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
Intramuscular veins: the most neglected source of thrombosis
Introduction: Venous thromboembolism is a common clinical problem. Its diagnosis in patients who have sustained trauma can be difficult due to nonspecific symptoms and the lack of characteristic findings on imaging studies. Thrombosis of the intramuscular veins of the lower leg is an uncommon manifestation of thrombotic disease, and due to its location and difficult diagnosis, it remains an underestimated and overlooked cause of painful lower limb edema. Case description: A 36-year-old man who suffered a knee injury while skiing presented with persistent swelling of the knee and shin lasting three weeks. Magnetic resonance imaging and ultrasound examination revealed no significant pathology, intra-articular damage, cartilaginous structures. An initial assessment of the venous system revealed no significant changes in the popliteal fossa and no signs of thrombosis. Due to increasing pain, tenderness and persistent swelling, the diagnosis was expanded to include a comprehensive ultrasound examination of the lower limb. Examination of the intramuscular veins revealed extensive thrombosis of the soleal and gastrocnemius veins, with preserved patency of the larger superficial and deep venous vessels. Conclusions: The presented case highlights the importance of intramuscular veins as the starting point for thromboembolic disease, which carries a risk of serious complications. Assessment of intramuscular veins is essential in the diagnosis of patients with persistent lower limb edema after trauma. A limited or cursory examination of the venous system may lead to delayed diagnosis and the development of complications. A comprehensive evaluation of the superficial and deep venous system, including intramuscular veins, should be standard practice in trauma patients.
Copyright (c) 2026 Anna Kozińska, Andrzej Zuzak, Agata Zarajczyk, Natalia Fidut, Monika Zbroja-Putowska, Maryla Kuczyńska, Małgorzata Drelich https://creativecommons.org/licenses/by-nc-sa/4.0
Physical activity as a non pharmacological intervention in Alzheimer’s disease: a narrative review
Background. Alzheimer’s disease (AD) is the leading cause of dementia, and disease‑modifying pharmacological options remain limited. Physical activity (PA) has emerged as a promising modifiable factor to mitigate cognitive decline and disease progression. Aim. To synthesize evidence from clinical and mechanistic studies on the effects of PA in AD, with emphasis on cognition, disease course, and key biological pathways. Material and methods. A targeted narrative search of PubMed and Scopus identified English‑language studies (2002–2025), prioritizing randomized controlled trials, systematic reviews, and meta‑analyses of exercise or PA interventions in individuals with AD, mild cognitive impairment, or preclinical AD; additional observational and mechanistic work was used to contextualize clinical findings. Evidence was synthesized qualitatively, without formal risk‑of‑bias assessment or quantitative meta‑analysis, focusing on cognition, neuropsychiatric symptoms, function, quality of life, and major mechanistic domains. Results. Most studies show that PA improves global cognition (especially executive function) and reduces neuropsychiatric symptoms, while memory effects are more limited. Resistance and multicomponent training yield greater cognitive benefits than aerobic exercise alone, likely via enhanced neurotrophic signaling, reduced Aβ/tau pathology, improved insulin sensitivity, attenuated neuroinflammation, and increased cerebral blood flow. Moderate‑intensity PA (≈150–180 min/week) appears optimal, slowing clinical progression most clearly in preclinical and mild AD, although effects on quality of life remain inconsistent. Conclusions. PA is a promising, safe, and accessible non‑pharmacological intervention, particularly in earlier AD stages, and should be considered a core component of strategies to reduce the burden of AD.
Copyright (c) 2026 Sabina Zaborowska, Paulina Pawlak, Olaf Wojcieszuk, Łukasz Starczewski, Adrianna Babik, Kamila Kamińska, Matylda Będkowska-Kuśmierek, Anna Złotnik, Kinga Krzysztofik, Antoni Klamka https://creativecommons.org/licenses/by-nc-sa/4.0
Axial Spondyloarthritis in Athletes: A Narrative Review of Diagnostic Challenges and Quality of Medical Management
Background. Axial spondyloarthritis (axSpA) is a chronic inflammatory disease affecting the spine and sacroiliac joints. In athletes, clinical identification is difficult due to symptomatic overlap with mechanical overuse and specific behavioral patterns of professional competitors. Aim. This review evaluates diagnostic hurdles of axSpA in athletes and analyzes medical management quality based on evidence from 2021–2026. Material and methods. Following SANRA guidelines, a systematic search of PubMed and Google Scholar was performed, focusing on peer-reviewed literature at the intersection of inflammatory diseases and sports medicine. Results. The athletic culture of enduring pain contributes to a diagnostic delay often exceeding seven years. Professional athletes frequently present with exercise-induced bone marrow edema on MRI, which can mimic active sacroiliitis. Effective management requires a multidisciplinary approach integrating modern pharmacotherapy with specialized physiotherapy, adhering to 2022 ASAS-EULAR recommendations and WADA regulations. Conclusions. A research gap exists regarding prospective studies in elite athletes. Improving care quality necessitates specialized screening protocols to differentiate physiological adaptations from systemic inflammation, ensuring career longevity and high quality of life.
Copyright (c) 2026 Zuzanna Kruczek, Martyna Kudła, Julia Kociuba, Agata Krawczyk, Dorota Kołkowicz, Paulina Łobaza, Natalia Pawełczak, Julia Kurcińska, Szymon Kurciński, Gabriela Zając, Paweł Czechowicz, Justyna Czechowicz, Mikołaj Antkiewicz, Aleksandra Arczyńska-Antkiewicz, Maria Drozd https://creativecommons.org/licenses/by-nc-sa/4.0
Assessing Overtraining Syndrome in Competitive Athletes: Biomarkers, Screening Tools, and Clinical Correlates
Background Overtraining syndrome (OTS) is a multifactorial clinical condition resulting from an imbalance between training load and recovery. It affects up to 64% of male and 60% of female athletes at least once during their career and carries significant consequences for physical performance, hormonal balance, immune function, and mental health. Despite its prevalence, OTS remains poorly defined and difficult to diagnose due to the absence of a single validated biomarker and substantial overlap with other conditions common in athletic populations. Aim To review the current evidence on the pathophysiology, diagnostic approaches, biomarkers, and prevention strategies related to overtraining syndrome, and to evaluate the utility of existing and emerging diagnostic frameworks. Material and methods A thorough analysis has been conducted following PRISMA recommendations. The research data have been derived from scientific databases of Embase, PubMed and Google Scholar. Key word choice was based on their relevance to the review subject beforehand. Results OTS arises from the interaction of metabolic, immunological, neuroendocrine, and autonomic dysregulation. The EROS study identified over 45 candidate biomarkers, yet none proved universally diagnostic. Multidomain assessment combining hormonal, immunological, and autonomic markers demonstrated superior diagnostic value over any single parameter. Prevention relies on integrated monitoring of training load, recovery, nutrition, sleep, and psychological well-being. Summary OTS diagnosis requires comprehensive clinical evaluation and systematic exclusion of alternative aetiologies. No pathognomonic marker exists; therefore, multiparametric frameworks remain the most reliable diagnostic approach. Early detection and prevention through multidimensional athlete monitoring constitute the most effective clinical strategy.
Copyright (c) 2026 Weronika Wajerowska, Barbara Nawracaj, Sonia Browarny, Bartosz Dubniański, Kacper Fudali , Mateusz Hejnowicz, Jan Tymec, Kornelia Stawińska https://creativecommons.org/licenses/by-nc-sa/4.0
Dry Eye Disease in Physically Active Individuals: The Role of Environmental Factors – A Narrative Review
Background. Dry eye disease (DED) is a multifactorial disorder of the ocular surface characterized by tear film instability, hyperosmolarity, inflammation, and neurosensory abnormalities. Environmental stressors and systemic factors play a significant role in its development. Physically active individuals are likely to be exposed to such conditions. Aim. To summarize current evidence on the impact of environmental factors and hydration on the development and severity of dry eye disease, with emphasis on physically active populations. Materials and methods. A narrative review was conducted using literature indexed in PubMed and Google Scholar databases, including studies published between 2001 and 2024. The publications were selected based on their relevance to epidemiology and pathophysiology. Results. DED affects a substantial proportion of the population worldwide. Environmental factors such as low humidity, air pollution, temperature variations, ultraviolet radiation and dehydration contribute to ocular surface stress. These factors influence tear osmolarity and may exacerbate symptoms, particularly in physically active individuals exposed to increased environmental and physiological stress. Conclusions. Environmental exposure and hydration status are important contributors to dry eye disease. Physically active individuals may be at increased risk due to combined exposure to environmental conditions and fluid imbalance, highlighting the importance of preventive strategies in this population.
Copyright (c) 2026 Natalia Mordal, Kacper Ściebura, Weronika Walendziak, Damian Zienkiewicz, Gabriela Makulec, Karolina Domosud, Wiktoria Wiśniewska, Magdalena Ostaszewska, Milena Majchrzyk, Anna Malczyk https://creativecommons.org/licenses/by-nc-sa/4.0
Training in Sync with the Cycle? The Impact of Hormonal Fluctuations During the Menstrual Cycle on Knee Joint Stability and ACL Injuries
Background. Anterior Cruciate Ligament injuries represent a significant "epidemic" in sports medicine, disproportionately affecting female athletes. Women tear their ACL 2 to 10 times more often than men participating in the same sports. This disparity suggests that beyond anatomical and biomechanical differences, unique biological factors - specifically hormonal fluctuations and their impact on ligament structure - play a critical role in injury susceptibility. Aim. The aim of this study was to conduct an analysis of the publications from the last decade regarding the influence of the menstrual cycle, sex hormones and oral contraceptives on knee joint laxity and ACL injury risk. Material and methods. A comprehensive PubMed literature search (2014–2024) was conducted, only clinically relevant, English, free full-text articles were included, supplemented by foundational studies. Results. A total of 17 original studies were included, 4 review studies have been inspected for a better understanding of older research. The analysis confirms that the pre-ovulatory and ovulatory phases are associated with increased anterior knee laxity due to peak estrogen levels. However, recent evidence suggests that increased laxity does not always result in altered biomechanics in elite athletes due to neuromuscular compensation. Conclusions. Current evidence identifies the late follicular and ovulatory phases as the period of highest ACL injury risk, driven by a simultaneous decline in both passive joint stability and active motor control. Importantly, utilizing oral contraceptives does not offer a complete solution, as they only address passive laxity while leaving neuromuscular deficits unresolved and posing systemic risks. Future injury prevention must therefore adopt a multidimensional approach, utilizing individualized screening that integrates menstrual history, specific anatomical predispositions, and objective biomechanical assessments.
Copyright (c) 2026 Iga Woźniakowska , Maja Zambrzycka, Aleksandra Misarko, Monika Jedwabnik, Stanisław Ścigała, Krzysztof Peszuk, Adrianna Dobrosielska, Hoang Viet Krajewski, Bartosz Olszewski, Weronika Lech https://creativecommons.org/licenses/by-nc-sa/4.0
Tapinarof 1% Cream in Plaque Psoriasis: Mechanism of Action, Pharmacology, Clinical Efficacy, and Emerging Therapeutic Horizons — A Systematic Review
Background. Psoriasis is a chronic, immune-mediated inflammatory dermatosis characterized by the hyperproliferation of keratinocytes and the formation of erythematous, scaly plaques. Traditional topical therapies, primarily corticosteroids and vitamin D analogs, are often limited by long-term safety concerns, such as skin atrophy. Tapinarof, a first-in-class, non-steroidal, small-molecule therapeutic agent that modulates the aryl hydrocarbon receptor (AhR), has recently emerged as a novel topical intervention. Aim. This paper evaluates the clinical efficacy, safety profile, and unique mechanism of action of tapinarof cream, 1%, for the treatment of plaque psoriasis in adults. Materials and Methods. A comprehensive review of the PSOARING 1 and PSOARING 2 Phase III clinical trials was conducted. Data were synthesized to assess primary endpoints, specifically the Physician’s Global Assessment (PGA) success—defined as a score of "clear" (0) or "almost clear" (1) with a minimum 2-grade improvement from baseline. Results. Clinical data demonstrate that tapinarof 1% cream, administered once daily, significantly improves Psoriasis Area and Severity Index (PASI) scores and PGA success compared to vehicle controls. Notably, tapinarof exhibits a unique "remittive effect," maintaining clinical response for a median of four months post-discontinuation. While generally well-tolerated, the most frequently reported adverse events include localized folliculitis and contact dermatitis, which were typically mild to moderate in severity. Conclusions. Tapinarof 1% cream represents a significant shift in the topical management of psoriasis, offering a potent, non-steroidal alternative with a durable off-treatment effect. Its ability to modulate the AhR pathway addresses both the inflammatory cascade and skin barrier dysfunction, positioning it as a foundational therapy for patients seeking long-term disease control without the risks associated with chronic corticosteroid use.
Copyright (c) 2026 Natalia Paluszkiewicz, Joanna Sowińska, Sandra Bryg, Aleksandra Cieślak, Sara Demkow, Zofia Leżańska, Mateusz Kwiatkowski, Katarzyna Marcinkowska, Karolina Siemińska, Emil Pałyga https://creativecommons.org/licenses/by-nc-sa/4.0
Is lipohypertrophy marely a cosmetic defect? The impact of lipohypertrophy on treatment and lives of patients with diabetes - a literature review
Background: : Lipohipertrophy (LH) is a common complication of diabetes, regardless of its type, in which the tissue exposed to insuline lead to hypertrophy of adipocytes and fibrosis. Despite it looks like only a visual problem, it has many negative consequences, that pose a threat to patients' health, lives, and quality of life. Aim: In this article we would like to present the multiple dimensions affected by this complication, as well as the potential benefits associated with the treatment of LH. Methods: A narrative review was conducted using the medical databases PubMed, Google Scholar, and ScienceDirect, with a focus on the impact of insulin-induced LH on the health and daily functioning of patients with diabetes. Results: The following aspects were analyzed: the impact of LH on glycemic control, risks associated with glycemic variability, long-term complications, quality of life, effects on the management of comorbidities, mental health, and treatment-related costs. Each of these domains was found to be significantly impaired or complicated by the presence of LH. Furthermore, improvements in patient health outcomes were observed in cases where regression of LH lesions was achieved. Conclusion: The entirety of the reviewed literature indicates that LH constitutes a substantial clinical challenge. Early detection, prevention, and effective management are essential for improving disease control and enhancing the quality of life for patients with diabetes.
Copyright (c) 2026 Alicja Graczyk, Michał Hajt, Natalia Grabowska, Dastin Misiaszek, Anna Wolszczak, Jakub Motor, Weronika Martynowska, Piotr Ciecierski https://creativecommons.org/licenses/by-nc-sa/4.0
Physical Activity in Cardiovascular Disease Prevention: A Narrative Review
Background. Cardiovascular disease (CVD) remains the leading global cause of death and a major source of disability despite advances in pharmacological and interventional care. Since a substantial part of the remaining burden is still related to modifiable behaviors, physical activity continues to play a central role in prevention. Aim. To summarize current evidence on physical activity as a non-pharmacological intervention in the primary and secondary prevention of CVD, with particular attention to dose-response relationships, sedentary behavior, major cardiometabolic risk factors and exercise-based cardiac rehabilitation. Material and methods. This narrative review used the uploaded outline as the organizing framework. PubMed and major society sources were searched for English-language publications from January 2018 to March 2026 using combinations of terms related to physical activity, cardiovascular prevention and sedentary behavior. International guidelines and scientific statements were prioritized. Results. Higher physical activity levels are consistently associated with lower all-cause and cardiovascular mortality, with the largest relative gains usually seen when people move from inactivity to modest activity. Device-based studies make this message easier to translate into practice through step counts and habitual movement patterns, while also showing that sedentary time is an in dependent cardiovascular risk exposure. Physical activity favorably affects endothelial function, inflammation, insulin sensitivity, adiposity, blood pressure, and lipid metabolism. In secondary prevention, exercise-based cardiac rehabilitation improves health-related quality of life and reduces hospital admissions, and telehealth-supported models can widen access for selected patients. Conclusions. Physical activity is key in cardiovascular prevention. Patients should be helped to move more, sit less, interrupt prolonged sitting, and maintain realistic activity patterns over time.
Copyright (c) 2026 The Author(s) https://creativecommons.org/licenses/by-nc-sa/4.0
Impact of Physical Activity on Symptoms and Quality of Life in Women with Endometriosis: A Narrative Review
Background. Endometriosis is an estrogen-dependent inflammatory disease that significantly impairs women’s quality of life through chronic pelvic pain, dysmenorrhea, dyspareunia, infertility, and psychological distress. Increasing attention has been directed toward non-pharmacological approaches, including physical activity. Aim. This review aimed to analyze current evidence on the effects of physical activity and different exercise modalities on symptoms and quality of life in women with endometriosis. Material and methods. A narrative review was conducted using PubMed, Scopus, and Web of Science, focusing on studies published between 2020 and 2026, including randomized controlled trials, systematic reviews, and observational studies. Results. Available evidence suggests that physical activity may reduce pain, improve quality of life, enhance mental well-being, and improve physical functioning. The most beneficial effects are associated with combined interventions including aerobic exercise, resistance training, and mind–body techniques. Conclusions. Physical activity may be an effective complementary strategy in the management of endometriosis; however, further high-quality studies are needed.
Copyright (c) 2026 Agata Chrobak, Kateryna Bessmylna , Alesia Kravets , Lizaveta Zhukava, Abdulrahman Alansi, Kai-Chiun Weng, Joanna Żukowska https://creativecommons.org/licenses/by-nc-sa/4.0
Targeted Temperature Management Post-Cardiac Arrest: Shifting Paradigms from Hypothermia to Strict Normothermia and its Impact on Neurological Prognostication
Background. Cardiac arrest (CA) remains a major global health challenge with high risk of severe neurological impairment. Post-cardiac arrest syndrome (PCAS), particularly hypoxic-ischemic brain injury, drives mortality and long-term disability. Targeted temperature management (TTM), traditionally a neuroprotective cornerstone, is currently being re-evaluated. Aim. To analyze current evidence on post-CA temperature management, focusing on the shift from therapeutic hypothermia to strict normothermia and its implications for neurological prognostication. Materials and methods. This narrative review synthesizes 30 peer-reviewed publications, including randomized trials, systematic reviews, and international guidelines (ERC, ESICM, NCS). It evaluates PCAS pathophysiology, hypothermia versus normothermia outcomes, technical TTM implementation, and multimodal neuroprognostication. Results. Recent high-quality evidence shows no significant benefit of routine therapeutic hypothermia (32–34°C) over strict normothermia in improving survival or neurological outcomes. Guidelines now emphasize active fever prevention (≤37.5°C) using precise control systems. While TTM modulates systemic inflammation (e.g., IL-6), this does not independently lower mortality. Neurological prognostication requires a delayed, multimodal approach integrating clinical assessments and biomarkers like neuron-specific enolase (NSE), while accounting for confounders. Conclusions. Post-CA management has shifted toward individualized, precision-based care, with strict normothermia and active fever prevention as the recommended standard. Accurate neuroprognostication necessitates adherence to guideline-directed timing and multimodal strategies. Future research should identify specific subgroups benefiting from hypothermia and develop adjunctive therapies.
Copyright (c) 2026 Piotr Kowalewski, Eliza Kuchta, Natalia Kowalczyk, Kacper Wrzosek, Karolina Dudek, Jan Błażukiewicz, Klaudia Ciupak, Klaudiusz Garbacki, Lena Popek, Bartosz Dudek, Halina Piecewicz-Szczęsna https://creativecommons.org/licenses/by-nc-sa/4.0
Health benefits of Chlorella vulgaris supplementation: a narrative review
Background Dietary supplements are a rapidly growing market, with many of them advertised as remedy for various diseases, or as healthy supplement to the everyday diet. One of these supplements is Chlorella vulgaris, an unicellular alga, which is advertised as a potent remedy for many civilizational diseases. Aim This narrative review aims to summarize current knowledge regarding the supplementation with Chlorella vulgaris, with an emphasis on the clinical, and sports-related use of this supplement, its safety, and efficacy. Materials and methods A narrative review was conducted using PubMed and Google Scholar databases concerning Chlorella vulgaris, with an emphasis on clinical trials, reviews, and meta-analyses. Results and conclusions Evidence suggests that Chlorella vulgaris supplementation may have a beneficial impact on many diseases, such as hypertension, hypercholesterolaemia, or diabetes. Moreover, it might have applications in improving physical endurance, and in the supplementation of micronutrients in some diets. However, some concerns regarding safety, contamination, and heterogeneity of composition still remain. Nevertheless, meta-analyses show, that the evidence for the health benefits is at most moderate, so more research in this area is needed.
Copyright (c) 2026 Kacper Szada-Borzyszkowski, Konstancja Owczarenko https://creativecommons.org/licenses/by-nc-sa/4.0
GLP-1 Receptor Agonists in Recreational Athletes: Emerging Weight-Reduction Strategy or Potential Health Risk? A Review of Current Evidence
Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are effective pharmacological agents for obesity treatment and are increasingly used beyond clinical indications. Their growing popularity among recreational athletes seeking rapid fat loss raises concerns regarding potential effects on muscle mass, exercise capacity, and overall health. Aim: This review summarizes current evidence on the metabolic, musculoskeletal, and performance-related effects of GLP-1 receptor agonists in recreationally active individuals. Material and Methods: A narrative review of PubMed-indexed studies published between 2015 and 2026 was conducted. Randomized controlled trials, meta-analyses, and experimental studies evaluating GLP-1 RAs in relation to body composition, skeletal muscle outcomes, metabolic adaptation, exercise tolerance, and safety were included. English-language full-text articles were analyzed. Results: GLP-1 receptor agonists consistently induce significant weight reduction, primarily through fat mass loss, although decreases in lean body mass are also reported. Improvements in insulin sensitivity and cardiometabolic markers may support exercise tolerance. However, concerns include potential muscle mass reduction, inadequate energy availability, gastrointestinal adverse effects, and limited data on strength, recovery, and long-term performance adaptation in recreational athletes. Conclusions: GLP-1 receptor agonists are effective for weight reduction, but their use in recreational sport requires caution. Potential metabolic benefits should be balanced against risks related to muscle preservation and exercise capacity. Sport-specific longitudinal studies are needed to clarify safety and performance implications.
Regenerative and Conventional Intra-Articular Therapies in Osteoarthritis: A Narrative Review with a Focus on Sports Medicine
Background. Osteoarthritis (OA) is one of the leading causes of chronic pain and functional limitation worldwide and represents a significant challenge not only in the general population but also in physically active individuals, where joint integrity is essential for maintaining mobility and performance. Aim. The aim of this study was to present current evidence regarding the efficacy and safety of conventional and modern intra-articular injections in the treatment of osteoarthritis, with particular emphasis on their relevance in sports medicine and physically active populations. Materials and Methods. This study was designed as a structured narrative review synthesizing available data on intra-articular therapies, including glucocorticosteroids, hyaluronic acid, platelet-rich plasma (PRP), collagen, mesenchymal stem cells (MSC), and bone marrow aspirate concentrate (BMAC), as well as injection techniques and combined therapeutic approaches. Results. Available evidence indicates that corticosteroids provide primarily short-term pain relief, whereas hyaluronic acid may offer moderate symptomatic improvement. Platelet-rich plasma demonstrates promising results in terms of longer-term pain reduction and functional improvement, which may be particularly relevant for maintaining physical activity levels. Cell-based therapies and collagen injections represent emerging approaches, although they require further standardization and high-quality clinical trials. Conclusions. Modern intra-articular injections may constitute an important component of integrated osteoarthritis management, particularly in individuals aiming to maintain mobility and physical performance. These therapies may play a key role within personalized treatment strategies in sports medicine and rehabilitation.
Copyright (c) 2026 Izabela Rafalska, Jakub Smagoń, Martyna Kaim, Melania Majewska, Natalia Piasecka, Wiktoria Siewiera, Joanna Bober, Natalia Kornacka, Krzysztof Bednarski, Magdalena Bochenek https://creativecommons.org/licenses/by-nc-sa/4.0
Beyond Athletic Performance: The Emerging Role of Creatine Supplementation in Clinical Medicine — A Narrative Review
Introduction. Creatine monohydrate is among the most extensively researched dietary supplements, yet it remains widely perceived as a tool of athletic performance enhancement. Its fundamental role in cellular energy homeostasis across metabolically demanding tissues — including skeletal muscle, brain, and myocardium — suggests a broader clinical relevance that has not been systematically addressed in recent literature. Materials and Methods. A narrative review was conducted using PubMed and Google Scholar, focusing on peer-reviewed original research, systematic reviews, meta-analyses, and position statements published up to April 2025. Search terms included combinations of "creatine," "creatine monohydrate," "phosphocreatine," and condition-specific terms covering skeletal muscle diseases, neurodegenerative disease, depression, sarcopenia, type 2 diabetes, cancer cachexia, traumatic brain injury, pregnancy, and renal safety. A total of 98 sources were included. Conclusions. Creatine supplementation demonstrates well-established ergogenic efficacy in sport and clinically meaningful benefits in skeletal muscle diseases, sarcopenia, and cognitive ageing. Promising evidence supports its adjunctive role in depression and type 2 diabetes, while data in traumatic brain injury remain largely paediatric. Evidence in cancer cachexia is predominantly negative. The safety profile of creatine monohydrate is reassuring across age groups; the observed rise in serum creatinine represents a pharmacokinetic artefact. Pregnant women and patients with advanced chronic kidney disease require individualised assessment. Across clinical areas, mechanistic evidence is often compelling but large trials with standardised dosing and clinically meaningful endpoints remain scarce. Creatine is not only for athletes — its accessibility, tolerability, and growing clinical evidence base make it a strong candidate for broader integration into clinical practice.
Copyright (c) 2026 Mateusz Zimowski, Zuzanna Panas, Izabela Ślinko, Gabriela Kuliś, Ewa Dryl-Jarmoc, Kacper Krawczuk, Jakub Dziemiańczuk, Piotr Kadysz, Agata Kolanek, Mateusz Czajkowski https://creativecommons.org/licenses/by-nc-sa/4.0
Long-Term Sequelae of COVID-19: A Review
Introduction. Long COVID (post-COVID-19 syndrome) is defined as a constellation of symptoms persisting or emerging at least three months after acute SARS-CoV-2 infection, lasting for a minimum of two months and not explained by an alternative diagnosis. It affects millions of patients worldwide regardless of the severity of primary infection, and its underlying pathophysiology remains incompletely understood. Aim. The aim of this review is to summarize the current state of knowledge on Long COVID syndrome, with a particular focus on its clinical manifestations across multiple organ systems, underlying pathophysiological mechanisms, and long-term consequences in both adult and pediatric populations. Methodology. A review of the literature was conducted through a systematic search of the PubMed database using the keywords: "Long COVID", "post-COVID syndrome", "post-acute sequelae of SARS-CoV-2", "PASC". Publications from 2020 to 2026 were included. Results. Long COVID affects multiple organ system. The most common symptoms are neurological, including fatigue, brain fog and memory impairment. Cardiovascular complications include POTS, myocarditis, arrhythmias and thromboembolic events. Pulmonary sequelae are common even after a mild course of the disease. Other documented complications include renal dysfunction, female fertility disorders and paediatric post-COVID syndrome. Immunological mechanisms appear to play a key role in the pathogenesis of the syndrome. Conclusions. Long COVID is a multisystemic and complex condition requiring a holistic diagnostic and therapeutic approach. There are currently no reliable biomarkers or targeted therapies. It poses a serious public health problem, and further research is needed to improve treatment outcomes.
Copyright (c) 2026 Jakub Orzeł, Aleksandra Skowron, Patrycja Pelczar, Aleksandra Przygoda https://creativecommons.org/licenses/by-nc-sa/4.0
Circadian Misalignment and Social Jetlag: Consequences for Physical Performance and Injury Risk in Young Adults.
Background. Circadian rhythms, governed by the suprachiasmatic nucleus and peripheral oscillators in skeletal muscle, regulate peak physiological performance windows. Social jetlag (SJL) - the discrepancy between biological time and social schedules - is highly prevalent in young adults due to a developmental shift toward "eveningness". Aim. This narrative review aims to synthesize current evidence regarding the impact of SJL on physical performance metrics and musculoskeletal injury risk in the young adult demographic. Material and method. A narrative synthesis of articles (systematic reviews, meta-analyses, and experimental studies) published between 2005 and 2026 was conducted. Analysis focused on cardiorespiratory fitness, neuromuscular power, and longitudinal injury data in tactical and athletic populations. Results. High levels of SJL (≥ 1.5-2 hours) are significantly associated with reduced cardiorespiratory fitness ( peak), particularly in males. In anaerobic domains, SJL blunts the natural diurnal rhythm of explosive power, resulting in lower vertical jump performance and reduced maximal voluntary contraction during morning training. Furthermore, prospective data from ROTC cohorts demonstrate that SJL is a robust behavioral predictor of musculoskeletal injury, with injured individuals exhibiting nearly double the SJL magnitude of their uninjured peers. Conclusions. Chronic circadian misalignment acts as a systemic "performance inhibitor" and a significant risk factor for injury. Mitigation requires "circadian literacy" in coaching and the implementation of chronotype-adjusted training schedules to align physical demands with endogenous biological windows.
Copyright (c) 2026 Alicja Sikorska, Emil Mian, Zuzanna Zapart, Martyna Szepietowska, Nina Nowicka, Jakub Bundyra, Agata Sochocka, Oliwia Gańska, Dominika Janik, Julia Parda https://creativecommons.org/licenses/by-nc-sa/4.0
Berberine as a Modulator of Metabolic and Hormonal Dysregulation in PCOS: Mechanisms of Action and Clinical Implications - A Narrative Review
Background. Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age and is a leading cause of anovulatory infertility. Its pathogenesis is considered multifactorial, involving polygenic susceptibility, environmental influences, and possible epigenetic modifications, although no definitive etiological trigger has been identified and no validated genetic screening is currently recommended. PCOS is associated with significantly reduced quality of life due to both metabolic and hyperandrogenic features, with diagnostic criteria remaining based on the Rotterdam framework. Materials and methods. An extensive literature review was conducted using sources retrieved from the PubMed and Google Scholar databases. Aim. The aim of this study was to analyze and synthesize the current body of evidence on polycystic ovary syndrome (PCOS), with a particular focus on evaluating the role of non-pharmacological interventions, especially berberine supplementation. Conclusions. Berberine exhibits pleiotropic benefits in women with PCOS, improving insulin sensitivity, glycemic control, and lipid profiles through modulation of key metabolic pathways. It also demonstrates antiandrogenic effects by reducing free testosterone and increasing SHBG levels, contributing to improved hormonal balance and reproductive function. Overall, berberine appears to be a promising and well-tolerated adjunct or alternative therapy, although further high-quality studies are needed to confirm its long-term efficacy and impact on reproductive outcomes.
Copyright (c) 2026 Ewa Buczkowska, Aleksandra Marciszewska, Agnieszka Piechowicz, Natalia Popczyk, Agnieszka Przybyłowska, Jakub Jopek, Michał Popczyk, Sylwia Bryksy, Hanna Tymchenko, Jakub Kaźmierczyk https://creativecommons.org/licenses/by-nc-sa/4.0
Management of Scheuermann's Disease: A Literature Review
Background. Scheuermann disease is a developmental spinal pathology, typically manifesting during adolescence, characterized by thoracic or thoracolumbar hyperkyphosis. While many cases remain asymptomatic, progressive spinal deformity can lead to chronic back pain, neurological issues, restrictive respiratory impairment, and significant psychosocial distress. Aim. The primary objective of this literature review is to comprehensively present the available conservative and surgical treatment modalities for patients diagnosed with Scheuermann's disease and to analyze the complex challenges associated with selecting the appropriate therapeutic strategy. Material and methods. A literature search was conducted across databases including PubMed, Scopus, and Web of Science to identify relevant studies. This primary electronic search was additionally supplemented by a manual search of reference lists to ensure comprehensive coverage of the topic. Results. Conservative protocols integrating physiotherapy and spinal orthoses yield statistically significant vertebral remodeling in skeletally immature cohorts with mild to moderate curves. Conversely, operative interventions, primarily exclusive posterior or combined anterior and posterior fusions, are generally considered for rigid deformities exceeding 70 to 75 degrees. Further clinical parameters substantiating the necessity for surgical correction include intractable back pain, concurrent neurological symptoms, restrictive pulmonary impairment, documented continuous progression of the deformity, and profound psychosocial distress arising from diminished self-esteem. Conclusion. Conservative management remains the optimal initial modality, particularly during the active growth period, while surgical intervention is warranted for patients with severe deformity progression, debilitating somatic symptoms, or significant aesthetic concerns that impair their quality of life.
Copyright (c) 2026 Kamil Tomasz Pielusiński, Michał Olejnik, Kamil Swoboda, Karolina Borkowska, Anna Polakowska, Alicja Pyzik, Oliwia Mróz, Andrzej Domański, Julia Domańska, Nadia Hornig https://creativecommons.org/licenses/by-nc-sa/4.0
When Heat Becomes a Risk: The Impact of Heatwaves on Hypertension - A Systematic Review
Introduction:Hypertension is considered one of the most common chronic diseases affecting over 30 % of the population of adults in the world. Also is the most important modifiable risk factor for cardiovascular disease(CVD). Heatwaves, defined as periods of extremely high temperatures lasting at least 2–3 days, pose a growing threat to public health amid climate change. The climate is changing, and simultaneously leading to a higher frequency of extreme weather events, including heatwaves. The impacts of heatwaves on human health and their underlying mechanisms, particularly regarding the cardiovascular system, are well-known. Heatwaves can impact blood pressure and control of hypertension through many different mechanisms. This paper aims to review the relationship between heatwaves and hypertension, including incidence, blood pressure variability, and cardiovascular outcomes. Materials and methods: A review of selected literature in the PubMed, Scopus, and ScienceDirect for studies published between 1990 and 2026.Conclusions:The rise of heatwaves as an increasingly concerning environmental issue, that can affect cardiovascular health will contribute to blood pressure regulation. Heat causes vasodilation initially, but there are compensatory mechanisms like dehydration, activation of the sympathetic nervous system, hormonal response which will result in transiently elevated blood pressure, and increased risk for cardiovascular events. Despite mounting research evidence, the link between heatwaves and the development of hypertension is poorly understood, current literature contains limited heterogeneous data on this topic. Additional research is needed to evaluate whether heatwaves act as a causal or triggering agent to cause dysregulation of blood pressure in order to develop effective public health interventions.
Copyright (c) 2026 Mateusz Czajkowski, Ewa Dryl-Jarmoc, Izabela Ślinko, Gabriela Kuliś, Zuzanna Panas, Kacper Krawczuk, Jakub Dziemiańczuk , Mateusz Zimowski, Piotr Kadysz, Agata Kolanek https://creativecommons.org/licenses/by-nc-sa/4.0
The Paradox of the Pouch: A Systematic-Narrative Hybrid Review of Snus and Nicotine Pouch Use on Athletic Performance, Prevalence, Health Outcomes, and Regulatory Status in Sport
Background. Oral nicotine products, including traditional snus and tobacco-free nicotine pouches (ONPs), are increasingly common among elite athletes [11, 15, 21]. They bypass the respiratory route via sublabial administration and are rapid and concentrated [5, 20]. Athletes use them as cognitive enhancers and stress and appetite suppressors [18, 30]. Nevertheless, a paradox remains: athletes consume ONPs seeking an ergogenic advantage despite no evidence and substantial health risks [17, 31]. Aim. This review combines current knowledge on the prevalence of ONPs in sports, critically reviews their effects on physical and cognitive performance, and examines associated health, toxicological, and regulatory implications. Materials and methods. Relevant literature from sports science, toxicology, and public health was reviewed, focusing on health and regulatory impacts of oral nicotine in athletic and general populations [6, 27]. The search used Google Scholar, PubMed, and other databases to evaluate recent developments comprehensively. Results. Evidence shows nicotine does not enhance physical performance and may impair cardiovascular readiness, anaerobic capacity, and physical endurance [18, 30, 31]. Perceived cognitive improvements stem from relief of nicotine withdrawal symptoms [17, 30]. Furthermore, ONPs risk oral damage, systemic cardiac strain, and addiction [4, 9, 24]. The unclear regulatory status of nicotine in sports, with aggressive marketing that exploits "tobacco-free" legal loopholes, demand updated anti-doping policies [8, 16, 25]. Conclusion. ONPs may serve as a harm-reduction tool for adult smokers [1, 19, 23], spread among nicotine-naïve athletes poses a novel and growing public health threat [7, 27]. Educational interventions, along with more extensive screening by sports governing bodies, are essential for athletes welfare.
Copyright (c) 2026 Abdulrahman Alansi, Kai-chiun Weng, Alesia Kravets, Lizaveta Zhukava, Agata Chrobak, Kateryna Bessmylna, Darya Volkava, Volha Sakovich, Ewa Kacynel, Wiktoria Myślicka https://creativecommons.org/licenses/by-nc-sa/4.0
Physical Activity as a Modulator of Epicardial Adipose Tissue Dysfunction and Adipokine Profile in Obesity: Cardioprotective Mechanisms and Clinical Implications. A Literature Review
Background. Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot surrounding the myocardium and coronary arteries, allowing locally secreted mediators to influence cardiac structure and function. In obesity, EAT expands and shifts from a cardioprotective to a pro-inflammatory and profibrotic phenotype, implicated in the coronary artery disease, atrial fibrillation and heart failure with preserved ejection fraction. Aim. To summarise current evidence on the effects of physical activity on EAT volume and adipokine secretion in patients with obesity and to outline the clinical implications of these relationships. Materials and methods. A narrative literature review was conducted using the PubMed/MEDLINE, Embase, and Cochrane Library databases. In total, 39 publications meeting predefined inclusion criteria – randomized controlled trials, systematic reviews, and meta-analyses – were analysed. Results. The reviewed studies show that endurance and resistance training markedly reduce epicardial adipose tissue (EAT) compared with non-exercise conditions. Evidence from quantitative syntheses suggests that this reduction is only partly explained by weight loss and aerobic, resistance, high-intensity interval and combined training programmes generally raise adiponectin levels, with high- intensity interval training (HIIT) producing the strongest effect. Conclusions. Structured physical activity lasting at least 12 weeks significantly reduces EAT volume and favourably modifies its adipokine secretion profile, partly independently of weight loss. These findings support physical activity recommendations in obesity that prioritise cardiometabolic risk reduction as the primary therapeutic goal rather than focusing solely on body-weight control.
Copyright (c) 2026 Edyta Lewandowska, Agata Król, Patrycja Kwitowska, Cezary Łuczyński, Emilia Muraszewska, Łukasz Muraszewski, Małgorzata Pyjecka, Maciej Paczkowski, Eryk Ubysz, Mariusz Wręczycki https://creativecommons.org/licenses/by-nc-sa/4.0
Nutrition and Urological Disorders: From Nephrolithiasis to Uro oncology – Practical Implications for Everyday Practice
Nutrition has become a key determinant across urological disorders, with particularly strong evidence in nephrolithiasis and emerging data in urologic oncology and functional conditions. This narrative review synthesizes current evidence on the role of diet, obesity, and broader dietary patterns in nephrolithiasis and urologic cancers, and translates these findings into practical dietary counselling strategies for everyday clinical practice. A selective review of recent guidelines, systematic reviews, meta-analyses, and key observational and mechanistic studies was performed, focusing on dietary and lifestyle determinants of kidney stone disease and major urologic malignancies, with particular attention to clinically actionable recommendations. For nephrolithiasis, convergent guideline and meta-analytic data support high fluid intake, normal dietary calcium, reduced sodium and animal protein, and plant-rich dietary patterns (DASH- or Mediterranean-like) as first-line preventive strategies rather than optional adjuncts. In urologic oncology, obesity and adverse dietary patterns are consistently associated with increased risk of kidney and bladder cancers and aggressive prostate cancer, while greater adherence to plant-forward, cancer-prevention dietary guidelines appears protective, although high-quality interventional data on survival remain limited. Emerging evidence suggests that diet, body composition, and the gut microbiome may modulate response to systemic therapies, including immune checkpoint inhibitors, but this area is still in early translational development. Current evidence justifies routine, pattern-based dietary counselling—centered on adequate hydration, plant-forward eating, moderation of sodium and animal protein, and weight management—as a core component of nephrolithiasis prevention and urologic cancer risk reduction.
Copyright (c) 2026 Tomasz Kandefer, Maria Sroka, Weronika Wasiniewska, Marcin Barański https://creativecommons.org/licenses/by-nc-sa/4.0
Twin-to-Twin Transfusion Syndrome: A Comprehensive Review of Fetal Impact and Management Strategies
Introduction Twin-to-Twin Transfusion Syndrome (TTTS) affects 10–15% of monochorionic diamniotic twin pregnancies and arises from unbalanced blood flow through placental vascular anastomoses. The presence of deep arteriovenous connections leads to chronic transfusion from one twin to the other, resulting in progressive hemodynamic imbalance. Without timely intervention, TTTS poses a high risk of fetal morbidity and mortality. Aim of the study The aim of this review was to present an up-to-date overview of current knowledge, clinical approaches, and fetal implications related to Twin-to-Twin Transfusion Syndrome. Materials and methods A structured literature search was performed in PubMed and Google Scholar to identify studies on Twin-to-Twin Transfusion Syndrome, focusing on management and fetal outcomes. The search included relevant keywords and Medical Subject Headings (MeSH). Additional studies were identified through manual screening of reference lists. Conclusion Twin-to-Twin Transfusion Syndrome (TTTS) is a severe complication of monochorionic twin pregnancies that requires early diagnosis and active management. Fetoscopic laser photocoagulation (FLP) remains the gold standard treatment, significantly improving survival. Despite therapeutic advances, affected fetuses still face risks of neurological and cardiac complications, highlighting the importance of long-term follow-up.
Copyright (c) 2026 Wiktoria Mikusek, Mikołaj Patelski, Maciej Czapla, Mateusz Surma, Jakub Molenda, Matylda Kuczma, Wiktoria Kotlarz, Marta Kamińska, Adrianna Klimczak, Barbara Pietrzak https://creativecommons.org/licenses/by-nc-sa/4.0
Olfactory Dysfunction in Psychiatric and Neurodegenerative Disorders: Clinical Relevance and Potential as a Biomarker
Olfactory dysfunction is increasingly recognized as a feature present in both psychiatric and neurodegenerative disorders. It has been linked to alterations in central neural processing as well as to progressive structural changes within the nervous system. This narrative review aims to compare olfactory dysfunction across major depressive disorder, schizophrenia, Alzheimer’s disease, and Parkinson’s disease, with particular emphasis on its clinical relevance and underlying mechanisms. A narrative review of current literature was conducted, focusing on studies assessing olfactory function in the selected disorders. Relevant findings were analysed in terms of clinical presentation, neurobiological correlates, and potential diagnostic value. Olfactory dysfunction was identified across all examined conditions. In psychiatric disorders, deficits appeared to be primarily related to functional alterations and were often dynamic or partially reversible, whereas in neurodegenerative diseases, olfactory impairment was associated with progressive structural and molecular pathology and frequently occurred in the prodromal phase. Across all groups, higher-order olfactory processes, particularly odor identification and discrimination, were most consistently affected. Olfactory dysfunction represents a multidimensional phenomenon that may reflect either transient functional changes or ongoing neurodegeneration, depending on the disorder. Its non-invasive assessment may serve as a useful complementary tool for early detection and monitoring of disease progression.
Copyright (c) 2026 Magda Sawin, Katarzyna Szeliga, Julia Lorek, Patrycja Waszkiewicz, Wiktoria Brzozowska, Daniel Grobecki, Jakub Korybski, Franciszek Jabłoński, Hanna Jabłońska, Adam Jarczak https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of ACE Inhibitors and Angiotensin Receptor Blockers on Aerobic Capacity and VO2 Max in Patients Undergoing Endurance Training
Background. Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) are foundational pharmacological therapies for hypertension and cardiovascular diseases. However, their potential interference with physiological adaptations to endurance training, particularly maximal aerobic capacity (VO2 max), remains a critical concern for clinicians and athletes. Aim. This review aims to synthesize the current evidence regarding the impact of ACEi and ARB therapy on VO2 max, hematological parameters, and cardiac remodeling in patients and healthy individuals undergoing structured endurance training. Material and methods. A narrative review was conducted using PubMed, Google Scholar, and the archives of the Journal of Education, Health and Sport and Quality in Sport. Search terms included "ACE inhibitors," "angiotensin receptor blockers," "VO2 max," and "endurance training." Inclusion criteria focused on peer-reviewed articles published between 2015 and 2025, emphasizing human clinical trials and systematic reviews. Results. Evidence suggests that while chronic RAAS inhibition does not significantly attenuate relative VO2 max gains in hypertensive populations or those with metabolic syndrome, it may compromise specific physiological determinants. Notably, ACEi treatment has been associated with a reduction in total hemoglobin mass expansion and a blunting of lean mass accrual. Furthermore, sex-specific responses indicate that women may experience a more pronounced inhibition of aerobic adaptations compared to men when using standard ARB dosages. Conclusions. ACEi and ARBs are generally compatible with aerobic exercise; however, their impact on hematological and morphological adaptations requires careful consideration, especially in high-performance or female cohorts. Exercise remains a vital synergistic co-therapy for managing hypertension alongside these medications.
Copyright (c) 2026 Mateusz Kowalski, Michał Rucki, Nikodem Cieleban, Aleksandra Maria Rucka, Magdalena Modliborska https://creativecommons.org/licenses/by-nc-sa/4.0
Neurological Aspects of Overtraining Syndrome in Competitive Dance: A Narrative Review
Background and aim: Overtraining Syndrome (OTS) is a maladaptive physiological and psychological response to prolonged high-intensity exercise without adequate recovery. Although musculoskeletal and endocrinological consequences of this condition are relatively well-documented, the neurological aspects of OTS remain underexplored. This narrative review aims to synthesize available evidence on the neurobiological mechanisms underlying OTS with special emphasis on the unique neurological demands of sport dance. Materials and methods: A narrative literature review was conducted using PubMed, Scopus, and Google Scholar databases. Search terms included: overtraining syndrome, competitive dance, sport dance, central fatigue, HPA axis, autonomic nervous system, serotonin, dopamine, neuroinflammation, cognitive function, and proprioception. Articles published between 2000 and 2025 in English were included. Studies pertaining to general athlete populations were included when dance-specific data were unavailable. Results: OTS in competitive dance involves dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, autonomic nervous system dysregulation, depletion of monoaminergic neurotransmitters (serotonin, dopamine), and neuroinflammatory processes. Dance-specific neurological vulnerabilities include impaired proprioception, disrupted motor engram execution, cerebellar and basal ganglia fatigue, and sleep-dependent motor memory consolidation deficits. Conclusions: The neurological profile of OTS in competitive dance is complex and multidimensional. The crucial aim is to early identificate the problem using validated psychometric tools, heart rate variability monitoring, and neurocognitive screening. A multidisciplinary approach — integrating sports medicine, neurology, and psychology — is essential for both prevention and treatment.
Copyright (c) 2026 Anna Ignatowicz, Gabriela Grylowska, Anna Paluch, Katarzyna Gunia, Aleksandra Adamczyk, Mateusz Banasik, Marcin Rebizant, Andrzej Palak, Agata Żak, Michał Tryba https://creativecommons.org/licenses/by-nc-sa/4.0
Exercise Therapy versus Pharmacological Management in Nonspecific Chronic Low Back Pain: A Narrative Review of Clinical Evidence and Recommendations
Chronic non-specific low back pain (NSCLBP) is defined as pain and discomfort lasting at least 12 weeks that cannot be clearly attributed to a specific structural pathology after excluding specific causes of back pain. It is a significant health problem with a major impact on patients' functioning, reducing quality of life, limiting mobility and increasing the number of comorbidities. NSCLBP is also associated with a higher risk of mortality. This is a global problem, it is estimated that chronic lower back pain affects around 8% of the adult population, providing a therapeutic challenge for physicians of many specialties across several continents. The treatment protocol for NSCLBP includes pharmacological and non-pharmacological interventions, which involve a variety of exercises that differ in terms of difficulty and effectiveness. Exercise-based therapies vary in type, intensity and clinical efficacy, ranging from core stabilization exercises, stretching and strength training to aerobic activities such as walking or swimming. Exercise is a key component in the treatment of NSCLBP, as evidenced by data showing significant reductions in pain and disability. Medication helps with the flare-ups, but cannot replace physical activity when it comes to achieving a genuine, lasting recovery and a return to normal activity.
Copyright (c) 2026 Marcel Artur Żukowski, Sandra Dachowska, Jan Haraj, Maciej Bieniek, Kinga Woźniak, Marcin Sobkowiak, Maria Namysł, Simon Matczak https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Regular Sport Participation on Bone Health and Osteoporosis Prevention: A Narrative Review
Background: Osteoporosis is a global public health challenge linked to population aging and sedentary lifestyles. Non-pharmacological prevention is essential. Aim: The aim of this study was to review current scientific literature on the impact of regular sport participation on bone health, with emphasis on its role in the prevention and treatment of osteoporosis. Material and Methods: A review of publications (2021–2026) from PubMed was conducted, including meta-analyses and clinical trials on the relationship between mechanical loading and bone mineral density (BMD). Results: High-impact and multi-directional sports (volleyball, basketball) provide the most potent osteogenic stimuli. In postmenopausal women, high-intensity resistance training (80-85% 1RM) mitigates bone loss and improves Health-Related Quality of Life (HRQoL). Sport also reduces fall risk in the elderly by enhancing postural stability. Conclusions: Regular sport participation is the "gold standard" for osteoporosis prevention. Optimizing peak bone mass in youth and maintaining skeletal integrity in old age are vital. Interdisciplinary collaboration is necessary to implement these findings into public health practice.
Copyright (c) 2026 Martyna Kudła, Julia Kociuba, Zuzanna Kruczek, Julia Kurcińska , Szymon Kurciński, Paulina Łobaza, Gabriela Zając , Agata Krawczyk , Paweł Czechowicz, Justyna Czechowicz, Mikołaj Antkiewicz, Aleksandra Arczyńska-Antkiewicz, Maria Drozd, Natalia Pawełczak, Dorota Kołkowicz https://creativecommons.org/licenses/by-nc-sa/4.0
GLP-1 Receptor Agonists in the Treatment of Obesity: A Narrative Review of Current Therapeutic Methods
Introduction. Obesity is now considered to be one of the largest public health challenges of the twenty-first century, with over one billion adults affected. With conventional treatments such as lifestyle modifications and bariatric surgery being either ineffective or unavailable to the majority of obese individuals, there is an urgency for the development of safe and effective pharmacologic therapies. GLP-1 receptor agonists have developed into a unique and highly successful class of drugs that produce clinically relevant weight loss in addition to improving cardiovascular and metabolic risk factors. Aim of the Study. This review aims to provide a practical and inclusive summary of GLP-1 receptor agonist therapy in obesity, focusing on mechanism of action, currently approved agents, clinical effectiveness, safety profiles and next generation therapeutic approaches. Methodology. A literature search was conducted in PubMed/MEDLINE and ClinicalTrials.gov, covering publications from 2015 to March 2026. Randomized controlled trials, systematic reviews, meta-analyses, and expert consensus papers were prioritized. Conclusions. The GLP-1 receptor agonists represent a paradigm shift in the treatment of obesity, achieving weight reductions of up to 21%. Both medications also appear to reduce cardiovascular disease risk in non-diabetic populations. While gastrointestinal side effects are the most commonly reported adverse reactions associated with these medications they can be effectively managed. As with all chronic diseases, once these medications are discontinued, patients will experience weight gain which emphasizes the importance of providing long term treatment options. Next-generation agents, including retatrutide and the cagrilintide-semaglutide combination, show even greater weight-reducing potential. Ensuring equitable access, long-term safety monitoring, and individualized treatment approaches remain the key challenges for the field.
Copyright (c) 2026 Konrad Borkowski, Wiktoria Leja, Maciej Błaszczak, Katarzyna Latalska, Maciej Szczupaj, Radosław Januszczak, Andżelika Pastuszak, Jakub Rudnicki, Julia Zjawiony, Zeeshan Zulfiqar https://creativecommons.org/licenses/by-nc-sa/4.0
The impact of bicycling on PSA levels: a narrative review
Background: Cycling is a widely popular form of physical activity that may influence serum prostate-specific antigen (PSA) levels, a key biomarker used in the detection and monitoring of prostate diseases. However, it remains unclear whether cycling has an effect on PSA concentrations. Aim: The aim of this review was to evaluate the effect of cycling on serum PSA levels and to identify factors that may influence changes in PSA after exercise. Material and methods: A narrative review of PubMed literature focused on the effects of cycling on PSA levels in adult men. Results: The findings were heterogeneous. Several studies reported small and transient increases in PSA levels, particularly when blood samples were collected immediately after prolonged or intensive cycling. In contrast, other studies found no significant changes in PSA concentrations. Factors such as timing of blood sampling, exercise intensity, and participant characteristics were identified as key determinants of PSA variability. Conclusions: Cycling does not appear to have a consistent or clinically significant effect on PSA levels. However, transient increases may occur under specific conditions. PSA results should therefore be interpreted with caution in individuals who have recently engaged in physical activity. Further research with standardized protocols is needed to clarify this relationship.
Copyright (c) 2026 Krzysztof Peszuk, Iga Woźniakowska , Maja Zambrzycka, Aleksandra Misarko, Monika Jedwabnik, Stanisław Ścigała, Weronika Lech, Adrianna Dobrosielska, Hoang Viet Krajewski, Bartosz Olszewski https://creativecommons.org/licenses/by-nc-sa/4.0
An Integrated Approach to Obesity Management: Clinical Synergy Between GLP-1 Receptor Agonists and Sports Medicine. A Narrative Review.
Background. Obesity is a complex neuroendocrine disease requiring long-term management. The emergence of GLP-1 receptor agonists has revolutionized weight loss outcomes; however, pharmacological monotherapy often leads to significant lean body mass (LBM) loss and metabolic adaptation. Aim. To analyze the clinical synergy between incretin-based pharmacotherapy and sports medicine protocols, focusing on functional tissue preservation and long-term metabolic health. Material and methods. A comprehensive review of scientific literature (2021–2026) was conducted, incorporating data from phase III clinical trials (STEP, SURMOUNT, SELECT) and exercise physiology research during pharmacological weight loss. Results. GLP-1 RA monotherapy results in LBM loss comprising 20–40% of total weight reduction. Structured resistance and aerobic training mitigates this loss, enhances muscle quality, and preserves bone mineral density. Combined therapy achieves superior visceral fat reduction and attenuates systemic inflammation while maintaining a higher basal metabolic rate compared to pharmacotherapy alone. Conclusions. Integrating sports medicine with modern pharmacotherapy represents a new standard in obesity treatment. Physical activity serves as a "metabolic anchor," preventing weight regain and improving patients' health-related quality of life (HRQoL).
Copyright (c) 2026 Julia Kociuba, Zuzanna Kruczek , Martyna Kudła, Agata Krawczyk , Natalia Pawełczak, Dorota Kołkowicz , Paweł Czechowicz, Justyna Czechowicz, Mikołaj Antkiewicz, Aleksandra Arczyńska, Maria Drozd, Paulina Łobaza, Szymon Kurciński, Julia Kurcińska , Gabriela Zając https://creativecommons.org/licenses/by-nc-sa/4.0
Nordic Walking and Functional Outcomes in Individuals with Type 2 Diabetes
Introduction and aim: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by impaired glucose regulation and insulin resistance. Physical activity plays a key role in its management. Nordic walking, involving the use of poles, may enhance exercise intensity and therapeutic effects. The aim of this study was to evaluate its impact on functional and metabolic outcomes in individuals with T2DM. Material and methods: This qualitative literature review is based on randomized controlled trials, systematic reviews, and meta-analyses. The analysis included studies involving adults with T2DM performing Nordic walking or structured walking interventions. Outcomes included HbA1c, VO₂max, body weight, BMI, muscle strength, and quality of life. Results: Nordic walking is associated with improved glycemic control, reduced HbA1c, body weight, and BMI, as well as enhanced insulin sensitivity. It also contributes to increased aerobic capacity, physical fitness, and functional performance. Additional benefits include improved body composition and quality of life. In some studies, Nordic walking demonstrated greater effectiveness than regular walking. Conclusions: Nordic walking is a safe and effective form of physical activity for individuals with T2DM. It supports improvements in metabolic and functional outcomes and can be recommended as part of comprehensive non-pharmacological management.
Copyright (c) 2026 Sebastian Szmeja, Piotr Wysokiński, Julia Masalska, Kacper Robert Toczydłowski, Natalia Mazek, Paweł Adam Król, Martyna Michalik, Maria Mamczak, Paweł Klimas, Stanisław Ferdynand Strzępek https://creativecommons.org/licenses/by-nc-sa/4.0
Intestinal Microbiota and Rheumatoid Arthritis: From Pathogenesis to Potential Therapies
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by progressive joint inflammation and multifactoral pathogenesis. Growing evidence indicates that the intestinal microbiota plays significant role in disease development and progression. Gut microbiota contributes to immune homeostasis, while dysbiosis-defined as altered microbial composition is associated with reduced diversity,expansion of pro-inflammatory taxa such as Prevotella copri and depletion of beneficial commensals. This review summarizes key mechanisms linking gut microbiota with RA, including increased intestinal permeability, immune dysregulation with Th17/Treg imbalance, molecular mimicry and altered production of microbial metabolites, particularly short-chain fatty acids. These processes are integrated within the concept of the gut-joint axis, explaining how intestinal disturbances may contribute to systemic and synovial inflammation. The potential of microbiota-derived biomarkers for diagnosis, prognosis and treatment response is also discussed. Additionally, emerging therapeutic strategies targeting gut microbiota, such as dietary interventions, probiotics and fecal microbiota transplantation are reviewed. Although promising, these approaches require further validation before clinical application.
The Impact of Lifestyle on Proper Thyroid Gland Function
Introduction. Lifestyle significantly influences the functioning of the thyroid gland, especially in the case of hypothyroidism. Regular physical activity, a proper diet, an adequate amount of sleep and stress reduction can contribute to improving hormonal test results and alleviating the symptoms of this condition. Recent studies also highlight the role of vitamin D and gut microbiota. Their proper levels and the balance of microorganisms in the gut may support the immune system and influence hormonal regulation. A balanced diet rich in essential micronutrients, such as iodine, selenium, and zinc is an important element supporting therapy. This paper provides an overview of current scientific reports on the impact of selected lifestyle factors on the course of hypothyroidism. Available research results suggest that modifying daily habits can be a significant supplement to therapy, positively affecting the functioning of the thyroid gland and the quality of life of patients. Research objective. The objective of this review is to summarize the current scientific evidence concerning the impact of selected lifestyle factors on thyroid gland function. Conclusions. Based on the analysis of the available literature, it can be concluded that lifestyle plays a significant role during hypothyroidism and in maintaining the proper functioning of the thyroid gland. A well-balanced diet, regular physical activity and effective reduction of chronic stress may support therapy, positively influence hormonal balance and contribute to the alleviation of disease symptoms. Furthermore, an increasing number of studies highlight the importance of maintaining adequate vitamin D levels and gut microbiota balance in the regulation of thyroid function and support of the immune system. Therefore, the modification of daily habits constitutes an important adjunct to the treatment of hypothyroidism and may contribute to improving patients’ quality of life.
Copyright (c) 2026 Julia Kanarszczuk, Zuzanna Kawa, Maria Kasprzak, Aleksandra Jędrzejewska, Aleksandra Jureczko, Klaudia Kleczaj, Łukasz Starczewski, Julia Jaworowska, Gabriela Babiarz, Damian Osiński https://creativecommons.org/licenses/by-nc-sa/4.0
Probiotics in Pediatric Atopic Dermatitis: Prevention and Therapeutic Potential – A Literature Review
Introduction. Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterised by impaired epidermal barrier and immune dysregulation. It is becoming increasingly prevalent in the pediatric population. Recent research highlights the role of the gut-skin axis and suggests that the intestinal microbiota may influence the development and course of inflammatory skin diseases, including AD. Aim of the study. This review aims to evaluate the current evidence regarding the use of probiotics in the treatment and prevention of atopic dermatitis in the pediatric population. Material and methods. A literature search was conducted using the PubMed database to identify relevant studies discussing the role of probiotics in treatment and prevention of atopic dermatitis in children. Meta-analyses, randomized controlled trials and systematic reviews were included. Results. Included studies suggest that probiotic supplementation may reduce the severity of atopic dermatitis, as measured by the SCORAD index, particularly in moderate-to-severe AD, and when administered for longer durations. Moreover, they may be useful in prevention of AD in high-risk infants, especially during the prenatal period. However, results vary depending on study design, probiotic strain, population and duration of supplementation. Conclusion. Probiotics may be a promising new strategy as an adjunct therapy in the treatment and prevention of pediatric atopic dermatitis. Nevertheless, further research, mostly well-designed randomized controlled trials are needed in order to determine optimal strains, dosage and duration of treatment.
Copyright (c) 2026 Zuzanna Zofia Kamińska, Agnieszka Zielińska, Martyna Mrozek, Małgorzata Blecharczyk, Igor Zydlewski, Aleksandra Malcher, Martyna Pacanowska-Trawnicka, Aleksandra Jakimowicz https://creativecommons.org/licenses/by-nc-sa/4.0
Exercise as a Therapeutic Intervention in Gestational Diabetes Mellitus: A Narrative Review of Clinical Outcomes and Glycemic Control
Background: Gestational diabetes mellitus (GDM) is one of the most common metabolic complications of pregnancy and is associated with adverse maternal and neonatal outcomes. Lifestyle modification remains the cornerstone of treatment, with increasing attention directed toward the therapeutic role of physical activity. Aim: This narrative review aimed to evaluate the impact of exercise as a therapeutic intervention on glycemic control and clinical outcomes in women with GDM. Material and Methods: A literature search was conducted using the PubMed database, including studies published from 2021 onwards. The review focused on randomized controlled trials, systematic reviews, and meta-analyses investigating the effects of physical activity on glycemic control, insulin therapy, and maternal and neonatal outcomes in GDM. Results: Available evidence suggests that regular physical activity improves glycemic control in women with GDM, particularly by reducing postprandial glucose levels. Exercise may also decrease the need for insulin therapy and contribute to improved maternal outcomes, including reduced excessive gestational weight gain. Additionally, physical activity appears to lower the risk of macrosomia and other selected neonatal complications. The effectiveness of exercise interventions depends on their type, intensity, timing, and, importantly, adherence. Conclusions: Exercise represents a safe and effective adjunct in the management of gestational diabetes mellitus. However, its clinical impact is influenced not only by physiological effects but also by practical factors such as feasibility and long-term adherence. Individualized and structured exercise recommendations may enhance the therapeutic potential of physical activity in GDM.
Copyright (c) 2026 Julia Kołodziejczyk, Maria Pietrzak, Marcela Łupina-Romaniuk, Aneta Chawryło, Paulina Pietraś, Dominika Piecuch, Karolina Oleksińska, Gabriela Świetlicka, Michał Stolarczyk, Karolina Pracoń https://creativecommons.org/licenses/by-nc-sa/4.0
Silver and Copper Nanoparticles in Advanced Wound Dressings for Chronic Venous Leg Ulcers: A Critical Clinical Review of Antibacterial Efficacy and Cytotoxicity
Background. Chronic venous leg ulcers (CVLUs) are a prevalent and clinically challenging condition, frequently complicated by polymicrobial biofilm infections that impair healing. Silver nanoparticles (AgNPs) and copper nanoparticles (CuNPs) have emerged as promising antimicrobial agents for incorporation into advanced wound dressings. Aim. This clinical review critically evaluates and compares the antibacterial efficacy and cytotoxic profiles of AgNPs and CuNPs in the context of chronic venous leg ulcer management. Material and methods. A narrative review of peer-reviewed literature was conducted using PubMed/MEDLINE (2015–2025). Results. Both AgNPs and CuNPs demonstrate comparable broad-spectrum antibacterial and anti-biofilm activity, including against multidrug-resistant organisms. CuNPs additionally exhibit pro-angiogenic and collagen-stimulating properties. Both nanoparticle types show dose-dependent cytotoxicity toward keratinocytes and fibroblasts, with safety thresholds remaining incompletely defined. Conclusions. AgNPs and CuNPs represent therapeutically comparable options for chronic venous leg ulcer management. Standardised clinical trials are needed to establish safe concentration ranges and optimal dressing formulations.
Autologous Chondrocyte Implantation in Physically Active Patients - A Narrative Review
Background. Focal articular cartilage defects of the knee represent a significant clinical problem, particularly in physically active patients and individuals with high functional demands. These lesions are associated with pain, functional limitation, and an increased risk of early osteoarthritis. Due to the limited intrinsic healing capacity of hyaline cartilage, various reparative strategies have been developed, among which autologous chondrocyte implantation (ACI) is one of the most important cell-based techniques. Aim. The aim of this study was to summarize current evidence regarding the biological basis, surgical techniques, clinical effectiveness, patient selection, and rehabilitation of ACI, with particular emphasis on physically active individuals. Materials and Methods. This study was designed as a structured narrative review synthesizing literature on cartilage biology, pathophysiology of focal defects, classification systems, operative treatment options, and ACI and MACI techniques. Consideration was also given to biomaterials, clinical outcomes, complications, patient selection, and rehabilitation strategies in individuals with increased functional demands. Results. Available evidence indicates that ACI enables formation of repair tissue with properties more similar to hyaline cartilage compared with marrow stimulation techniques. This results in clinically meaningful improvement in pain and knee function, particularly in physically active patients. Compared with microfracture, ACI may provide more durable outcomes, although success depends on appropriate patient selection, correction of biomechanical abnormalities, and structured rehabilitation. Conclusions. ACI represents a valuable treatment option for physically active patients with focal knee cartilage defects, although it remains technically demanding and requires further optimization.
Copyright (c) 2026 Jakub Smagoń, Izabela Rafalska, Martyna Kaim, Melania Majewska, Natalia Piasecka, Wiktoria Siewiera, Joanna Bober, Natalia Kornacka, Krzysztof Bednarski, Magdalena Bochenek https://creativecommons.org/licenses/by-nc-sa/4.0
Cold Water Immersion during Pregnancy: Risk Analysis, Benefits, and Guidelines. A Review of Current Evidence
Aim: To review scientific reports and clinical guidelines regarding Cold Water Immersion (CWI) impact on the maternal body and fetal well-being, focusing on vascular, metabolic, and neuroendocrine risk stratification. Material and Methods: Analysis of PubMed, Wiley Online Library, and international expert consensuses was conducted, focusing on CWI in pregnancy, thermal stress physiology, and brown adipose tissue (BAT) adaptation. Results: Research on CWI in pregnancy is limited, necessitating clinical caution. Safety depends on pre-conception cold adaptation. In adapted women, CWI promotes beneficial hematological changes and insulin sensitivity (BAT activation). Identified risks include third-trimester aortocaval compression syndrome (ACCS) and "autonomic conflict" inducing arrhythmias. Current consensus advises against CWI initiation during pregnancy for novices due to catecholamine release and fetal hypoxia risks. Conclusions: CWI in pregnancy is permissible only as a continuation of long-term pre-conception practice, without obstetric or cardiac contraindications. It requires medical supervision, 50% immersion time reduction, and safety protocols (no head submersion). Correct implementation in adapted women supports maternal vascular resilience and programs neonatal metabolism via BAT stimulation, improving glycemic stability and thermogenesis after birth.
Copyright (c) 2026 Anna Kwiatkowska, Agnieszka Przepióra, Anna Żmigrodzka, Maria Orłowska, Jana Kozłowska, Maria Sanocka, Joanna Falana, Aleksandra Wielogórska, Karolina Trojnar, Klaudia Czernic-Goławska , Agnieszka Kamińska https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Physical Activity in Managing Endometriosis
Endometriosis is a chronic gynecological disorder affecting millions of women worldwide, leading to chronic pain, infertility, and reduced quality of life. Conventional treatment methods, including hormonal therapy and surgical interventions, often do not provide sufficient relief or have long-term side effects, increasing the need for complementary therapies [1]. Physical activity is emerging as a non-pharmacological strategy that may help alleviate endometriosis symptoms through its impact on inflammatory processes, hormone regulation, and pain modulation [2]. Various studies have investigated the relationship between exercise and endometriosis, suggesting potential benefits such as reduced pain intensity, improved circulation, and better overall well-being. However, discrepancies in study designs, exercise protocols, and patient adherence make it difficult to establish standardized guidelines for physical activity as a therapeutic approach [3,4]. This review synthesizes the current research findings on the relationship between physical activity and endometriosis, explaining the biological mechanisms involved and highlighting the need for further well-controlled studies to develop practical recommendations.
Copyright (c) 2026 Magdalena Papież, Karolina Bartkiewicz, Julia Kostro, Anna Libera, Zofia Jędra, Karolina Domosud, Karolina Domosud, Gabriela Makulec, Damian Zienkiewicz, Lizaveta Novik, Maciej Kozicki https://creativecommons.org/licenses/by-nc-sa/4.0
The impact of intensive endurance training on the risk of atrial fibrillation and quality of life in veteran athletes – a literature review
Background: Regular physical activity is a cornerstone of cardiovascular prevention; however, recent evidence points to a "physical activity paradox." Master athletes engaged in long-term, high-intensity endurance sports show an increased incidence of atrial fibrillation (AF). This presents challenges regarding training safety and the quality of life for patients whose identity is tied to sports. Aim: To summarize current knowledge on the link between long-term endurance training and AF risk in master athletes, and to analyze its impact on their quality of life and physical performance. Materials and Methods: A literature review (PubMed, Scopus, Web of Science, 2020–2026) was conducted, including cohort studies, meta-analyses, and ESC guidelines. Fifty-eight relevant references were analyzed. Results: Analysis confirms a "U-shaped" or "J-shaped" relationship between exercise dose and AF risk. Endurance athletes have a 2 to 10 times higher AF risk than sedentary individuals, linked to structural remodeling (atrial enlargement, fibrosis) and autonomic changes. AF significantly reduces quality of life in previously active individuals. Moderate training reduction and early radiofrequency (RF) ablation are highly effective in improving outcomes. Conclusions: Despite arrhythmia risks, the cardiovascular benefits of exercise outweigh mortality risks; however, master athletes require an individualized clinical approach. Education on intensity modification and monitoring psychophysical well-being are key to maintaining high quality of life in these patients.
The Impact of GLP-1 Receptor Agonists on Physical Functioning and Quality of Life in Adults with Obesity: A Narrative Review
Background. Obesity is a chronic disease associated with impaired physical functioning and reduced quality of life. GLP-1 receptor agonists have emerged as an effective therapeutic option for weight reduction and may also provide additional benefits in these areas. Aim. The aim of this study was to present the current state of knowledge on the effects of GLP-1 receptor agonists on physical functioning and quality of life in adults with obesity. Material and methods. This study is a narrative literature review. The analysis was based primarily on publications identified in PubMed, as well as on full-text articles available in PubMed Central (PMC) and on publishers’ websites. Publications from 2021–2025 concerning adults with overweight or obesity were primarily included. Results. Available evidence indicates that GLP-1 receptor agonists, particularly semaglutide, effectively reduce body weight and may also have favorable effects on physical functioning and quality of life. The most promising findings concern improvements in patient-reported physical functioning, limitations in daily activities, and weight- and health-related quality of life. Limitations of therapy include adverse effects, the possibility of weight regain after treatment discontinuation, high cost, and limited availability of these agents. Conclusions. The evaluation of the efficacy of GLP-1 receptor agonists should not be limited solely to body weight reduction, but should also take into account the impact of therapy on physical functioning and quality of life.
Copyright (c) 2026 Marcela Łupina-Romaniuk, Julia Kołodziejczyk , Maria Pietrzak, Aneta Chawryło , Dominika Piecuch , Karolina Oleksińska , Gabriela Świetlicka , Paulina Pietraś , Michał Stolarczyk , Karolina Pracoń https://creativecommons.org/licenses/by-nc-sa/4.0
Seborrheic Dermatitis: A Contemporary View of Pathogenesis, Diagnosis and Treatment – A Narrative Review of the Current Literature
Background. Seborrheic dermatitis (SD) is a common, chronic, relapsing inflammatory dermatosis affecting sebum-rich areas, primarily the scalp, face, and intertriginous regions. Despite its generally benign nature, the relapsing course, visible distribution of lesions, and pruritus may substantially reduce patients’ quality of life. Methods. A targeted literature review was conducted in the PubMed and Cochrane Library databases. Systematic reviews, meta-analyses, randomized clinical trials, and up-to-date narrative reviews on seborrheic dermatitis were included. The search terms comprised: “seborrheic dermatitis”, “Malassezia”, “topical treatment”, “anti-inflammatory treatment”, and “maintenance therapy”. Results. Available evidence supports a multifactorial pathogenesis of SD, involving Malassezia yeasts, epidermal barrier dysfunction, and an abnormal host immune response. Topical antifungals remain the cornerstone of treatment, while short courses of anti-inflammatory therapy are effective during flares. Increasing emphasis is placed on maintenance strategies and steroid-sparing approaches. New nonsteroidal anti-inflammatory agents show promising efficacy and safety. Conclusions. Long-term control of seborrheic dermatitis is best achieved through a stepwise therapeutic approach aimed at rapid management of flares and maintenance strategies that reduce relapse frequency
Copyright (c) 2026 Gabriela Panek, Kacper Kość, Natalia Muzyka, Adam Prusek, Jakub Giersz, Magdalena Rumin, Remigiusz Piliński, Dominika Gosztyła, Amanda Abramowicz, Weronika Bukwald https://creativecommons.org/licenses/by-nc-sa/4.0
Bridge Enhanced ACL Repair Throughout Varied Patient Populations: Clinical Outcomes, Patient Priorities, and Equity Focused Research Gaps
Background. Bridge-enhanced anterior cruciate ligament repair (BEAR) alternative to ACL reconstruction Interest has grown due to its ability to maintain tissue continuity, preserve hamstring strength, and support faster recovery. However, evidence of its effectiveness across diverse patient populations remains limited. Aim. Integrate current evidence on clinical outcomes, patient-centered benefits, safety, and equity-related research gaps associated with BEAR in varied patient groups and clinical settings. Material and methods. This review includes evidence from randomized clinical trials, first-in-human cohort studies, registry data, post-market observational studies, case reports, surgical technique publications, and patient preference research. Results. Early real-world data suggest good short-term safety and functional outcomes across broader adult groups, including women and middle-aged patients. However, evidence remains concentrated in young, active populations, with limited subgroup analyses and insufficient long-term data in older or non-elite patients. Conclusions. BEAR is a promising alternative to standard ACL reconstruction for selected patients with acute ACL tears, offering comparable stability and function with better muscle preservation and faster early recovery. Larger, long-term, and more inclusive studies are still needed to clarify its role across diverse patient populations and support individualized clinical decision-making.
Copyright (c) 2026 Kai-Chiun Weng, Abdulrahman Alansi, Alesia Kravets, Kateryna Bessmylna, Lizaveta Zhukava, Agata Chrobak, Darya Volkawa, Volha Sakovich, Ewa Kacynel, Wiktoria Myślicka https://creativecommons.org/licenses/by-nc-sa/4.0
Beyond the Muscle: Assessing the Efficacy of Oral Creatine Supplementation in Modulating Brain Bioenergetics and Cognitive Performance
Background. The human brain is a metabolically demanding organ, accounting for nearly 20% of the body's total resting energy expenditure. While creatine has historically been viewed primarily as a supplement for muscle hypertrophy, the discovery of brain-type creatine kinase (BB-CK) has shifted scientific consensus, highlighting its critical role as a neuroprotective metabolite and potential nootropic agent during transient "energy gaps." Aim. This review aims to synthesize current scientific evidence on how oral creatine supplementation can modulate brain bioenergetics and affect overall cognitive performance. Material and methods. This narrative literature review synthesized data from PubMed, Scopus, and the Cochrane Library. The search focused on keywords including “creatine”, “cognitive function”, and “brain bioenergetics”, incorporating systematic reviews, meta-analyses, and randomized controlled trials published in English or Polish, without time restrictions. Results. Current evidence suggests that creatine facilitates the efficient recycling of ATP, which is essential for maintaining neuronal membrane potentials and signal transduction. Supplementation appears to fortify brain bioenergetics, particularly during periods of intense cognitive activity, sleep deprivation, or mental fatigue, helping to bridge the gap when ATP consumption exceeds aerobic synthesis. Conclusions. Oral creatine supplementation emerges as a promising public health strategy to support brain bioenergetics and mitigate cognitive decline. It serves as an effective intervention to enhance cognitive performance under metabolic stress, though further research is warranted to optimize dosing protocols specifically for neurological health.
Copyright (c) 2026 Marta Omiecińska , Aleksandra Anna Miciak, Aleksandra Karolina Węglarz, Patrycja Anna Borowiecka, Jagoda Anna Adamarczuk, Jacek Głuski, Nina Urantówka, Aleksandra Wojtera, Karina Barbara Kaszowska, Tomasz Piotr Dąbrowski, Karolina Kaczmarz-Chojnacka https://creativecommons.org/licenses/by-nc-sa/4.0
The Effect of Chia Seeds (Salvia hispanica L.) Consumption on Health A Literature Review
Background. Chia (Salvia hispanica) is a plant species native to Mexico and Guatemala. Chia seeds possess significant nutritional properties, as they contain a high amount of antioxidants, as well as minerals valuable for human health and vitamins E, B1, and B3. Chia seed oil contains a very high concentration of omega-3 fatty acids. Due to their high nutritional value, chia seeds are recommended for inclusion in the daily diet of both adults and children. Methodology. A review was conducted using PubMed. Search terms included: chia seeds, salvia hispanica, omega-3 acids, alpha-linolenic acid. Studies published between 2019 and 2025 were reviewed. Results. Chia seeds (Salvia hispanica) are highly nutritious, due to their high dietary fiber content (approx. 30–35%), which has a beneficial effect on intestinal motility and glucose metabolism. They are a rich source of α-linolenic acid (ALA) from the omega-3 group, which exhibits cardioprotective effects, positively influences the lipid profile, and reduces the risk of cardiovascular diseases, as well as being a very important component of neuronal membranes, crucial for the development of the nervous system. Chia seeds also provide significant amounts of minerals, particularly calcium, magnesium, phosphorus, and iron, which may support the functioning of the skeletal and enzymatic systems. The presence of phenolic compounds and other antioxidants contributes to the reduction of oxidative stress and may have anti-inflammatory effects. Conclusions. Salvia hispanica offers broad therapeutic potential in nutrition and preventive potential in medicine in particular in children, for whom an adequate intake of omega-3 fatty acids is crucial due to the rapid development of their nervous system, as well as the development of the heart and circulatory system. Chia has cardioprotective, neuroprotective, and anti-inflammatory properties and has a positive effect on intestinal function.
Copyright (c) 2026 Aleksandra Skowron, Jakub Orzeł, Patrycja Pelczar, Aleksandra Przygoda https://creativecommons.org/licenses/by-nc-sa/4.0
Xenon as a Potential Enhancer of Hypoxic Adaptation Rather Than Its Substitute: A Narrative Review
Background. Xenon has been proposed as a potential agent influencing erythropoiesis through activation of hypoxia-inducible pathways. However, its role in high-altitude physiology and hypoxic adaptation remains unclear and controversial. Aim. This study aimed to evaluate whether xenon may act as a modulator of hypoxic adaptation rather than a substitute for hypoxic exposure. Material and methods. This study is a narrative literature review based on scientific publications indexed in the PubMed database between 1998 and 2025. The literature search included keywords such as xenon, hypoxia, HIF-1α, erythropoietin, hypoxic adaptation, and acclimatization. Original studies, review articles, and experimental studies investigating the physiological and molecular effects of xenon were included. Studies not related to hypoxia or adaptive physiological responses were excluded. Results. Available evidence indicates that xenon transiently increases erythropoietin levels via activation of the HIF pathway; however, these effects do not translate into sustained physiological adaptations such as increased hemoglobin mass or improved aerobic performance. Notably, most studies have evaluated xenon in isolation, without integration into complex adaptive conditions such as combined hypoxia and physical training. Conclusions. Xenon does not appear to substitute for hypoxic adaptation. Its potential role as a modulator of hypoxia-induced physiological responses remains insufficiently explored and requires further investigation within integrated experimental models.
Copyright (c) 2026 Michał Tryba, Anna Paluch, Gabriela Grylowska, Katarzyna Gunia, Aleksandra Adamczyk, Mateusz Banasik, Marcin Rebizant, Agata Żak, Andrzej Palak, Anna Ignatowicz https://creativecommons.org/licenses/by-nc-sa/4.0
Comprehensive Non-Pharmacological Management of Rheumatoid Arthritis: A Multidisciplinary Approach
Background. Rheumatoid arthritis (RA) is a chronic autoimmune disease that leads to joint destruction, chronic pain, and significant functional impairment. While pharmacological treatment remains the cornerstone of therapy, it is increasingly recognized that optimal patient outcomes require a holistic approach. Non-pharmacological interventions are essential to address the physical, psychological, and social challenges faced by patients. Aim. The aim of this study is to evaluate the effectiveness of various non-pharmacological strategies in the management of RA and to highlight the importance of a coordinated, multidisciplinary team in improving patient quality of life and functional status. Material and methods. A comprehensive review of current clinical guidelines and recent literature (from databases such as PubMed and Scopus) was conducted. The analysis focused on interventions including physical therapy, occupational therapy, nutritional counseling, psychological support, and patient education programs within a multidisciplinary framework. Results. The findings indicate that regular aerobic and resistance exercise, combined with joint protection techniques, significantly reduce pain and fatigue while improving joint mobility. Dietary interventions (e.g., Mediterranean diet) and psychological interventions (e.g., Cognitive Behavioral Therapy) contribute to better disease control and mental well-being. A multidisciplinary approach, involving rheumatologists, physiotherapists, dietitians, and psychologists, leads to higher treatment adherence and better functional outcomes compared to monodisciplinary care. Conclusions. Non-pharmacological management is a vital component of RA care that complements medical treatment. A well-structured, multidisciplinary approach ensures personalized care, targets diverse symptoms, and empowers patients to manage their condition effectively, ultimately leading to a better quality of life.
Copyright (c) 2026 Zofia Możdżan, Adrian Majtas, Konrad Gronek, Edward Zheng, Agnieszka Olejnik, Jakub Tambor, Mateusz Polak, Igor Tambor, Aleksandra Błasiak, Laura Biskup https://creativecommons.org/licenses/by-nc-sa/4.0
Scoliosis In Young Athletes: Influence of Gymnastic Training and Screening Strategies
Objective. This review aims to evaluate the prevalence of scoliosis among young athletes, specifically focusing on the biomechanical influence of gymnastic training and the efficacy of various screening strategies for early detection. Methods. A comprehensive analysis of recent literature and clinical studies (including rhythmic, artistic, and acrobatic gymnastics) was conducted. The review synthesizes data on epidemiological trends, training-related risk factors, and diagnostic accuracy of non-invasive screening tools. Results. Research indicates that young gymnasts exhibit a significantly higher prevalence of scoliosis compared to the general population, with "scoliosis suspected status" reaching approximately 28.8% in competitive cohorts. The etiology is multifaceted, often described through the "dangerous triad" of generalized joint hyperlaxity, delayed skeletal maturity, and asymmetric mechanical loading. High training volumes—exceeding 22–26 hours per week—and the repetitive execution of spinal hyperextension elements ("the arch") are identified as primary contributors to sagittal curvature alterations and overuse injuries. However, active sports participation, when properly monitored, can also play a protective role in reducing curve progression. Effective screening remains the cornerstone of management; the Adam’s Forward Bend Test (AFBT) combined with scoliometer measurements (ATR) and modern 3D surface topography (ST) provides a reliable, radiation-free framework for monitoring athletes during the critical growth period of 10–15 years. Conclusion. Young gymnasts represent a high-risk group for the development of spinal deformities. Integrating standardized, non-invasive screening protocols into routine pre-participation physical evaluations (PPE) is essential for early diagnosis and the success of conservative treatment strategies, ensuring the long-term musculoskeletal health of adolescent athletes.
Copyright (c) 2026 Anna Dziegciarczyk, Zuzanna Wiater, Aleksandra Włodarczyk, Kamil Swoboda, Karolina Brankowska, Michał Kuryłek, Andrzej Dziegciarczyk, Filip Banyś, Anna Polakowska, Alicja Pyzik, Marta Jakubowska https://creativecommons.org/licenses/by-nc-sa/4.0
Does Moderate to Vigorous Physical Activity Fully Offset the Cardiometabolic Risks of Prolonged Sitting? A Review of Current Evidence
The aim of this paper is to discuss the “active couch potato” phenomenon, defined as a situation in which individuals who meet physical activity recommendations simultaneously spend a very large amount of time sitting, and to answer the question of whether regular exercise can fully compensate for the metabolic consequences of a sedentary lifestyle. Based on studies from recent years, the combined effects of sitting time, activity of varying intensity, metabolic profile status, adipose tissue (including visceral and hepatic fat), insulin resistance, risk of metabolic syndrome, and type 2 diabetes were analyzed. Data from population and interventional studies indicate that a high level of moderate-to-vigorous physical activity (MVPA) improves insulin sensitivity, lipid profile, and cardiovascular risk; however, prolonged, uninterrupted sitting remains an independent risk factor for poorer metabolic health, even in “sufficiently active” individuals [1, 5, 6, 8, 10, 19]. Individuals described as “active couch potatoes” – meeting activity recommendations but sitting >10 h/day – exhibit a less favorable cardiometabolic profile compared to individuals with a similar exercise volume but shorter sitting time and a greater proportion of light-intensity activity [6, 8, 19]. Short-term reductions in step count and increases in sitting lead to rapid deterioration of insulin receptor sensitivity, increased liver fat, and worsening dyslipidemia, partially reversible after returning to habitual movement levels [1, 5, 15]. Available data suggest that regular exercise markedly reduces, but does not completely eliminate, the adverse effects of prolonged sitting. Therefore, the optimal strategy includes a combination of MVPA, reduction of total sitting time, and frequent interruption of sitting with short episodes of light- or moderate-intensity activity.
Copyright (c) 2026 Antoni Anczyk, Karolina Handzel, Jacek Wysoczański, Wiktoria Śliwa, Wiktoria Tłoczek, Daria Twardowska, Dominik Kret, Wiktoria Szlachta, Krzysztof Karbowiak, Natalia Nawrat, Filip Basta https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Zinc in the Pathophysiology and Treatment of Depressive Disorders: A Literature Review
Background. Depression is one of the most common mental disorders worldwide and represents a major public health concern. Increasing evidence suggests that dietary factors, including trace elements such as zinc, may play a role in the development and course of depressive disorders. Zinc is involved in numerous biological processes within the central nervous system, including neurotransmission, neuroplasticity, immune regulation, and oxidative balance. Aim. The aim of this study was to review the current literature on the role of zinc in the pathophysiology and treatment of depressive disorders, with particular emphasis on underlying biological mechanisms, clinical findings, and potential therapeutic implications. Material and methods. The studies cited in the presented review were selected from Pubmed and Google Scholar. The search included studies between 2020 and 2026. The key words used for the search included: depression; zinc; zinc deficiency; zinc supplementation Results. The available literature indicates that zinc deficiency is frequently observed in patients with depression and is associated with greater severity of symptoms. Experimental and clinical studies suggest that zinc influences key mechanisms implicated in depression, including NMDA receptor modulation, regulation of brain-derived neurotrophic factor (BDNF), dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, and inflammatory processes. Furthermore, zinc supplementation may enhance the efficacy of antidepressant therapy and improve clinical outcomes, particularly when used as an adjunctive treatment. Conclusions. Zinc appears to play a significant role in the pathophysiology of depression and may represent a promising target for adjunctive therapeutic strategies. However, further well-designed randomized controlled trials are required to establish optimal supplementation protocols and to better define the clinical applicability of zinc in depressive disorders.
Copyright (c) 2026 Aleksandra Przygoda, Aleksandra Skowron, Jakub Orzeł, Patrycja Pelczar https://creativecommons.org/licenses/by-nc-sa/4.0
Clinical Efficacy, Mechanism of Action, and Adverse Effects of SGLT2 Inhibitors and GLP-1 Receptor Agonists in the Treatment of Type 2 Diabetes – a Systematic Review
Introduction: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease with a multifactorial background. Long-term persistent hyperglycemia leads to the development of cardiovascular and renal complications, significantly worsening patient prognosis. In recent years, new medications have been introduced to the market whose effects extend beyond glycemic control, such as SGLT2 inhibitors and GLP-1 receptor agonists. In addition to their glucose-lowering effects, these drugs also show cardio- and nephroprotective properties. [1,2,3,4,5] Aim of the study: The aim of this study is to review the literature on type 2 diabetes, its pathophysiology and complications, and also to present the mechanisms of action, clinical efficacy assessment, and safety of drugs from the SGLT2 inhibitor and GLP-1 receptor agonist groups. Methods and materials: A review of the literature available in the PubMed database was conducted using key search terms. Conclusions: SGLT2 inhibitors and GLP-1 receptor agonists effectively reduce blood glucose levels and body weight in patients with T2DM, and their effects are not limited solely to glucose lowering. These drugs slow the progression of chronic kidney disease, reduce albuminuria, and decrease the risk of cardiovascular diseases. Despite adverse effects, their benefits outweigh the potential risks, making them an important component of modern T2DM therapy.
Copyright (c) 2026 Łukasz Starczewski, Damian Osiński, Zuzanna Kawa, Maria Kasprzak, Aleksandra Jędrzejewska, Aleksandra Jureczko, Klaudia Kleczaj, Julia Jaworowska, Gabriela Babiarz, Julia Kanarszczuk https://creativecommons.org/licenses/by-nc-sa/4.0
Creatine supplementation beyond skeletal muscles: cognitive and neuroprotective effects and underlying mechanisms – a narrative review
AIM: The aim of this narrative review was to gather and evaluate current evidence on the effects of creatine supplementation on cognitive function and brain health, with emphasis on mechanisms related to energy metabolism and potential neuroprotective properties. MATERIALS AND METHODS: A narrative literature review was conducted using PubMed and Google Scholar, including randomized controlled trials, systematic reviews, and meta-analyses. The analysis focused on cognitive aspects such as memory, attention, and processing speed, as well as studies examining brain creatine metabolism, especially under conditions of increased metabolic demand. RESULTS: Overall, the evidence suggests that creatine has small but fairly consistent effects on cognitive performance, mainly in short-term and working memory. Regarding attention and processing speed, current evidence suggests that although individual studies show varying degrees of effect, creatine supplementation does not have a significant positive impact on attention and processing speed. The benefits appear more noticeable in situations where the brain is under metabolic stress, such as sleep deprivation, mental fatigue, hypoxia, aging, or low baseline creatine levels. These effects are most likely linked to improved ATP availability, enhanced phosphocreatine buffering, and support of mitochondrial function. CONCLUSIONS: Creatine may offer modest, context-dependent support for cognitive function, particularly when brain energy metabolism is challenged. While effects in healthy individuals seem limited, it may still be a safe and potentially useful option in specific populations. Further research is needed to better define its role and optimal use.
Copyright (c) 2026 Mikołaj Mińkowski, Zuzanna Oćwieja , Agata Wyborska , Karolina Fengler, Olga Jakubowska , Dominika Kominiak , Marcel Gascon Carreno , Katarzyna Solecka , Agata Urbanik , Kamila Pietrzak https://creativecommons.org/licenses/by-nc-sa/4.0
Maternal and Environmental Risk Factors for Congenital Heart Diseases in Offspring: A Review Article
Background. Congenital heart diseases (CHDs) are the most common congenital anomalies and a leading cause of infant morbidity and mortality. Although genetic factors play an important role, many cases remain unexplained, highlighting the contribution of maternal and environmental exposures. Aim. This review aims to provide a comprehensive and up-to-date synthesis of non-genetic maternal risk factors associated with CHDs in offspring. Material and methods. A literature review was conducted using PubMed, NCBI and Google Scholar, including studies published between 2010 and 2025. Systematic reviews, meta-analyses, cohort and case-control studies evaluating maternal and environmental exposures were analyzed. Results. Evidence indicates that maternal diabetes and obesity are key risk factors, with clear dose-response relationships. Additional contributors include smoking (active and passive), alcohol consumption, infections, fever, psychological stress and environmental pollutants. Protective effects of folic acid and multivitamin supplementation were also observed. Interaction effects between environmental exposures and parental behaviors further increase CHD risk. Conclusions. CHD etiology is multifactorial, involving modifiable maternal and environmental factors. Identification and reduction of these exposures, particularly during early pregnancy, are essential for prevention. Further prospective and mechanistic studies are needed to clarify causal pathways and improve risk reduction strategies.
Copyright (c) 2026 Agnieszka Zielińska, Zuzanna Zofia Kamińska, Małgorzata Blecharczyk, Martyna Mrozek, Igor Zydlewski, Martyna Pacanowska-Trawnicka, Aleksandra Jakimowicz, Aleksandra Malcher https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Erectile Dysfunction on Quality of Life and Mental Health in Men
Erectile dysfunction (ED) is a prevalent and multifactorial condition that affects men worldwide, with vascular, hormonal, neurological, and psychological factors contributing to its development. Beyond impairing sexual performance, ED has significant consequences for mental health, quality of life, and interpersonal relationships, and may serve as an early indicator of systemic diseases such as cardiovascular disease and metabolic syndrome. Men with ED frequently experience depression, anxiety, reduced self-esteem, and relational difficulties, highlighting the importance of evaluating both psychological and physical health in this population. Effective management includes pharmacological interventions such as sildenafil or tadalafil, psychosexual therapy, and lifestyle modifications, all of which can improve erectile function as well as psychological well-being. A holistic, multidisciplinary approach involving primary care physicians, urologists, and mental health professionals is essential to optimize outcomes and address both the physiological and psychosocial aspects of ED. Recognizing ED as a multidimensional condition underscores the need for comprehensive assessment and integrated care strategies to enhance quality of life and overall health in affected men.
Copyright (c) 2026 Jakub Hobot, Michał Iwanicki, Maciej Hobot https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Coffee and Caffeine on Health and the possibilities of their supplementation for different populations- a narrative review
Background. Caffeine is the most widely consumed psychostimulant in the human diet, found in over 60 plant species and ingested mainly through coffee, tea, and soft drinks. Many people perceive caffeine as unhealthy, yet growing evidence suggests moderate intake carries substantial benefits across multiple disease domains, though it has not been systematically considered as a clinical supplement. Aim. To synthesize evidence on the health effects of caffeine and coffee and evaluate the feasibility of recommending supplementation as a preventive or adjunctive measure for specific patient populations. Material and methods. A literature search was performed using PubMed and Google Scholar, focusing on conditions most common in today's society. We prioritised meta-analyses, prospective cohort studies and RCTs, supplemented by governmental and NGO sources for statistics and policies. Results. Consumption of 2–5 cups of coffee per day was consistently associated with reduced all-cause mortality, lower risk of several cancers, and cardiovascular diseases. A linear inverse relationship was observed between intake and type 2 diabetes risk, also noted for decaffeinated coffee. Caffeine was associated with reduced Parkinson's disease risk and slower progression. Moderate intake of 3–5 cups appeared to lower depression risk, more strongly in women, and 2–3 cups daily was linked to reduced dementia risk and better cognitive outcomes, again more prominently in women. Conclusions. Clinicians should consider integrating caffeine and coffee into preventive care discussions, accounting for contraindications, sleep disturbances, and dependence risk. Supplementation may benefit those at elevated risk of cardiovascular disease, type 2 diabetes, certain cancers, Parkinson's disease, depression, and dementia, particularly women and older adults. Further RCTs are needed to establish precise dosing guidelines.
Copyright (c) 2026 Andrzej Palak Palak, Gabriela Grylowska, Marcin Rebizant, Agata Żak, Anna Ignatowicz, Anna Paluch, Katarzyna Gunia, Mateusz Banasik, Michał Tryba, Aleksandra Adamczyk https://creativecommons.org/licenses/by-nc-sa/4.0
Impact of Pilot Fatigue and Sleep Deprivation on Cognitive Performance and Flight Safety – A Narrative Review
Pilot fatigue and sleep deprivation are two very serious and persistent risks to global aviation safety. In particular night flying and cross-continental travels result in a continuous fatigue build-up and may lead to diminished pilots’ performance. This review combines findings from recent research concerning the impact of sleep loss and fatigue on the cognition of pilots. In particular factors like working memory, focusing attention, reaction times, decision making and situational awareness are discussed. The presented review demonstrated that moderate levels of sleep deprivation lead to measurable decreases in human alertness, psychomotor speed and executive functioning. Moreover, it was proved fatigue played a pivot role in a large number of aviation incidents and accidents. Presented reports indicate that aviation regulatory agencies, airline managers and researchers should give high priority to reducing pilot fatigue in order to protect both the health of pilots and the safety of passengers.
Copyright (c) 2026 Katarzyna Latalska, Wiktoria Leja, Maciej Błaszczak, Zeeshan Zulfiqar, Jakub Kot, Katarzyna Czechowicz, Maciej Szczupaj, Andżelika Pastuszak, Konrad Borkowski, Jakub Rudnicki https://creativecommons.org/licenses/by-nc-sa/4.0
Exercise Therapy in Type 2 Diabetes Mellitus with Special Emphasis on Running: Effects on Glycemic Control, Metabolic Adaptations, and Psychosocial Outcomes – A Narrative Review
Type 2 diabetes mellitus is a chronic metabolic disease that affects over 500 million adults all over the world and represents one of the most important public health challenges of the 21th century. Regular physical activity and structured exercise therapy in particular, is a cornerstone of evidence-based T2DM management. This narrative review synthesizes current evidence on the effects of exercise training on glycemic control and related metabolic, physiological, and psychosocial outcomes in individuals with T2DM, with special emphasis on running as a clinically relevant and globally accessible form of aerobic exercise. A structured literature search was conducted in PubMed, Scopus, and Google Scholar, encompassing publications from the last decade, with particular emphasis on studies published between 2020 and 2026. Evidence from meta-analyses and randomized controlled trials consistently demonstrates that structured aerobic exercise produces significant reductions in glycated haemoglobin (HbA1c) and fasting blood glucose. Additionally, prospective cohort study data found running to significantly reduce the risk of developing T2DM by 28%. Studies have also reported a dose response relationship when examining performed run by duration, frequency, distance, and speed. Molecular mechanisms responsible for the glycemic improvements due to exercise include AMPK mediated GLUT4 translocation into skeletal muscle cells, changes in post translational modification to insulin signaling proteins, and increased mitochondrial biogenesis. In addition to improving glycemia, regular exercise has been shown to decrease both visceral and hepatic ectopic fat, improve multiple cardiometabolic risk factors, and produce psychologically relevant advantages including reduced symptoms of depression and anxiety. Therefore, exercise therapy, using running as one of its most accessible and effective forms, provides advantageous approach to managing all aspects of T2DM.
Copyright (c) 2026 Maciej Szczupaj, Jakub Rudnicki, Marta Krzyżanowska, Wiktoria Leja, Maciej Błaszczak, Katarzyna Latalska, Andżelika Pastuszak, Konrad Borkowski, Julia Zjawiony, Zeeshan Zulfiqar https://creativecommons.org/licenses/by-nc-sa/4.0
Telerehabilitation for Chronic Low Back Pain: A Review of Current Evidence and Clinical Perspectives
Background. Chronic low back pain (CLBP) is a widely prevalent and multifactorial condition defined as pain lasting more than 12 weeks, associated with functional limitations and increased healthcare burden. Despite recommended treatments, barriers such as limited access to care and time constraints may reduce adherence. Telerehabilitation has emerged as a promising approach enabling remote delivery of rehabilitation. Aim. The aim of this review was to evaluate current evidence and clinical perspectives on telerehabilitation in the management of chronic low back pain. Materials and Methods. A literature review was conducted using PubMed, Google Scholar and SpringerLink databases, including studies published between 2016 and 2026. Articles were selected based on predefined inclusion and exclusion criteria and analyzed qualitatively. Results. Available evidence indicates that telerehabilitation may reduce pain intensity and improve functional outcomes in individuals with chronic low back pain, with effects generally comparable to conventional physiotherapy. High adherence, completion rates and patient satisfaction support its feasibility. Telerehabilitation may also improve access to care and reduce time and healthcare costs. However, results remain heterogeneous and depend on intervention type and delivery mode. Conclusions. Telerehabilitation appears to be a practical alternative or adjunct to face-to-face rehabilitation. Nevertheless, further high-quality studies are required to standardize interventions and confirm long-term effectiveness.
Copyright (c) 2026 Katarzyna Szeliga, Magda Sawin, Julia Lorek, Patrycja Waszkiewicz, Wiktoria Brzozowska, Daniel Grobecki, Franciszek Jabłoński, Hanna Jabłońska, Jakub Korybski, Adam Jarczak https://creativecommons.org/licenses/by-nc-sa/4.0
AI Fatigue and Mental Health Implications: A Comprehensive Literature Review
Introduction. The quick use of artificial intelligence (AI) in healthcare, technology, and businesses brings benefits like faster work and helpful decision support. However, it also creates new problems, causing worse mental health, burnout, and something called "AI fatigue". This means workers feel stressed by the technology, overwhelmed by too much information, anxious about AI capabilities, and tired from constantly having to adapt to new systems. Materials and methods. This review summarizes 22 studies published between March 2025 and March 2026. The researchers used different methods, such as surveys of hundreds of people, interviews, and advanced data models. The studies included many types of workers, such as doctors, technology professionals, factory workers, and office employees. Literature review. The studies show that AI can sometimes help workers, for example, by saving doctors time on paperwork. But often, poorly designed AI makes stress worse. The biggest reason for AI fatigue is that it increases the workload, creating new tasks like monitoring the system instead of removing work. Other major problems include a lack of help from managers, confusing AI systems, and not enough training. Conversely, workers feel much better when their company supports them, when they are trained well, and when the AI is clear and easy to understand. Keeping human control over the AI is also very important for reducing stress and protecting professional independence. Summary and Conclusions. AI fatigue is a serious and measurable problem, but it can be managed with the right approach. The review clearly shows that preventing this fatigue is the responsibility of companies and AI designers, not the individual workers. To successfully use AI, organizations must treat it as a major workplace change. They must protect their employees' well-being and not just focus on making them work faster.
Copyright (c) 2026 Piotr Sosiński, Natalia Piasecka https://creativecommons.org/licenses/by-nc-sa/4.0