of Pain Rating Scales
Pain is one of the most prevalent and distressingsymptoms in patients receiving palliative care, oftenleading to a profound reduction in quality of life. Effectivepain control requires accurate and systematic assessment, yet the multidimensional and subjective nature of painmakes this process complex. This review summarizes the most commonly used pain rating tools in palliativemedicine, including the Numeric Rating Scale (NRS), Visual Analog Scale (VAS), Verbal Rating Scale (VRS), Wong–Baker FACES Pain Rating Scale (WBS), FLACC Scale, McGill Pain Questionnaire (MPQ), and Abbey PainScale (APS). Each scale’s characteristics, advantages, and limitations are discussed in relation to different patientpopulations, such as cognitively impaired or non-verbalindividuals. The article emphasizes that the choice of assessment tool should be individualized, reflecting the patient’s clinical condition, communication ability, and cognitive status. Accurate pain assessment forms the foundation of effective analgesic therapy and improvedpatient outcomes in palliative medicine.
Copyright (c) 2026 Michał Kotowicz, Magdalena Zielińska, Paweł Szajewski, Aleksandra Zagórska, Joanna Ciećwierz, Maria Koczkodaj, Magdalena Bieniak-Pentchev https://creativecommons.org/licenses/by-nc-sa/4.0
Kisspeptin and Leptin as Treatments for Functional Hypothalamic Ammenorhea (FHA): Experimental Approach or Emerging Therapy?
Functional hypothalamic amenorrhea (FHA) is a common cause of amenorrhea among women in reproductive age. The disturbance is often associated with stress and deficiency in energy availability caused by either intensive exercise or improper nutrition. Those factor affect the hypothalamic-pituitary-gonadal axis and further absence of ovulation and normal menstrual cycle. Treatment should be directed to treatment of the etiology, however sometimes it is not enough. For this reason, novel therapies emerged to counteract the consequences of FHA to support restoring that lifestyle changes are not capable of. This review summarizes current knowledge on the leptin and kisspeptin treatment, which recently gained more interest, due to it physiological basis in hypothalamic-pituitary-gonadal axis. Furthermore, paper evaluates clinical data, its limitations and safety consideration, and more importantly, the need for future research.
Copyright (c) 2026 Malgorzata Bednarczyk, Michał Karol, Kamila Koseska, Jan Borowicz, Bartosz Górecki, Kinga Kloch, Patryk Romaniuk, Mariia-Khrystyna Lohin, Aleksandra Strawińska https://creativecommons.org/licenses/by-nc-sa/4.0
Long-Term Safety of JAK Inhibitors in Dermatology: A Literature Review of 2020-2025
Background. In recent years, Janus kinase (JAK) inhibitors have become an important therapeutic option in dermatology. Agents such as abrocitinib, upadacitinib, baricitinib, deucravacitinib, and ruxolitinibhave significantly changed the management of chronic inflammatory skin diseases, including atopic dermatitis, alopecia areata, psoriasis, and vitiligo. By targeting specific signalling pathways within the JAK–STAT axis, these drugs provide rapid and targeted immunomodulation, offering an alternative to traditional systemic therapies and biologics. However, their long-term safety remains a concern, particularly regarding infections, laboratory abnormalities, dermatologic adverse effects, malignancies, and thromboembolic events. Aim. To summarize the current evidence on the safety profile of JAK inhibitors used in dermatology focusing on data published after 2020. Material and methods. A literature search was conducted in PubMed, Scopus, Frontiers and Cochrane Library databases for studies published between January 2020 and December 2025. Results, JAK inhibitors are effective and generally well tolerated when prescribed with appropriate patient selection and monitoring. The most frequently reported adverse events included infections,laboratory abnormalities, and mild dermatologic reactions, while serious complications such as malignancies or thromboembolic events were uncommon. Conclusion, Evidence from 2020–2025 indicates that JAK inhibitors are effective and generally safe in dermatology. Continued patient monitoring, individualized risk assessment, and further long termstudies are necessary to fully characterize their safety profile.
Copyright (c) 2026 Marcela Słomianny, Michał Czechowski, Gabriela Sikora, Karolina Kutnik, Karolina Kolada, Katarzyna Gunia, Filip Dudek, Dominik Lese https://creativecommons.org/licenses/by-nc-sa/4.0
GLP-1 Analogues in Rheumatology - The Influence of Obesity on the Effectiveness of Biological Treatment
Obesity and overweight are becoming a global health challenge and are increasingly prevalent in patients with rheumatic diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), and systemic lupus erythematosus (SLE). Adipose tissue serves as an active endocrine organ, secreting adipokines and proinflammatory cytokines, including leptin, tumor necrosis factor alpha (TNF-alpha), and interleukin 6 (IL-6). Obesity exacerbates inflammatory processes, increases the number of classically activated macrophages (M1) and reduces adiponectin levels, which may sustain and amplify the immune response typical of autoimmune diseases. Available studies indicate that obesity is associated with a lower likelihood of achieving minimal disease activity, particularly in RA and PsA. In RA patients, a higher body mass index (BMI) correlates with greater pain, a higher Health Assessment Questionnaire (HAQ) score, and a lower chance of remission, even with similar treatment. In the case of PsA, obesity increases the risk of disease onset. In SLE, a higher BMI is associated with increased disease activity and excessive fatigue. Research suggests that the effectiveness of TNF-alpha inhibitors may be reduced in patients with obesity, while the response to medications such as tocilizumab or abatacept is often independent of BMI. At the same time, abundant data confirm that weight loss brings tangible benefits – improving functional outcomes, and increasing the chance of achieving minimal disease activity, particularly in RA and PsA. Preliminary observations regarding Glucagon-Like Peptide-1 (GLP-1) agonists indicate their possible anti-inflammatory effects, although further research is needed. In summary, obesity significantly affects the course of rheumatic diseases and the effectiveness of therapy, and weight loss is an important element in supporting treatment.
Copyright (c) 2026 Julia Agnieszka Michalak, Klaudia Martyna Patrzykąt, Anna Maria Zakrzewska, Aleksander Midera, Julia Aleksandra Leśniak, Michał Borowski, Klaudia Elżbieta Niwińska, Zofia Czaplińska-Paszek, Natalia Maria Leśniak, Kinga Popielarska https://creativecommons.org/licenses/by-nc-sa/4.0
Managing Refractoriness: Modern Strategy for Refractory Celiac Disease
Celiac disease (CD), also known as gluten-sensitive enteropathy, is the most common autoimmune disorder in today’s society. CD is associated with both human leukocyte antigen (HLA) and non-HLA genes. It often coexists with other autoimmune diseases, such as juvenile diabetes and thyroid disease. Diagnosis often relies on biopsy results, but serological tests are also very useful when screening patients suspected of having CD. Although our knowledge of celiac disease seems thorough, the pathogenesis of refractory celiac disease (RCD) is still under research. Treating RCD can be challenging, and it is crucial to provide care in experienced tertiary centers. Treatment may involve dietary and pharmacological approaches, depending on the type of RCD. This reduces the risk of disease progression and alleviates the symptoms. Investigations into other innovative treatment methods are ongoing.
Copyright (c) 2026 Roksana Grzeszczak, Aleksandra Fałczyńska, Aleksandra Balak, Weronika Szkudlarek, Katarzyna Rotte, Maksymilian Grabarczyk, Igor Piotrowski https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Sauna Bathing on Cardiovascular Homeostasis: From Molecular Mechanism to Clinical Benefits
Background. Cardiovascular diseases (CVD) reamin the leading cause od death wordwilde, thereby demanding noveland scalable preventive approaches. In recent years, sauna bathing and infrared Waon therapy have emerged as potentialpleiotropic intervention replicating the effects of aerobic training. Aim. This review aims to summarize the evidence currently available from large prospective cohort studies and from randomized controlled trials on the influence of short-term thermal stress on hemodynamic parameters, endothelial function, arterial stiffness and long-term cardiovascular prognosis. Results. Observational studies strongly indicate that dose-dependent sudden cardiac death (63% reduction), stroke (61%), and hypertension are low in the frequent sauna users (4-7 times per week). These effects are mediated through upregulation of heat shock proteins (HSPs) modulation of the autonomic nervous system, and suppression of systemic inflammation. However, the results of studies testing these advanced exercise training strategies in patients with established CAD are conflicting regarding potential improvement in vascular function compared to healthy subjects, potentially resulting from a "healthy user" bias or structural limitations when disease is severe. Conclusions. Acute heat treatment may serve as a hormetic stressor that triggers beneficial pleiotropic adaptations. While the epidemiological evidence on risk reduction is strong for modification of these potentially reversible factors, the failure to demonstrate vascular benefit in short-term trial of advanced CAD patients demands additional investigation into the optimal approach regarding patient population, timing and duration of therapy.
Copyright (c) 2026 Filip Matusiak, Klaudia Brzoza https://creativecommons.org/licenses/by-nc-sa/4.0
Teprotumumab as a Breakthrough in Thyroid Eye Disease Therapy: A Comprehensive Review
Background. Thyroid Eye Disease (TED) is a complex autoimmune condition associated with Graves' disease, causing disfigurement, visual impairment, and reduced quality of life. For decades, options were limited to non-specific anti-inflammatory treatments like glucocorticosteroids and radiotherapy, often failing to address symptoms like proptosis and diplopia. Identifying the insulin-like growth factor-1 receptor (IGF-1R) as a driver of TED pathophysiology led to targeted therapies. Aim. This study reviews teprotumumab as a breakthrough TED therapy, analyzing its mechanism, efficacy, and place in treatment algorithms relative to traditional methods. Material and methods A literature review was conducted using databases (PubMed, Embase, ClinicalTrials.gov) for articles up to November 2025. Analysis prioritized pivotal trials (OPTIC, OPTIC-X), meta-analyses, and reviews focusing on TED pathophysiology and IGF-1R inhibition. Results. TED pathogenesis involves crosstalk between TSHR and IGF-1R on orbital fibroblasts, triggering inflammation and adipogenesis. While traditional treatments offer limited relief with side effects, teprotumumab, the first FDA-approved IGF-1R inhibitor, targets these mechanisms. Clinical data shows superior efficacy in reducing proptosis and improving diplopia compared to palliative care. Conclusions. Teprotumumab is a breakthrough in TED management, shifting from symptomatic to targeted disease modification. By addressing orbital remodeling causes, it offers distinct advantages over traditional therapies, fulfilling a major unmet need.
Copyright (c) 2026 Marceli Mesyasz, Mateusz Piszka, Eliza Kwapień, Hubert Dacyl, Aleksandra Owczarska, Julia Żerdka, Patryk Brasse, Jan Banach, Jakub Bartkowski, Filip Czarnecki https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Gut Microbiota in the Pathophysiology of Depression: A Narrative Review
Depression is a complex psychiatric disorder with incompletely understood pathophysiology. Increasing evidence implicates gut microbiota dysbiosis in depression through the microbiota-gut-brain axis. This narrative review summarizes experimental and clinical studies published between 2013 and 2025 examining associations between gut microbiota and depressive disorders. Findings indicate that depression is linked to altered microbial diversity, immune activation, intestinal barrier dysfunction, dysregulation of the hypothalamic-pituitary-adrenal axis, and disturbances in tryptophan metabolism. While preclinical studies suggest a potential causal role of gut microbiota in depressive-like behavior, human evidence remains largely associative. Modulation of gut microbiota represents a promising but still exploratory direction for future depression research and therapy.
Effectiveness of recovery methods in reducing delayed onset muscle soreness (DOMS): A narrative review
Background. Delayed onset muscle soreness (DOMS) represents a significant physiological challenge in professional and recreational sports, characterized by muscle tenderness, stiffness, and reduced force production peaking 24–72 hours post-exercise. Aim. The primary aim of this study is to evaluate the effectiveness of widely implemented recovery strategies—stretching, massage, foam rolling, cryotherapy, compression garments, and nutritional supplementation—in reducing DOMS. Material and methods. A narrative review was conducted based on an analysis of peer-reviewed literature indexed in PubMed, Scopus, and Web of Science. The review focuses on mechanisms of action, practical application protocols, and reported outcomes of interventions targeting exercise-induced muscle damage (EIMD). Results. Current evidence indicates that stretching has a negligible influence on DOMS reduction. Conversely, massage and foam rolling significantly alleviate perceived soreness through neuromuscular and myofascial modulation. Cryotherapy yields mixed results, offering short-term analgesic benefits while potentially blunting long-term hypertrophic adaptations. Compression garments demonstrate moderate effectiveness in reducing swelling and perceived fatigue. Nutritional strategies, particularly omega-3 fatty acids and polyphenols, show potential for modulating inflammation. Conclusions. Effective recovery requires a multimodal approach. While mechanical therapies (massage, foam rolling) provide superior symptom relief, thermal and nutritional interventions should be periodized according to training goals. Stretching should not be employed as a primary tool for DOMS reduction.
Copyright (c) 2026 Radosław Starzyk, Sara Śmiałek, Julia Florek, Dominika Cholewa, Natalia Guzik, Dominik Jaklik, Wiktor Słaby, Adrian Groele, Patrycja Dębska, Marcin Miczek https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Protein Intake: Benefits, Risks, and Metabolic Effects – A Literature Review
This work is a literature review examining the effects of dietary protein intake on muscle strength, body composition, metabolic health, hormonal regulation, and gastrointestinal function in healthy adults, including athletes. The review covers studies on moderate and high protein intake from various sources and considers differences related to age, training level, and macronutrient balance. Research shows that higher protein intake supports increases in lean body mass and lower-body strength, especially in resistance-trained and older adults consuming at least 1.6 g/kg/day. During caloric restriction, increased protein intake helps preserve muscle mass in overweight and obese individuals. Very high protein intake above 3.4 g/kg/day may reduce testosterone levels in men, whereas moderate intakes do not produce hormonal disturbances. Protein source influences metabolic outcomes: animal and seafood protein intake is linked to a higher risk of hyperuricemia, while plant proteins, particularly soy, show protective effects. The impact of protein intake on gut function depends on carbohydrate availability, with high-protein, low-carbohydrate diets increasing constipation risk. Studies also show wide variability in dietary protein intake among athletes, emphasizing the need for individualized nutrition strategies. Overall, the review concludes that optimal protein intake depends on training type, age, diet composition, and protein quality. High-protein diets generally support muscle health and metabolic function, but the long-term consequences of very high protein intake require further study.
Copyright (c) 2026 Paulina Jakubowska, Mikołaj Szaryński, Martyna Jakubowska, Julia Gólcz, Adam Sikorski, Michał Bursztyn, Adrian Gólcz, Karolina Kadłubowska, Natalia Chojnowska, Jan Rytel, Tomasz Bursztyn https://creativecommons.org/licenses/by-nc-sa/4.0
Practical Problems and Solutions in Junior High School Physical Education from a Stakeholder Perspective
Research Background and Purpose: Despite educational reforms promoting holistic development, junior high physical education in China remains heavily exam-oriented. This study applies stakeholder theory to identify key actors, analyze their interests, and propose strategies to reduce test-driven practices. Research Methods: Through literature review and logical analysis, we examine the development of stakeholder classification models and assess their relevance to physical education, while also investigating the root causes of current problems in the field. Research Results: The study identifies four phases in stakeholder theory: initial exploration (1980–1990), deepening development (1990–2000), steady advancement (2000–2010), and innovative breakthrough (2010–2025). Significant test-oriented tendencies were observed in junior high physical education across teaching objectives, content, methods, assessment, and broader sociopolitical dimensions. Key contributing factors include grade-driven instruction, limited awareness among schools and teachers, narrow assessment criteria, and cultural-academic pressures. Research Conclusions: Proposed solutions emphasize shifting toward game-based and life-relevant content, adopting scientific and personalized teaching methods, and diversifying evaluation mechanisms. Aligning the core interests of stakeholders at both macro-policy and micro-practice levels is essential to restoring physical education’s fundamental role in supporting students’ holistic development. Research Value: Theoretically, this work expands stakeholder theory into physical education, offering a systematic lens for understanding complex educational interactions. Practically, it provides a actionable framework to help policymakers, administrators, and teachers better allocate resources and reform teaching practices, supporting a shift toward student-centered physical and mental development.
Copyright (c) 2026 Xianghan Xiao, Linghui He, Chen Li, Yangyan Hu https://creativecommons.org/licenses/by-nc-sa/4.0
The Complex Relationship Between Body Mass Index and Suicide Risk: From Epidemiology to Biological Mechanisms – A Review
Introduction. Suicide is one of the most serious public health problems worldwide. In the context of risk marker searches, researchers focus on Body Mass Index (BMI). Scientific studies remain unclear, indicating both a potential protective effect of obesity and an increased risk of suicidal behaviors in extreme weight categories. Purpose. This study reviews literature regarding the correlation between BMI and the risk of suicidal ideation and behaviors, considering potential underlying mechanisms. Materials and methods. A PubMed search was conducted. Epidemiological and clinical studies covering adult and adolescent populations from Europe, North America, and Asia were analyzed. The review included completed suicides, attempts, ideation, biomarkers (serotonin, leptin, cytokines), and psychosocial factors. Summary. The literature indicates a complex relationship between BMI and suicide risk, often assuming a "U" or "J" shape. Some studies found lower suicide mortality in overweight and obese individuals. However, recent research shows that extreme obesity or being underweight increases risk. Insulin resistance might lower impulsivity, but chronic inflammation and leptin resistance could increase vulnerability. For adolescents, subjective weight perception is a key risk factor. In adults, obesity can affect the selection of less lethal suicide methods. Conclusions. BMI is an important but complex marker of suicide risk. The "obesity paradox" may result from physical barriers hindering suicide completion. Clinical assessment should include body weight and its dynamic changes, subjective body image, and metabolic profile.
Copyright (c) 2026 Martyna Świątecka, Jakub Kaźmierczyk, Aleksandra Marciszewska, Ewa Buczkowska, Jakub Jopek, Sylwia Bryksy, Agnieszka Piechowicz, Natalia Popczyk, Agnieszka Przybyłowska, Hanna Tymchenko https://creativecommons.org/licenses/by-nc-sa/4.0
Dietary Supplements and Popular Nutritional Strategies among Young Adults
Dietary supplements and various nutritional strategies have become an integral part of young adults' lives in recent years, a trend observed in an increasing proportion of the population. The popularity of supplementation has been rising, driven by the easy availability of preparations, the influence of social media, and the belief that health and physical performance should be supported with additional substances. However, growing attention is being paid to the inadequate regulation of the dietary supplement market and the fact that some of the preparations available online contain ingredients that do not match the manufacturer's declaration. At the same time, there has been a marked increase in the interest in restrictive dietary strategies, such as the ketogenic diet, high-protein diet, plant-based diets, and intermittent fasting. Although these approaches may offer metabolic and performance-related benefits, they can also adversely affect the health of young adults if used improperly. The aim of this study was to present current evidence on the efficacy and safety of the most commonly used supplements and dietary strategies in the young adult population. Reports from clinical trials, observational studies and systematic reviews published between 2014 and 2024 were analyzed, with particular focus on health risks such as hepatotoxicity, electrolyte disturbances, interactions between active ingredients, and the risk of deficiencies associated with inadequately balanced diets. The available data indicate that although some supplements have a favorable safety profile, their unsupervised and combined use increases the risk of adverse effects. Similarly, many dietary patterns can be effective but require appropriate planning and, in some cases, professional supervision. These findings highlight the need for targeted health education, routine clinical assessment of supplement and diet use, and stricter regulation of the dietary supplement market.
Hypertrophic Cardiomyopathy in Athletes: A Paradigm Shift in Exercise Safety, the Role of Comorbid Factors, and the Impact of Anabolic Steroids - A Literature Review
Hypertrophic cardiomyopathy (HCM) in athletes is a complex condition requiring individualized risk assessment and interdisciplinary management. Advances in diagnostics, including advanced cardiac imaging and multiparametric risk stratification, allow differentiation between pathological hypertrophy and physiological adaptations in athletes. Current guidelines support carefully supervised participation in moderate and, in selected cases, high-intensity physical activity for low-risk patients. Targeted therapy, particularly the myosin inhibitor mavacamten, improves left ventricular outflow gradients, exercise tolerance, and quality of life, especially when combined with personalized training programs. Chronic use of anabolic-androgenic steroids can induce HCM-like cardiomyopathy, promote fibrosis, impair diastolic function, and increase arrhythmic risk, highlighting the need for thorough history-taking and advanced imaging. Comorbidities such as hypertension, obesity, and coronary artery disease exacerbate remodeling and arrhythmic risk, while complications like atrial fibrillation, HFpEF, and sudden cardiac death remain critical considerations. An integrated approach combining diagnostics, therapy, exercise guidance, and management of comorbidities allows safer and more flexible physical activity for athletes with HCM.
Copyright (c) 2026 Martyna Jakubowska, Paulina Jakubowska, Mikołaj Szaryński, Julia Gólcz, Adam Sikorski, Adrian Gólcz, Karolina Kadłubowska, Jan Rytel, Natalia Chojnowska, Tomasz Bursztyn, Michał Bursztyn https://creativecommons.org/licenses/by-nc-sa/4.0