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
A Symptom-Driven Imaging Protocol for Temporomandibular Disorders in Elite Athletes: Integrating AI and Conventional Modalities
Background. Temporomandibular disorders (TMDs) affect the TMJ, masticatory muscles, and related structures. They are critical in sports medicine, as athletes face unique stressors—from facial trauma to exertional bruxism—impacting postural stability and quality of life. Despite their clinical significance, standardized imaging protocols for professional athletes are lacking. Aim. This narrative review presents an evidence-based, symptom-oriented algorithm for selecting efficient imaging modalities for TMDs in athletes. It combines conventional imaging (MRI, CBCT) with cutting-edge AI and DL screening methods to establish a contemporary diagnostic protocol. Material and methods. A literature search (2018–2026) was conducted across PubMed/MEDLINE, Scopus, WOS, and IEEE Xplore. It included studies on biomechanics, neurophysiology, sports medicine, imaging techniques (MRI, CBCT, US), and DL applications in orofacial diagnostics. Results. Diagnostic protocols should be tailored to athletes' specific clinical signs and sport-related risks. While MRI remains the gold standard for soft tissue, disc derangements, and early inflammation, CBCT offers superior resolution for osseous degeneration and fractures. Furthermore, recent DL models (e.g., TMJ-PanoNet) enable sensitive prescreening using widely available 2D panoramic radiographs. Conclusions. A symptom-oriented, AI-assisted imaging protocol improves diagnostic speed, accuracy, and treatment outcomes. Early detection of TMJ dysfunctions helps control TMD progression, reduce chronic pain, and restore biomechanical balance, potentially preventing premature career termination in professional athletes.
Copyright (c) 2026 Marta Kołodziej-Sieradz, Anna Magdalena Terlecka, Hubert Jarosław Ćwiek, Paulina Klaudia Gryz, Kacper Komorowski, Karolina Jolanta Pilarska, Anna Aleksandra Szwankowska, Anna Baczyńska, Błażej Boruszczak, Adam Wiktor Rożenek https://creativecommons.org/licenses/by-nc-sa/4.0
The impact of e-cigarette smoking on the body and sport activity - a review of articles
This review article presents a thorough analysis of the available data regarding the effects of e-cigarette use on human health. The authors provide the current state of knowledge based on numerous clinical, laboratory, and observational studies. Special attention is given to the mechanisms of action of e-cigarettes and the chemical composition of the aerosol they generate, which - despite the absence of combustion - contains a number of potentially toxic compounds. The article discusses the effects of vaping on various body systems, including cardiovascular, respiratory, nervous systems, and the oral cavity. Additionally, the topic of the impact of physical activity is discussed.
Copyright (c) 2026 Martyna Toczek, Alekasandra Płusa, Damian Broda, Daria Komissarova, Izabela Ciesielska, Paulina Janczylik, Łukasz Głąb, Paulina Ryszka, Dawid Cyls https://creativecommons.org/licenses/by-nc-sa/4.0
Heel Pain in a Young Athlete – Haglund’s Disease
Haglund’s disease is a significant cause of posterior heel pain, particularly among physically active individuals. It is associated with a posterosuperior calcaneal prominence leading to irritation of the retrocalcaneal bursa and Achilles tendon. The condition has a multifactorial etiology, including anatomical, biomechanical, and environmental factors. Diagnosis is based on clinical examination and imaging modalities such as X-ray, MRI, and ultrasound. Treatment includes both conservative and surgical approaches depending on symptom severity.
Copyright (c) 2026 Olga Komar, Marek Kochański, Natalia Pokrywka, Kinga Szymańska, Dawid Suwała, Iga Barczak, Mateusz Gąbka , Agata Trześniowska https://creativecommons.org/licenses/by-nc-sa/4.0
Use of GLP-1 Analogues in Patients with Schizophrenia and Other Neuropsychiatric Disorders: A Literature Review
Background: Schizophrenia is a chronic mental disorder associated with an increased risk of metabolic disturbances such as obesity, insulin resistance, and type 2 diabetes, as well as cognitive impairment. This is due to both the pathophysiology of the disease and the use of second-generation antipsychotics. Aim of the study: To review the literature on the use of GLP-1 analogs in the treatment of metabolic and cognitive disorders in patients with schizophrenia and other neuropsychiatric diseases. Methodology: The analysis was based on publications from PubMed and Google Scholar, using keywords related to schizophrenia, GLP-1 analogs, and metabolic disorders. Studies from 1999 to 2026 were analyzed. Results: GLP1 analogs show beneficial effects on weight reduction and improvement of glucose and lipid parameters in patients with schizophrenia. There are also indications that they may impact cognitive functions and could be used in other neuropsychiatric disorders. They have a good safety profile and do not exacerbate psychotic symptoms. Conclusion: GLP1 analogs are a promising therapeutic strategy in schizophrenia and may have broader applications in neuropsychiatric diseases; however, further clinical studies are required.
Copyright (c) 2026 Maja Pernal, Zofia Roguska, Paweł Poniewozik, Krzysztof Grabowski, Natalia Dziuba, Aleksandra Sim, Joanna Mioduszewska, Paweł Rot, Piotr Poniewozik, Andrzej Zuzak https://creativecommons.org/licenses/by-nc-sa/4.0
Preoperative Optimization in Total Knee Arthroplasty: Beyond Weight Loss
Total knee arthroplasty is one of the most commonly performed orthopaedic surgeries worldwide. However, a significant number of patients experience post-operative complications and do not achieve satisfactory functional results after their surgical procedure. While obesity has been the main focus in pre-operative risk discussions for many years, more recent evidence indicates that there are several other modifiable factors which have equal to or greater prognostic value than obesity. This narrative review will synthesis current evidence on these same five key domains of optimization prior to surgery: glycemic control; nutritional status; physical conditioning; psychological readiness; and broader comorbidity management. Diabetes mellitus and perioperative hyperglycemia consistently have higher rates of wound dehiscence, readmission and periprosthetic joint infection. Malnourishment before surgery (up to 40% of patients undergoing arthroplasty) individually increases the risk of early implant failure and wound complications. Structured prehabilitation programs enhance functional capacity in the weeks leading up to surgery and accelerate recovery following surgery. Benefits from prehabilitation are greatest among those with the lowest levels of functional ability at baseline. Depression, anxiety, kinesiophobia and unreasonable expectations by patients are among the strongest independent predictors of poor reported outcomes and patient dissatisfaction following surgery. Finally, both preoperative anemia and smoking each contribute to adverse outcomes as well as overall comorbidity burden. The evidence supports moving away from weight-centred risk stratification towards a multidisciplinary approach to optimize all domains prior to surgery. Systematic screening for these domains and targeted intervention may result in reduced complication rates and improved reported outcomes.
Copyright (c) 2026 Wiktoria Leja, Maciej Błaszczak, Katarzyna Latalska, Katarzyna Czechowicz, Maciej Szczupaj, Andżelika Pastuszak , Konrad Borkowski , Jakub Rudnicki , Julia Zjawiony, Zeeshan Zulfiqar https://creativecommons.org/licenses/by-nc-sa/4.0
Therapeutic Hypothermia in Neonatal Hypoxic-Ischemic Encephalopathy: Current Evidence and Clinical Practice- A Literature Review
Background: Hypoxic-ischemic encephalopathy (HIE) remains a major cause of neonatal mortality and long term neurodevelopmental impairment worldwide. Therapeutic hypothermia (TH) is currently the standard of care for newborns with moderate-to-severe HIE; however, several aspects of its use remain controversial. Aim: The aim of this paper is to present the current state of knowledge regarding the use of therapeutic hypothermia in newborns with HIE with particular emphasis on mechanisms of action, eligibility criteria, course of therapy, clinical efficacy and adverse effects, as well as to discuss current controversies and directions for further research. Material and methods: A narrative literature review was conducted using the PubMed database to identify studies on therapeutic hypothermia in newborns with hypoxic-ischemic encephalopathy. Publications from the past 11 years were included with particular emphasis on studies published within the last 5 years. Relevant original articles and review papers focusing on clinical outcomes and effectiveness were analyzed. Results: Therapeutic hypothermia reduces the risk of death and severe neurodevelopmental disability in newborns with moderate and severe HIE. Its neuroprotective effects are associated with reduced cerebral metabolism, decreased oxidative stress, modulation of inflammatory response, and inhibition of apoptosis. However, its efficacy in mild HIE and in preterm infants remains inconclusive. The most common adverse effects include cardiovascular, metabolic, and hematological disturbances requiring close monitoring. Conclusions: Therapeutic hypothermia is an effective and relatively safe treatment for HIE; however, it does not completely eliminate the risk of neurodevelopmental impairment. Further research is needed to optimize treatment protocols, expand its use to other populations and evaluate combination therapies.
Copyright (c) 2026 Alicja Trzepizur, Monika Spaczyńska-Kwiatkowska , Zuzanna Socha, Izabela Ochońska , Dawid Studziński, Sandra Michałek, Julia Pakulska https://creativecommons.org/licenses/by-nc-sa/4.0
Neuropathological Landscape of Repetitive Brain Trauma and CTE in Modern Sport
Background: Repetitive brain trauma has become a significant problem in modern sport, particularly in athletes exposed to repeated head impacts. Such injuries have been associated with chronic traumatic encephalopathy (CTE), a progressive neurodegenerative disease characterized by abnormal accumulation of hyperphosphorylated tau protein and other neuropathological changes. Aim: The aim of this study was to review current scientific knowledge on the neuropathological consequences of repetitive brain trauma in athletes, with particular emphasis on chronic traumatic encephalopathy. Material and methods: This study was conducted as a literature review. Relevant research articles related to repetitive brain injury and chronic traumatic encephalopathy (CTE) were identified through a PubMed database search using the following keywords: chronic traumatic encephalopathy, repetitive brain trauma, traumatic brain injury, neuropathology, and contact sports. The selected publications were analyzed to summarize the current state of knowledge on the neuropathology of CTE. Results: The reviewed studies indicate that repetitive head impacts can lead to progressive neurodegenerative changes, including abnormal tau protein deposition, neuroinflammation, neuronal loss, and axonal damage. These neuropathological alterations are considered key features of chronic traumatic encephalopathy. Conclusions: Repetitive brain trauma may significantly contribute to the development of chronic traumatic encephalopathy. Further research is needed to improve early diagnosis, prevention strategies, and clinical treatment of athletes exposed to repeated head impacts.
Copyright (c) 2026 Agnieszka Przepióra, Anna Żmigrodzka, Agnieszka Kamińska, Maria Orłowska, Klaudia Czernic-Goławska, Jana Kozłowska, Maria Sanocka, Joanna Falana, Aleksandra Wielogórska, Anna Kwiatkowska, Karolina Trojnar https://creativecommons.org/licenses/by-nc-sa/4.0
Efficacy and safety of GLP-1 Receptor Agonists for BMI Reduction in Children and Adolescents with Obesity: A Narrative Review
Background. Obesity arises as a global health issue, increasingly affecting children and adolescents. Excess body weight is associated with multiple metabolic risks and poor quality of life. Lifestyle therapy remains the cornerstone of weight management, the obtained effects are often modest. GLP-1 receptor agonists appear to improve BMI reduction, metabolic parameters, and present with good tolerability. Aim. This narrative review aims to summarize and discuss the current evidence on theefficacy and safety of selected long-acting GLP-1 receptor agonists in children and adolescents with obesity. Material and methods. A literature review was performed using the PubMed database. Studies evaluating the efficacy of using GLP-1 receptor agonists, with a focus on BMI reduction, improvement in metabolic parameters, safety, and tolerability in children and adolescents, were included in the analysis. Results. Semaglutide appeared to be the most effective GLP-1 receptor agonist in reducing BMI and improving metabolic risk factors. Liraglutide demonstrated moderate effectiveness in body mass reduction and modest improvement in metabolic parameters, with no significant benefits observed in children with Prader-Willi syndrome. Exenatide XR showed no significant effect on BMI reduction and limited benefits in the analyzed population. The most commonly reported side effects across the studies were gastrointestinal disorders, with an overall acceptable safety profile. Conclusions. Semaglutide and liraglutide are effective pharmacological options to support BMI reduction and improve metabolic profile in the pediatric population. Lifestyle therapy should remain the foundation of body weight reduction, supported by appropriate pharmacological treatment. Further research is needed to evaluate the long-term efficacy and safety of GLP-1 receptor agonists in the treatment of obesity in children and adolescents.
Copyright (c) 2026 Justyna Pestka, Aniela Figiel, Paweł Zaborek, Mateusz Bernad, Katarzyna Widomska, Robert Marguła https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of High-Intensity Interval Training (HIIT) On Polycystic Ovary Syndrome (PCOS) - A Narrative Review
The purpose of research. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age, characterized by metabolic, hormonal, reproductive, and psychological disturbances. Its pathophysiology involves insulin resistance, hyperandrogenism, and chronic low-grade inflammation. This review evaluates the effects of high-intensity interval training (HIIT) on metabolic, hormonal, reproductive, and psychological outcomes in women with PCOS. Material and methods. A literature search was conducted in PubMed, Scopus, and Google Scholar for studies published between 2010 and 2025. Randomized controlled trials, cohort studies, and systematic reviews evaluating HIIT in women with PCOS were included and analyzed qualitatively. Results. HIIT improves insulin sensitivity, reduces body mass index, and favorably modifies lipid profiles. Reductions in testosterone levels and improvements in menstrual regularity were observed, although data on gonadotropins and SHBG remain inconclusive. HIIT also reduces depression, anxiety, and stress, enhancing quality of life. Conclusions. HIIT is a promising, safe, and effective adjunctive therapy for PCOS, benefiting metabolic, hormonal, reproductive, and psychological parameters. Further large-scale randomized trials are needed to confirm long-term effects and optimize exercise protocols.
Copyright (c) 2026 Dominika Krakowiak, Kornelia Nieradka, Patrycja Kwitowska, Emilia Muraszewska, Łukasz Muraszewski, Eryk Ubysz https://creativecommons.org/licenses/by-nc-sa/4.0
Ketogenic Diet Overview: Downsides May Outweigh Benefits
Introduction: Due to the growing problem of high mortality and incidence of civilization diseases, including metabolic syndrome and obesity, there is an urgent need to find effective ways to prevent it. The purpose of this study was to review the effects of a ketogenic diet on particular systems and organs, as well as to analyze possible associated risks. Methods: Systematic review and current research about the impact of Ketogenic Diet to different systems was made. Authors wanted to highlight pros and cons of conveying this type of nourishment. Results: Consequently, there has been an increased focus on a healthy diet. Mass media allow access to abundant information on the purported beneficial effects of various diets, whether it is a weight loss diet, a cleansing diet, or a diet aimed at supporting the functioning of individual organs. The Ketogenic Diet is one of the most frequently used nowadays. It significantly reduces carbohydrate intake to just 5-10% of the total calorie consumption in favor of approximately 55% to 60% fat intake. According to previous research, we should emphasize the fact that conducting this type of diet can reveal many side effects. Conclusion: Despite the advantages of the diet for people suffering from obesity and diabetes mellitus type 2, for most individuals it results only in temporary improvements and an increase of unfavorable effects. Overall, according to our research, the risks of the ketogenic diet might outweigh its benefits. The Ketogenic Diet is an example of a nutrition trend that should not be used on such a large scale.
Copyright (c) 2026 Paula Nowocień, Angelika Kordylewska-Kubus, Iga Paszkiewicz, Dominik Nowocień, Marta Wróbel https://creativecommons.org/licenses/by-nc-sa/4.0
Sudden Cardiac Death (SCD) in Young Athletes – A Review of Current Guidelines and Key Studies
Background: Sudden cardiac death (SCD) in young athletes is a rare but catastrophic event that exerts a profound impact on the medical community, athletic organizations, and society. While regular physical activity provides robust cardiovascular benefits, vigorous exertion can act as a trigger for fatal arrhythmias in individuals with underlying and often clinically silent structural or electrical cardiac abnormalities. Aim: The objective of this study is to synthesize current epidemiological data, explore the pathophysiological etiologies of SCD in young athletes, evaluate ongoing debates regarding screening modalities, and outline the contemporary clinical framework—emphasizing the shift toward Shared Decision-Making and robust secondary emergency prevention. Material and methods: This comprehensive narrative review synthesizes data from modern prospective investigations utilizing mandatory reporting systems, such as the National Collegiate Athletic Association databases and the US Registry for Sudden Death in Athletes, as well as a comparative analysis of the latest international guidelines (HRS 2024, ACC/AHA 2025). Results: The incidence of SCD is highly variable across subpopulations, demonstrating significant disparities based on sex, race, and sporting discipline, with the highest risk identified in Black male basketball players,. Key etiologies include structural conditions like HCM and ACM, autopsy-negative findings linked to channelopathies, and mechanical triggers such as commotio cordis,,. Furthermore, the evolution of ECG interpretation criteria has improved specificity, reducing false-positive rates to between 1.3% and 3%. Conclusions: There is a paradigm shift away from paternalistic disqualification toward Shared Decision-Making, allowing many athletes to safely return to play while emphasizing the rigorous implementation of Emergency Action Plans and rapid access to automated external defibrillators as the most effective survival interventions.
Copyright (c) 2026 Anna Żmigrodzka, Agnieszka Przepióra, Maria Orłowska, Jana Kozłowska, Maria Sanocka, Aleksandra Wielogórska; Karolina Trojnar, Klaudia Czernic-Goławska; Agnieszka Kamińska, Joanna Falana, Anna Kwiatkowska https://creativecommons.org/licenses/by-nc-sa/4.0
Physical Activity During Pregnancy and Its Impact on Postpartum Depression Risk: A Narrative Review
Background. Pregnancy and the early postpartum period involve physiological and psychosocial changes that may increase vulnerability to depressive symptoms after childbirth. Safe and accessible preventive strategies, including physical activity, are therefore of growing interest. Aim. The aim of this narrative review was to summarize current evidence on the relationship between physical activity during pregnancy and the risk of postpartum depression. Material and methods. A structured search of PubMed, Scopus, and Google Scholar was conducted. Studies on pregnant women, prenatal physical activity, and postpartum depressive symptoms assessed with validated instruments, especially the Edinburgh Postnatal Depression Scale, were included. Results. Available evidence suggests that women who remain physically active during pregnancy tend to report fewer postpartum depressive symptoms. Better outcomes were most often observed with regular moderate-intensity exercise, programs lasting at least 12 weeks, and activity levels meeting current recommendations. Aerobic exercise, yoga, mind-body exercise, and relaxation-oriented interventions appear particularly promising. Conclusions. Prenatal physical activity may be an accessible and clinically relevant component of postpartum depression prevention. Further studies are needed to clarify the most effective dose, modality, and implementation strategy.
Copyright (c) 2026 Klaudia Czernic-Goławska, Joanna Falana, Jana Kozłowska, Maria Orłowska, Anna Kwiatkowska, Aleksandra Wielogórska, Karolina Trojnar, Agnieszka Przepióra, Anna Żmigrodzka, Maria Sanocka, Agnieszka Kamińska https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Running on Mental Health - A Literature Review
This literature review explores the relationship between running and mental health, synthesizing findings from empirical studies, clinical trials, and meta-analyses. Running has been shown to improve mood, reduce symptoms of anxiety and depression, and enhance self-esteem, emotional stability, and overall psychological well-being. Biological mechanisms underlying these effects include increased neuroplasticity, improved mitochondrial function, and modulation of key neurotransmitters such as serotonin, dopamine, and endorphins. Psychological and social mechanisms such as enhanced self-efficacy, sense of agency, and social connectedness further contribute to long-term mental health benefits. Despite methodological and demographic limitations in current research, the evidence suggests that running is a practical, accessible, and low-cost approach to promoting mental well-being. Future directions include developing personalized exercise programs and integrating running into public health and therapeutic frameworks.
Copyright (c) 2026 Joanna Łopińska, Ewelina Struzynska, Marta Majchrzycka, Martyna Graczyk, Mateusz Majchrzak, Natalia Czapla, Natalia Graczyk, Weronika Ziółkowska, Wiktor Wisoky, Piotr Ignyś https://creativecommons.org/licenses/by-nc-sa/4.0
Burnout Syndrome in Athletes: Mechanisms, Risk Factors and Prevention - A Narrative Review
Background. Athlete burnout is an increasingly recognized problem in modern sport, associated with high training demands, psychological stress, and environmental pressures. It may significantly affect athletes’ performance, mental health, and long-term engagement in sport. Aim. The objective of this review was to provide an overview of current evidence on athlete burnout, focusing on its underlying mechanisms, key determinants, associated outcomes, and approaches to prevention. Materials and methods. A narrative literature review was conducted using the PubMed and Scopus databases. Publications from January 2016 to March 2026 were included, encompassing original studies, systematic reviews, and meta-analyses addressing burnout in athletes. Results. The reviewed literature demonstrates that athlete burnout develops through complex interactions between physiological strain, psychological processes, and contextual factors within the sporting environment. Major contributors include excessive training demands, insufficient recovery, ineffective coping strategies, and unsupportive coaching conditions. Burnout is linked to declines in athletic performance, deterioration in mental well-being, and increased risk of sport discontinuation. Interventions targeting training regulation, psychological skills, and the social environment appear to play a key role in mitigating burnout symptoms. Conclusions. Athlete burnout represents a complex and multidimensional condition with significant implications for both performance and health. A comprehensive and individualized approach, integrating physical, psychological, and environmental strategies, is essential for effective prevention and management.
Copyright (c) 2026 Franciszek Włodarczyk, Magdalena Zapalska, Lidia Kulig, Eliza Wiercioch, Barbara Izabela Krupska, Stanisław Włodarczyk, Julia Anna Malec, Weronika Maria Woźniak, Marcin Wieleba, Zuzanna Winiarska https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Recreational Long-Distance Running on the Cardiovascular System of Amateurs – Health Benefits and the Risk of Overload: A Review
Background. Long distance running has surged in popularity among recreational athletes. While moderate exercise prevents cardiovascular disease, extreme endurance events by amateurs—often lacking professional medical monitoring—raise clinical concerns regarding myocardial overload. Aim. To systematize current knowledge on the physiological benefits and potential cardiovascular risks of recreational long-distance running in amateur athletes. Material and methods. A narrative review was conducted using PubMed, Web of Science, and Scopus. We analyzed 35 peer-reviewed English articles from the last two decades focusing on amateur runners. Data extraction targeted echocardiography, cardiac magnetic resonance, and biochemical markers of myocardial injury. Results. Regular running induces favorable cardiovascular adaptations ("athlete's heart"), improving metabolic profiles and reducing all-cause mortality. Conversely, acute extreme exertion (e.g., marathons) consistently triggers transient exercise-induced cardiac fatigue (EICF) and the release of cardiac biomarkers (troponins, BNP). The right ventricle is disproportionately affected by this acute strain, whereas half-marathons induce significantly less impairment. Long-term veteran amateurs exhibit a higher prevalence of atrial fibrillation and elevated coronary artery calcification (CAC) scores; however, these plaques are predominantly calcified and stable. Conclusions. Recreational running provides substantial, dose-dependent cardiovascular benefits, but extreme distances expose amateurs to acute cardiac fatigue and chronic structural remodeling. To safely maximize outcomes, amateurs should prioritize structured recovery, distance moderation, and routine cardiovascular screening before severe events.
Copyright (c) 2026 Mikołaj Hobot, Gabriela Dobosz, Zuzanna Przybylska, Aleksandra Purpura , Wiktor Rolski , Paulina Michalska, Bartłomiej Przystaś, Magdalena Grzechowiak, Sebastian Podeszwa https://creativecommons.org/licenses/by-nc-sa/4.0
Clinical and Pathophysiological Effects of Inhalation Exposure to Magnesium Carbonate and Rubber-Derived Pollutants in Indoor Climbing Facilities: A Review
Background. Indoor climbing has experienced exponential growth in global popularity. Consequently, athletes and facility staff are spending increasing amounts of time in enclosed environments characterized by unique air quality challenges. The extensive use of climbing chalk (predominantly magnesium carbonate) to enhance friction, combined with the continuous abrasion of specialized rubber from climbing shoes, generates high concentrations of airborne particulate matter (PM). The clinical and pathophysiological implications of prolonged inhalation of these specific pollutants remain a critical area of occupational and sports medicine. Aim. To systematically review the current evidence regarding the indoor air quality of climbing facilities, focusing on the clinical and pathophysiological effects of inhalation exposure to magnesium carbonate and rubber-derived particulate matter on the human respiratory system.
Copyright (c) 2026 Jakub Dariusz Karczewski, Aleksandra Białek, Aleksandra Sadok, Wojciech Kubas, Wojciech Jan Niemcewicz, Kamila Ryń, Aleksandra Koźlicka, Jakub Klajda, Mikołaj Czerniakowski, Zuzanna Gorczyca https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Matcha Green Tea on Human Health – Mechanisms of Action, Clinical Evidence, and Health Effects
Matcha green tea, a powdered whole-leaf preparation from shade-grown Camellia sinensis, exhibits a unique biochemical profile rich in catechins (particularly EGCG), L-theanine, caffeine, and chlorophyll, distinguishing it from conventional green teas. This narrative review synthesizes evidence on matcha's composition, mechanisms of action, and health effects. Mechanistically, EGCG activates the Nrf2/Keap1 antioxidant pathway, suppresses inflammatory signaling, and synergizes with L-theanine/caffeine to enhance cognitive function, while modulating gut microbiota toward beneficial taxa like Coprococcus. Clinical and preclinical studies demonstrate cardiometabolic benefits including improved glycemic control, lipid profiles, and hepatic protection against NAFLD, alongside cognitive enhancements and reduced exercise-induced fatigue. Preliminary data suggest anti-cancer potential via apoptosis induction and metabolic inhibition in tumor cells. Despite promising mechanistic insights, human trials remain limited by small samples, short durations, and heterogeneous preparations. Matcha emerges as a functional food with multifaceted health potential, warranting large-scale randomized controlled trials to establish optimal dosing, long-term efficacy, and safety for evidence-based recommendations.
Copyright (c) 2026 Bartosz Wróbel, Lena Wójcik, Michał Filipski, Kuba Ptaszkiewicz, Filip Basta https://creativecommons.org/licenses/by-nc-sa/4.0
Long QT Syndrome in Athletes: Diagnosis, Risk Stratification, and Management for Safe Sports Participation
Background. Long QT Syndrome (LQTS) is a hereditary cardiac channelopathy that predisposes individuals to malignant arrhythmias and sudden cardiac death. In athletes, physiological cardiac adaptations can mask or mimic LQTS, complicating diagnosis and risk assessment. Methods. This review synthesizes current evidence on the diagnosis, risk stratification, management, and safe sport participation in athletes with LQTS, drawing from cohort studies, clinical guidelines, and expert consensus. Results. Diagnosis in athletes requires careful ECG evaluation, exercise testing, and genetic analysis to distinguish pathological QT prolongation from training-related changes. Risk stratification integrates clinical history, genotype, and monitoring tools, including wearable ECG devices. With appropriate therapy, primarily beta-blockers, and individualized monitoring, many athletes can safely participate in moderate- to high-intensity exercise. Conclusions. Early recognition, structured assessment, and multidisciplinary management enable safe sports participation for athletes with LQTS while reducing the risk of sudden cardiac death. Genotype-specific approaches and continuous monitoring further optimize safety while supporting athletic performance.
Copyright (c) 2026 Natalia Piasecka, Melania Majewska, Izabela Rafalska, Jakub Smagoń, Natalia Kornacka, Martyna Kaim, Joanna Bober, Magdalena Bochenek, Wiktoria Siewiera, Krzysztof Bednarski, Piotr Sosiński https://creativecommons.org/licenses/by-nc-sa/4.0
Biological Clock and Reproductive Longevity: Molecular Insights into Ovarian Aging and the Role of Physical Activity
Introduction. The "biological clock" remains the primary determinant of female reproductive potential, as fertility is strictly limited by a finite pool of oocytes. In modern society, including professional athletes, the trend toward delayed childbearing has increased the clinical relevance of age-related fertility decline. This review explores the molecular foundations of ovarian aging and the impact of lifestyle on reproductive longevity. Materials and Methods. A narrative review was conducted using PubMed and Google Scholar, focusing on clinical guidelines (ASRM, ESHRE) and recent research regarding oocyte depletion, biomarkers (AMH, AFC), and the influence of physical activity and psychosocial stress on fertility outcomes. Literature Review. Reproductive aging is driven by oxidative stress, mitochondrial dysfunction (reduced ATP production), and degradation of cohesin proteins, leading to increased embryonic aneuploidy and miscarriage rates. While AMH and AFC are reliable for assessing follicle quantity, they remain limited in predicting oocyte quality or spontaneous conception. In active populations, extreme physical exertion and psychological pressure can modulate the ovarian microenvironment, potentially affecting reproductive success and long-term quality of life. Summary and Conclusions. Despite advancements in ART, female age remains the most critical predictor of fertility. To optimize reproductive longevity, it is essential to integrate early fertility education and individualized counseling into the routine medical care of active women.
Copyright (c) 2026 Zuzanna Panas, Izabela Ślinko, Gabriela Kuliś, Ewa Dryl Jarmoc, Kacper Krawczuk, Jakub Dziemiańczuk, Mateusz Zimowski, Piotr Kadysz, Agata Kolanek, Mateusz Czajkowski https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Physical Exercise During Chemotherapy in Women with Breast Cancer: A Narrative Review
Background. Breast cancer is the most frequently diagnosed malignancy in women worldwide. Advances in oncologic therapy have markedly improved survival, yet chemotherapy and other treatments produce adverse effects such as fatigue, cancer‑related cognitive impairment, and reduced quality of life. Aim. To synthesize recent evidence on the impact of structured exercise interventions on physical fitness, cognitive function, and health‑related quality of life (HRQOL) in women undergoing or recovering from breast‑cancer treatment. Methods. A structured literature search of PubMed, PEDro, and Scopus identified English‑language studies published in the past ten years that evaluated exercise programs in adult women receiving or having completed chemotherapy. Trials were screened for outcomes related to cardiorespiratory fitness, muscle strength, fatigue, cognition and HRQOL as well as biological mechanisms and limitations. Results. The majority of randomized controlled trials reported that supervised aerobic, resistance, or combined exercise programs significantly attenuated fatigue and enhanced HRQOL (Ficarra et al., 2022). Meta‑analyses confirm a small but reliable improvement in cognitive function across diverse exercise modalities (Hung et al., 2025). Exercise also produced clinically meaningful gains in cardiorespiratory fitness, muscle strength, and shoulder range of motion, while being safe with few serious adverse events. Conclusions. Structured, supervised exercise initiated early during chemotherapy is safe and yields consistent benefits in physical fitness, cognition, and HRQOL for women with breast cancer. Standardized protocols and larger, high‑quality RCTs are needed to refine dosage guidelines and elucidate underlying molecular mechanisms.
Copyright (c) 2026 Małgorzata Niewęgłowska, Oliwia Krazińska , Mateusz Bernad, Katarzyna Widomska, Aleksandra Bender, Paulina Walczak, Bartłomiej Szymulewicz, Kacper Dąbrowski, Jakub Łukaszewicz , Magdalena Gałach https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Physical Activity in Lower Extremity Peripheral Artery Disease
Peripheral artery disease (PAD) is a common disorder characterised by a reduced blood circulation caused by stenosis or occlusion of peripheral arteries of the limbs, predominantly affecting the lower extremities. This condition is typically related to atherosclerosis, but it might also be caused by vasculitis, fibromuscular dysplasia, or adventitial cystic disease. Although atherosclerotic occlusive disease of the lower extremities has high mortality and morbidity rates, it remains underdiagnosed and undertreated condition. The risk factors of PAD are similar to those for coronary and cerebrovascular disease. The most common symptom of PAD is intermittent claudication, but recent studies show that asymptomatic PAD is several times more common in the population than intermittent claudication. The medical approach to peripheral artery disease is multifaceted and includes smoking cessation, lipid-lowering therapy, antiplatelet therapy, antithrombotic therapy, peripheral vasodilators, blood pressure management, glycemic control and various methods of revascularization. An important, although frequently neglected aspect is an exercise therapy. Walking exercise is first-line therapy for PAD-related walking impairment. Supervised walking exercise and structured home-based walking exercise each not only improve walking ability, but also have other benefits, which we would like to discuss in this review.
Copyright (c) 2026 Julia Kaczmarek, Oliwia Dziewięcka, Dominik Gajewski, Zuzanna Głowacka, Jakub Grandos, Konrad Gronek, Beata Huszcza, Kinga Kościółek, Agnieszka Olejnik, Edward Zheng, Wojciech Ziębka https://creativecommons.org/licenses/by-nc-sa/4.0
Depression in Athletes and Antidepressant Therapy: Implications for Performance, Recovery, and Training Adaptation
Depression is a prevalent mental health disorder affecting both the general population and athletes, despite the latter often being perceived as psychologically resilient. Athletes are exposed to unique stressors such as performance pressure, injuries, overtraining, and psychosocial challenges, which may increase their vulnerability to depressive symptoms. Pharmacological treatment, particularly with antidepressants, plays a central role in the management of moderate to severe depression; however, its potential impact on physical performance, recovery, and training adaptation remains a relevant concern in sports medicine.The aim of this study was to evaluate the role of antidepressant therapy in athletes, with particular emphasis on different pharmacological classes and their effects on performance and recovery. This study was conducted as a narrative review of literature identified through PubMed, Scopus, and Web of Science. Studies were selected based on predefined eligibility criteria focusing on antidepressant use in athletes or physically active individuals and their effects on physiological, psychological, and performance-related outcomes. Data were analyzed qualitatively.The findings indicate that different classes of antidepressants exert distinct effects. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly used and generally well tolerated but may contribute to fatigue and reduced motivation. Serotonin–norepinephrine reuptake inhibitors (SNRIs) may improve energy levels and pain modulation, although they can affect cardiovascular responses. Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) are less suitable due to unfavorable side-effect profiles. Atypical antidepressants demonstrate heterogeneous effects, highlighting the importance of individualized treatment.In conclusion, antidepressant therapy is essential in managing depression in athletes but requires a personalized and interdisciplinary approach.
Copyright (c) 2026 Urszula Zaluska, Jagienka Perzyńska , Weronika Bagińska, Natallia Pawelec, Jaśmina Podkościelna, Kamila Ryszkowska, Simone Szymczyk, Aleksandra Purska, Jan Jakubczyk, Kinga Krzyżowska https://creativecommons.org/licenses/by-nc-sa/4.0
Beyond Exercise: Sport-Based, Family-Centered, and Technology-Assisted Interventions Supporting Children with Autism Spectrum Disorder
Background Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition characterized by deficits in social communication and restricted, repetitive behaviors. Its growing prevalence and functional burden have increased interest in non-pharmacological interventions, particularly physical activity and sport-based programs, as potential strategies to improve physical and neurobehavioral outcomes in pediatric populations. Aim This narrative review aimed to summarize current evidence on the effects of physical activity and exercise interventions on motor, cognitive, behavioral, and psychosocial outcomes in children and adolescents with ASD. Material and methods A narrative literature review was conducted using peer-reviewed studies on exercise-based interventions in pediatric ASD populations. Included were systematic reviews, meta-analyses, randomized controlled trials, and experimental studies assessing outcomes such as motor skills, executive functioning, social interaction, sleep, and behavioral regulation. Results Evidence indicates that structured physical activity may positively affect multiple domains in children with ASD. Exercise interventions were associated with improvements in motor skills, executive functions, and social abilities, along with reductions in behavioral problems and anxiety. Some studies also reported improved sleep and overall well-being. However, significant heterogeneity in intervention types, duration, and outcome measures was noted. Conclusions Physical activity is a valuable complementary element of multidisciplinary ASD management, supporting both physical health and neurobehavioral functioning. Further well-designed studies with standardized protocols and long-term follow-up are needed to determine optimal intervention strategies and their sustained effects.
Copyright (c) 2026 Piotr Szopa, Antoni Klamka, Sabina Jóźwiak, Simone Szymczyk, Aleksandra Komoń, Kacper Król, Artur Grobelny, Aleksandra Płusa, Olga Stodulska, Urszula Załuska https://creativecommons.org/licenses/by-nc-sa/4.0
Management of Anterior Cruciate Ligament Rupture: A Narrative Review of Emerging Therapeutic Methods
​​Background. Anterior cruciate ligament (ACL) rupture is a common orthopedic injury that significantly impacts athletic performance and long-term joint stability. While surgical reconstruction (ACLR) remains the current gold standard, there are concerns regarding graft failure, persistent rotational laxity, and the development of post-traumatic osteoarthritis. Aim. This narrative review aims to analyze emerging therapeutic methods in ACL management, including modern surgical techniques, orthobiologic therapies, and tissue engineering, in terms of their clinical efficacy and limitations regarding their implementation in clinical practice. Methodology. A literature search was conducted using PubMed, Web of Science, and Google Scholar. Meta-analyses, randomized controlled trials, and systematic reviews focusing on innovative therapeutic methods for ACL injuries were included. Results. Primary repair with internal bracing and bridge-enhanced ACL repair technique show promise in joint preservation but are strictly dependent on tear morphology. Extra-articular augmentation have potential to reduce rotational laxity in high-risk cohorts. Platelet-rich plasma and mesenchymal stem cells may promote "ligamentization," though clinical evidence remains inconsistent due to a lack of standardized preparation protocols. Tissue engineering techniques, such as 3D bioprinting and electrospinning offer biomimetic potential, although there are significant regulatory and economic barriers. Conclusions. Emerging therapeutic methods in ACL injury management offer promising advantages when combined with traditional ACLR. However, their widespread implementation is currently limited by high costs, a lack of long-term clinical data, and the need for standardized application protocols. Future research is needed to determine the long-term effectiveness of these techniques and to define their precise role in routine clinical practice.
Copyright (c) 2026 Simon Matczak, Maria Namysł, Marcin Sobkowiak, Kinga Woźniak, Maciej Bieniek, Marcel Żukowski, Mikołaj Modelski, Julia Osada, Nikola Dzierbicka, Agnieszka Kulpa https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of GLP-1 Receptor Agonists on Reproductive Function in Women with Obesity and Metabolic Disorders: A Narrative Review
Background: Obesity and related metabolic disorders, including insulin resistance and polycystic ovary syndrome (PCOS), impair female fertility and increase the risk of adverse obstetric outcomes. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of anti-obesity medications effective in promoting weight loss and improving metabolic control. Aim: To summarize current evidence on the effects of GLP-1 receptor agonists on female reproductive function, particularly in PCOS and the preconception period. Materials and Methods: A literature search was performed using the PubMed database to identify relevant studies published in English within the last 10 years. The selected studies were analyzed to summarize current evidence regarding the potential role of GLP-1 RAs in preconception care and female fertility. Results: GLP-1 receptor agonists promote weight loss, improve insulin sensitivity, and reduce androgen levels. In women with PCOS, treatment has been associated with improved menstrual regularity and increased ovulation rates, and may enhance endometrial receptivity. Current evidence does not indicate a clear increase in congenital malformations after first-trimester exposure; however, discontinuation before planned conception is recommended due to limited safety data. Conclusions: GLP-1 receptor agonists may improve metabolic health and reproductive outcomes in women with obesity and PCOS. However, most studies focus on surrogate outcomes, while evidence for definitive endpoints-particularly live birth rates-remains limited. Further prospective studies are needed to clarify their role in preconception care.
Copyright (c) 2026 Emilia Muraszewska, Łukasz Muraszewski, Patrycja Kwitowska, Małgorzata Pyjecka, Eryk Ubysz, Agata Król, Edyta Lewandowska, Cezary Łuczyński, Maciej Paczkowski, Mariusz Wręczycki https://creativecommons.org/licenses/by-nc-sa/4.0
Reproductive and Obstetric Outcomes in Patents with OHVIRA Syndrome: A Narrative Review
Background. Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is a rare congenital malformation of the female urogenital tract. Although its anatomical features, diagnostic and surgical approaches are well described, its impact on reproductive and obstetric outcomes is not yet fully established. Aim. To review the available literature and summarize the impact of OHVIRA syndrome on fertility and obstetric outcomes. Material and methods. A narrative review of the literature was conducted using PubMed and Google Scholar database. Studies published within the last 5 years were screened. Inclusion criteria comprised observational studies and case series including at least three patients with a confirmed diagnosis of OHVIRA/HWW syndrome and reported reproductive outcomes. Five studies providing the most comprehensive and comparable data were included in the analysis. Results. A total of 562 patients with OHVIRA syndrome were analyzed. Among women attempting conception, infertility rates ranged from 0% to 36%. Overall, 120 pregnancies were reported in 56 women. The live birth rate was 48.3%, with substantial heterogeneity across studies. The majority of pregnancies were implanted in the uterus contralateral to the obstructed hemivagina. Obstetric complications included miscarriage, intrauterine growth restriction (IUGR), preterm birth, breech presentation, and cesarean deliveries were more frequent than in the general population. Endometriosis and pelvic inflammatory disease were commonly reported and may negatively affect reproductive outcomes. Conclusions. OHVIRA syndrome, although rare, has important implications for reproductive health. While fertility may be preserved in many patients, pregnancy outcomes appear less favorable, with an increased risk of obstetric complications. Early diagnosis and timely surgical management are crucial to optimize reproductive potential.
Copyright (c) 2026 Aniela Figiel, Paweł Zaborek, Justyna Pestka, Robert Marguła, Katarzyna Widomska, Mateusz Bernad https://creativecommons.org/licenses/by-nc-sa/4.0
Physical Activity and Diet in Asthma Patients: Benefits, Risks, and Practical Recommendations - A Review of a Literature
Introduction. Historically, individuals with asthma were often limited in physical activity due to fear of exercise-induced bronchoconstriction, and diet was largely overlooked in routine care. Aim. This narrative review summarizes evidence on benefits/risks of physical activity and diet in asthma management, providing practical recommendations for safe exercise and healthy eating. State of knowledge. Regular physical activity improves cardiorespiratory fitness, exercise tolerance, symptom control, and quality of life in asthma, while reducing inflammation in well-controlled disease. However, exercise can trigger bronchoconstriction, particularly in poorly controlled asthma or with environmental triggers (cold air, allergens, pollution). Dietary patterns significantly influence outcomes: Mediterranean- or plant-rich diets (fruits, vegetables, whole grains, omega-3 foods) improve control and reduce exacerbations, while Western diets (saturated fat, ultra-processed foods) worsen disease severity. Summary. Individualized exercise programs and plant-based dietary patterns should be integrated into asthma management to enhance functional capacity and symptom control. When asthma is well-controlled and environmental factors considered, physical activity and healthy eating are safe and beneficial. High-quality RCTs are needed to optimize protocols and assess long-term impact of combined lifestyle interventions on asthma control.
Copyright (c) 2026 Maja Gewald, Aleksandra Tołkacz, Julia Sobczak, Adrianna Król, Aleksandra Kwiatkowska, Aleksandra Kosikowska https://creativecommons.org/licenses/by-nc-sa/4.0
Physical Activity and Mental Health in Children and Adolescents with Overweight and Obesity: Mechanisms and Effects on Depressive and Anxiety Symptoms -Narrative Review
Background: Childhood obesity is associated with an increased risk of anxiety and depressive symptoms, representing a growing global mental health concern. Aim: The aim of this review was to examine the impact of physical activity on anxiety and depressive symptoms in children and adolescents with overweight or obesity, with particular emphasis on underlying neurobiological, psychosocial, and behavioral mechanisms. Material and methods: This narrative review synthesizes current evidence on the effects of physical activity on mental health outcomes in children and adolescents with overweight or obesity. A literature search was conducted using PubMed, Scopus, and Web of Science, including studies published between January 2015 and January 2026. Both observational and interventional studies, including randomized controlled trials, systematic reviews, and meta-analyses, were considered. Findings were synthesized narratively. Results: Available evidence indicates that physical activity is associated with small-to-moderate reductions in depressive and anxiety symptoms in youth, with more consistent effects observed for depression. These benefits are mediated through multiple neurobiological, psychosocial, and behavioral pathways. Intervention effectiveness appears to depend on factors such as duration, intensity, supervision, and the inclusion of psychosocial components. However, substantial heterogeneity across studies and limited long-term data remain important limitations. Conclusions: Physical activity represents a promising, accessible, and cost-effective strategy for improving mental health outcomes in children and adolescents with overweight or obesity. To maximize benefits, interventions should be structured, inclusive, and supported by behavioral and motivational strategies. Further research is needed to optimize intervention design and clarify causal mechanisms.
Copyright (c) 2026 Agata Wyborska , Zuzanna Oćwieja, Karolina Fengler , Olga Jakubowska, Dominika Kominiak, Marcel Gascon Carreno, Mikołaj Mińkowski, Kamila Pietrzak, Agata Urbanik, Katarzyna Solecka https://creativecommons.org/licenses/by-nc-sa/4.0
Sleep and the Menstrual Cycle from Puberty to Menopause: A Review of Literature with Extra Focus on Athletes
Introduction Sleep is essential for recovery and is influenced by circadian rhythms and hormonal changes across a woman’s lifespan. However, evidence on how the menstrual cycle affects sleep remains inconsistent. As sleep is critical for athletic performance, understanding these relationships is important for optimizing recovery in female athletes. Aim This review examines clinical evidence on how ovarian hormone fluctuations and related symptoms influence sleep across different life stages, with a focus on athletes. Material and Methods A literature search was conducted in PubMed using keywords such as “menstrual cycle,” “estradiol,” “luteal,” “perimenopause,” “sleep,” “sleep disturbances,” and “athletes.” Results In adolescents, menstrual pain is a greater cause of poor sleep than cycle phase. During reproductive years, sleep disturbances are more common in the luteal phase, although lifestyle and health factors also contribute. Athletes similarly report poorer sleep and fatigue in this phase, with training load and physical symptoms playing a major role. In menopause, reduced deep sleep and weakened circadian rhythms lead to more frequent sleep disruptions. Conclusions Sleep varies across life stages, with the luteal phase being most associated with disturbances. For adolescents and athletes, managing pain and physical stress may be more effective than tracking cycle phases. Improving women’s sleep requires individualized approaches focused on overall health and symptom management.
Copyright (c) 2026 Maja Zambrzycka, Iga Woźniakowska, Aleksandra Misarko, Monika Jedwabnik, Stanisław Ścigała, Krzysztof Peszuk, Weronika Lech, Adrianna Dobrosielska, Hoang Viet Krajewski, Bartosz Olszewski https://creativecommons.org/licenses/by-nc-sa/4.0
Physical Exercise as a Supportive Intervention in Attention-Deficit / Hyperactivity Disorder
Background. Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders worldwide and remains an important public health concern. The disorder is characterized by persistent inattention, hyperactivity, and impulsivity that impair functioning across multiple domains. Purpose: This narrative review aimed to synthesize current evidence on the effects of physical activity and structured exercise interventions on cognitive performance, behavioral symptoms, and neurobiological mechanisms in individuals with ADHD. Materials and methods: Peer-reviewed studies published between 2010 and 2025 were identified through PubMed, Scopus, Web of Science, and ScienceDirect. Studies evaluating exercise interventions in people with ADHD and reporting cognitive, behavioral, or neuropsychological outcomes were included. Results: Available evidence suggests that physical exercise may reduce ADHD symptom severity and improve executive functions, especially working memory, inhibitory control, and cognitive flexibility. These effects are likely mediated by neurobiological adaptations involving catecholamines, neurotrophic factors, and enhanced neural efficiency. Conclusions. Physical exercise appears to be a promising adjunctive intervention in ADHD management. Although it should not replace pharmacotherapy when indicated, regular physical activity may strengthen therapeutic outcomes and support cognitive, behavioral, and emotional functioning.
Copyright (c) 2026 Gabriela Kuliś, Ewa Dryl-Jarmoc, Izabela Ślinko, Zuzanna Panas, Mateusz Zimowski , Jakub Dziemiańczuk, Mateusz Czajkowski, Kacper Krawczuk, Piotr Kadysz , Agata Kolanek https://creativecommons.org/licenses/by-nc-sa/4.0
Epidemiology and pathomechanics of overuse injuries in single figure skating: A systematic review (2020–2026)
Background. Figure skating is a sport characterized by a unique combination of artistic expression and extreme athletic demands. The introduction of the new ISU Judging System in the 2004/2005 season drastically changed the landscape of the sport, promoting the execution of highly scored, multi-rotational jumps. This forces athletes to generate higher vertical velocities, resulting in the absorption of impact forces ranging from 4 to 5 times their body weight on a single lower limb during landing. Combined with early sport specialization, very high training volumes, and the specific, mobility-restricting design of the skating boot, these factors have led to a drastic increase in injury rates, predominantly characterized by overuse injuries. Aim. The aim of this study is to systematize and critically analyze the latest scientific literature from 2020 to 2026 (including fundamental works serving as a historical and biomechanical background) regarding the epidemiology, pathomechanics, and risk factors of overuse injuries in single figure skaters. Results. The results indicate that overuse injuries account for 50% to nearly 70% of all injuries in single figure skating. The most frequently injured areas are the foot and ankle (approx. 29%), knee joint (approx. 19%), and lower back (approx. 15%). Stress fractures and bone stress reactions, including spondylolysis, constitute a significant percentage of diagnoses. The stiffness of the skating boot forces a compensatory transfer of landing forces to the lumbopelvic-hip complex (LPHC). The main identified risk factors include chronological age (the cumulative effect of loading), lack of jump count monitoring, early specialization, and Relative Energy Deficiency in Sport (RED-S).
Copyright (c) 2026 Aleksandra Białek, Jakub Karczewski, Aleksandra Sadok, Wojciech Kubas, Kamila Ryń, Aleksandra Koźlicka, Wojciech Niemcewicz, Mikołaj Czerniakowski, Jakub Klajda, Zuzanna Gorczyca https://creativecommons.org/licenses/by-nc-sa/4.0
Integrating dietary strategies and physical activity in the management of irritable bowel syndrome (IBS)
Introduction IBS is a chronic disorder of gut–brain interaction characterized by recurrent abdominal pain associated with altered bowel habits and substantial impairment in quality of life and psychosocial functioning. Pharmacological therapies often provide only partial symptom relief, prompting growing interest in non-pharmacological strategies such as diet modification and physical activity. This article aims to synthesize contemporary evidence on dietary approaches and physical activity in IBS and to propose a practical, lifestyle-oriented model of care. Materials and methods This narrative review examines recent research on IBS, focusing on diet and physical activity as treatment approach. Sources include articles from PubMed database, along with WHO guidelines. Results Evidence indicates that first-line general dietary advice, optimization of soluble fibre intake and selective use of probiotics can alleviate global IBS symptoms. Low-FODMAP diet programs, implemented in structured restriction, reintroduction and personalization phases, consistently reduce abdominal pain, bloating and stool irregularities, though long-term strict restriction may adversely affect nutritional adequacy and microbiota diversity. Emerging data suggest that regular, moderate-intensity aerobic exercise and mind–body activities such as yoga lead to clinically relevant reductions in symptom severity and improvements in quality of life, potentially via effects on gut motility, stress regulation and microbial composition, although existing studies are limited by small samples and heterogeneous protocols.
Copyright (c) 2026 Karolina Bury, Katarzyna Młynarczyk, Hanna Naliuka, Ewa Byjoś, Mateusz Zbylut, Katarzyna Fabiś, Sylwia Buczek, Weronika Mstowska, Patrycja Mateja, Kamila Milewska https://creativecommons.org/licenses/by-nc-sa/4.0
Ursodeoxycholic Acid (UDCA) in Symptomatic Patients with Uncomplicated Cholelithiasis Unfit for or Refusing Surgery: A Narrative Review
Background. Cholelithiasis is one of the most prevalent gastrointestinal disorders worldwide, affecting approximately 10–20% of the adult population in developed countries. Although laparoscopic cholecystectomy remains the gold standard treatment for symptomatic gallstones, a significant subset of patients is either unsuitable for surgery due to comorbidities, advanced age, anesthesia-related risks, or declines operative management. In such cases, ursodeoxycholic acid (UDCA) has been proposed as a non-invasive therapeutic alternative. Aim. This narrative review aims to critically evaluate the current evidence regarding the mechanisms, indications, efficacy, and limitations of UDCA therapy in symptomatic patients with uncomplicated gallstone disease who are not undergoing surgical intervention. Material and Methods. A narrative review was conducted by integrating data from clinical guidelines, randomized controlled trials, cohort studies, and systematic reviews. Particular emphasis was placed on outcomes such as symptom control, gallstone dissolution, recurrence rates, and patient selection criteria. Results. UDCA demonstrate beneficial effects in carefully selected patient populations, particularly in terms of gallstone dissolution and symptom relief. However, its clinical utility is limited by strict eligibility criteria, a slow therapeutic response, and high recurrence rates following treatment discontinuation. Conclusion. UDCA may represent a valuable non-surgical treatment option in selected high-risk patients when individualized appropriately. Nevertheless, its overall effectiveness remains limited, and careful patient selection is essential to optimize therapeutic outcomes.
Copyright (c) 2026 Marcin Rebizant, Anna Paluch, Gabriela Grylowska, Katarzyna Gunia, Aleksandra Adamczyk, Mateusz Banasik, Agata Żak, Andrzej Palak, Anna Ignatowicz, Michał Tryba https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Cryotherapy in Sports Recovery: A Critical Review of Current Evidence
Background. Cryotherapy, defined as the therapeutic application of cold, is increasingly used in sports medicine to enhance post-exercise recovery and support athletic performance. The most common modalities include whole-body cryotherapy, local cryotherapy, and cold water immersion. Aim. This article aims to discuss the current evidence on the role of cryotherapy in sports recovery, including its physiological mechanisms, practical applications, benefits, limitations, and impact on training adaptations. Materials and methods. A focused narrative review of relevant literature was conducted to examine the effects of cryotherapy on muscle soreness, fatigue, inflammation, recovery, and athletic performance. Studies on whole-body cryotherapy, local cryotherapy, and cold water immersion were included. Summary. Available evidence suggests that cryotherapy may reduce muscle soreness and perceived fatigue in the short term. However, long-term effects remain inconsistent, and frequent post-exercise cooling may impair muscle adaptation and hypertrophy. The review also highlights the gap between scientific evidence and the commercial promotion of cryotherapy. Conclusions. Cryotherapy may be useful in selected athletic settings, but its application should be individualized and aligned with training goals. Further research is needed to determine optimal protocols and long-term effects on performance.
Copyright (c) 2026 Kamila Bakuła, Iga Maria Nowicka, Paweł Rios Turek, Emilia Dybała https://creativecommons.org/licenses/by-nc-sa/4.0
Cardiorespiratory Fitness as a Modifiable Target in Scoliosis Surgery: A Narrative Review of Prehabilitation and Perioperative Exercise Interventions
Background. Adolescent idiopathic scoliosis (AIS) is associated with clinically significant cardiorespiratory impairment, including reduced peak oxygen consumption, ventilatory inefficiency, and diminished exercise tolerance, even in mild-to-moderate curves. These deficits are compounded by lower habitual physical activity, creating a deconditioning cycle that compromises physiological reserve before surgical correction. Aim. To evaluate current evidence on the relationship between physical activity, cardiorespiratory fitness, and surgical outcomes in AIS, with emphasis on the potential of prehabilitation to optimize perioperative cardiorespiratory function. Material and methods. A narrative literature review was conducted using PubMed, covering studies published between 2003 and 2026. The search combined free-text terms and MeSH headings related to scoliosis, preoperative physical activity, and surgical outcomes. Included study types were randomized controlled trials, systematic reviews, and meta-analyses involving human subjects published in English. Results. AIS patients demonstrate VO2max values reduced by 23% compared to healthy peers, with vigorous physical activity associated with a 24% reduction in AIS odds. Scoliosis-specific exercises reduce curve progression by 70-73%, while surgical prehabilitation reduces pulmonary morbidity by 60% and overall morbidity by 37%. The only AIS-specific prehabilitation RCT confirmed durable cardiopulmonary improvements persisting 12 months postoperatively. Postoperative rehabilitation further enhances respiratory muscle strength, thorax mobility, and quality of life while reducing hospital stay. Conclusions. Evidence supports incorporating cardiorespiratory-targeted exercise in both preoperative and postoperative phases of scoliosis surgery. Large-scale multicenter RCTs with standardized protocols and cardiopulmonary endpoints are urgently needed in the AIS population.
Copyright (c) 2026 Jana Kozłowska, Agnieszka Przepióra, Maria Orłowska, Anna Żmigrodzka, Maria Sanocka, Aleksandra Wielogórska, Karolina Trojnar, Klaudia Czernic-Goławska, Agnieszka Kamińska, Joanna Falana, Anna Kwiatkowska https://creativecommons.org/licenses/by-nc-sa/4.0
Cotadutide as an Innovative Approach to Glycemic Control and Weight Reduction in Patients with Type 2 Diabetes - A Contemporary Review
Background. Type 2 diabetes is a chronic metabolic disorder associated with impaired insulin secretion and insulin resistance, leading to persistent hyperglycemia and multiple complications. Despite advances in pharmacotherapy, many patients fail to achieve optimal metabolic control, highlighting the need for novel therapeutic approaches. Aim. The aim of this study was to present the current state of knowledge regarding cotadutide as a potential therapeutic option in the treatment of type 2 diabetes, with particular emphasis on its mechanism of action, clinical efficacy, and safety profile. Materials and methods. A narrative review of available literature was conducted, including clinical trials, meta-analyses, and preclinical studies evaluating the efficacy and safety of cotadutide in patients with type 2 diabetes and related metabolic disorders. Results. Cotadutide is a dual GLP-1 and glucagon agonist, that demonstrates a significant improvement regarding glycemia, body weight reduction and positive influence on metabolic parameters, in comparison to placebo. Clinical trials showed decrease in HbA1c, body weight and albuminuria, as well as potential benefits in liver and kidney function. The most common adverse effects involve the gastrointestinal tract. Conclusions. Cotadutide is a promising factor in diabetes type 2 treatment. It shows a broad spectrum of positive effects on metabolic parameters. However, further analysis and large-scale, long-term studies are required to establish its efficacy and safety.
Copyright (c) 2026 Zuzanna Wątek, Jan Szewczyk, Alicja Smolińska, Patrycja Krawczyk, Katarzyna Łysynkiewicz, Izabela Grzyb https://creativecommons.org/licenses/by-nc-sa/4.0
Effects of Vitamin D Supplementation on Obesity and Its Metabolic Complications A Narrative Review
Background. Obesity and metabolic syndrome are major contributors to global cardiometabolic morbidity and mortality. Vitamin D deficiency is highly prevalent in individuals with obesity and has been implicated in adverse metabolic regulation. However, evidence regarding the efficacy of vitamin D supplementation in improving obesity-related outcomes remains inconsistent. Aim. The aim of this review was to assess current evidence regarding the effects of vitamin D supplementation on obesity and its metabolic complications. Review methods A narrative literature review was conducted using electronic searches of the PubMed database, supplemented by reports from the World Health Organization and other peer-reviewed sources. Preference was given to systematic reviews, meta-analyses, randomized controlled trials, and high-quality observational studies published in English between 2010 and 2024. Results. Evidence from randomized controlled trials and meta-analyses consistently demonstrates that vitamin D supplementation increases serum 25-hydroxyvitamin D concentrations in individuals with overweight and obesity. However, its effects on obesity-related metabolic outcomes remain limited and inconsistent. Most studies report no significant improvements in insulin sensitivity, glycemic control, blood pressure, or overall body weight. Some trials have observed modest reductions in body fat mass, body mass index, or waist circumference. Small improvements in selected lipid parameters and inflammatory biomarkers have also been reported, although these findings are not consistently replicated. Potential metabolic benefits appear more pronounced in individuals with baseline vitamin D deficiency. Conclusions. Current evidence does not support vitamin D supplementation as an effective standalone therapy for obesity or its major metabolic complications. Its clinical role appears primarily adjunctive, particularly in individuals with confirmed vitamin D deficiency.
Copyright (c) 2026 Natalia Paszke, Piotr Wiśniewski, Wiktor Buczko, Jan Gajewski, Grzegorz Machelski, Marzena Mędrek, Grzegorz Kuropatwa, Mariola Mika, Kacper Mąkosa https://creativecommons.org/licenses/by-nc-sa/4.0
Integration of Artificial Intelligence in Magnetic Resonance Imaging analysis and Liquid Biopsy in diagnosing and monitoring Glioblastoma Multiforme - A Systematic Review
Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor among adults and is associated with rapid progressions and poor prognosis. Modern diagnostic techniques, including molecular biology, have improved the perception of disease development emphasizing the role of disturbed signaling pathways, genetic mutations and tumor microenvironment. The following review aims to conclude current comprehension of molecular mechanisms leading to GBM development and contemporary diagnostic and therapeutic approaches. Articles present in PubMed database published from 2022 onwards were researched to perform analysis of tumor biology, subcellular mechanisms and diagnostic possibilities. Magnetic resonance imaging (MRI) remains the most fundamental diagnostic method which enhanced by modern approaches such as radiomics and artificial intelligence (AI) supports proper diagnosis and enables tumor characteristics analysis. Moreover, combining imaging with modern pathomorphological methods such as liquid biopsy can lead to increased accuracy and personalization in diagnostics. To conclude, GBM development is a complex process combining genetic alterations and disturbed molecular pathways that can be detected using modern diagnostic techniques. Advanced pathomorphological methods and AI-supported imaging lead to accurate diagnosis, proper therapeutic decisions and better patient outcome.
Copyright (c) 2026 Antonina Zatyka, Aleksander Krupski, Michał Marusza, Victoria Stielow https://creativecommons.org/licenses/by-nc-sa/4.0
Obesity — the major groups of its complications
Background: Obesity has evolved from a simple metabolic condition into a complex, chronic systemic disease that has reached pandemic proportions in the 21st century. It serves as a primary driver for a multitude of chronic pathologies across virtually every human organ system. Aim: This narrative review aims to provide a comprehensive analysis of the major groups of obesity complications, exploring their pathophysiological mechanisms and epidemiological impact across the lifespan, with a focus on pediatric development and geriatric well-being. Material and methods: A systematic search of PubMed, MEDLINE, Google Scholar. Selection criteria prioritized peer-reviewed articles, meta-analyses, and cohort studies published between 2014 and 2026, focusing on the mechanisms of metabolic, cardiovascular, respiratory, musculoskeletal, and psychosocial impairment. Results: Metabolic complications of obesity include type 2 diabetes and hyperuricemia, while cardiovascular effects range from hypertension to coronary artery disease. Respiratory health is compromised by mechanical and inflammatory pathways, leading to obstructive sleep apnea and hypoventilation. Pediatric studies demonstrate that excessive weight significantly accelerates skeletal and dental maturation, while geriatric data highlight severe declines in self-esteem and social integration. Conclusions: The complications of obesity are intrinsically linked to chronic low-grade inflammation and hormonal dysregulation. Management must move beyond simple weight loss to address the systemic inflammatory environment and the varied psychosocial consequences.
Copyright (c) 2026 Aleksandra Rucka, Michał Rucki, Nikodem Cieleban, Magdalena Modliborska, Mateusz Kowalski https://creativecommons.org/licenses/by-nc-sa/4.0
Exercise as a Component of Enhanced Recovery After Surgery (ERAS): A Narrative Review
Background. Enhanced Recovery After Surgery (ERAS) protocols represent a multimodal, evidence-based approach aimed at reducing surgical stress, minimizing complications, and accelerating postoperative recovery. While ERAS pathways have demonstrated significant improvements in perioperative outcomes, the role of exercise—encompassing both prehabilitation and early postoperative mobilization—remains insufficiently standardized and inconsistently implemented despite growing evidence supporting its clinical benefits. Aim. The aim of this narrative review was to evaluate the role of exercise as a component of ERAS protocols, with particular emphasis on prehabilitation and early postoperative mobilization, and to identify current limitations and propose a structured framework for integrating physical activity into perioperative care. Material and methods. A narrative literature review was conducted using PubMed, Scopus, and Web of Science databases. The search strategy included keywords such as “ERAS”, “prehabilitation”, “exercise”, “physical activity”, and “early mobilization”. Eligible studies included randomized controlled trials, systematic reviews, meta-analyses, and observational studies related to perioperative exercise. The selected literature was analyzed qualitatively to identify key mechanisms, clinical outcomes, and implementation barriers. Results. Exercise interventions were shown to improve functional capacity, enhance metabolic resilience, and reduce postoperative complications. Prehabilitation was associated with increased cardiorespiratory fitness and improved tolerance to surgical stress, particularly in high-risk and oncological patients. Early postoperative mobilization contributed to improved pulmonary function, reduced thromboembolic risk, and faster recovery of functional independence. However, significant variability was observed in exercise protocols, including differences in timing, intensity, and implementation, highlighting a lack of standardization within ERAS pathways. Key barriers included patient-related factors, organizational constraints, and limited integration of exercise into clinical practice. Conclusions. Exercise represents a critical yet underutilized component of ERAS protocols. Its structured integration, including prehabilitation and early mobilization, has the potential to significantly improve perioperative outcomes and recovery. The development of standardized, evidence-based exercise protocols and enhanced interdisciplinary collaboration are essential to optimize implementation and maximize clinical benefits.
Copyright (c) 2026 Klaudia Kasperska, Kamil Arciszewski, Paweł Stenzel, Karolina Niewola, Jakub Szumiło, Dominika Walczak, Karolina Orda, Natalia Hariasz, Mariana Markiv, Michał Słowik https://creativecommons.org/licenses/by-nc-sa/4.0
Lateral Epicondylitis: Bridging Clinical Assessment and Imaging in Diagnosis and Management - A Review of Current Evidence
Background. Lateral epicondylitis (tennis elbow) is an overuse tendinopathy of the wrist extensors associated with repetitive gripping and wrist extension. It is a common cause of lateral elbow pain and functional impairment. The condition is currently regarded as predominantly degenerative, although inflammatory features may be present at the initial stage of the disease. Aim. The aim of this study was to review current evidence on the histopathology, diagnosis, and role of imaging in the evaluation and differential diagnosis of lateral epicondylitis, with consideration of main treatment approaches. Material and methods. A literature search was conducted using databases such as PubMed and Google Scholar. The review included peer-reviewed articles focusing on lateral epicondylitis, its histopathology, clinical presentation, diagnostic methods, and imaging techniques, including ultrasound and magnetic resonance imaging. Results. Clinical history and physical examination, including provocation tests and assessment of grip strength, remain the cornerstone of diagnosis. Differential diagnosis is essential due to the proportion of misdiagnosed cases. Imaging studies play a complementary role - ultrasonography allows for dynamic assessment and identification of tendon abnormalities, while MRI enables a more detailed evaluation of intra-articular structures and the extent of tissue damage. Radiography (X-ray) and computed tomography arthrography (CTA) are mainly used in selected cases. Conclusions. Lateral epicondylitis requires a comprehensive diagnostic approach based primarily on clinical assessment, supplemented by imaging when necessary. Ultrasonography represents the primary imaging modality for evaluating this condition, whereas magnetic resonance imaging is particularly useful in cases requiring more in-depth assessment and in treatment planning.
Copyright (c) 2026 Gabriela Grylowska, Anna Paluch, Aleksandra Adamczyk, Agata Żak, Katarzyna Gunia, Andrzej Palak, Marcin Rebizant, Mateusz Banasik, Anna Ignatowicz, Michał Tryba https://creativecommons.org/licenses/by-nc-sa/4.0
Modern Diagnostic Methods and Pathomechanisms of Eosinophilic Esophagitis – A Review
Introduction. Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease characterized by eosinophil-predominant inflammation of the esophageal mucosa. Over the last two decades, the incidence and prevalence of EoE have increased significantly, making it one of the most important causes of dysphagia and food impaction in children and adults. The disease results from complex interactions between genetic predisposition, environmental factors, and immune system dysregulation, particularly involving Th2-mediated inflammatory pathways. Aim of the Study. The aim of this review is to summarize current knowledge regarding the pathomechanisms underlying eosinophilic esophagitis and to analyze modern diagnostic methods used in clinical practice and research. Particular emphasis is placed on immunological mechanisms, molecular pathways, biomarkers, and emerging technologies that may improve early detection and disease monitoring. Materials and Methods. A literature review was conducted using major scientific databases including PubMed, Scopus, and Web of Science. Articles published between 2000 and 2025 were analyzed using keywords such as “eosinophilic esophagitis,” “pathophysiology,” “diagnostic methods,” “biomarkers,” and “immunology.” Only peer-reviewed studies and reviews focusing on molecular mechanisms, clinical diagnostics, and emerging technologies were included. Conclusion. Current evidence suggests that EoE is driven primarily by Th2 immune responses involving cytokines such as IL-4, IL-5, and IL-13, leading to eosinophil recruitment, epithelial barrier dysfunction, and progressive esophageal remodeling. Advances in diagnostic technologies, including molecular profiling, minimally invasive sampling, and artificial intelligence–assisted histology, are expected to significantly improve disease detection and personalized management.
Copyright (c) 2026 Karolina Szamocka, Aleksandra Strzewiczek https://creativecommons.org/licenses/by-nc-sa/4.0
Diabulimia in Adult Patients with Type 1 Diabetes - Review of Literature
Background: “Diabulimia” refers to intentional insulin restriction/omission in type 1 diabetes (T1D) to influence weight. It remains unrecognized in formal classification systems, complicating clinical coding. This behavior is a dangerous form of disordered eating linked to metabolic decompensation (recurrent ketoacidosis) and poorer prognosis. Aim: This article synthesizes evidence on diabulimia in adults with T1D, focusing on epidemiology, etiology, diagnostics, clinical presentation, complications, treatment, and prevention. Material and methods: A narrative synthesis was conducted using peer-reviewed reviews, observational studies, and case reports addressing: (I) insulin restriction as disordered eating, (II) acute metabolic crises (DKA), (III) chronic complications, and (IV) diagnostic challenges in adults (adult-onset T1D, LADA, secondary diabetes). Results: Diabulimia is characterized by weight-motivated insulin restriction and remains underdiagnosed due to a lack of formal criteria and overlap with diabetes distress. Evidence indicates a clinically meaningful prevalence of disordered eating in T1D adults, though data for older groups are limited. Reported outcomes include recurrent DKA and a rapid pathway to microvascular and neuropathic complications driven by chronic hyperglycemia. Conclusion: Diabulimia in adults is a high-risk condition at the interface of endocrinology and mental health. It requires interdisciplinary management, proactive detection of poor metabolic control, exclusion of diagnostic mimics (LADA/secondary diabetes), and combined psychological and diabetes-care interventions.
Copyright (c) 2026 Karol Piotrowski, Małgorzata Jerczak, Tomasz Pluszyński, Natalia Padula, Iga Piórkowska, Mikołaj Polewka, Aleksandra Polańska, Kacper Paczosa, Filip Przybył https://creativecommons.org/licenses/by-nc-sa/4.0
How Does Caffeine Enhance Athletic Performance? A Literature Review of Its Effects, Mechanisms of Action, Safety, Side Effects, and Sport- and Sex-Based Differences.
Introduction: Caffeine is a methylxanthine compound naturally found in coffee beans, tea leaves, and cocoa. It is among the most widely consumed psychoactive substances worldwide. Its primary mechanism of action involves antagonism of adenosine receptors within the central nervous system, resulting in reduced perception of fatigue and enhanced alertness. Caffeine’s effects on the peripheral nervous system include increased intracellular calcium release and inhibition of phosphodiesterase activity, thereby enhancing muscle contractility and promoting utilization of energy substrates [1]. The metabolic effects of caffeine encompass multiple biochemical pathways [8]. Although caffeine exerts a multifactorial effect on aerobic performance its use should be carefully considered in the context of potential adverse effects [12]. Evidence derived from studies conducted in diverse athletic populations suggests that caffeine supplementation may represent an effective strategy for optimizing performance while preserving long-term athlete health. Aim of the study :The aim of this study is to systematically analyze available literature regarding the effects of caffeine, its mechanisms of action, safety profile, adverse effects, and variability in response according to sport discipline and sex. Material and Methods: Review and analysis of randomized clinical trials and clinical trials from 2010 to 2025 available on PubMed and Google Scholar. Conclusions: The findings indicate that caffeine may serve as an effective ergogenic aid across a wide range of sports disciplines, provided that it is administered within safe dosage ranges tailored to individual needs—taking into account the specific characteristics of the discipline, athlete-related factors and individual tolerance [2]. Furthermore, current evidence indicates comparable magnitude of benefits in both female and male athletes across various disciplines [5], highlighting the broad applicability of caffeine as an ergogenic aid.
Copyright (c) 2026 Martyna Pacanowska-Trawnicka, Małgorzata Blecharczyk, Igor Zydlewski, Martyna Mrozek, Aleksandra Jakimowicz, Agnieszka Zielińska, Zuzanna Kamińska, Aleksandra Malcher https://creativecommons.org/licenses/by-nc-sa/4.0
Sinus Bradycardia in Endurance Athletes From Physiological Adaptation to Potential Pathology
Sinus bradycardia is a common electrocardiographic finding in trained athletes and a hallmark feature of the athlete’s heart. Reduced resting heart rate, particularly in endurance athletes, reflects physiological adaptation to long-term intensive training and is usually asymptomatic. In highly trained individuals, heart rate values may fall well below standard clinical thresholds while maintaining normal cardiovascular function. Exercise-induced bradycardia has traditionally been attributed to increased parasympathetic activity and reduced sympathetic tone. However, recent evidence indicates that intrinsic remodeling of the sinoatrial node also contributes to this phenomenon. Molecular and electrophysiological adaptations, including alterations in ion channel expression and pacemaker cell function, play an important role in the reduction of intrinsic heart rate. Although generally considered benign, sinus bradycardia in athletes has raised concerns regarding its potential long-term clinical implications. Emerging data suggest that prolonged endurance training may be associated with an increased risk of clinically significant bradyarrhythmias later in life, including sinus node dysfunction and atrioventricular conduction abnormalities. Differentiating physiological adaptation from early pathological remodeling remains a key challenge in sports cardiology. Accurate evaluation requires integration of clinical assessment, electrocardiography, ambulatory monitoring, and cardiac imaging. This review summarizes current knowledge on the mechanisms, clinical significance, and diagnostic evaluation of sinus bradycardia in athletes, with particular emphasis on the balance between beneficial adaptation and potential adverse remodeling associated with long-term endurance training.
Copyright (c) 2026 Wiktoria Śliwa, Daria Twardowska, Wiktoria Tłoczek, Kamil Topolski, Barbara Jelonek, Karolina Klubikowska, Małgorzata Wandzel, Dagmara Porada, Barbara Tomczak , Monika Wandasiewicz https://creativecommons.org/licenses/by-nc-sa/4.0
A Review of Recent reports on the Role of SSRI Use in Understanding the Pathomechanism and Treatment of Premenstrual Syndrome (PMS) as a Significant Clinical and Health Problem in Reproductive-Age Women
Introduction. PMS affects 47% of women of reproductive age. It is a cyclical disorder responsible for somatic or mental symptoms during the luteal phase of the menstrual cycle. Etiology includes hormonal changes, GABA-A conduction disturbances, inflammation, genetic factors, and lifestyle. SSRIs are first-line medications used to treat severe PMS. Awareness of the pathomechanisms of the disease and the effects of treatment will allow us to better understand it, effectively treat it and minimize negative social and family consequences. Aim of the study. Discussion of the mechanism of action of SSRIs, with particular emphasis on more recent reports on the etiology and treatment of PMS in women of reproductive age. Materials and methods. A systematic review of the PubMed database from the last decade was conducted using the following keywords: PMS, PMDD, SSRI, allopregnanolone. Pediatric studies were excluded. Conclusions. SSRIs have a favorable safety profile, few adverse events, are effective at low doses with continuous and intermittent administration, and have a short half-life. The best-studied SSRIs to date are sertraline and fluoxetine, which have a beneficial effect on allopregnanolol levels and GABAergic conductance, as well as serotonin levels, which directly translates into a reduction in PMS symptoms in women of reproductive age. However, further research is needed to fully understand and utilize their mechanism of action in the symptomatic treatment of PMS.
Copyright (c) 2026 Patrycja Jarczyńska , Knieszko Fahim, Jakub Franaszek, Nadia Herchi , Martyna Jabrzyk, Wojciech Kijowski , Mateusz Klusek , Karolina Michalak , Maciej Przybył https://creativecommons.org/licenses/by-nc-sa/4.0
Assessment of Quality of Life in Patients with Double-J Ureteral Stents – A Questionnaire-Based Study
Double-J (DJ) ureteral stents are widely used in modern urology to ensure effective drainage of the upper urinary tract in conditions such as urolithiasis, ureteral obstruction, malignancies, and postoperative management. Despite their clinical benefits, they are often associated with symptoms that impair patients’ quality of life. The aim of this study was to evaluate the impact of DJ ureteral stents on quality of life in patients treated at the Department of Urology, University Clinical Hospital in Opole, focusing on urinary symptoms, pain, daily functioning, and treatment effectiveness. The study included 200 patients with indwelling DJ stents. Data were collected using a proprietary questionnaire assessing demographics, indications, stent duration, symptoms, quality of life, and pharmacotherapy. Descriptive statistics were used. Lower urinary tract symptoms were common, especially nocturia (72%), urgency (68%), and incomplete emptying (61%). Pain was reported by many patients, including lower abdominal (55%) and lumbar pain. Overall, 74% reported reduced quality of life, affecting sleep, work, and sexual activity. Pharmacological treatment was used by 57%, mainly alpha-blockers and anticholinergics; 62% reported improvement, though full relief was rare. Longer stent duration was associated with greater symptom severity. DJ stents significantly impair quality of life due to frequent symptoms and pain. Pharmacological treatment provides partial relief. Minimizing stent duration and individualized management may reduce morbidity.
Copyright (c) 2026 Jakub Hobot https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Virtual Reality Exposure Therapy in Anxiety Disorders and Its Impact on Quality of Life: A Literature Review
Background. Among the most common mental illnesses in the world, anxiety disorders are linked to severe impairments in everyday functioning and quality of life. The gold standard for treatment is still exposure-based cognitive behavioral therapy (CBT), but it is frequently constrained by psychological and practical obstacles associated with real- life exposure. Aim. This literature review aims to evaluate the effectiveness, mechanisms of action, and clinical applications of virtual reality exposure therapy (VRET) in the treatment of anxiety disorders. Materials and methods. A narrative literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar. The search included studies published between 2015 and 2026 that examined the use of VRET in clinical populations with anxiety disorders. Randomized controlled trials, observational studies, and systematic reviews were all included. Results. Results show VRET works well for various anxiety conditions - fear of heights, social situations, trauma responses. Unlike real-life exposure, it matches results yet gives more precision, comfort, fewer risks. New tech upgrades make simulations feel closer to reality, easier to reach. Conclusions. The use of virtual reality exposure therapy (VRET) for the treatment of anxietydisorders is still developing and research has shown that it can be an effective and a more accessible form of treatment than other traditional methods. There are some limitations to date such as differing types of studies conducted with some providing no longitudinal data, but further exploration is needed to provide more consistent methodology and standards for evaluating long-term efficacy.
Copyright (c) 2026 Jakub Kot, Julia Zjawiony, Wiktoria Leja, Maciej Błaszczak, Zeeshan Zulfiqar, Katarzyna Latalska, Maciej Szczupaj, Andżelika Pastuszak, Konrad Borkowski, Jakub Rudnicki https://creativecommons.org/licenses/by-nc-sa/4.0
From GLP-1 Agonism to Triple-Receptor Therapy. Narrative Review of Semaglutide, Tirzepatide, and Retatrutide in Obesity Management.
Background: Obesity is a chronic multifactorial disease that affects a growing proportion of the global population. According to the WHO, obesity is now a global concern. From 1990 to 2022, the prevalence of obesity among minors increased from 2% to 8%, and among adults, it rose from 7% to 16%. The growing global prevalence of obesity has intensified the need for pharmacological therapies. Aim: This narrative review presents the clinical efficacy, metabolic effects, and safety profiles of semaglutide, tirzepatide, and retatrutide, with particular emphasis on their underlying mechanisms of action. Materials and Methods: A narrative review was conducted based on key randomised controlled trials, including the STEP, SURMOUNT, and phase II retatrutide programs. Data on weight reduction, metabolic parameters, and adverse events were extracted and analysed. Mechanistic insights were integrated to interpret differences in clinical outcomes. Results: All three therapies produced significant weight reduction and metabolic improvements, with efficacy increasing in relation to the number of targeted receptors. Semaglutide resulted in a weight loss of up to 16.0%, tirzepatide achieved a reduction of 20.9%, and retatrutide demonstrated the highest efficacy, with a weight loss of 24.2%. All agents were associated with improvements in cardiac, glycemic, and lipid profiles. Gastrointestinal adverse events were frequent and dose-dependent, resulting in higher discontinuation rates at higher doses. Conclusions: Incretin agonists represent a significant advancement in obesity pharmacotherapy, with multi-receptor targeting translating into superior metabolic outcomes. Retatrutide demonstrates the highest potential efficacy among studied agents, although further phase III data are required. These findings support the concept that obesity is a chronic disease that requires long-term treatment and highlight the growing role of mechanism-based pharmacotherapy in its management.
Copyright (c) 2026 Jerzy Darmoń, Joanna Makowska, Karolina Domańska, Natalia Piegza, Anna Sieczka, Maria Windyga, Krzysztof Paweł Darmoń, Aleksandra Papuga, Makary Hejduk https://creativecommons.org/licenses/by-nc-sa/4.0
Partial Heart Transplantation for Congenital Heart Disease. A Narrative Review of Current Knowledge and Future Directions
Background. Partial heart transplantation (PHT), also referred to as living valve replacement, is an emerging surgical strategy for irreparable valvular defects. By implanting viable donor valve tissue, PHT provides grafts capable of somatic growth, addressing a key limitation of conventional prosthetic valves in pediatric patients, in whom the lack of growth potential necessitates repeated reoperations. Aim. This review aims to introduce the concept of partial heart transplantation to a broader clinical audience and to summarize current clinical experience. We discuss indications, technical considerations, and organizational challenges associated with PHT in infants, and outline potential applications in older children and adults. Methods. A structured literature search was conducted in databases using selected keywords related to partial heart transplantation and congenital heart disease. Because the available evidence remains early and heterogeneous, a narrative review approach was adopted with SANRA quality criteria. The included literature consisted mainly of case reports, case series, and review articles. Results. The largest reported case series included 19 patients who underwent PHT between April 2022 and December 2024. Replacement of semilunar valves was associated with significant annular growth and preserved valvular function during follow-up. At the time of publication, none of the transplanted valves required explantation due to graft failure. Early observations suggest that, owing to the relatively low immunogenicity of cardiac valves, immunosuppressive requirements after PHT may be lower than those required after orthotopic heart transplantation. Conclusion. Evidence for PHT is currently limited to small cohorts with short follow-up. Multicenter collaboration and standardized registry-based data collection will be essential to define indications, evaluate long-term outcomes, and establish the role of PHT within contemporary valve replacement strategies.
Copyright (c) 2026 Katarzyna Widomska, Mateusz Bernad, Aleksandra Bender, Paulina Walczak, Małgorzata Niewęgłowska, Bartłomiej Szymulewicz, Kacper Dąbrowski, Jakub Łukaszewicz, Oliwia Krazińska, Magdalena Gałach, Aniela Figiel, Paweł Zaborek, Justyna Pestka, Robert Marguła https://creativecommons.org/licenses/by-nc-sa/4.0
The Use of Platelet-Rich Fibrin in the Treatment of Burn Wounds: A Literature Review
Background. Platelet-rich fibrin (PRF) is an autologous fibrin-based biomaterial prepared from the patient’s blood by centrifugation. After tissue injury, such as a burn, platelets become activated and accumulate within the wound site, where they release chemokines, cytokines, and growth factors that are essential for regulating and supporting the wound healing process [1]. Aim. In this literature review, we summarize the available evidence regarding the use of PRF in burn wound management. Materials and methods. A literature search was conducted in PubMed and Google Scholar using combinations of the keywords “platelet-rich fibrin” and “burn wounds”. English-language meta-analyses, systematic reviews, clinical trials, original studies, case series, and case reports were screened without date restrictions, and studies reporting human data on PRF use in burn wound healing were included. Reference lists of eligible articles were also manually reviewed. Results. The available literature suggests that platelet-rich fibrin may influence burn wound healing, indicating its potential as a beneficial adjunct in burn wound management. Conclusions. PRF appears to be a promising adjunct in burn wound management. However, further well-designed studies are required to establish standardized protocols and confirm efficacy.
Copyright (c) 2026 Łukasz Szymański, Natalia Gołąbek, Milena Mordarska, Alicja Kodura, Alicja Piwowarczyk, Jan Łozowski, Joanna Paluchowska, Julia Białas, Artur Merc, Przemysław Piątek https://creativecommons.org/licenses/by-nc-sa/4.0
The Use of Coconut Oil Pulling in the Prevention and Treatment of Periodontal Diseases and Dental Caries - A Literature Review
Background. Modern dentistry increasingly seeks natural methods to support traditional hygiene procedures. Although oil pulling, originating from Ayurvedic medicine, has been a subject of controversy, recent studies indicate its genuine clinical efficacy. Aim. The objective of this paper is to analyze the impact of coconut oil on the oral microbiome, gingival health, and plaque reduction. Material and methods. A review of the available scientific literature from the years 2016-2025 was conducted to evaluate the clinical efficacy and mechanisms of coconut oil in oral hygiene. Results. A review of the literature demonstrates that coconut oil possesses unique physicochemical properties resulting from its high lauric acid content and the process of saponification. During intensive oral rinsing, the oil reacts with salivary enzymes, leading to the formation of soap-like substances that facilitate the mechanical removal of biofilm. Lauric acid has proven antimicrobial properties, inhibiting the growth of pathogens such as Streptococcus mutans. Clinical trials confirm that regular oil pulling leads to a statistically significant reduction in Plaque Index (PI) and Gingival Index (GI), achieving effects comparable to chlorhexidine, without adverse effects. Conclusions. Coconut oil pulling is an effective, safe, and cost-efficient method for supporting the prevention of periodontal diseases and dental caries. Due to its lack of toxicity, this method is particularly recommended for children and pregnant women.
Copyright (c) 2026 Natalia Smyczyńska, Mikołaj Kubik, Aleksandra Jędras, Wojciech Pondo https://creativecommons.org/licenses/by-nc-sa/4.0
Management of Infectious Mononucleosis in Paediatric Athletes
Background. Infectious mononucleosis (IM), most commonly caused by the Epstein–Barr virus (EBV), affects primarily adolescents and young adults between 15 and 24 years of age, populations with high rates of sports participation. Although IM is usually self-limited, ,its symptoms most often include fever, pharyngitis, posterior cervical lymphadenopathy, fatigue, and malaise. Aim of study. This review aims to summarize the current evidence on the diagnosis, clinical management, and return to play (RTP) recommendations for athletes and paediatric athletes with IM. Materials and Methods. The review was based on a search of articles published in the PubMed database. Search terms included: infectious mononucleosis, Epstein-Barr virus, splenic rupture, splenomegaly, return to play and Monospot test Current state of knowledge. Prolonged fatigue and the risk of splenic rupture may significantly disrupt training and competition. The most relevant sports-related complication is splenic rupture, which is associated with splenomegaly and occurs most often early in the disease course. Conclusions. RTP decisions should be individualized based on symptom resolution, clinical findings, the type of sport (contact vs non-contact), and shared decision-making. The general consensus is to avoid contact sports and strenuous training for at least 3–4 weeks. Ultrasound may be helpful in selected cases, but its routine use is limited by the wide variability in baseline spleen size and the absence of validated thresholds for safe RTP.
Copyright (c) 2026 Katarzyna Tłustochowicz, Adrianna Kowalik, Agnieszka Krajewska, Magdalena Korba, Wiktoria Polkowska, Natalia Malicka, Agnieszka Maria Korzeniewska, Julia Agnieszka Dębczak, Karolina Łuczak https://creativecommons.org/licenses/by-nc-sa/4.0
Arrhythmias in Amateur Athletes: Warning Sign or Physiological Adaptation?
The prevalence of arrhythmias detected in physically active adults has increased in parallel with the growing participation of amateur athletes in endurance and high-intensity sports and with widespread use of wearable ECG-capable devices. Exercise training induces autonomic and structural cardiac remodeling that may manifest as bradyarrhythmias or ectopy and is frequently benign. However, long-standing high-volume endurance exercise has also been associated with a higher burden of atrial fibrillation and, in selected individuals, ventricular arrhythmias, raising the clinical challenge of distinguishing physiological “athlete’s heart” adaptations from arrhythmic phenotypes that may reflect underlying structural or electrical heart disease. This narrative review synthesizes current evidence regarding epidemiology, proposed mechanisms, ECG interpretation, diagnostic evaluation, detraining, management, and return-to-sport considerations for amateur athletes presenting with arrhythmias. Particular attention is given to atrial fibrillation, premature ventricular contractions, and ventricular tachyarrhythmias, as well as to the role of pre-participation evaluation and shared decision-making.
Copyright (c) 2026 Daria Twardowska, Wiktoria Śliwa, Wiktoria Tłoczek, Kamil Topolski, Barbara Jelonek, Małgorzata Wandzel, Karolina Klubikowska, Dagmara Porada, Barbara Tomczak , Monika Wandasiewicz https://creativecommons.org/licenses/by-nc-sa/4.0
Tranexamic Acid in Total Knee and Hip Arthroplasty: Dosing Strategies and Routes of Administration – A Narrative Review
Introduction and purpose: Perioperative blood loss remains a significant concern in total knee and hip arthroplasty (TKA, THA), leading to decreased hemoglobin levels and an increased requirement for blood transfusions. Tranexamic acid (TXA), a potent antifibrinolytic agent, is widely utilized to mitigate perioperative bleeding. The objective of this review is to evaluate TXA dosing strategies and administration routes, with a particular focus on timing, multidose protocols, and their subsequent impact on blood loss and clinical outcomes. Description of the state of knowledge: TXA effectively reduces total blood loss, hidden blood loss, and hemoglobin decline in TKA and THA. A single preoperative dose limits early bleeding but fails to suppress postoperative hyperfibrinolysis. Extended and multidose regimens within the first 24 hours provide superior control of fibrinolytic activity. Intravenous, oral, and topical routes show comparable efficacy, while combined strategies may enhance hemostasis. Additionally, TXA exerts anti-inflammatory effects (lowering IL-6 and CRP), reducing pain and edema while improving early clinical outcomes. Conclusions: TXA effectively reduces total and hidden blood loss in TKA and THA without increasing thromboembolic risk. Maximum clinical benefits are achieved through individualized, extended multidose regimens that ensure sustained suppression of postoperative hyperfibrinolysis and inflammation (IL-6, CRP). Optimized TXA protocols significantly enhance early recovery by reducing postoperative pain and edema.
Copyright (c) 2026 Szymon Kopciał, Karolina Kornatowska, Mateusz Wiekiera, Adrianna Wiekiera, Paweł Budzik https://creativecommons.org/licenses/by-nc-sa/4.0
The impact of high-intensity resistance training on intraocular pressure and ocular hemodynamics: A literature review
Background. Intraocular pressure (IOP) is influenced by physiological stressors, including resistance exercise (RE). While physical activity is generally protective, high-intensity strength training may induce significant acute IOP spikes, posing a risk for individuals with or at risk of glaucoma. Aim. This systematic review evaluated the acute effects of RE on IOP in healthy adults and identified physiological and methodological factors influencing these fluctuations. Material and methods. A systematic review was conducted using PubMed, Web of Science, and Scopus. Selection criteria included quantifiable exercise intensity (e.g., % 1RM) and standardized IOP protocols. Data analyzed the influence of the Valsalva maneuver (VM), muscle mass, and measurement timing (intra- vs. post-exercise). Results. RE-induced IOP changes are intensity-dependent; loads exceeding 80% 1RM cause spikes up to 200% (exceeding 40 mmHg) when measured during effort. A methodological discrepancy was identified: intra-repetition measurements reported hypertensive peaks, whereas post-exercise assessments showed rapid stabilization or hypotension. The VM was a dominant factor magnifying IOP elevations due to impaired venous drainage. Conversely, Blood Flow Restriction (BFR) training appears to be a safer alternative, eliciting hypertrophy at lower intensities with minimal impact on ocular hemodynamics. Conclusions. Acute RE induces a biphasic IOP response: an extreme, transient increase during exertion followed by rapid stabilization. Traditional post-exercise measurements significantly underestimate the mechanical stress on the optic nerve. High-intensity lifts with the VM should be approached with caution in clinical populations. Future longitudinal research is required to determine the cumulative effects of repeated acute IOP spikes on optic nerve integrity.
Copyright (c) 2026 Iga Piórkowska, Karol Piotrowski, Małgorzata Jerczak, Tomasz Pluszyński, Natalia Padula, Mikołaj Polewka, Aleksandra Polańska, Kacper Paczosa, Filip Przybył https://creativecommons.org/licenses/by-nc-sa/4.0
The use of machine learning as a diagnostic and monitoring tool for bipolar disorder
Introduction: Bipolar disorder (BD) is a disorder in which patients experience alternating episodes of depression, mania or hypomania, and sometimes mixed episodes. BD is associated with serious comorbidities and a shorter average life expectancy. Both diagnosis and treatment are long-term processes, often requiring prophylaxis for many years. Early diagnosis and rapid intervention may help extend life expectancy through the use of artificial intelligence. Aim of the study: The aim of this study is to summarize the current state of knowledge regarding the use of machine learning as a tool supporting diagnosis and monitoring the course of bipolar disorder. Materials and methods: A review of literature available in the PubMed and Google Scholar databases was conducted. The literature used in the article comes from the years 2019–2024. The following keywords were used: bipolar disorder, machine learning, artificial intelligence, diagnosis and treatment of bipolar disorder. Results: Artificial intelligence plays an important role in the diagnosis and monitoring of patients with BD, supporting differential diagnosis, prediction of relapses, and personalization of treatment. Analyses based on EEG signals and brain imaging suggest that AI may distinguish individuals with BD from healthy individuals, although more consistent research results are needed. AI in psychiatry also faces limitations such as difficulties in accessing large, high-quality datasets and insufficient physician training. Conclusions: Recent studies demonstrate that artificial intelligence techniques may be effective in the diagnosis and monitoring of bipolar disorder, although machine learning still requires further improvement. Keywords: bipolar disorder, machine learning, artificial intelligence, diagnosis of bipolar disorder, treatment of bipolar disorder.
Copyright (c) 2026 Klaudia Kleczaj, Julia Jaworowska, Damian Osiński, Zuzanna Kawa, Maria Kasprzak, Aleksandra Jędrzejewska, Aleksandra Jureczko, Łukasz Starczewski, Gabriela Babiarz, Julia Kanarszczuk https://creativecommons.org/licenses/by-nc-sa/4.0
Environmental tobacco smoking and its consequences for allergy and asthma in children - a review
Background. Asthma is one of the most common chronic respiratory diseases in children. Among important non-modifiable environmental risk factors—independent of genetic predisposition—is exposure to environmental tobacco smoke (ETS). Children are particularly vulnerable due to the immaturity of their respiratory and immune systems. Aim. This study reviews the impact of passive smoking on asthma and allergy outcomes in children. Material and methods. Studies were selected from PubMed, including publications from 2020 to 2026. The search terms included “passive smoking,” “asthma,” and “children.” Non-English articles were excluded. Results. The literature shows a strong association between ETS exposure and increased risk of asthma and allergic diseases in children. Both prenatal and postnatal exposure were linked to higher incidence of wheezing, bronchial hyperreactivity, and physician-diagnosed asthma. ETS exposure was also associated with elevated IgE levels and increased sensitization to allergens, as well as a higher prevalence of atopic dermatitis and allergic rhinitis. A dose–response relationship was observed, with greater exposure linked to more severe symptoms. Mechanistically, ETS impairs mucociliary clearance, disrupts epithelial barriers, and promotes airway inflammation. Early-life exposure may have long-term effects on lung development and immune function. Conclusion. ETS is a significant and preventable risk factor for asthma and allergic diseases in children. Reducing prenatal and postnatal exposure is essential to protect respiratory health and improve long-term outcomes.
Copyright (c) 2026 Patrycja Pelczar, Aleksandra Skowron, Jakub Orzeł, Aleksandra Przygoda https://creativecommons.org/licenses/by-nc-sa/4.0
Obesity as a Risk Factor for Endometrial Cancer – Pathophysiological Mechanisms
Background. Endometrial cancer is the most common gynecological malignancy in developed countries. Obesity is a major modifiable risk factor, promoting inflammation, hyperinsulinemia, increased estrogen production, and metabolic disturbances that contribute to carcinogenesis. Aim. This narrative review summarizes current evidence on the pathophysiological mechanisms linking obesity with endometrial cancer and highlights the relevance of molecular classification and lifestyle-related prevention. Material and methods. A narrative analysis of open-access publications (2008–2026) was conducted, focusing on epidemiology, metabolic and hormonal pathways related to obesity, and molecular subtypes of endometrial cancer described by The Cancer Genome Atlas (TCGA). Results. Obesity contributes to endometrial cancer through estrogen excess, insulin resistance, IGF-1 signaling, chronic inflammation, and adipokine imbalance. Four molecular subtypes are recognized: POLE ultramutated, mismatch repair deficient, p53-abnormal, and non-specific profile. Physical activity may reduce cancer risk. Conclusions. Understanding obesity-related molecular pathways in endometrial cancer may improve risk stratification and treatment decisions. Preventive strategies, including weight control and regular physical activity, may reduce disease burden. Key words: endometrial cancer, obesity, molecular classification, TCGA, physical activity.
Copyright (c) 2026 Patrycja Pietraszkiewicz, Paula Żak, Inez Michalska, Zuzanna Korbel, Katarzyna Pinkowska, Zuzanna Taciak, Filip Glista, Anna-Maria Grzeczka, Mikołaj Jaszowski, Agnieszka Dąbrowska, Weronika Klara Nawrocka https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Sleep and Sleep Deprivation in Epileptic Seizures
Background. Sleep is a fundamental physiological process that regulates brain network stability and neuronal excitability.In epilepsy sleep–wake regulation is closely linked to the occurrence of epileptiform discharges and seizure susceptibility.Sleep disturbances,deprivation,and irregular sleep–wake rhythms are recognized as modifiable factors affecting seizures,disease course,and diagnostic yield. Aim of the study. The aim of this study was to summarize the current evidence on the relationship between sleep physiology,sleep deprivation,and epileptiform brain activity,focusing on mechanisms linking sleep stages with seizure generation and the clinical relevance of sleep EEG. Material and methods. A narrative review of the literature was conducted using PubMed,Google Scholar,and selected academic sources.The analysis included original research articles,clinical studies,systematic reviews,and expert consensus papers published from 2010 through 2025. Results. The reviewed evidence shows that non–rapid eye movement (NREM) sleep, especially slow-wave sleep, promotes neuronal synchronization and interictal discharges, while rapid eye movement (REM) sleep suppresses epileptic activity. Sleep deprivation lowers seizure threshold by disrupting excitatory–inhibitory balance and sleep–wake transitions. EEG during sleep or after deprivation increases detection of epileptiform abnormalities. Irregular or fragmented sleep also increases seizure risk, even without reduced total sleep time. Conclusion. Sleep significantly influences epileptiform activity through stage-dependent mechanisms.Sleep deprivation and irregular sleep patterns are important seizure provoking factor,while sleep EEG is a valuable diagnostic tool. Recognizing sleep as a modifiable factor is important for epilepsy diagnosis and disease management.
Copyright (c) 2026 Joanna Kania, Dominika Miazga, Anna Gęborys, Katarzyna Mazurek, Karolina Niekurzak, Maciej Jędrak, Weronika Grodzińska, Julia Matuszewska, Magdalena Dubaj, Łukasz Fussek https://creativecommons.org/licenses/by-nc-sa/4.0
Diagnosis of Small Intestinal Bacterial Overgrowth: Current Methods, Limitations, and Future Directions -a narrative literature review
Background: Small intestinal bacterial overgrowth (SIBO) is a condition characterized by an abnormal alteration and/or increase in bacterial populations within the small intestine, leading to excessive carbohydrate fermentation and gas production. Clinical manifestations are nonspecific and include abdominal pain, bloating, diarrhea, and nutritional deficiencies. Despite increasing clinical recognition, accurate diagnosis remains challenging. Aim: To review currently available diagnostic methods for SIBO and evaluate their diagnostic accuracy and limitations. Material and methods: This study was conducted as a narrative literature review. A literature search was performed in the PubMed and Scopus databases. Systematic reviews, meta-analyses, original research articles, and clinical guidelines were included. The search was conducted using a combination of keywords including: “Small Intestinal Bacterial Overgrowth”, “SIBO”, “breath test”, “hydrogen breath test”, “methane breath test”, “small bowel aspirate”, “intestinal methanogen overgrowth”, and “SIBO diagnosis”. The literature screening and selection were performed independently by the authors. Studies published in languages other than English were excluded. No time restrictions were applied to the literature search. Results: Breath tests, particularly the glucose hydrogen breath test (GHBT) and lactulose hydrogen breath test (LHBT), are widely used due to their non-invasive nature and availability. However, their diagnostic accuracy remains limited. Small bowel aspirate remains the diagnostic gold standard but is invasive and methodologically limited. Conclusions:Current diagnostic methods for SIBO have significant limitations. Diagnostic results should therefore always be interpreted within the clinical context, highlighting the need for more accurate and standardized diagnostic approaches.
Copyright (c) 2026 Bartłomiej Szymulewicz, Kacper Dąbrowski, Aleksandra Podeszwa, Jakub Łukaszewicz , Małgorzata Niewęgłowska, Paulina Walczak, Aleksandra Bender, Katarzyna Widomska, Mateusz Bernad, Oliwia Krazińska, Magdalena Gałach https://creativecommons.org/licenses/by-nc-sa/4.0
Sleep disturbances in inflammatory bowel disease: mechanisms, clinical consequences, and therapeutic implications
Background. Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, is commonly associated with sleep disturbances and fatigue. Sleep disruption interacts bidirectionally with immune and neuroendocrine pathways, affecting disease activity, relapse risk, and long-term outcomes. Aim. This review synthesizes current evidence on the relationship between sleep disturbances and IBD, focusing on pathophysiological mechanisms, clinical correlations, and prognostic and therapeutic implications. It evaluates whether sleep disorders are secondary to inflammation or independent contributors to disease progression, supporting the integration of sleep assessment into IBD care. Material and methods. A narrative review of studies published between 2000 and 2025 was conducted using PubMed and Scopus. Search terms included “inflammatory bowel disease”, “Crohn’s disease”, “ulcerative colitis”, “sleep”, “circadian rhythm”, “fatigue”, and “cytokines”. Included were clinical and preclinical studies, systematic reviews, and meta-analyses addressing sleep and inflammatory mechanisms in IBD. Selection was based on relevance and methodological quality. Results. Pro-inflammatory cytokines (IL-1, IL-6, TNF-α) regulate NREM sleep, while their chronic elevation in IBD contributes to sleep fragmentation and systemic inflammation. Sleep deprivation worsens intestinal barrier function via ER stress in goblet cells, increasing mucosal inflammation. Dysregulation of the HPA axis and leptin signaling further enhances immune activation. Poor sleep correlates with subclinical inflammation, higher relapse risk, fatigue, and long-term complications. Psychological comorbidities and pharmacotherapy additionally influence sleep quality. Conclusions. Sleep disturbances are common in IBD, mechanistically linked to its pathophysiology, and impact disease course. Routine sleep assessment and targeted interventions may improve quality of life and potentially modify outcomes.
Copyright (c) 2026 Filip Przybył, Małgorzata Jerczak, Mikołaj Polewka, Karol Piotrowski, Iga Piórkowska, Aleksandra Polańska, Tomasz Pluszyński, Kacper Paczosa, Natalia Padula https://creativecommons.org/licenses/by-nc-sa/4.0
Application of Neural Networks and Machine Learning Models in the Diagnosis, Classification and Individual Treatment of Schizophrenia
Introduction. Schizophrenia is a chronic, severe, and progressive mental disorder whose course is influenced by genetic, epigenetic, and environmental factors. Symptoms typically appear between the ages of 16 and 30 and can be divided into three categories: positive, negative and cognitive symptoms. In recent years, the use of artificial intelligence techniques in psychiatry has increased. Numerous studies demonstrate the effectiveness of methods such as deep learning in the diagnosis and treatment of psychiatric disorders. Aim of the study. To summarize the current state of knowledge regarding the application of neural networks and machine learning models in the diagnosis, classification and personalized treatment of schizophrenia. Methods and materials. A literature review was conducted using publications available in the PubMed and Google Scholar databases from 2019-2024. The most relevant and recent studies were selected using appropriate keywords. Results. Artificial intelligence techniques enable the development of diagnostic and prognostic models identifying patients with schizophrenia based on MRI and EEG data, as well as audio, video recordings and genetic information. Patient classification is mainly based on EEG and MRI analyses. However, the use of machine learning for treatment personalization remains limited. Ethical issues, data protection, and the nature of the physician-patient relationship in psychiatry remain important challenges. Conclusions. Artificial intelligence shows potential in the diagnosis, prognosis and treatment of schizophrenia, but its implementation in clinical practice requires further research, methodological improvement and careful consideration of ethical and legal aspects.
Copyright (c) 2026 Aleksandra Jureczko, Damian Osiński, Zuzanna Kawa, Maria Kasprzak, Aleksandra Jędrzejewska, Klaudia Kleczaj, Łukasz Starczewski, Julia Jaworowska, Gabriela Babiarz, Julia Kanarszczuk https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Intensive Physical Training on the Functioning of the Hypothalamic–Pituitary–Ovarian Axis in Female Athletes
Background Intensive physical training plays a crucial role in improving physical fitness and athletic performance; however, in female athletes it may also disrupt hormonal balance, particularly within the hypothalamic–pituitary–ovarian (HPO) axis. These disturbances are often associated with low energy availability and may lead to significant reproductive and systemic health consequences. Aim The aim of this review was to analyze current scientific evidence regarding the impact of intensive physical training on the functioning of the HPO axis in female athletes, with particular emphasis on underlying physiological mechanisms, health outcomes, and prevention strategies. Material and methods A narrative literature review was conducted based on publications from 2014 to 2026. Scientific databases including PubMed, Google Scholar, Scopus, and Web of Science were searched using relevant keywords related to HPO axis function, menstrual disorders, Female Athlete Triad, and Relative Energy Deficiency in Sport (RED-S). Only peer-reviewed review articles, clinical studies, and observational studies were included.
Copyright (c) 2026 Maria Sanocka, Agnieszka Przepióra, Anna Żmigrodzka, Agnieszka Kamińska, Maria Orłowska, Klaudia Czernic-Goławska, Jana Kozłowska, Joanna Falana, Aleksandra Wielogórska, Anna Kwiatkowska, Karolina Trojnar https://creativecommons.org/licenses/by-nc-sa/4.0
Optical Coherence Tomography (OCT) as a Retinal Biomarker for Brain Neurodegeneration: A Narrative Review
Background. Optical coherence tomography is a rapidly developing imaging technique being increasingly used for the diagnosis of neurodegenerative diseases. It has brought forth new innovations for these diseases. Measurements of the retinal layers, macular and separate layer thicknesses, ganglion cell complex and choroidal thickness etc, have proven to be an excellent indication in differentiating these diseases using non-invasive and minimally invasive procedures. Aim. To summarize available information and studies about the usage of OCT in neurodegenerative diseases which might create a new path for their diagnosis and treatment. Materials and Methods. A literary search was done using the PubMed database to identify relevant studies published in English within the last 10 years. The selected studies were analysed to summarize current evidence regarding the potential role of OCT and OCTa in neurodegenerative diseases. Results. Various studies have proven significant correlation between OCT measurements and neurodegenerative diseases. This increasingly developing correlation may help in the diagnosis and clinical treatment of these illnesses. However, there is a need for further studies and research to be conducted as non-specificity of OCT findings across the diseases remain a significant factor to be considered before mainstream usage. Conclusions. OCT usage has proved to be a field which deserves more gravity towards it. The anatomical origin as well as similarity of the eye and brain in function may help us understand and diagnose these diseases better in the foreseeable future.
Copyright (c) 2026 Agata Król, Emilia Muraszewska , Łukasz Muraszewski , Patrycja Kwitowska, Eryk Ubysz, Edyta Lewandowska, Cezary Łuczyński, Maciej Paczkowski , Mariusz Wręczycki , Małgorzata Pyjecka https://creativecommons.org/licenses/by-nc-sa/4.0
Sodium Butyrate Supplementation: Current Evidence, Clinical Indications, and Limitations
Introduction and purpose: Butyrate is one of the most important short-chain fatty acids produced by the gut microbiota through fermentation of undigested dietary components, especially dietary fiber. It plays a key role in intestinal homeostasis by supporting colonocyte metabolism, maintaining epithelial barrier integrity, and modulating immune responses. The aim of this paper was to review current evidence on sodium butyrate supplementation, with particular attention to its mechanisms of action, clinical indications, and limitations of the available evidence. A brief description of the state of knowledge: Experimental studies suggest that butyrate exerts anti-inflammatory, immunomodulatory, and barrier-protective effects. Its mechanisms include histone deacetylase inhibition, signaling through short-chain fatty acid-sensitive G protein-coupled receptors, and modulation of pathways related to NF-κB activation. Clinical findings are most promising in ulcerative colitis, especially with microencapsulated formulations. In irritable bowel syndrome, metabolic disorders, and pediatric inflammatory bowel disease, the results remain limited or inconsistent. Summary: Sodium butyrate supplementation appears to be a promising supportive strategy in selected clinical settings, but current evidence does not justify its use as a universally effective intervention. Further well-designed clinical trials are needed to identify optimal indications, dosing regimens, and patient groups most likely to benefit.
Copyright (c) 2026 Karolina Michalak, Knieszko Fahim, Jakub Franaszek, Nadia Herchi, Martyna Jabrzyk, Patrycja Jarczyńska, Wojciech Kijowski, Mateusz Klusek, Maciej Przybył https://creativecommons.org/licenses/by-nc-sa/4.0
The Importance of Resistance Training in Addressing Insulin Resistance and Type 2 Diabetes: A Narrative Review
Introduction: Insulin resistance and type 2 diabetes mellitus are serious global health challenges, which are caused by aging population, increasing levels of obesity and insufficient amount of physical activity. Although pharmacological treatment is still a central part of managing diabetes, a substantial number of patients are not able to achieve optimal glycemic control, showing the need for effective lifestyle interventions. Resistance training has become a promising strategy which targets main pathophysiological mechanisms underlying insulin resistance. Purpose: This narrative review aims to summarize and critically evaluate current evidence on the effects of resistance training on insulin sensitivity, metabolism of glucose and cardiometabolic health across diverse populations, including patients with type 2 diabetes, insulin resistance, obesity, metabolic syndrome, and older adults. Material and Method: A comprehensive literature search was conducted using the PubMed/MEDLINE database and included studies published up to 2025. Only peer-reviewed articles written in English were included in the review. Particular emphasis was placed on randomized controlled trials, systematic reviews, and meta-analyses. Results: Evidence from randomized controlled trials and meta-analyses demonstrates that resistance training improves glycemic control, reduces insulin resistance as well as enhances body composition and functionality. Comparative analyses indicate that resistance training provides benefits that are complementary to aerobic exercise, dietary interventions, and pharmacotherapy, particularly when weight loss strategies are added. Conclusions: The findings support resistance training as a safe and effective component of comprehensive management strategies for insulin resistance and type 2 diabetes.
Copyright (c) 2026 Katarzyna Siwicka, Konrad Szewczyk, Laura Janasik, Patrycja Kociucka, Krzysztof Sadowski, Julia Modelska, Anita Jeleń, Anna Podolska, Karolina Paluchowicz https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Tranexamic Acid in Managing Traumatic Hemorrhage: A Review of Current Evidence
Introduction. Traumatic hemorrhage is one of the leading causes of death among patients with severe injuries. Tranexamic acid (TXA), a synthetic antifibrinolytic agent, has shown potential to reduce massive blood loss and decrease mortality. Aim. The aim of this study was to analyze current evidence regarding the efficacy and safety of tranexamic acid in the treatment of traumatic hemorrhage and to assess the factors influencing its therapeutic effect. Methods. A literature review was conducted covering publications (2010-2026), including clinical studies, randomized controlled trials, systematic reviews, and meta-analyses concerning the use of TXA in trauma patients. Data on the timing and route of administration, dosing, efficacy, and safety of therapy were analyzed. Results. TXA reduces blood loss and may lower mortality, especially when administered early after injury. Intravenous use is standard, while intraosseous or intramuscular routes may be used prehospital. TXA is generally safe, but monitoring for thromboembolic events and dose-related adverse effects is recommended in patients with multiple injuries. Conclusions. TXA is an effective and safe option in traumatic hemorrhage management. Its efficacy depends on timing, dosing, and patient factors. Early use improves outcomes, but further research is needed to optimize treatment and assess alternative administration routes.
Copyright (c) 2026 Aleksandra Makulec, Aleksandra Szredzka, Katarzyna Otrębska, Dominika Lewandowska, Aleksandra Jóźwik-Szymańska, Natalia Kostecka, Laura Mikuła, Zuzanna Bogdan-Groszyk, Jan Kucharski, Helena Muszyńska https://creativecommons.org/licenses/by-nc-sa/4.0
Omega-3 Supplementation in Athletes: Impact on Performance, Recovery After Physical Exercise and Effects on Injury Recovery - Systematic Review
Introduction. The process of recovering from strenuous physical activity is a concern for various groups, ranging from elite athletes to recreationally active individuals. High-force or unfamiliar eccentric exercise routines can cause significant damage to muscle fibers, often leading to soreness, inflammation, and a temporary decline in performance. Given these challenges, there is a growing interest in nutritional strategies, including omega-3 supplementation, to mitigate the adverse effects of intense training and facilitate faster recovery. Purpose of the work. The aim of this article was to conduct a systematic review, characterize the effects of supplementation, and explore the practical benefits of omega-3 supplementation for athletes in terms of muscle performance, recovery, and brain and cardiovascular health. This review synthesizes findings from recent studies to provide insights into the benefits, impact on performance, recovery, effects on injury recovery and potential limitations of omega-3 supplementation for athletes. Materials and methods. A systematic search was conducted in PubMed, Scopus, and Web of Science for articles published between January 2010 and December 2024. Keywords included "omega-3 supplementation," "athletic performance," "sports recovery," and "injury recovery." Eligible studies included randomized controlled trials (RCTs), observational studies, and meta-analyses that focused on omega-3 supplementation in healthy athletes. Results. Several studies have examined the potential ergogenic effects of omega-3 fatty acids. Key findings include endurance, muscle strength and power, reaction time, and cognitive function. Importantly, the evidence consistently supports the role of omega-3 fatty acids in recovery from injury, especially in reducing inflammation. Most studies used doses of 2 to 4 grams of EPA and DHA combined daily. Benefits were typically seen after 4 to 12 weeks of ongoing supplementation.
Copyright (c) 2026 Aleksandra Sadowska, Patrycja Śliwa-Tytko, Aleksandra Welkier, Joanna Miśkiewicz, Aleksandra Dudek, Patrycja Pietrusińska, Jakub Moder, Adam Sobiński, Anna Dziewierz, Paula Kwaśniewska https://creativecommons.org/licenses/by-nc-sa/4.0
Atrial Fibrillation in Physically Active Individuals: Effects of Pharmacological and Interventional Management on Athletic Quality of Life
Introduction: Atrial fibrillation (AF) is a common arrythmia in physically active individuals, particularly enduranse arhletes, raising important considerations regarding the cardiovascular effects of long-term high-intensity exercice. This review explores the correlation between AF and high-intensity training, focusing on how medical and interventional therapies impact athletic performance and quality of life. Aim of work: The aimara of this work is to review the current literature regardinf pharmacological and interventional management strategies for atrial fibrillation (AF) in athlestes, with particular empasis on their impactada on exercise capacity and sport-specific quality of life. Futhermore, the review aims to highlight gasps in studies and propose dirrections for future research and therapeutic innovation in the management of AF amonh physically active individuals. Material and Methods: The review was based on an analysis of articles published up to 2025 in the PubMed database, Google Scholar, and recent guidelines. The keywords we used included: atrial fibrillation, management, athlete, quality of life. Results: AF in athletes is often paroxysmall and asymptomatic, complicating diagnosis. Rate and rhythm control medications are frequently limited by negative effects on exercise capacity. Catheter abaltion, especially pulmonary vein isolaton, demonstrates superior rhythm control and allows atheltes to return to peak performance. Anticoagulation, while neccessary in some cases, presents bleeding risks in contact sports, requiring individualized approaches. Conclusions: Management of AF in atheltes must balance arrhythmia control with performance presevation. Catheter ablation offers the most consistent improvements in athletic qualty of life, whereas pharmacologic therapy is often restrictive. Tailored tretment strategies and futher athlete-specifc research are essential for optimizing care in this unique population.
Copyright (c) 2026 Julia Kępska, Oliwia Sędziak, Magdalena Jabłonowska, Karolina Szpilczyńska, Julia Gąsiorowska, Monika Cieślak, Marta Miklejewska, Katarzyna Kleszczewska, Laura Gawlik, Anna Krasowska https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Physical Activity During Pregnancy on Labor Outcomes - a Narrative Review
Background: Childbirth is shaped by biological, psychological, and environmental factors, with maternal lifestyle being a key modifiable determinant. Physical activity during pregnancy is widely recommended by WHO and ACOG for its safety and health benefits. Beyond general health outcomes, increasing attention has been directed toward the role of prenatal physical activity in influencing labor outcomes. Aim: The aim was to summarize current research on the relationship between prenatal physical activity and labor outcomes. Material and methods: A literature search was conducted in PubMed, Scopus, and Google Scholar for studies published between 2010 and 2025. Randomized controlled trials, cohort studies, and systematic reviews on prenatal physical activity and labor outcomes were included and analyzed qualitatively. Results: Evidence shows that physically active pregnant women may experience shorter labor, reduced cesarean delivery rates, and higher chances of spontaneous vaginal birth. Prenatal exercise does not negatively impact neonatal outcomes, including birth weight, Apgar scores, or gestational age, highlighting its safety for both mother and child. Conclusions: Moderate physical activity during pregnancy is safe and can enhance labor outcomes. Integrating structured exercise into prenatal care offers a feasible strategy to improve maternal fitness and support positive obstetric outcomes.
Copyright (c) 2026 Kornelia Nieradka, Dominika Krakowiak, Patrycja Kwitowska, Emilia Muraszewska, Łukasz Muraszewski, Eryk Ubysz https://creativecommons.org/licenses/by-nc-sa/4.0
Delirium as a Presenting Feature of Occult Malignancy: A Case Report
Background: Delirium is a psychiatric syndrome prevalent in elderly patients. According to the DSM-5-TR and ICD-11 it is characterized by a disturbance in awareness, orientation and attention. Treating delirium is difficult as the underlying medical conditions are not always apparent. Etiology is heterogeneous and can be attributed to infection, electrolyte imbalances, substance withdrawal or other factors disrupting homeostasis. Aim: The aim of this case report is to highlight the importance of considering metastatic malignancy in the differential diagnosis of delirium in elderly patients. Furthermore, it underscores the value of interdisciplinary collaboration between psychiatrists and internal medicine specialists in the diagnosis and management of such cases. Materials and methods: A narrative literature review was conducted using PubMed, the WHO ICD database, Oxford University Press, and The Lancet, including meta-analyses, case reports, systematic reviews, and international treatment guidelines published up to 2025. Case presentation: This case presents an 82 year old woman admitted to the psychiatric hospital, with a preliminary diagnosis of organic mood disorder. Exhibiting visual hallucinations, suicidal thoughts, fluctuating disturbances of consciousness and delusions of persecution. During hospitalization laboratory findings revealed elevated C-reactive protein levels and leukocytosis. Broad spectrum antibiotic therapy was administered after the collection of blood and urine samples. Due to suspected somatic causes of delirium and ineffectiveness of antibiotic therapy, the patient was transferred to the internal medicine department. During further diagnostic workup, the patient was found to have metastatic cancer of idiopathic origin. Conclusions: This case report presents delirium as a possible indicator of physiological imbalance, such as a tumor, providing insight into how psychiatric symptoms may act as markers of an underlying systemic disease.
Copyright (c) 2026 Sara Demkow, Joanna Sowińska, Aleksandra Cieślak, Natalia Paluszkiewicz, Sandra Bryg, Karolina Siemińska, Mateusz Kwiatkowski, Zofia Leżańska, Emil Pałyga, Katarzyna Diana Marcinkowska https://creativecommons.org/licenses/by-nc-sa/4.0
Relationship Between Akkermansia muciniphila Abundance and Exercise-Induced Fat Mass Reduction
Background: Obesity is a major health concern linked to type 2 diabetes, cardiovascular diseases, and NAFLD. Growing evidence highlights the role of gut microbiota dysbiosis in these disorders. Akkermansia muciniphila, a mucin-degrading bacterium, is inversely associated with adiposity, inflammation, and insulin resistance. Physical activity improves metabolic health, but variability in outcomes suggests additional modulators, including gut microbiota. Aim: This review aimed to summarize the relationship between A. muciniphila, physical exercise, and fat mass reduction, and to examine underlying physiological and microbiological mechanisms. Materials and Methods: A structured narrative review with elements of systematic analysis was conducted. Databases (including PubMed) were searched for experimental and clinical studies assessing associations between A. muciniphila and metabolic parameters, the effects of exercise on gut microbiota, and mechanisms linking microbiota changes with metabolic outcomes. Both animal and human studies were included. Results: Animal studies consistently show that aerobic and moderate exercise increase A. muciniphila abundance, enhance microbial diversity, improve glucose tolerance, and reduce fat mass. Human studies show more variable results, with modest increases in A. muciniphila and metabolic improvements, particularly in overweight or metabolically impaired individuals. Proposed mechanisms include improved gut barrier integrity, immune modulation, increased short-chain fatty acid production, AMPK activation, and microbiota–adipose tissue cross-talk. Conclusions: Physical activity modulates gut microbiota, with A. muciniphila as a potential mediator of exercise-induced fat loss and metabolic improvement. Although human evidence is heterogeneous, targeting this bacterium through exercise and lifestyle interventions may support obesity prevention and metabolic health.
Copyright (c) 2026 Agnieszka Chmurska, Aleksandra Majchrzyk, Aleksandra Strzępek, Mateusz Smerdzyński, Agnieszka Janaszek, Kinga Kałuża, Karolina Frączek, Julia Łyżwa, Michał Pater , Natalia Kałwa https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Digital Stress on The Hypothalamic-Pituitary-Ovarian Axis and Menstrual Cycle – A Systematic Review with Implications of Digital Health Technologies
The growing use of digital technology has created a new form of chronic psychological stress. Digital stress significantly affects female hormonal and reproductive health. This systematic review explores how digital and lifestyle related stress affects the hypothalamic-pituitary-adrenal (HPA) axis. It also examines the HPA and hypothalamic-pituitary-ovarian (HPO) axes relationship, specifically how it influences menstrual cycle regulation. A comprehensive literature search was performed using PubMed-indexed studies from January 2022 through March 2026 to identify relevant studies on all aspects of stress, neuroendocrinology, and menstrual health. These results indicate that chronic stress causes prolonged activation of the HPA axis resulting in increased cortisol levels and disrupts the negative feedback loops of hormones that are normally involved in the regulation of the menstrual cycle. This disruption prevents normal secretion of Gonadotrophin releasing hormone (GnRH) which disrupts Luteinising Hormone (LH) and Follicle Stimulating Hormone (FSH) activity which contributes to menstrual disorders or anovulatory cycles. There is emerging data suggesting that certain types of digital stressors such as excessive screen time, social media or sleep disturbance may contribute to these outcomes by creating chronic stress states and circadian disruptions. Despite providing new avenues for identifying menstrual and stress related fluctuations through digital health technologies, there continue to be limitations and validations required for these tools. Collectively, the review demonstrates a complex interplay among modern lifestyle characteristics and endocrine regulation supporting continued investigation into the role of digital stress in women's reproductive health.
Copyright (c) 2026 Antonina Zatyka, Aleksander Krupski, Michal Marusza, Victoria Stielow https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Mode of Delivery on the Development of Gut Microbiota and the Risk of Atopic Diseases in Children: A Literature Review
Introduction: In recent years, the prevalence of atopic diseases among children has increased. Increasing evidence suggests that early gut microbiota development, shaped in part by the mode of delivery, feeding practices, and perinatal antibiotic exposure, may play an important role in the pathogenesis of these conditions. Aim: This study aimed to investigate the association between mode of delivery, early-life gut dysbiosis, and the risk of developing atopic diseases in children, including atopic dermatitis, allergic asthma, allergic rhinitis, and food allergies. Methods: A review of observational studies, cohort studies, meta-analyses, and review articles published between 2005 and 2025 was conducted using the PubMed and Google Scholar databases. Results: Vaginal delivery promotes favourable colonization of the neonatal gut, whereas caesarean section is associated with delayed maturation of the gut microbiota and a predominance of bacteria typically found on the skin and in the hospital environment. In numerous studies, caesarean section has been associated with an increased risk of asthma, allergic rhinitis, atopic dermatitis, and food allergy. Breastfeeding demonstrated a protective effect, while perinatal antibiotic exposure may further disrupt microbiota homeostasis. Probiotics and synbiotics are being considered as potential tools for microbiota modulation; however, their efficacy has not been conclusively confirmed. Conclusions: Caesarean section should be considered a potential risk factor rather than a direct cause of atopy. Supporting the proper development of the gut microbiota may be an important component of the early prevention of atopic diseases in children.
Copyright (c) 2026 Paweł Rot, Joanna Mioduszewska, Piotr Poniewozik, Natalia Dziuba, Aleksandra Sim, Maja Pernal, Zofia Roguska, Andrzej Paweł Zuzak, Paweł Poniewozik, Krzysztof Grabowski https://creativecommons.org/licenses/by-nc-sa/4.0
Water-Based Exercise As a Multidimensional Non-Pharmacological Intervention In Fibromyalgia Treatment: A Narrative Review
Background. Fibromyalgia, as a multidimensional syndrome, requires interventions that target multiple aspects of the disease simultaneously. This complexity underscores the importance of non-pharmacological strategies aimed at improving patients’ overall well-being. Among such interventions, aquatic therapy represents a structured form of physical activity, which offers additional therapeutic benefits related to the physical properties of water. Aim. The purpose of this study is to evaluate the therapeutic efficacy of aquatic therapy as a part of non-pharmacological management of fibromyalgia. Material and methods. This narrative review was conducted using PubMed and Google Scholar as the main sources of examined studies, including meta-analyses, systematic reviews and clinical trials. Results. Studies consistently show that hydrotherapy is associated with clinically meaningful improvements in core fibromyalgia symptoms, including pain, functional capacity and psychological well-being. Conclusions. Aquatic exercise positively influences physical function and psychological well-being in patients with fibromyalgia syndrome. As a non-pharmacological treatment, it may be effectively incorporated into multimodal care strategies. Future research should focus on the long-term effects of hydrotherapy and the development of standardized aquatic exercise protocols for patients with FMS.
Copyright (c) 2026 Anita Jeleń, Anna Podolska, Karolina Paluchowicz, Katarzyna Siwicka, Konrad Szewczyk, Laura Janasik, Patrycja Kociucka, Krzysztof Sadowski, Julia Modelska https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Breastfeeding on Mental Disorders in Children and Adults and the Role of Mother’s Mental Health: A Literature Review
Background. Beyond providing nutrition to infants, breastfeeding plays a significant role in their physical, cognitive, and emotional development. An icreasing number of studies indicate that it may affect the child's mental health later in life through various mechanisms. The mental state of the mother can modify lactation and breast milk composition, potentially impacting infant development. Aim of the study. A review of literature on the impact of breastfeeding during infancy on mental disorders, including depression, anxiety disorders, autism spectrum disorders, and personality disorders, in childhood and adulthood, considering the mother's mental health as a potential modulating factor. Methodology. The review was conducted using PubMed and Google Scholar. Studies from 1998-2025 were analyzed. Results. Studies show breastfeeding supports cognitive development, reduces risk of mental disorders and promotes resilience to psychosocial stress. The mother's mental state and treatment may affect lactation and breast milk composition, influencing infant development. Conclusion. Breastfeeding may protect aspects of a child's mental health and cognitive development long-term. The mother's mental health influences breast milk composition and breastfeeding quality. Research remains inconclusive due to environmental and genetic factors, requiring more studies on breastfeeding's effects on cognition and mental health.
Copyright (c) 2026 Zofia Roguska, Maja Pernal, Joanna Mioduszewska, Paweł Rot, Piotr Poniewozik, Natalia Dziuba, Aleksandra Sim, Andrzej Paweł Zuzak, Paweł Poniewozik, Krzysztof Grabowski https://creativecommons.org/licenses/by-nc-sa/4.0
Paraneoplastic Syndromes Associated with Ovarian Teratomas - Systematic Review
Ovarian teratomas are germ cell tumors characterized by their ability to differentiate into tissues derived from all three embryonic germ layers. Although most teratomas are benign, particularly mature cystic teratomas, they may be associated with a wide spectrum of paraneoplastic syndromes. These syndromes are not caused by the direct presence of the tumor but rather by immune-mediated or hormonal mechanisms triggered by the neoplasm. The most well-recognized association is anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, although other neurological, hematological, and systemic manifestations have also been described. This systematic review aims to analyze the types of paraneoplastic syndromes associated with ovarian teratomas, their pathophysiology, clinical presentation, and diagnostic significance. Particular attention is given to neurological autoimmune syndromes, which often precede tumor diagnosis and may serve as an early clinical indicator of an underlying neoplasm. Understanding these associations is essential for timely diagnosis and appropriate management, which frequently involves a combination of tumor resection and immunotherapy.
Copyright (c) 2026 Wiktoria Kulczykowska , Sylwia Krzyśkowska, Anna Kozińska, Kamila Krukowska, Martyna Krupa, Laura Krawiec https://creativecommons.org/licenses/by-nc-sa/4.0
The Effects of Relative Energy Deficiency in Sport (RED-S) on Endocrine, Bone, and Metabolic Health and Athletic Performance: A Narrative Review
Background: Relative Energy Deficiency in Sport (RED-S) is a syndrome caused by low energy availability that impairs multiple aspects of athletes’ health and performance. It affects both female and male athletes and may lead to endocrine, bone, and metabolic disturbances, as well as impaired recovery and increased injury risk. Aim: To review the effects of Relative Energy Deficiency in Sport (RED-S) on athletes’ endocrine, bone, and metabolic health, as well as on athletic performance and injury risk. Material and methods: A narrative review of studies published between 2016 and 2025 was conducted using PubMed, Scopus, and Web of Science to evaluate the effects of LEA and RED-S on endocrine, bone, metabolic, and performance-related outcomes in athletes Results: RED-S was consistently associated with endocrine and metabolic disturbances, impaired bone health, and a higher risk of bone stress injuries. Evidence for adverse effects on recovery, training adaptation, and performance was also identified, although these findings were more heterogeneous. Conclusions: RED-S is a multisystem condition that can compromise athletes’ endocrine, bone, and metabolic health, with the strongest evidence relating to skeletal health and bone stress injury risk. Early recognition and correction of low energy availability are essential to protect both health and athletic performance.
Copyright (c) 2026 Patrycja Kwitowska, Eryk Ubysz, Łukasz Muraszewski, Emilia Muraszewska, Kornelia Nieradka, Dominika Krakowiak https://creativecommons.org/licenses/by-nc-sa/4.0
Foreign Bodies in the Ear Canal in Children: A Literature Review
Foreign bodies in the external auditory canal (EAC) are a common pediatric emergency, especially in children aged 1–4 years due to exploratory behavior and limited risk awareness. Common objects include beads, toy parts, organic materials, and button batteries, the latter posing significant risk of tissue damage. Clinical presentation ranges from asymptomatic cases to otalgia, hearing loss, and otorrhea. Diagnosis relies primarily on history and otoscopic examination, with imaging reserved for selected cases. Management should be prompt and individualized, using techniques such as forceps, suction, hooks, or irrigation, while complex cases may require sedation or general anesthesia. Delayed or unsuccessful removal increases complication risk, including infection and tympanic membrane perforation. Early recognition, appropriate management, and caregiver education are essential to prevent complications and improve outcomes.
Copyright (c) 2026 Marcin Barański, Weronika Wasiniewska, Tomasz Kandefer, Maria Izabela Sroka https://creativecommons.org/licenses/by-nc-sa/4.0
Effectiveness of non-pharmacological pain management for severe symptoms in primary dysmenorrhea in sport
Background: Primary dysmenorrhea predominantly affects young women, significantly impacting their well-being, quality of life, psychological and sexual health, as well as other aspects of daily functioning. This condition manifests primarily as severe menstrual pain in the absence of an identifiable organic pathology. Aim: This narrative review evaluates the available treatment options for primary dysmenorrhea. Our aim was to synthesize and critically analyze the existing evidence on the effectiveness of various pain management strategies for severe symptoms of primary dysmenorrhea to inform clinical practice. Methods: To assess the efficacy of pain management in severe primary dysmenorrhea, we conducted a systematic literature review using databases including PubMed, ScienceDirect, ResearchGate, and Google Scholar. We included randomized controlled trials (RCTs), cohort studies, and case-control studies published between 2022 and 2025. Data were extracted and categorized in tables based on different characteristics. Results: Physical therapy, acupuncture, herbal remedies, relaxation techniques, and psychotherapy demonstrated potential as complementary therapies. A personalized, multimodal approach integrating multiple interventions may yield superior outcomes. Conclusion: Non-pharmacological therapies are effective in managing primary dysmenorrhea. Adjunctive interventions such as physical therapy, acupuncture, herbal medicine, relaxation techniques, and psychotherapy may enhance treatment outcomes.
Copyright (c) 2026 Jana Kozłowska, Zofia Gołąbek, Simone Szymczyk, Kacper Król, Sabina Jóźwiak, Julia Nowosielska, Katarzyna Jaczewska, Patryk Barczuk, Aleksandra Rejmer, Jakub Lech https://creativecommons.org/licenses/by-nc-sa/4.0
Musculoskeletal asymmetries in adolescent fencers: developmental adaptations and injury implications – a narrative review
Introduction: Fencing is an asymmetric sport, that combined with a dynamic development in young athletes can contribute to some functional imbalances especially in the musculoskeletal system. In young athletes, one-sided training loads can worsen physiological asymmetries associated with growth and puberty, potentially increasing the risk of overload injuries. Aim of the study: The aim of this narrative review was to analyse the available literature on the nature of musculoskeletal asymmetries in fencers during their developmental years, their relationship to maturation processes, and potential injury implications. Methods: A review of publications from 2000 to 2025 was conducted using PubMed, Scopus, Web of Science and SPORTDiscus databases. Studies on the population aged 10–18 and works related to biomechanics, biological maturation and injuries in asymmetrical sports, with particular emphasis on fencing, were included. Results: The available data indicate that young fencers exhibit asymmetries in muscle strength, range of motion and body segment alignment, especially in the lower limbs, shoulder girdle and spine. Small differences may determine a functional adaptation to the specifics of the discipline, but their intensity during the pubertal growth speed may increase the risk of overload injuries, including knee and lower back pain. The limited number of extensive studies makes it difficult to clearly determine cause-and-effect relationships. Conclusions: Musculoskeletal asymmetries in young fencers are an adaptive-pathological phenomenon, depending on the stage of biological development and the training load. Early observation of functional parameters and the implementation of correct training should be an integral part of injury prevention in this population.
Copyright (c) 2026 Wiktor Wisoky, Natalia Czapla, Ewelina Strużyńska, Weronika Ziółkowska, Joanna Łopińska, Marta Majchrzycka, Martyna Graczyk, Piotr Ignyś, Natalia Graczyk, Mateusz Majchrzak https://creativecommons.org/licenses/by-nc-sa/4.0
Health Benefits of Oats – a review of Cardiovascular, Glycemic, and Gut Effects, and more
Oat (Avena sativa L.), particularly as oatmeal, is distinguished by its high β-glucan content, a soluble dietary fiber with proven therapeutic potential. Meta-analyses and randomized controlled trials confirm that regular intake of oats or β-glucan-enriched products lowers total and LDL-cholesterol without significantly affecting HDL-cholesterol or triglycerides, while also improving anthropometric measures in individuals with mild metabolic disturbances. Additionally, β-glucan slows glucose absorption, reducing postprandial glycemia and long-term glycemic control markers like HbA1c and HOMA-IR in type 2 diabetes patients, as well as stabilizing glucose variability in type 1 diabetes. Oats favourably modulate gut microbiota, boosting short-chain fatty acid (SCFA) production, beneficial bacterial abundance, and intestinal barrier integrity, thereby supporting the gut-metabolism axis. Preliminary data also suggest benefits for satiety, inflammation reduction, and cognitive function. Despite promising results, heterogeneity in β-glucan dose, form, and intervention duration highlights the need for further high-quality studies, including long-term trials with well-characterized oat preparations.
Copyright (c) 2026 Bartosz Wróbel, Lena Wójcik, Michał Filipski, Justyna Klonowska, Kuba Ptaszkiewicz, Szymon Kosek https://creativecommons.org/licenses/by-nc-sa/4.0
BPC-157 and GHK-Cu in Wound Healing and Tissue Repair: A Review of Clinical Efficacy and Safety
Background: BPC-157 and GHK-Cu are synthetic peptides with potential in tissue repair, influencing molecular mechanisms in healing, angiogenesis and inflammation. Objective: This review synthesizes preclinical and clinical research on BPC-157 and GHK-Cu efficacy and safety in wound healing and tissue repair, examining mechanistic pathways and translational potential in clinical and sports medicine. Methods: Literature searches of PubMed, Embase and Cochrane Library included studies on wound healing, tissue regeneration, safety and clinical uses of BPC-157 and GHK-Cu without publication date restrictions. Results: Preclinical studies show BPC-157 promotes skin, tendon, muscle and bone healing via specific signaling pathways and growth factor upregulation. GHK-Cu enhances collagen/elastin synthesis, angiogenesis and fibroblast migration. Limited human trials evaluated BPC-157 for knee pain and IV safety, while GHK-Cu showed promise in skin quality trials. Both appear safe but lack comprehensive RCTs. Conclusion: BPC-157 and GHK-Cu show therapeutic potential in wound healing, though evidence is largely preclinical. Extensive human trials are needed to establish clinical efficacy. This review provides groundwork for future research and highlights safety for sports medicine practitioners.
Copyright (c) 2026 Olaf Wojcieszuk, Łukasz Starczewski, Adrianna Babik, Kamila Kamińska, Matylda Będkowska-Kuśmierek, Anna Złotnik, Kinga Krzysztofik, Antoni Klamka, Paulina Kawalec, Kamil Bronikowski https://creativecommons.org/licenses/by-nc-sa/4.0
Autologous Platelet Concentrates in Sports Medicine: Mechanisms of Tissue Regeneration and Clinical Applications – A Narrative Review
Background. Sports-related musculoskeletal injuries remain a major problem in both professional and recreational athletes because of their high incidence, prolonged recovery, and the limited regenerative potential of some tissues. In this context, regenerative medicine has attracted increasing interest, particularly through the use of autologous platelet concentrates, which may enhance repair by delivering growth factors and other bioactive mediators to injured tissues. Aim. To summarize current evidence on autologous platelets concentrates in sports medicine, with emphasis on their biological mechanisms, major formulations, clinical applications, and limitations. Material and methods. A narrative literature review was conducted using PubMed, Scopus, and Web of Science, focusing mainly on studies published between 2010 and 2026. Eligible publications included randomized controlled trials, clinical studies, observational studies, and review articles evaluating autologous platelet concentrates in sports-related musculoskeletal injuries. Results. Autologous platelet concentrates may promote tissue regeneration through the release of mediators involved in angiogenesis, cell proliferation, inflammatory modulation, and extracellular matrix remodeling. Major formulations include platelet-rich plasma, leukocyte-rich and pure platelet-rich plasma, platelet-rich fibrin, injectable platelet-rich fibrin, and concentrated growth factors. Clinical studies suggest potential benefits in selected tendon, muscle, ligament, and cartilage injuries, although findings remain inconsistent. The main limitations include protocol heterogeneity, variable product composition, and lack of standardization. Conclusions. Autologous platelet concentrates are promising adjuncts in sports medicine, but their effectiveness appears to be indication-specific rather than universal. Further protocol standardization and high-quality clinical trials are needed to support broader evidence-based use.
Copyright (c) 2026 Karolina Niewola, Paweł Stenzel, Natalia Hariasz, Karolina Orda, Dominika Walczak, Klaudia Kasperska, Jakub Szumiło, Mariana Markiv, Michał Słowik, Kamil Arciszewski https://creativecommons.org/licenses/by-nc-sa/4.0
Hypothyroidism in Female Athletes: Differentiation from Overtraining Syndrome and Implications for Athletic Performance – A Narrative Review
Introduction. Hypothyroidism and overtraining syndrome (OTS) may present with similar symptoms in female athletes, including fatigue, reduced exercise tolerance, mood disturbances, sleep problems, and impaired performance, which may complicate differential diagnosis. Aim of the study. To review the overlap between hypothyroidism and OTS in female athletes, identify key elements of differential diagnosis and discuss implications for treatment and return to sport. Material and Methods. A narrative literature review was conducted using PubMed, Scopus, and Google Scholar for studies published between 1990 and 2025, with emphasis on review articles, consensus statements, clinical guidelines, and papers addressing symptom overlap, laboratory evaluation, and athletic performance. Results. Both hypothyroidism and OTS are associated with persistent fatigue, delayed recovery, sleep disturbances, mood changes, and reduced training capacity. However, hypothyroidism is more often linked to cold intolerance, weight gain, cognitive complaints, and other features of endocrine dysfunction. Thyroid-stimulating hormone (TSH) and free thyroxine (fT4) are the most useful laboratory markers in differential diagnosis, whereas biochemical abnormalities in OTS remain nonspecific. Coexisting low energy availability and relative energy deficiency in sport (RED-S) may further complicate clinical assessment. Conclusions. In female athletes with fatigue and declining performance, hypothyroidism should be considered alongside OTS, especially when symptoms persist despite training modification. Early recognition of thyroid dysfunction may support appropriate treatment and safer return-to-sport decisions.
Copyright (c) 2026 Ewelina Struzynska, Weronika Ziółkowska, Wiktor Wisoky, Natalia Czapla, Joanna Łopińska, Piotr Ignyś, Natalia Graczyk , Martyna Graczyk, Marta Majchrzycka, Mateusz Majchrzak https://creativecommons.org/licenses/by-nc-sa/4.0
Modern Non‑Surgical Management of Carpal Tunnel Syndrome: Mechanisms, Clinical Evidence and Therapeutic Potential: A Literature Review
Background: Carpal tunnel syndrome (CTS) is the most prevalent entrapment neuropathy and represents a major functional and socioeconomic burden. Although surgical decompression remains the gold standard for advanced disease, current guidelines emphasize non-invasive management in mild‑to‑moderate CTS. This has stimulated rapid development of novel therapeutic strategies aimed at reducing median nerve compression, modulating inflammation, and supporting neural regeneration. Aim of the study: To provide a comprehensive review of contemporary non-surgical methods used in CTS treatment, including extracorporeal shock wave therapy (ESWT), low‑level laser therapy (LLLT), ultrasound-based interventions, as well as platelet-rich plasma (PRP) injections, and to assess their mechanisms, clinical efficacy and potential therapeutic relevance. Methodology: The review was conducted using PubMed, Google Scholar and Research Gate databases, focusing on peer-reviewed literature published between 2021 and 2026. Results: The study shows that ESWT provides only short‑term symptom relief, while the clinical effects of LLLT remain inconsistent due to variable treatment parameters. Among all evaluated methods, PRP demonstrates the most substantial therapeutic and regenerative potential, yielding marked, lasting improvements in symptom severity and nerve conduction that surpass those achieved with corticosteroid injections. Conclusions: Modern conservative interventions differ considerably in effectiveness and mechanisms of action. While ESWT and LLLT may serve as supportive therapies, ultrasound-based methods-particularly USG‑guided techniques-and PRP injections display superior therapeutic value. Despite encouraging results, further high‑quality, long‑term randomized trials are needed to standardize treatment protocols and confirm the comparative effectiveness of these methods.
Copyright (c) 2026 Piotr Poniewozik, Natalia Dziuba, Aleksandra Sim, Maja Pernal, Zofia Roguska, Andrzej Paweł Zuzak, Paweł Poniewozik, Krzysztof Grabowski, Joanna Mioduszewska, Paweł Rot https://creativecommons.org/licenses/by-nc-sa/4.0
Exercise-induced gastrointestinal injury in endurance athletes: mechanisms, risk factors and clinical implications – a review
Background. Gastrointestinal (GI) disturbances are commonly reported among endurance athletes and significantly affect performance and health. Prolonged, high-intensity exercise leads to physiological stress responses impairing GI function. Mechanisms such as splanchnic hypoperfusion, increased intestinal permeability, heat stress, and dehydration contribute to exercise-induced gastrointestinal syndrome. Aim. This review summarizes knowledge on exercise-induced GI injury in endurance athletes, focusing on epidemiology, pathophysiological mechanisms, risk factors, clinical manifestations, and management strategies. Material and methods. A literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for studies up to 2025. Keywords related to GI symptoms, endurance exercise, intestinal permeability, and splanchnic hypoperfusion were used. Original research articles, systematic reviews, and meta-analyses were included. Results. GI symptoms like nausea, diarrhea, and bloating affect 30% to 90% of athletes depending on conditions. Mechanisms involve reduced splanchnic blood flow, epithelial injury, increased permeability, endotoxin translocation, systemic inflammation, and microbiota alterations. Risk factors include exercise duration, heat stress, dehydration, nutrition, and NSAID use. Severe complications like GI bleeding or ischemic colitis occur in rare cases. Conclusions. Exercise-induced GI injury is a multifactorial condition resulting from physiological, environmental, and nutritional stressors. Understanding these mechanisms and risk factors is essential for effective prevention and management strategies to protect GI health and optimize performance.
Copyright (c) 2026 Aleksandra Purpura, Wiktor Rolski, Zuzanna Przybylska, Paulina Michalska, Bartłomiej Przystaś, Magdalena Grzechowiak, Sebastian Podeszwa, Mikołaj Hobot, Gabriela Dobosz https://creativecommons.org/licenses/by-nc-sa/4.0
Monoclonal antibodies against CGRP in migraine prevention: current state of knowledge
Background. Migraine is one of the most common neurological disorders and has a significant impact on patients’ quality of life. In recent years, growing attention has been directed toward targeted therapies focused on the calcitonin gene-related peptide (CGRP) pathway, which represent a novel option in migraine prevention. Aim. The aim of this study was to present the current state of knowledge regarding the use of monoclonal antibodies targeting CGRP in migraine prevention, with particular emphasis on their mechanisms of action, clinical efficacy, and safety profile. Materials and methods. A narrative literature review was conducted using the PubMed and Scopus databases. Publications from recent years were included, encompassing original studies, systematic reviews, and meta-analyses addressing anti-CGRP monoclonal antibody therapy in migraine treatment. Results. Available evidence indicates that monoclonal antibodies targeting the CGRP pathway effectively reduce the number of migraine days and improve patients’ quality of life, including in individuals who are resistant to previous preventive therapies. Sustained therapeutic effects have also been observed in long-term follow-up. These therapies are characterized by a favorable safety profile, with adverse events typically being mild in nature. However, the available findings remain partly heterogeneous, and data concerning specific patient populations are still limited. Conclusions. Anti-CGRP monoclonal antibodies represent an effective and well-tolerated option for the preventive treatment of migraine. Their use may significantly improve disease control, particularly in patients with an inadequate response to previous therapies. However, further studies are required to evaluate long-term safety and to optimize therapeutic strategies.
Copyright (c) 2026 Marcin Wieleba, Katarzyna Wiktoria Witczak, Weronika Maria Woźniak, Zuzanna Winiarska, Eliza Wiercioch, Franciszek Włodarczyk, Barbara Izabela Krupska, Magdalena Zapalska, Lidia Kulig, Julia Anna Malec https://creativecommons.org/licenses/by-nc-sa/4.0
Diet and Endometriosis: A Comprehensive Review of Current Evidence
Endometriosis is a chronic, estrogen-dependent inflammatory disease affecting 10% of women of reproductive age. Patients often experience symptoms such as pelvic pain, dysmenorrhea, gastrointestinal disturbances, and infertility. Conventional treatment methods, including hormonal therapy and surgery, offer limited relief and high recurrence rates. Dietary interventions have gained interest as potential adjuncts to symptom management. This study reviews current evidence on the impact of diet on the development, symptom severity, and progression of endometriosis, focusing on specific nutrients, dietary patterns, and elimination diets. A literature search was conducted using PubMed and Google Scholar for English-language, peer-reviewed studies published up to 2025. Keywords were “Endometriosis”, “Diet”, “Gluten-free”, “Vitamin D”, “Omega-3”, “FODMAP Diet”. Original research articles, randomized controlled trials, and systematic reviews (only if original data were also reported) were analysed. Anti-inflammatory, antioxidant-rich diets are associated with symptom reduction. Omega-3 fatty acids show protective effects, while high consumption of red meat and trans fat may increase the risk of endometriosis. Vitamin D shows potential benefits in experimental models, but clinical evidence remains inconclusive. Gluten-free and low-fermentable oligo-, di-, monosaccharide and polyol (FODMAP) diets may relieve gastrointestinal symptoms in selected patients, but should be implemented with caution. Dairy products and dietary fiber may offer protective effects, though data remain inconsistent. While current evidence suggests that diet may influence endometriosis, most data remain observational. Further randomized controlled trials are needed to confirm causality and develop evidence-based dietary guidelines for endometriosis management.
Copyright (c) 2026 Matylda Kuczma, Marta Kamińska, Adrianna Klimczak, Barbara Pietrzak, Mikołaj Patelski, Maciej Czapla, Mateusz Surma, Jakub Molenda, Wiktoria Mikusek, Wiktoria Kotlarz https://creativecommons.org/licenses/by-nc-sa/4.0
Metformin as a New Therapeutic Option for Endometriosis: Promise, Limits and Future Directions
Endometriosis is a chronic, estrogent-dependent, inflammatory disease affecting a plethora of women of reproductive age and is a major cause of pelvis pain and subfertility. Current treatments – surgery and hormonal supression are often only partly effective, lead to further fertility issues or have substantial adverse effects, creating an unmet need for a non-hormonal, disease modyfing therapy option (Carvalho, J. C., et al; 2021). Metformin, a biguanide used worldwide as a first-line insulin-sensitizing drug for type 2 diabetes, has emerged as a therapeutic option for endometriosis because of its pleiotropic anti-inflammatory, anti-proliferative, anti-angiogenic and metabolic effects. This paper analyses mechanistic, preclinical and early clinical evidence on metformin use in endometriosis, with particular attention to how the drug interacts with the known pathophysiology of the disease (Kimber-Trojnar, Ż., et al; 2022). Rather than an immediate replacement for standard hormonal therapies, metformin currently appears best positioned as a promising adjuvant or alternative for selected patients – particularly those with co-existing metabolic dysfunction pending high-quality clinical trials (Zhang, H., et al; 2023).
Copyright (c) 2026 Karolina Bartkiewicz, Magdalena Papież, Zofia Jędra, Anna Libera, Maciej Jakub Kozicki, Julia Maria Kostro, Lizaveta Novik, Gabriela Makulec, Karolina Domosud, Damian Zienkiewicz https://creativecommons.org/licenses/by-nc-sa/4.0
Postbiotics as effective and safe "vaccines" against various respiratory diseases: literature review
Background: Respiratory diseases, including COPD, asthma, and allergic rhinitis, pose a significant health and economic burden, prompting the search for new preventive and therapeutic strategies. Increasing attention is paid to microbiome-based therapies and the gut-lung axis as targets for immunomodulatory interventions. Postbiotics - defined as non-viable microorganisms or their components that exert beneficial biological effects - have emerged as a promising area of research. Aim of the study: This study presented the current state of knowledge regarding postbiotics and assessed their potential in the prevention and treatment of respiratory diseases, with particular emphasis on their mechanisms of action. Methodology: The review was conducted using PubMed and supplementary Google Scholar. Studies from 2012 to 2026 were analyzed. Results: Postbiotics demonstrate multiple mechanisms of action, including modulation of the immune response, regulation of cytokine production, influence on the Th1/Th2 balance, and enhancement of epithelial barrier integrity. Experimental and clinical evidence suggests that postbiotics may reduce the frequency and severity of infections, decrease exacerbations of chronic respiratory diseases, and support the treatment of atopic and neaplastic conditions. In addition, they have a favorable safety profile, potentially better than probiotics, especially in populations with compromised immunity. Conclusion: Postbiotics represent a diverse and promising group of compounds with significant potential for both preventive and therapeutic applications in respiratory diseases. However, further well-designed, large-scale clinical trials are necessary to confirm their efficacy and safety.
Copyright (c) 2026 Paweł Poniewozik, Maja Pernal, Joanna Mioduszewska, Paweł Rot, Piotr Poniewozik, Natalia Dziuba, Aleksandra Sim, Andrzej Zuzak, Zofia Roguska, Krzysztof Grabowski https://creativecommons.org/licenses/by-nc-sa/4.0
Intercostal Nerve Cryoanalgesia in Pectus Excavatum Repair – A Narrative Review
Background. Effective postoperative pain management is a major challenge after minimally invasive pectus excavatum repair. Cryoanalgesia has developed as a potential support to conventional analgesic strategies. This narrative review summarizes current evidence for the efficacy of intercostal nerve cryoanalgesia after Nuss procedure in pediatric population with pectus excavatum. Aim. The aim of this narrative review was to sum up current evidence comparing intercostal nerve cryoanalgesia with conventional analgesic strategies following surgical repair of pectus excavatum in pediatric population. Material and methods. A narrative literature review was performed using PubMed and Cochrane databases. Studies evaluating intercostal nerve cryoanalgesia in pediatric patients undergoing the Nuss procedure were analyzed, with particular focus on length of hospital stay, procedure duration, pain outcomes, and opioid consumption. Results. Cryoanalgesia was associated with a shorter hospital stay compared to conventional analgesic strategies and longer time of procedure. Pain outcomes and opioid usage varied across studies. Conclusions. Cryoanalgesia appears to be a promising adjunct to postoperative pain management strategies for patients undergoing minimally invasive repair of pectus excavatum. Across the reviewed studies, the cryoanalgesia was associated with shorter hospital stay and longer procedural time compared to standard analgesic strategies. Pain outcomes and opioid usage varied across studies, but available evidence suggests that cryoanalgesia of intercostal nerves may reduce postoperative opioid usage and improve postoperative pain control. Further high-quality randomized trials are necessary to evaluate the optimal cryoanalgesia protocol.
Copyright (c) 2026 Robert Rudolf Marguła, Michał Szostawicki, Aniela Figiel, Paweł Zaborek, Mateusz Bernad, Katarzyna Widomska, Justyna Pestka https://creativecommons.org/licenses/by-nc-sa/4.0
Role of Ultrasound Elastography in Differentiating Pancreatic Cancer: Present and Future Directions
Aim. To review the diagnostic value of ultrasound elastography in the assessment of focal pancreatic lesions, particularly its role in differentiating benign from malignant lesions during endoscopic ultrasound (EUS) examinations. Materials and Methods. A narrative review of published studies on ultrasound elastography techniques, including strain elastography (SE), acoustic radiation force impulse (ARFI), and shear wave elastography (SWE), was conducted. The analysis focused on elastography parameters such as strain ratio (SR), strain histogram (SH), and shear wave velocity (SWV), as well as their reported diagnostic performance in pancreatic imaging. Results. Ultrasound elastography allows non-invasive assessment of tissue stiffness, with malignant pancreatic lesions generally demonstrating higher stiffness than benign or inflammatory lesions. Studies report high sensitivity of EUS elastography for detecting malignancy (approximately 90–97%) with diagnostic accuracy around 87–89%, although specificity remains moderate. Quantitative techniques such as SWE provide more reproducible measurements than qualitative strain-based assessment. Emerging approaches combining elastography parameters with artificial intelligence and radiomic analysis show potential to further improve diagnostic accuracy. Conclusion. EUS elastography is a useful complementary technique in the evaluation of focal pancreatic lesions. Although it cannot replace biopsy due to limited specificity, it may improve lesion characterisation and help target the most suspicious areas for tissue sampling. Future integration with artificial intelligence may further enhance diagnostic performance.
Copyright (c) 2026 Justyna Jankowska, Szymon Marciszuk, Agnieszka Olejnik, Mateusz Zdaniewicz , Jonatan Rataj, Paweł Budzik, Aleksandra Jagura-Sukiennik , Magdalena Stolarczyk , Julia Bezak, Marlena Radzka, Klaudia Patrycja Forystek https://creativecommons.org/licenses/by-nc-sa/4.0
Granulocyte Colony-Stimulating Factor (G-CSF): Clinical Use and Oncological Concerns
Granulocyte colony-stimulating factor is a hematopoietic cytokine mainly produced by myeloid cells. Its primary role is to stimulate and promote neutrophil proliferation, which is commonly used in oncology to prevent myelosuppression often caused by cytotoxic treatment. Growing evidence suggests that its biological activity may extend beyond hematopoiesis and modulate tumor dynamics. Several studies indicate that elevated G-CSF levels and receptor expression are associated with greater aggressiveness and a more unfavourable prognosis. The role of G-CSF in fostering an immunosuppressive microenvironment, supporting metastasis, and promoting tumor growth has become a common area of research. Furthermore, studies have already claimed a higher incidence of secondary malignancies, like acute myeloid leukemia (AML) and myelodysplastic syndrome, among patients receiving G-CSF along with cytotoxic treatment.
Copyright (c) 2026 Barbara Pietrzak, Mikołaj Patelski, Adrianna Klimczak, Wiktoria Kotlarz, Marta Kamińska, Matylda Kuczma, Jakub Molenda, Maciej Czapla, Mateusz Surma, Wiktoria Mikusek https://creativecommons.org/licenses/by-nc-sa/4.0
Multi-modal return-to-play criteria after ACL reconstruction: systematic review
Background: Traditional 9-month return-to-play (RTP) clearance after anterior cruciate ligament reconstruction (ACLR) lacks objective functional testing. This systematic review evaluates multi-modal criterion-based RTP protocols versus chronological clearance in team sport athletes. Methods: The study selection process followed PRISMA 2020 guidelines. Databases searched included PubMed, Scopus, and Web of Science (January 2015–March 2026). Eligible studies included systematic reviews, prospective cohorts, and randomized controlled trials involving ≥15 adult team-sport athletes after primary ACL reconstruction with ≥12 months follow-up. Risk of bias was assessed using AMSTAR-2 and ROBINS-I tools. Meta-analysis was performed using RevMan 5.4.1. Results: 22 studies (n=3,247 athletes; 64% soccer). RTP to pre-injury level: 72% (95% CI 68-76%). Re-injury incidence: 18.3% (24 months). Multi-modal protocols (H/Q ratio ≥85%, hop LSI ≥85%, ACL-RSI ≥75) reduced re-injury 47% versus time-based clearance (RR=0.53, 95% CI 0.38-0.74, p<0.001). Conclusions: Current evidence suggests that criterion-based RTP protocols may represent a more reliable clinical standard. Polish hospital implementation requires affordable alternatives: handheld dynamometry (2,500 PLN), smartphone applications, standardized clearance checklists. Three-phase framework proposed for resource-limited settings.
Copyright (c) 2026 Weronika Ziółkowska, Wiktor Wisoky, Natalia Czapla, Ewelina Strużyńska, Joanna Łopińska, Marta Majchrzycka, Martyna Graczyk, Piotr Ignyś, Natalia Graczyk, Mateusz Majchrzak https://creativecommons.org/licenses/by-nc-sa/4.0
The Radiography and Ultrasonography in the Diagnosis and Monitoring of Necrotizing Enterocolitis in Neonates: A Focused Review
Necrotizing enterocolitis (NEC) is a devastating gastrointestinal disease that predominantly affects preterm neonates and remains a major source of morbidity and mortality in neonatal intensive care units (NICUs). An early diagnosis and timely surveillance is key to optimizing the outcome of the patients. Abdominal X ray (X Ray) remains the cornerstone of the imaging of NEC with pneumatosis intestinalis, portal venous gas and pneumoperitoneum being well defined radiological signs. With the increasing role of ultrasonography (USG) in the management of NEC, the bedside evaluation of bowel thickness, vascularity, motility and the assessment of fluid collections can sometimes detect signs of NEC before they become evident on radiography. This review summarizes the role of radiography and ultrasonography in the imaging of NEC, highlights their respective merits and shortcomings, and describes the practical approaches for their use in clinical practice. It also discusses the role of contrast enhanced ultrasound, near-infrared spectroscopy and artificial intelligence in the imaging of NEC.
Copyright (c) 2026 Marta Majchrzycka, Natalia Czapla, Martyna Graczyk , Natalia Graczyk , Piotr Ignyś, Joanna Łopińska, Mateusz Majchrzak, Ewelina Strużyńska, Wiktor Wisoky, Weronika Ziółkowska https://creativecommons.org/licenses/by-nc-sa/4.0
Hemophilia in Women: Beyond the Carrier State - Clinical, Genetic, and Diagnostic Challenges
Background: Hemophilia is a genetic bleeding disorder resulting from a deficiency of specific coagulation factors. The most common forms, hemophilia A and B, are X-linked and mainly affect males, with females usually being asymptomatic carriers. Some females may experience clinically significant bleeding due to reduced clotting factor activity or other genetic or biological aspects. Aim: The aim of this study was to address hemophilia in women, including its clinical manifestations, associated challenges, and the genetic mechanisms underlying symptomatic individuals, such as Turner Syndrome, X-chromosome abnormalities, or a 46, XY karyotype. Materials and methods: A comprehensive literature review was conducted using major databases, including PubMed, Google Scholar, ResearchGate, and ScienceDirect, covering publications from 1975 to March 2026, as well as educational materials and reports from hemophilia-related platforms and organizations. Results: Symptomatic hemophilia in women may be caused by a variety of factors, such as Turner syndrome, mutations on the X chromosome, or a 46, XY karyotype. In most cases, further genetic diagnostics reveal the alterations responsible for this phenotype. Conclusions: Regardless of the phenotypic presentation, in cases of fully symptomatic hemophilia in women, extended diagnostic evaluation for genetic disorders should be considered.
Copyright (c) 2026 Sylwia Haba, Ewa Dapkiewicz, Natalia Haba, Jan Tarka, Dawid Gąsowski https://creativecommons.org/licenses/by-nc-sa/4.0
Botulinum Toxin Type A in the Treatment of Post-Stroke Spasticity - A Review of Current Evidence
Background: Post-stroke spasticity (PSS) affects up to 42% of stroke survivors and significantly impairs rehabilitation. Botulinum toxin type A (BoNT-A) is a first-line pharmacological treatment that reduces muscle overactivity by inhibiting acetylcholine release at the neuromuscular junction. Aim: To summarize the current evidence on BoNT-A therapy for PSS, with emphasis on mechanisms of action, optimal administration timing, injection guidance, dosing, safety, and functional outcomes, to inform individualized neurorehabilitation. Material and Methods: A literature search of PubMed was conducted to identify relevant studies on the efficacy and safety of BoNT-A in adult patients with PSS (2013–2026). Records were screened by title, abstract, and full text against predefined inclusion criteria. Results: BoNT-A effectively reduces PSS with Grade A evidence, with the greatest benefit when administered early (3–12 weeks post-stroke). Imaging- or electrophysiology-guided injections improve precision. Therapeutic effects are temporary (approximately 12 weeks), requiring repeated administration. Adverse events are mild and uncommon, supporting a favorable safety profile. Conclusions: BoNT-A is a safe and effective treatment for PSS, particularly when initiated early and guided by imaging or electrophysiological techniques. Its impact on functional recovery remains variable, highlighting the need for individualized treatment strategies integrated with comprehensive rehabilitation programs.
Copyright (c) 2026 Julia Bajko, Artur Ciszewski, Juliusz Błażewicz, Agnieszka Irena Bullmann, Michał Chmielewski, Michał Piskor, Kinga Kapusta, Klaudia Pazio, Dominika Strzalińska, Maciej Kowalczuk https://creativecommons.org/licenses/by-nc-sa/4.0
Caffeine in Sport: Performance Enhancer or Hidden Player in Cancer Biology? A Narrative Review
Caffeine is one of the most widely used ergogenic aids in sport, known for its performance-enhancing effects on endurance, strength, and cognitive function. Beyond these well-established roles, emerging evidence suggests that caffeine may also influence biological pathways associated with carcinogenesis. This narrative review provides a sports-oriented perspective on caffeine as a bioactive compound with potential implications extending beyond performance. Current evidence indicates that caffeine modulates mechanisms such as DNA damage response, apoptosis, oxidative stress, and immune regulation. While experimental findings suggest possible anticancer effects, human evidence remains inconsistent and largely observational. Given the widespread and repeated use of caffeine in athletic populations, understanding its broader biological impact is essential. Although caffeine cannot be considered an anticancer agent, its dual role in performance enhancement and health-related pathways highlights the need for integrative research bridging sports science and oncology.
Copyright (c) 2026 Juliusz Błażewicz, Artur Ciszewski, Julia Bajko, Michał Piskor, Dominika Strzalińska, Kinga Kapusta , Jakub Zadykowicz, Klaudia Pazio, Michał Chmielewski, Maciej Kowalczuk https://creativecommons.org/licenses/by-nc-sa/4.0
The Efficacy and Safety of Ibogaine Treatment for Substance Use Disorders - A Narrative Review
Introduction and aim of the study. Substance use disorders, including opioid, cocaine, and alcohol dependence, represent a significant global health challenge with high relapse rates despite existing treatments. Ibogaine, a naturally occurring indole alkaloid derived from Tabernanthe iboga, has attracted increasing scientific interest due to its reported ability to reduce withdrawal symptoms and cravings. Our study aims to evaluate the efficacy and safety of ibogaine in the treatment of substance use disorders and to determine its therapeutic potential. Materials and methods. The paper is based on an analysis of studies available in databases such as PubMed, Google Scholar, and other scientific databases. Observational studies, retrospective surveys, controlled trials, and review papers on the use of ibogaine in the context of opioid, cocaine, and alcohol dependence were used. Conclusions. Ibogaine, due to its modulation of serotonergic, dopaminergic, and glutamatergic neurotransmitter systems, shows promising potential in the treatment of substance use disorders. However, serious safety concerns exist, particularly cardiotoxicity manifesting as QT prolongation and potentially fatal arrhythmias. It is advisable to conduct further large-scale randomized controlled trials aimed at a more thorough evaluation of the efficacy and safety of ibogaine in the treatment of addiction.
Copyright (c) 2026 Milena Majchrzyk, Weronika Walendziak, Magdalena Ostaszewska, Damian Zienkiewicz, Gabriela Makulec, Karolina Domosud, Natalia Mordal; Kacper Ściebura; Wiktoria Wiśniewska, Anna Malczyk https://creativecommons.org/licenses/by-nc-sa/4.0
The Effect of Different Nicotine Delivery Systems on Cardiovascular Health and Hemodynamic Load: A Literature Review
Introduction: Active and passive smoking are leading global causes of cardiovascular (CVD) mortality, accounting for 2.25 million deaths annually (2021 data). Alternative nicotine delivery systems (e-cigarettes, heated tobacco products [HTP], snus, nicotine pouches) have surged in popularity, driven by aggressive marketing, 15,000 known flavor additives, and misconceptions of negligible harm, especially among youth. This study assesses how eliminating combustion in these products modifies CVD risk. Nicotine's independent role in atherosclerosis pathogenesis remains under investigation. It strongly stimulates the sympathetic nervous system, increasing plasma adrenaline up to 2.5-fold. This heightens hemodynamic load, potentially triggering acute CVD events, particularly in patients with existing cardiac conditions. Materials and methods: A PubMed literature review was conducted using keywords: "Nicotine pharmacokinetics", "Cardiovascular risk", "E-cigarettes", "Heated tobacco products", "Snus", "Nicotine pouches", "Endothelial dysfunction". Conclusions: Eliminating combustion (pyrolysis) significantly reduces released toxins compared to tobacco smoke. HTP aerosols contain >90% fewer harmful substances, and e-cigarettes release <2 µg of HPHC versus 3000 µg in tobacco. However, these products remain unsafe for the CV system. Nicotine's sympathomimetic effects increase blood pressure and heart rate, and exacerbate insulin resistance; animal studies indicate up to a 57% decrease in insulin-dependent glucose uptake. Furthermore, HTP and ENDS aerosols induce inflammation (increased IL-6, TNF-α, hsCRP), oxidative stress, and secondary vascular endothelial dysfunction. Popular flavor additives (cinnamaldehyde, eugenol, diacetyl) also demonstrate proven cytotoxic effects. Alternative nicotine products have high addictive potential and an undeniably negative CV impact, highlighting an urgent need for long-term health outcome studies.
Copyright (c) 2026 Jakub Dziemiańczuk, Ewa Dryl-Jarmoc, Izabela Ślinko, Gabriela Kuliś, Zuzanna Panas, Kacper Krawczuk, Mateusz Zimowski, Piotr Kadysz, Agata Kolanek, Mateusz Czajkowski https://creativecommons.org/licenses/by-nc-sa/4.0
Exercise and Depression: The Role of Physical Activity in Mental Health
Depressive disorders represent a major global health burden and are associated with significant impairment in quality of life and increased risk of comorbid conditions. Despite the availability of conventional treatments, a substantial proportion of patients do not achieve full remission, highlighting the need for complementary therapeutic strategies. In recent years, physical activity has emerged as a promising and accessible intervention for both the prevention and treatment of depression. This narrative review aims to summarize current evidence on the role of physical activity in mental health, with particular emphasis on the underlying biological and psychological mechanisms. Exercise has been shown to influence multiple pathways implicated in the pathophysiology of depression, including modulation of inflammatory processes, regulation of the hypothalamic–pituitary–adrenal axis, enhancement of neuroplasticity, and effects on neurotransmitter systems. In addition, psychological mechanisms such as improved self-perception, stress reduction, behavioral activation, and increased social interaction contribute to the antidepressant effects of physical activity. Evidence from observational studies and meta-analyses indicates that regular physical activity is associated with a reduced risk of developing depression and may significantly alleviate depressive symptoms in affected individuals. Furthermore, physical activity represents a low-cost, widely accessible intervention with minimal side effects, making it a valuable component of both clinical practice and public health strategies. In conclusion, physical activity plays a multidimensional role in the prevention and management of depression and should be considered an integral part of comprehensive mental health care. These findings highlight the importance of incorporating physical activity into comprehensive treatment strategies for depression.
Copyright (c) 2026 Melania Majewska, Natalia Piasecka, Izabela Rafalska, Jakub Smagoń , Natalia Kornacka, Martyna Kaim, Joanna Bober, Magdalena Bochenek, Wiktoria Siewiera, Krzysztof Bednarski, Julia Biernikiewicz https://creativecommons.org/licenses/by-nc-sa/4.0
Gut microbiota and mental health: the role of physical activity, stress response, and lifestyle interventions
Mikrobiota jelitowa jest coraz częściej uznawana za istotny regulator zarówno procesów fizjologicznych, jak i zdrowia psychicznego. Coraz więcej dowodów sugeruje, że zmiany w składzie mikroflory jelitowej, powszechnie określane jako dysbioza, są związane z rozwojem depresji, zaburzeń lękowych i zaburzeń reakcji na stres. Oś mikrobiota–jelita–mózg stanowi złożoną i wielowymiarową sieć komunikacyjną, obejmującą szlaki neuronalne, immunologiczne, endokrynologiczne i metaboliczne. Czynniki związane ze stylem życia, zwłaszcza aktywność fizyczna i nawyki żywieniowe, wydają się istotnie wpływać na skład mikrobiomu jelitowego, a w konsekwencji na stan zdrowia psychicznego. Regularne ćwiczenia fizyczne wiążą się ze zwiększoną różnorodnością mikroorganizmów i zmniejszeniem stanu zapalnego, a diety bogate w błonnik i związki bioaktywne mogą sprzyjać korzystnej aktywności mikroorganizmów. Materiały i metody: Niniejszy przegląd narracyjny przeprowadzono z wykorzystaniem baz danych PubMed, Google Scholar i UpToDate, a także recenzowanych artykułów z czołowych czasopism naukowych. Słowa kluczowe obejmowały mikrobiotę jelitową, depresję, lęk, reakcję na stres, oś jelitowo-mózgową, aktywność fizyczną i interwencje związane ze stylem życia. Uwzględniono artykuły opublikowane w latach 2010–2025. Wyniki: Aktualne dowody wskazują na istotny związek między mikrobiotą jelitową a zdrowiem psychicznym, mediowany poprzez szlaki zapalne, modulację neuroprzekaźników oraz regulację osi podwzgórze-przysadka-nadnercza. Jednak wyniki pozostają niejednorodne, a związki przyczynowo-skutkowe nie zostały jeszcze w pełni ustalone. Obserwacje te podkreślają potencjał interwencji w stylu życia ukierunkowanych na mikrobiotę jako strategii wspomagających w zarządzaniu zdrowiem psychicznym.
Copyright (c) 2026 Karolina Rymska, Mikołaj Lewandowski, Dominika Dmowska, Paweł Zdebski, Alicja Serafin, Dominik Chrzanowski, Wiktoria Bajek, Marcelina Kaczmarek, Kinga Żmuda, Monika Skalska https://creativecommons.org/licenses/by-nc-sa/4.0
Protein Supplementation and its Impact on the Body and Health of Athletes, Bodybuilders and Patients
Background. Protein supplementation and high protein diets are widely used in sports and clinical nutrition to improve muscle mass, recovery and body composition. However, their systemic effects remain debated and depend on protein source, intake level and individual health status. Aim. The aim of this study was to review current evidence on the effects of protein supplementation and high protein intake on different physiological systems. Material and Methods. A narrative review was conducted using PubMed, Scopus and Google Scholar. Studies published between 2017 and 2026 were included. Results. Protein intake supports increases in muscle strength, fat free mass, recovery and body composition. It does not appear to negatively affect bone health or kidney function in healthy individuals, although effects may depend on context. Conclusions: Protein intake within recommended ranges appears safe and beneficial, but its effects depend on multiple factors and require further long term research.
Copyright (c) 2026 Agnieszka Kamińska, Anna Żmigrodzka, Agnieszka Przepióra, Maria Orłowska, Jana Kozłowska, Maria Sanocka, Aleksandra Wielogórska, Karolina Trojnar, Klaudia Czernic-Goławska, Joanna Falana, Anna Kwiatkowska https://creativecommons.org/licenses/by-nc-sa/4.0
Therapeutic potential of indoor climbing: from physical fitness to neurorehabilitation and mental health
Background Rock climbing is experiencing a global surge in popularity, integrating resistance and isometric training with high neurological stimulation. It challenges the traditional dichotomy between cardiovascular and strength sports by offering a complex, interval-based exertion where movement precision is as vital as power. Aim This review explores rock climbing as a health intervention, focusing on physiological adaptations, musculoskeletal health, and therapeutic efficacy in psychiatry and neurorehabilitation. Material and Methods This paper reviews recent literature, including meta-analyses and randomized controlled trials. The analysis covers physiological parameters (VO2 max, bone density, core strength), Bouldering Psychotherapy (BPT) for depression, neurorehabilitative protocols for Parkinson’s disease, Multiple Sclerosis, and Autism Spectrum Disorder (ASD), alongside an assessment of injury risks. Results Climbing significantly improves VO2 max, grip strength, and core stability, proving effective for chronic low back pain. In mental health, BPT reduces moderate depression symptoms (average 8.3-point decrease on the MADRS), achieving outcomes comparable to Cognitive Behavioral Therapy with long-term sustainability. In neurorehabilitation, climbing reduces Parkinson’s motor symptoms (tremor by 51%, rigidity by 30%), aids fatigue management in Multiple Sclerosis, and enhances selective attention in children with ASD. Overuse injuries, particularly to the finger pulley system, remain the primary risk factor (up to 68% of adult injuries). Conclusions Rock climbing is a safe, multi-modal intervention offering significant physiological, psychological, and neurological clinical benefits. It shifts patient identity from limitations to capabilities, warranting integration into standard healthcare. However, clinicians must remain vigilant regarding overuse injuries and skeletal maturity in adolescents.
Copyright (c) 2026 Tomasz Pluszyński, Natalia Padula, Karol Piotrowski, Małgorzata Jerczak, Iga Piórkowska, Filip Przybył, Mikołaj Polewka, Aleksandra Polańska , Kacper Paczosa https://creativecommons.org/licenses/by-nc-sa/4.0
The role of myokines in obesity-related osteoarthritis: linking physical activity to joint health
Background: Osteoarthritis is a chronic, degenerative joint disease, which manifests mainly with joint pain, but with disease progression may also lead to much lower quality of life and disability. Its progression is associated with obesity and a sedentary lifestyle, while physical activity seems to be a protective factor. Studies in murine models suggest a potential role for myokines – molecules secreted by skeletal muscle during contraction. They appear to have anti-inflammatory effects and may improve joint health. Aim: The aim of this review was to evaluate the role of myokines as potential mediators linking obesity, physical activity and osteoarthritis progression. Additionally, we aimed to summarise current evidence on the impact of obesity and weight loss on osteoarthritis and to assess the immunomodulatory functions of selected myokines, particularly irisin and IL-6. Materials and methods: This paper is a narrative review. A literature search was conducted in the PubMed database up to February 2026. For part 2., the following terms were used: “osteoarthritis” combined with “obesity” with a preference for meta-analyses and large cohort studies. For part 3., the following terms were used: “myokines”, “irisin”, “IL-6” alone or combined with “obesity” or “knee osteoarthritis”. Due to the narrative nature of this review, selection bias cannot be excluded. Conclusions: Obesity is associated with osteoarthritis progression, as it increases joint pain and radiographic progression. Weight loss and physical exercise are effective treatment strategies in patients with osteoarthritis both treated surgically and non-surgically. Irisin shows anti-inflammatory effects in in vitro and in vivo studies, but in human it is rather a modulator or marker of exercise efficacy. IL-6 is a highly context-dependent cytokine that is generally considered pro-inflammatory but may also exert anti-inflammatory effects when acting as a myokine.
Copyright (c) 2026 Mateusz Pysiewicz, Paweł Budzik, Olga Stadnicka, Elizabeth Malaya, Szymon Mokrzecki, Julia Elżbieta Wolnik, Martyna Grzywacz https://creativecommons.org/licenses/by-nc-sa/4.0
How Exercise Affects Gut Bacteria and Stomach Problems – A Summary Review
Background. The human gastrointestinal tract contains a large community of microorganisms, known as the gut microbiota. Their metabolic and immunological functions influence host physiology. Disruption of this community, called dysbiosis, contributes to many gastrointestinal disorders. Physical activity is increasingly recognized as a lifestyle factor that can alter microbial composition and function. Aim. This review summarizes current evidence on the effects of physical activity on gut microbiota and assesses the clinical relevance of these changes for patients with irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), and functional constipation. Material and methods. A narrative study was conducted using literature from PubMed, MEDLINE, and Google Scholar. Studies published between 2018 and 2025, including clinical intervention trials, cross-sectional studies, and animal experiments, were included. Results. Moderate aerobic exercise often boosts the diversity of gut microbes and increases the number of butyrate-producing bacteria, such as Akkermansia muciniphila, Faecalibacterium prausnitzii, and Bifidobacterium spp. The alterations result in reduced intestinal inflammation, increased stool concentrations of short-chain fatty acids, and faster intestinal transit. Structured exercise regimens have been demonstrated to significantly reduce symptoms of IBS and chronic constipation. Intense exercise may reduce stomach motility and increase gut permeability in certain individuals, although there is limited controlled data on SIBO. Conclusions. Regular moderate exercise represents a low-cost, accessible adjunct to conventional management of common gastrointestinal disorders. Standardized clinical protocols and longer follow-up studies are still needed before definitive exercise prescriptions can be established.
Copyright (c) 2026 Karolina Trojnar, Anna Żmigrodzka, Agnieszka Przepióra, Maria Orłowska, Jana Kozłowska, Maria Sanocka, Aleksandra Wielogórska, Klaudia Czernic-Goławska, Agnieszka Kamińska, Joanna Falana, Anna Kwiatkowska, Gabriela Trojnar, Urantuya Battsengel https://creativecommons.org/licenses/by-nc-sa/4.0
Pectoralis Major Muscle Rupture – Review of Treatment Options
Introduction In recent decades, the incidence of pectoralis major (PM) ruptures has risen, largely due to the increased popularity of high-intensity weight training and the use of anabolic steroids among athletes. Failing to address a PM rupture can result in permanent physical deformity and long-term functional impairment. While early detection and prompt surgical intervention often simplify the repair process and improve success rates, modern reconstructive advancements now allow for effective treatment even in chronic cases. Aim of study This review aims to evaluate the current state of knowledge regarding the anatomy, diagnostic metrics, and both operative and non-operative treatment options for acute and chronic pectoralis major ruptures. State of knowledge Pectoralis major (PM) ruptures primarily affect men between the ages of 20 and 40. Patients often report hearing an audible "pop" or experiencing a distinct tearing sensation at the moment of injury. If left unaddressed, these injuries progress into a chronic state. While the medical literature lacks a single, universal definition for chronic PM ruptures, the typical threshold used is six weeks following the initial trauma. Summary (conclusion) Conservative, non-surgical treatment of PM ruptures is generally limited to elderly or low-demand individuals, specific partial tears, or patients with medical contraindications to surgery. In contrast, surgical intervention is considered the gold standard, as it consistently produces the most favorable clinical and cosmetic results. While acute injuries typically allow for a straightforward direct repair, chronic cases are more complex and often require surgeons to utilize autografts or allografts to bridge retracted tissue. Despite these technical challenges, surgical treatment for chronic injuries remains highly recommended, as patients can still achieve high levels of satisfaction and functional recovery.
Copyright (c) 2026 Zuzanna Wiater, Anna Dziegciarczyk, Aleksandra Włodarczyk, Kamil Swoboda, Karolina Borówka, Karolina Brankowska, Marta Jakubowska, Michał Olejnik, Paulina Tymińska, Witold Jerzy Kądziołka https://creativecommons.org/licenses/by-nc-sa/4.0
3,4-Methylenedioxymethamphetamine: From Dangerous Party Drug to Potential Therapeutic Agent
Introduction and aim of the study: 3,4-methylenedioxymethamphetamine (MDMA) is a stimulant drug with widespread consumption. It is used mainly in recreational settings, due to its ability to induce various pleasurable, mood-enhancing effects. Prolonged and excessive MDMA misuse can lead to multiple negative outcomes ranging from cognitive dysfunction or emotional dysregulation to severe life-threatening consequences such as hyperthermia. Despite its harmful potential, MDMA presents promising therapeutic applications in MDMA-Assisted Therapy. In this study we aim to review both the dangers and potential psychiatric applications of MDMA. Materials and methods: A literature search was conducted using databases such as PubMed and Google Scholar. The review focused on peer-reviewed articles and international reports regarding the use of MDMA, both recreational and in the treatment of various psychiatric conditions. Conclusions: While MDMA has traditionally been associated mainly with recreational use and addiction, research suggests it has the potential to become a valuable therapeutic adjunct in treating such psychiatric conditions as PTSD, alcohol dependence, depression and anxiety. Furthermore, it could be beneficial in the athletic populations. However, existing studies are limited by small sample sizes, highlighting the need for further large-scale research to confirm these findings. Keywords: MDMA, MDMA-Assisted Therapy, PTSD, alcohol dependence, depression, anxiety, mental health of athletic populations
Copyright (c) 2026 Magdalena Ostaszewska, Milena Majchrzyk, Damian Zienkiewicz, Gabriela Makulec, Karolina Domosud, Weronika Walendziak, Natalia Mordal, Kacper Ściebura, Wiktoria Wiśniewska, Anna Malczyk https://creativecommons.org/licenses/by-nc-sa/4.0
Hepatitis C Virus Infection in Pregnant Women - Current Treatment Practices
Hepatitis C Virus (HCV) is a single-stranded RNA virus with hepatotropic potential classified within the Flaviviridae family. HCV infection still remains a global problem. According to the World Health Organisation (WHO), about 50 million people were chronically infected in 2025. Available data suggest that the number of seropositive births fluctuates between 2,2 to 5,5 million worldwide. The therapy of hepatitis C during pregnancy continues to be a challenge, in light of the risk of theratogenic effects that may carry. Matherials and methods. The literature review was conducted using databases: Scopus and Pubmed. The review included the recent years publications and analysis of six different clinical trials focused on the safety and efficacy of the HCV infection treatment during pregnancy with Direct-Active Antivirals (DAAs). Results. According to the results of analyzed in this review clinical trials it can be concluded that DAAs therapy is effevctive. Various combinations of DAAs, including Sofosbuvir/Velpatasvir and Sofosbuvir/Ledipasvir showed similar therapeutic potential and safety for women and their newborns. Conclusions. More clinical trials in larger groups of pregnant patients should be performed to understand the effectivenes and safety of the DAAs therapy among women in pregnancy. Available results of conducted research show that Direct-Active Antivirals are well-tolerated and they reduce the risk of mother-to-child-transmission of the HCV.
Copyright (c) 2026 Magdalena Zapalska, Barbara Izabela Krupska , Julia Anna Malec , Lidia Kulig, Franciszek Włodarczyk, Weronika Maria Woźniak, Marcin Wieleba, Zuzanna Winiarska, Katarzyna Wiktoria Witczak, Eliza Wiercioch https://creativecommons.org/licenses/by-nc-sa/4.0
Scheuermann’s Disease: A Narrative Review of Treatment Standards
Background. Scheuermann's disease is a structural spinal deformity characterised by thoracic or thoracolumbar hyperkyphosis, defined by anterior wedging of ≥5° across three or more contiguous vertebrae, Schmorl's nodes, and endplate irregularities. Incidence ranges from 0.4% to 10% in adolescents. The atypical form shows higher prevalence among young athletes. Aim. The purpose of this article is to evaluate and summarise the current state of knowledge regarding Scheuermann's disease. Material and methods. A narrative literature review was conducted using Google Scholar, PubMed, Springer Link, and Scopus, with keywords related to Scheuermann's disease. English-language articles from September 2015 to January 2026 were included, with exceptions for historical sources. Results. The natural course is mostly benign. Conservative treatment, comprising of physiotherapy, bracing, and analgesia, aims to halt progression, reduce pain, and improve posture, with bracing achieving approximately 50% correction and major pain improvement. Surgical treatment, standardised as a posterior approach, offers adequate correction with fewer complications than anterior-posterior approach. The key complication is junctional kyphosis. Sports participation is permitted post-treatment, as tolerated. Conclusions. Scheuermann's disease is an important cause of juvenile thoracic hyperkyphosis, with persisting gaps in etiology, diagnostics, and management. Most patients lead normal lives. Conservative treatment is sufficient in most cases, with surgery reserved for patients that didn’t respond to initial measures. Deformity progression is reported in long-term observations, regardless of treatment.
Copyright (c) 2026 Hubert Jarosław Ćwiek, Marta Kołodziej-Sieradz, Anna Magdalena Terlecka, Paulina Klaudia Gryz, Kacper Komorowski, Karolina Jolanta Pilarska, Anna Aleksandra Szwankowska, Anna Baczyńska, Błażej Boruszczak, Adam Wiktor Rożenek https://creativecommons.org/licenses/by-nc-sa/4.0
Anterior Cruciate Ligament Injuries in Modern Football: A Review
Background: Anterior cruciate ligament (ACL) injuries are among the most severe and debilitating orthopedic traumas in modern football. The high-intensity nature of the sport, which demands frequent pivoting, rapid deceleration, and high-impact contact, significantly predisposes players to these injuries. Aim of the study: This comprehensive review aims to synthesize current epidemiological data, analyze in-depth injury mechanisms (including neurocognitive factors), evaluate surgical and non-operative management strategies, detail criteria-based return-to-sport (RTS) protocols, and review the efficacy of modern prevention strategies for ACL injuries in football players. Material and Methods: A comprehensive review of the literature was conducted utilizing 20 selected peer-reviewed articles, including national registries, meta-analyses, and systematic video analysis studies published between 2012 and 2025. Results: Recent literature indicates a substantial burden of ACL injuries in football, heavily influenced by the level of play, gender, and exposure type. Amateur players present a higher incidence rate (0.074/1000h) compared to professionals (0.058/1000h). Match-play exponentially increases the risk compared to training. Non-contact mechanisms account for over 55% of injuries, primarily occurring during defensive pressing and rapid deceleration. Emerging evidence highlights neurocognitive errors as significant contributors to non-contact ruptures. Female athletes face a 1.5 to 1.6-fold higher risk due to anatomical, hormonal, and biomechanical disparities. While surgical reconstruction (ACLR) remains the gold standard, returning to pre-injury performance is highly challenging. Only approximately 44-55% of athletes successfully return to competitive play, with fear of reinjury (kinesiophobia) acting as the primary barrier in 33% of failed cases. Furthermore, the risk of a secondary ACL injury reaches up to 30% in adolescent populations.
Copyright (c) 2026 Mikołaj Czerniakowski, Aleksandra Sadok, Wojciech Kubas, Aleksandra Białek, Jakub Karczewski, Wojciech Jan Niemcewicz, Kamila Ryń, Aleksandra Koźlicka, Jakub Klajda, Zuzanna Gorczyca https://creativecommons.org/licenses/by-nc-sa/4.0
Catheter Ablation in Pediatric Wolff–Parkinson–White Syndrome – A Narrative Review
Background. Wolff–Parkinson–White (WPW) syndrome is a frequent cause of supraventricular tachycardia in children and results from an accessory atrioventricular pathway causing ventricular pre-excitation. Although often asymptomatic, it carries a risk of serious arrhythmias and may impair cardiac function due to ventricular dyssynchrony. Catheter ablation is the main treatment for symptomatic patients and is increasingly considered in selected asymptomatic cases. Aim. This narrative review aims to summarize current evidence regarding the efficacy, safety, and functional outcomes of catheter ablation in pediatric patients with WPW syndrome. Methods. This narrative review analyzed selected clinical and observational studies involving pediatric patients with Wolff–Parkinson–White syndrome. Studies evaluating electrophysiological characteristics, ablation results, and functional effects were included and synthesized thematically, focusing on efficacy, safety, recurrence, and cardiac and exercise outcomes. Results. Available data suggest that catheter ablation achieves high acute success rates exceeding 85–90%, with overall long-term success approaching 99% after repeat procedures. Recurrence occurs in approximately 5–12% of cases but is usually effectively managed with re-ablation. The procedure demonstrates a favorable safety profile, especially when performed in specialized centers. Importantly, elimination of accessory pathway conduction may improve left ventricular function and reverse pre-excitation–related dyssynchrony. Preliminary evidence also suggests improvements in exercise capacity following successful ablation. Conclusions. Catheter ablation is an effective and safe treatment for pediatric WPW syndrome, offering not only arrhythmia control but also potential benefits in cardiac function and physical performance. Further prospective studies are needed to better define long-term functional outcomes and optimize management strategies in asymptomatic patients.
Copyright (c) 2026 Magdalena Gałach, Mateusz Bernad, Katarzyna Widomska, Aleksandra Bender, Paulina Walczak, Małgorzata Niewęgłowska, Bartłomiej Szymulewicz, Kacper Dąbrowski, Jakub Łukaszewicz, Oliwia Krazińska https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Smoking on Inflammatory Bowel Disease: A Literature Review
Background. Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic immune-mediated condition with a rapidly rising global prevalence. While genetic factors are significant, environmental modifiers—specifically tobacco use—play a critical role in disease onset and progression. Background. Smoking cigarettes is a highly prevalent habit worldwide that has a massive impact on the human immune system, significantly influencing the onset and progression of various inflammatory conditions, including inflammatory bowel disease. Background. Cigarette smoking is one of the most common environmental exposures globally, significantly affecting the gut immune system and serving as a major modifying factor in chronic conditions such as inflammatory bowel disease. Aim. This literature review aims to synthesize current evidence regarding the impact of smoking on the development and clinical trajectory of CD and UC. Methodology. A comprehensive review was conducted using the PubMed and Google Scholar databases, focusing on peer-reviewed literature and consensus guidelines published between 2021 and 2026. Results. The literature confirms that smoking significantly increases the risk and severity of CD. In contrast, observational data traditionally suggest a protective effect of current smoking on UC onset, a phenomenon termed the "smoking paradox". However, recent genetic investigations using Mendelian randomization challenge the causality of this protection, suggesting it may stem from residual confounding. Conclusions. Despite the observational paradox in UC, the systemic harms and treatment interference associated with tobacco use necessitate universal cessation strategies. This review provides a clinical roadmap for managing smoking status in the modern era of IBD care.
Copyright (c) 2026 Krzysztof Grabowski, Joanna Mioduszewska, Paweł Rot, Piotr Poniewozik, Natalia Dziuba, Aleksandra Sim, Maja Pernal, Zofia Roguska, Andrzej Paweł Zuzak, Paweł Poniewozik https://creativecommons.org/licenses/by-nc-sa/4.0
Antiviral peptides as emerging therapeutic agents: a narrative review of engineering strategies, delivery innovations, and clinical perspectives
Background. Viral infections remain a major global health threat despite advances in vaccines and antiviral drugs due to the rapid emergence of resistance and new viral pathogens. Antiviral peptides (AVPs) are promising broad-spectrum therapeutic agents because of their structural diversity and multiple biological activities. Aim. The aim of this narrative review is to summarize current knowledge on antiviral peptides, focusing on their classification, mechanisms of action, molecular engineering strategies, delivery systems, and clinical perspectives. Material and methods. A narrative review of recent peer-reviewed literature on antiviral peptides, engineering techniques, and modern drug-delivery approaches, including liposomes, polymer nanoparticles, and mucosal systems, was conducted. Results. AVPs act at multiple stages of viral replication, including inhibition of viral attachment and fusion, disruption of viral envelopes, interference with intracellular replication, and modulation of immune responses. Engineering strategies such as cyclization, PEGylation, D-amino acids, and lipidation improve stability and pharmacokinetics, while novel delivery systems enhance bioavailability. Clinical translation is limited by short half-life, toxicity, cost, and regulatory challenges. Conclusions. Antiviral peptides are promising broad-spectrum therapeutics, and further interdisciplinary research is needed to enable their clinical application.
Copyright (c) 2026 Maryia Bohdzel, Raman Sazon, Vladimir Gurskii, Yuliya Hlukhava, Krystsina Babkova, Iuliia Ilina, Alicja Korpacka, Patrycja Anna Borowiecka, Pavel Proborshch, Nadzeya Skadorva https://creativecommons.org/licenses/by-nc-sa/4.0
Physical Activity, Rehabilitation and Health Education in High-Risk Patients: Lessons from Vascular Ehlers–Danlos Syndrome
Background. Physical activity is a fundamental component of health, prevention, and education; however, in selected high-risk populations, safe exercise prescription remains a major challenge. Vascular Ehlers–Danlos syndrome (vEDS) represents an extreme model of exercise-related risk due to marked vascular fragility. Aim. The aim of this study was to analyse the safety of physical activity in vEDS and to provide practical implications for sport participation, rehabilitation, and health education. Material and methods. A narrative review of available literature was performed, focusing on exercise- and sport-related complications, rehabilitation practices, and current recommendations for physical activity in patients with vEDS. Results. Analysis of reported cases shows that both competitive sports and low-intensity activities, including standard rehabilitation exercises, may trigger severe and potentially fatal vascular events. At the same time, appropriate low-load, supervised physical activity may support functional capacity and quality of life. Current recommendations are inconsistent and largely based on expert opinion, leading to uncertainty among patients and professionals responsible for exercise guidance. Conclusions. The findings highlight the need for a structured, education-based approach to physical activity in high-risk populations. In vEDS, exercise prescription should prioritise safety, individualisation, and professional supervision. The development of clear guidelines and improved education of clinicians, physiotherapists, and sport practitioners is essential to ensure safe participation in physical activity while minimising the risk of serious complications.
Copyright (c) 2026 Kamila Ryszkowska, Kinga Krzyżowska , Jagienka Perzyńska, Natalia Pawelec, Jaśmina Podkościelna, Weronika Bagińska, Urszula Załuska, Aleksandra Purska, Jakub Grabiński https://creativecommons.org/licenses/by-nc-sa/4.0
Common and Rare Complications of Lichtenstein Inguinal Hernioplasty
Inguinal hernia repair remains one of the most frequently performed surgical procedures globally, with approximately 20 million operations conducted annually. While the Lichtenstein tension-free technique using polypropylene mesh is considered the "gold standard" due to its low recurrence rates and high safety profile, the procedure is still associated with a spectrum of potential complications. The most common among these include localized hematomas, seromas, surgical site infections and chronic pain. Furthermore, surgical manipulation within the spermatic cord may result in significant testicular complications. Certain outcomes, such as mesh migration or late-onset infections, may arise many years following the initial intervention. The primary strategy for mitigating these issues lies in the meticulous selection and execution of appropriate operative techniques. Rehabilitation includes early mobilization to the restoration of full physical activity. This study aims to provide a comprehensive review of the diverse range of complications associated with Lichtenstein inguinal hernioplasty.
Copyright (c) 2026 Aleksandra Grelowska, Adrian Ołubiec, Aleksandra Oto, Rafał Ejsner, Julia Kaczmarek, Katarzyna Barczyńska, Michał Błażuk, Nela Poznańska, Tomasz Sys https://creativecommons.org/licenses/by-nc-sa/4.0
Efficacy and Safety of Tirzepatide in the Treatment of Obesity: A Review of Current Clinical Trials
Background: Obesity is a chronic disease with increasing prevalence and substantial health consequences. In recent years, advances in incretin-based pharmacotherapy have enabled greater weight loss than was achievable with earlier medications. Aim: To evaluate the efficacy and safety of tirzepatide in the treatment of obesity based on current clinical trial evidence. Materials and methods: A narrative review of key randomized trials from the SURMOUNT program (including SURMOUNT-1 and SURMOUNT-4), longer-term follow-up data, and meta-analyses was performed. Outcomes included mean percent weight change, clinically relevant weight-loss thresholds, durability of effect after treatment withdrawal, and adverse events. Results: In SURMOUNT-1, tirzepatide produced a significant, dose-dependent reduction in body weight, achieving a mean weight loss of up to approximately 21% at 72 weeks compared with placebo, and a substantial proportion of participants reached ≥20% weight loss at higher doses. In SURMOUNT-4, continued therapy was essential to maintain weight loss, whereas treatment discontinuation was associated with clinically meaningful weight regain. The most common adverse events were gastrointestinal (nausea, diarrhea, vomiting), typically mild to moderate in severity. Conclusions: Tirzepatide is an effective pharmacological option for obesity with an acceptable safety profile; however, maintenance of benefits requires long-term treatment. Further studies are needed to clarify durability of effect and long-term safety over multiple years.
Copyright (c) 2026 Wojciech Kijowski, Knieszko Fahim, Jakub Franaszek, Nadia Herchi, Martyna Jabrzyk, Patrycja Jarczyńska, Mateusz Klusek, Karolina Michalak, Maciej Przybył https://creativecommons.org/licenses/by-nc-sa/4.0
The Impact of Exocrine Pancreatic Insufficiency in Patients with Chronic Pancreatitis on Bone Health - a Literature Review
Background. Chronic pancreatitis is described as irreversible damage to the pancreas leading to endocrine and exocrine dysfunction. Exocrine pancreatic insufficiency (EPI) results in maldigestion and malabsorption of nutrients that is associated with developing osteopenia and osteoporosis that elevates bone fragility and puts patients at higher risk of higher low fracture rates. Aim. This review aims to outline current evidence on the pathophysiological mechanism, prevalence, risk factors and clinical implications of osteoporosis in patients with EPI secondary to chronic pancreatitis. Material and methods. A comprehensive literature search was performed using electronic databases (including PubMed, Web of Science, and ClinicalKey), to identify studies examining osteoporosis in patients with chronic pancreatitis. Searches were performed using relevant keywords and combinations such as “chronic pancreatitis,” “exocrine pancreatic insufficiency,” “osteoporosis,” “osteopenia,” and “bone mineral density.” Studies published in English were considered. Manual screening of references from all included studies was performed to locate further relevant studies Extracted data were synthesized qualitatively using a literature review approach, focusing on prevalence, risk factors, pathophysiology, and clinical outcomes related to bone health in this population. Conclusion. Patients with chronic pancreatitis and long-term exocrine pancreatic insufficiency frequently display reduced bone mineral density, resulting in increased osteoporosis risk and fragility fractures. Enzyme therapy should be provided to improve nutrient absorption. Further research is needed to precisely determine fracture-related morbidity and mortality in this population.
Copyright (c) 2026 Małgorzata Jerczak, Filip Przybył, Tomasz Pluszyński, Iga Piórkowska, Natalia Padula, Kacper Paczosa, Mikołaj Polewka, Aleksandra Polańska, Karol Piotrowski 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. Key words: type 2 diabetes mellitus, SGLT2 inhibitors, GLP-1 receptor agonists, heart failure, chronic kidney disease
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
Physical activity and pharmacological interventions in reversing stress-induced hippocampal atrophy: An analysis of molecular mechanisms
Background: Chronic stress, unlike its acute adaptive form, leads to a persistent disruption of homeostasis and an increasing allostatic load. A central component of the biological response to stress is the activation of the hypothalamic-pituitary-adrenal (HPA) axis, which leads to the release of glucocorticoids, particularly cortisol. The hippocampus, due to its high density of glucocorticoid receptors, becomes one of the main target structures for cortisol action. Its chronic excess becomes neurotoxic to the hippocampal structure and leads to its atrophy. Aim:The aim of this study is to analyze the mechanisms leading to hippocampal damage and to evaluate the clinical evidence regarding the reversibility of these changes through pharmacological and non-pharmacological interventions. Material and methods:The literature review was conducted by searching the electronic databases PubMed and Google Scholar. The search process utilized a combination of the logical operators AND/OR and the following keywords: chronic stress, cortisol, hippocampal atrophy, neuroplasticity, HPA axis, BDNF, physical exercise. Results: Chronic exposure to cortisol leads to dendritic atrophy, loss of synaptic spines, and inhibition of neurogenesis within the hippocampus. Recent reports, however, highlight the key role of the mTORC1 signaling pathway and BDNF expression in reversing these deficits. While psychoplastogens such as ketamine promote rapid synaptic remodeling, regular physical activity facilitates sustained structural adaptations.Conclusions: Hippocampal damage caused by chronic stress is not a completely irreversible process. The transition from a neurotoxic state to structural regeneration is possible through multi-track molecular pathways activated by both modern pharmacotherapy and systematic physical activity. This synergy opens new perspectives in education and sports medicine, aiming at the biological reconstruction of brain structures and improvement of the quality of life.
Copyright (c) 2026 Paulina Pawlak, Olaf Wojcieszuk, Łukasz Starczewski, Adrianna Babik, Kamila Kamińska, Matylda Będkowska-Kuśmierek, Anna Złotnik, Kinga Krzysztofik, Antoni Klamka, Paulina Kawalec https://creativecommons.org/licenses/by-nc-sa/4.0
Mental Disorders in Postpartum Period and Lactation: A Literature Review
Traditionally, postpartum mental problems have been characterized as major depressive disorder, obsessive-compulsive disorder, bipolar disorder, postpartum psychosis, and postpartum blues. The difficult postpartum phase is characterized by major changes in one's physical, biological, social, and emotional makeup. This period necessitates significant interpersonal and personal adjustment, especially for primigravida women. A wide range of emotions are typical during pregnancy and the postpartum phase, ranging from anticipation, fulfillment, and excitement to feelings of anxiety, confusion, frustration, guilt, and sadness. This may cause the mother's psychological condition to deteriorate. Misdiagnosis and inadequate treatment of prenatal mental illnesses are common. Both the mother and the child may have long-term effects from postpartum mental health disorders.The postpartum psychological state might become so severe that hospitalization is required. Furthermore, this conditions might have a negative impact on mother-infant connection and attachment. Early diagnosis and starting the treatment of postpartum psychiatric disorder is important, which can result in faster and quicker recovery. When the disease is mild or in its early stages, non-pharmacological treatment methods like psychotherapy, psychoeducation, and social and familial support might be beneficial. When the condition is more serious, medication is used. However, women should be mindful of the risks and benefits of using psychoactive medications during lactation, even though pharmacological treatment is more effective. Numerous factors, such as the mother's medication dosage, the time and frequency of dosing, the mother's drug metabolism rate, and the infant's drug metabolism, influence how much drug an infant is exposed to.
Copyright (c) 2026 Aleksandra Sadowska, Aleksandra Welkier, Adam Sobiński, Paula Kwaśniewska, Patrycja Śliwa-Tytko, Joanna Miśkiewicz, Aleksandra Dudek, Patrycja Pietrusińska, Jakub Moder, Anna Dziewierz https://creativecommons.org/licenses/by-nc-sa/4.0
Pharmacological treatment options for obesity in children with insulin resistance: a targeted review
Background. Childhood and adolescent obesity is an increasing global health concern. Many obese children develop insulin resistance, which contributes to metabolic complications including type 2 diabetes, dyslipidemia, hypertension, and non-alcoholic fatty liver disease. Although lifestyle modification remains the primary treatment, it is often insufficient in cases of severe obesity or marked insulin resistance. In recent years, pharmacological therapies have been increasingly used in pediatric obesity, but their efficacy and safety in insulin-resistant children are not fully established. Aim. This review aims to summarize current evidence on pharmacological treatment options for obese children with insulin resistance, with a focus on efficacy, safety, and research gaps relevant to clinical practice. Material and methods. A literature review was conducted using PubMed, MEDLINE, Scopus, and Web of Science. Studies evaluating pharmacological therapies such as metformin, GLP-1 receptor agonists, and orlistat were included. Randomized controlled trials, systematic reviews, meta-analyses, and observational studies reporting changes in BMI, metabolic parameters, and adverse events were analyzed. Conclusions. Available evidence suggests that pharmacological agents, including metformin, orlistat, GLP-1 receptor agonists, and phentermine/topiramate, can reduce body weight and improve metabolic outcomes in obese children and adolescents with insulin resistance. GLP-1 receptor agonists show the greatest BMI reduction. Safety profiles vary, with gastrointestinal adverse effects being most common. Long-term safety data, particularly in children under 12 years of age, remain limited, highlighting the need for individualized therapy and further research.
Copyright (c) 2026 Marta Drozdowska, Emilia Borychowska, Aleksandra Bystros, Michalina Czudowska, Karolina Gwóźdź, Klaudia Kurzątkowska, Dominika Marszałek, Zofia Mierzejewska, Aleksandra Ocimek, Magdalena Zawadzka https://creativecommons.org/licenses/by-nc-sa/4.0
The Effects of Photobiomodulation (Red Light Therapy) on Delayed Onset Muscle Soreness (DOMS) and Muscle Recovery in Adults: A Narrative Review
Background. Photobiomodulation (PBM) has gained attention as a potential non-invasive strategy to enhance muscle recovery following exercise-induced muscle damage. However, its effectiveness remains inconsistent across studies in human trials. Objective. The aim of this review was to critically evaluate the effects of PBM on delayed onset muscle soreness (DOMS), functional muscle recovery, and biochemical markers of muscle damage in humans. Methods. A narrative review of recent studies investigating PBM in the context of exercise-induced muscle damage was conducted. Relevant articles were identified through electronic databases and analysed qualitatively. Results. Most studies suggest that PBM may reduce DOMS, improve recovery of muscle function, and attenuate biochemical markers such as creatine kinase. Mechanistic evidence supports enhanced mitochondrial activity, increased ATP production, and modulation of oxidative stress and inflammation as potential pathways for these effects. However, some studies reported no significant benefits, reflecting variability in PBM parameters, timing of application, exercise modalities, and participant characteristics. Conclusion. PBM shows promise as a supportive recovery strategy for athletes and physically active individuals, particularly in contexts requiring rapid post-exercise recovery. Nevertheless, standardized treatment protocols and further high-quality studies are necessary to confirm its efficacy and determine optimal application parameters.
Copyright (c) 2026 Eliza Wiercioch, Marcin Wieleba, Franciszek Włodarczyk, Barbara Izabela Krupska, Magdalena Zapalska, Zuzanna Winiarska, Weronika Maria Woźniak, Lidia Kulig, Julia Anna Malec, Michał Krzysztof Woszczek https://creativecommons.org/licenses/by-nc-sa/4.0
Oral Collagen Peptide Supplementation and Skin Health: Evidence from Human Studies and Implications for Connective Tissue Function
Collagen is the main structural protein of connective tissues and plays an important role in maintaining skin structure, elasticity, and hydration. In recent years, oral collagen peptide supplementation has attracted considerable scientific interest as a nutritional strategy aimed at supporting skin health and connective tissue metabolism. The aim of this review was to summarize current evidence from human clinical studies investigating the effects of oral collagen peptide supplementation on skin-related outcomes and to discuss its potential implications for connective tissue in the context of physical activity. A literature search was conducted in the PubMed database focusing on human studies evaluating oral collagen supplementation and its effects on skin physiology. Studies assessing skin hydration, elasticity, wrinkle depth, and dermal matrix structure were included in the analysis. The reviewed clinical trials generally report improvements in skin hydration and elasticity following several weeks of collagen peptide supplementation. Some studies also indicate reductions in wrinkle depth and improvements in dermal structure. In addition, evidence suggests that collagen supplementation combined with physical activity may support connective tissue adaptation. Overall, oral collagen peptide supplementation may represent a promising nutritional strategy supporting skin health and potentially connective tissue function.
Copyright (c) 2026 Ewa Dryl-Jarmoc, Gabriela Kuliś, Izabela Ślinko, Mateusz Zimowski, Mateusz Czajkowski, Jakub Dziemiańczuk, Zuzanna Panas, Kacper Krawczuk, Piotr Kadysz, Agata Kolanek https://creativecommons.org/licenses/by-nc-sa/4.0
Cardiac Arrhythmias in Athletes and Their Impact on Health and Sports Participation: A Narrative Review
Background: Sport and physical activity induce structural, functional, and electrical adaptations of the heart, known as the “athlete’s heart.” Although usually physiological, these changes may overlap with pathological conditions and increase susceptibility to arrhythmias, including sudden cardiac death (SCD). Endurance and mixed sports particularly affect cardiac remodeling and electrophysiology. Aim: To summarize common cardiac arrhythmias in athletes, describe their mechanisms, and discuss clinical implications for diagnosis, management, and prevention of sudden cardiac events. Materials and Methods: A literature review was conducted based on recent studies and meta-analyses on cardiac adaptations and arrhythmias in athletes. Key topics included sinus bradycardia, atrioventricular (AV) block, premature ventricular contractions (PVCs), atrial fibrillation (AF), and arrhythmias linked to SCD, such as long QT syndrome, Brugada syndrome, Wolff–Parkinson–White syndrome, and arrhythmogenic right ventricular cardiomyopathy. Results: Sinus bradycardia and AV block are common in endurance athletes and are mainly related to increased vagal tone. PVCs are usually benign but require evaluation. AF is more prevalent in endurance athletes and is associated with atrial enlargement and fibrosis. Rare arrhythmias related to channelopathies and cardiomyopathies significantly contribute to SCD risk. Diagnosis includes ECG, echocardiography, Holter monitoring, exercise testing, and cardiac MRI. Management ranges from observation to pharmacological therapy or invasive procedures. Conclusions: Regular monitoring is essential to distinguish physiological adaptations from pathological arrhythmias. Early diagnosis and individualized management enable safe sports participation and reduce SCD risk.
Copyright (c) 2026 Maria Orłowska, Agnieszka Przepióra, Anna Żmigrodzka, Jana Kozłowska, Maria Sanocka, Aleksandra Wielogórska, Agnieszka Kamińska, Anna Kwiatkowska, Klaudia Czernic-Goławska, Joanna Falana, Karolina Trojnar https://creativecommons.org/licenses/by-nc-sa/4.0
The impact of beetroot juice supplementation on performance in endurance sports
Background. Dietary nitrate (NO3-) from beetroot juice (BRJ) enhances nitric oxide bioavailability via the NO3-, NO2-, NO pathway, which is particularly effective during high-intensity exercise. Aim. To evaluate the impact of BRJ on endurance performance in running, cycling, and swimming (2020–2025) and establish standardized dosing protocols. Material and methods. A systematic review of PubMed, Scopus, and Web of Science was performed, focusing on meta-analyses and RCTs assessing exercise economy (VO2), time-trial results, and recovery markers in recreational and elite athletes. Results. BRJ reduces submaximal oxygen cost by 1.5–5.0%. Recreational athletes exhibit a ~15.7% increase in time-to-exhaustion, while cyclists show power output improvements of 1.2–3.0%. Swimming-specific data indicate enhanced stroke efficiency and accelerated lactate clearance. Elite athletes require chronic loading (3–7 days) to overcome the "ceiling effect" associated with high baseline nitric oxide levels. Conclusions. BRJ is a safe and validated ergogenic aid. Optimal performance gains require a chronic protocol (>8 mmol NO3-/day) for 3–7 days, with specific focus on ingestion timing and preserving the oral microbiome.
Copyright (c) 2026 Wojciech Kubas, Aleksandra Sadok, Aleksandra Białek, Jakub Karczewski, Wojciech Jan Niemcewicz, Kamila Ryń, Aleksandra Kożlicka, Jakub Klajda, Mikołaj Czerniakowski, Zuzanna Gorczyca https://creativecommons.org/licenses/by-nc-sa/4.0
Therapeutic Strategies for the Management of Knee Pain – A Review of Current Therapies and Perspectives
Background. Knee pain can significantly impact patients' quality of life. Pain emerging with age is most commonly associated with osteoarthritis of the knee. Aim. Current clinical management comprises three lines of treatment. Results. The first and second lines focus on conservative and pharmacological management, while the third involves surgical intervention. Conclusions. This paper discusses both current therapeutic standards and innovative treatment methods.
Copyright (c) 2026 Tymoteusz Białowąs, Dominika Karolak, Natalia Sara Kuśmierowska, Monika Kuś, Grzegorz Słomkowski, Kacper Cholewiński, Daria Valipur Kolti, Milena Polak, Magdalena Natalia Nowak, Konrad Wiśniewski https://creativecommons.org/licenses/by-nc-sa/4.0
Glycemic Control in Young Men Aged 18–30 Years with Type 1 Diabetes: The Role of Lifestyle and Physical Activity
Introduction: Type 1 diabetes mellitus (T1DM) is a chronic metabolic disease requiring continuous glycemic monitoring and intensive insulin therapy [1]. Early adulthood is a critical period characterized by lifestyle changes that may negatively affect metabolic control, particularly among young men [2,3,17]. Aim: The aim of this study was to analyze factors influencing glycemic control in young men aged 18–30 years with T1DM, with particular emphasis on physical activity and lifestyle behaviors [4,11,18]. Materials and Methods: A narrative review of scientific literature was conducted, including interventional (RCT) and observational studies assessing physical activity and glycemic control in young men with T1DM [5–10,12–16,18–24,30]. Results: Structured physical activity was associated with improvements in HbA1c, time-in-range (TIR), and glycemic variability. Aerobic exercise decreased HbA1c by −0.4% to −0.7% (p < 0.001; 95% CI −0.82 to −0.28), resistance training increased TIR by 6–10% (p = 0.01–0.03), and combined aerobic/resistance training provided the greatest benefits (HbA1c −0.55%; TIR +11–13%; p < 0.001). Observational studies confirmed inverse correlations between overall activity and HbA1c (r = −0.32 to −0.45; p < 0.01) [6,9,12,15,16,19–23,26,27,29]. Conclusions: Structured exercise, particularly combined aerobic and resistance training, exerts clinically meaningful effects on glycemic control in young men with T1DM. Individualized physical activity prescriptions should be integrated into diabetes management [1,4,7–30].
Copyright (c) 2026 Paweł Dyczek, Wiktoria Staniszewska, Adrian Pączek, Aleksandra Kowalczyk, Julia Hofman 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
Plantar Fasciitis: A Common and Underestimated Condition - A Review of the Current Literature
Introduction and purpose. Plantar fascia is a structure ensuring proper stabilization of the foot. Its malfunction impacts the organism as a whole. Untreated pathology leads to further health consequences. Plantar fasciitis (PF) is one of the most common and neglected foot pathologies. The knowledge on this topic is still insufficient. The purpose of this article is to consolidate current knowledge on plantar fasciitis. It is essential to highlight this problem, because it is a condition that continues to be underrepresented in scientific research. Material and methods. Medical databases including PubMed, Google Scholar and Embase were searched for scientific articles on risk factors, pathophysiology, symptoms, diagnostic methods, treatment and state of knowledge among society on plantar fasciitis. The identified studies were analyzed and combined into a single article. State of knowledge. One in ten people develops PF. Its peak incidence ranges from 40 to 60 years old. It occurs in athletic and non-athletic populations. There is no clear consensus among researchers on possible risk factors. Plantar Fasciitis leads to sharp pain at the plantarmedial aspect of the heel. The diagnosis is based on medical history and physical examination. There are numerous methods used in treatment of PF. Not all of them are scientifically proven but they are clinically successful when used. There is still a lack of research on prevention of PF. Awareness of the existence of this medical condition is not sufficient in the general population. Conclusions. Plantar fasciitis is a common yet underrepresented condition in scientific research, with many studies limited by small sample sizes and short follow-up periods. Increasing awareness of risk factors is essential, as untreated plantar fasciitis may become chronic. Although various treatment options exist, preventive measures remain insufficiently studied despite their importance.
Copyright (c) 2026 Natalia Kapturska, Piotr Kardaszewski, Kinga Cymerys, Magdalena Mąka , Sabina Kadłubek, Julia Woźniak, Szymon Kalinowski , Jakub Kamiński, Dominik Sikora, Ewa Góralczyk https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of Vitamin D and Physical Activity in Endometriosis: Implications for Pain Relief, Physical Function and Reproductive Health- A Literature-Based Review
Purpose of research. The aim of this study was to evaluate the roles of vitamin D and physical activity in the management of endometriosis, with particular emphasis on their effects on pain reduction, physical function, and reproductive health in affected women. Research materials and methods. A literature-based review was conducted using major scientific databases, including PubMed, Scopus, and Web of Science. The analysis included original studies, randomized controlled trials, systematic reviews, and meta-analyses focusing on vitamin D status, supplementation, and physical activity interventions in women with endometriosis. Basic results. Vitamin D exhibits immunomodulatory, anti-inflammatory, antiproliferative, and anti-angiogenic properties mediated through the vitamin D receptor (VDR), which is widely expressed in reproductive tissues. Lower serum levels of 25-hydroxyvitamin D may be associated with increased risk and severity of endometriosis; however, clinical evidence regarding pain reduction remains inconsistent. Physical activity, including aerobic exercise and mind–body interventions such as yoga, has been shown to reduce pain, improve quality of life, and positively influence psychological well-being through anti-inflammatory and neuroendocrine mechanisms. Emerging evidence suggests that optimizing vitamin D levels, combined with regular physical activity, may produce synergistic effects, particularly in improving physical performance, reducing inflammation, and supporting bone health. Conclusions. Vitamin D and physical activity may serve as safe and effective complementary strategies in the management of endometriosis. Their integration into a personalized, multidisciplinary approach may improve patient outcomes; however, further high-quality studies are required to establish standardized clinical guidelines.
Copyright (c) 2026 Aleksandra Głowacka, Aleksandra Kurek, Dominika Domińczak, Sofiia Ivanchuk, Patryk Górecki, Anhelina Kaminskaya, Tetiana Savchak, Hubert Feretycki, Aladdin Salama, Shafea Abdulla https://creativecommons.org/licenses/by-nc-sa/4.0
Eye Injuries in Combat Sports - Literature Review
Background: Eye injuries are an important cause of morbidity and can lead to permanent visual impairment, particularly in young, physically active individuals engaged in combat sports, where deliberate strikes to the head and face, close contact and full‑contact rules create a high‑risk environment for ocular trauma (Akanno et al., 2025; Doherty et al., 2025; Zachovajevas et al., 2025). Aim: To review and synthesize current evidence on the epidemiology, mechanisms, risk factors and discuss prevention strategies in the context of combat‑related ocular trauma. Materials and Methods: A narrative review with elements of a systematic search was conducted in PubMed (2000-2026) focusing on full‑contact and mixed combat disciplines. Priority was given to large epidemiological studies and systematic reviews on MMA and boxing injuries. Additional data were drawn from population‑based analyses of sports‑related eye injuries, retinal screening in collision sports and studies on combat ocular trauma. Results: In professional boxing and MMA, eye injuries accounted for roughly one‑third of all injuries mainly eyebrow/eyelid lacerations, orbital hematomas, and corneal abrasions; in boxing, eye injuries were linked to higher loss rates. Systematic reviews of MMA show 66.8-78% of injuries involve the head, often the orbital‑eyelid region. Population studies indicate that collision and combat sports are major sources of sports-related eye trauma in young males. Conclusions: Eye injuries in combat sports are frequent, clinically significant and likely underreported. Integrating IOC‑recommended ophthalmic screening and standardized surveillance with rule and equipment modifications, education and prompt specialist management-guided in part by experience from collision sports and combat ocular trauma-offers a rational framework to reduce visual morbidity in this population.
Copyright (c) 2026 Bartłomiej Kozdra, Mikołaj Olszok, Krzysztof Karbowiak, Natalia Makselan, Natalia Nawrat, Handzel Handzel, Antoni Antczyk, Daniel Wijas, Michał Kluś https://creativecommons.org/licenses/by-nc-sa/4.0
An Assessment of Dental Practitioners' Pain and Evidence-Based Physical and Management Strategies
Background. Dentistry is a highly demanding profession that requires specific physical postures during clinical procedures. The prolonged adherence to such postures throughout a practitioner’s career can lead to musculoskeletal discomfort and chronic pain. These physical and ergonomic challenges may contribute to occupational burnout and reduced job satisfaction. Aim. The aim of this study is to identify the most prevalent sites of musculoskeletal at dentists and to discuss evidence-based strategies for alleviating such discomfort, with the ultimate objective of enhancing occupational longevity in the dental workforce. Material and methods. A systematic search of high-quality academic databases was conducted to identify peer-reviewed studies reporting statistical data and clinical management strategies related to the most prevalent musculoskeletal disorders among dental professionals. From the initial pool of literature, 56 studies - comprising randomized controlled trials, systematic reviews, and clinical studies - were selected for the further and more precise review and selected to discuss in this paper. Results. Mostly cited musculoskeletal disorders among dental professionals include neck pain, low back pain, hip pain, shoulder pain, and forearm and wrist pain, with carpal tunnel syndrome and forearm discomfort. For neck pain, evidence-based recommendations are manual therapy and therapeutic exercise programs, which have demonstrated efficacy in reducing pain and improving function. Low-back and hip pain are best addressed through mind-body and core-stabilizing interventions: tai chi, yoga, and Pilates, as well as core-based or stabilization exercises, which enhance postural control and reduce mechanical stress. In the case of shoulder pain, treatment protocols suggest a combination of stretching exercises and radiofrequency ablation. In Forearm pain and carpal tunnel syndrome, a multimodal approach is recommended.
Copyright (c) 2026 Kamil Arciszewski, Paweł Stenzel, Karolina Niewola, Jakub Szumiło, Klaudia Kasperska, Dominika Walczak, Karolina Orda, Natalia Hariasz, Mariana Markiv, Michał Słowik https://creativecommons.org/licenses/by-nc-sa/4.0
Impact of Hearing Loss in the Pediatric Population on Physical Activity and Daily Life: A Literature Review
Background: Hearing loss is a common sensory impairment in the pediatric population that can significantly affect speech, language development, academic performance, and social interaction. Beyond communication challenges, it may also influence physical activity. Aim: The aim of this literature review is to critically evaluate the evidence on how hearing loss affects physical activity participation and daily functioning in children. Methodology: A literature search was conducted to identify relevant studies published between 1992 and 2026 using electronic databases, including PubMed, Google Scholar, ResearchGate, Scopus and Web of Science. Results: Children with hearing loss often engage less in physical activity and may face balance, coordination, and motor skill challenges. Hearing loss can also affect daily life and social participation, although early intervention and appropriate support can help improve functional outcomes and quality of life. Conclusions: Young people with hearing loss are generally less physically active and participate less in sports than their hearing peers due to communication, environmental, and psychosocial barriers. Since physical activity supports both physical and mental well-being, adapting sports programs to their needs can improve participation and overall psychosocial functioning.
Copyright (c) 2026 Jakub Florek, Natalia Dziuba, Magdalena Damek, Natalia Dyjak, Michał Grzyb, Miłosz Dziuba https://creativecommons.org/licenses/by-nc-sa/4.0
Sex Differences in Stress Fracture Incidence and Risk Factors in Athletes: A Narrative Review
Background. Stress fractures are a prevalent overuse injury in athletes, with female athletes consistently reporting higher incidence rates than males. This disparity is driven by an interplay of anatomical, hormonal, biomechanical, and training-related factors. Aim. This narrative review aims to synthesise the current evidence on sex differences in stress fracture incidence and to identify the key risk factors underlying this disparity. Methods. A narrative literature review was conducted using PubMed, Web of Science, and Scopus. Studies published between 2015 and 2026, with an emphasis on 2020–2026, were included. Peer-reviewed original research articles, systematic reviews, and meta-analyses addressing stress fractures in athletes with sex-stratified data were considered. Results. Female athletes exhibit higher rates of tibial, metatarsal, and tarsal stress fractures compared to males. Contributing factors include smaller bone cross-sectional geometry, lower cortical bone density, and distinct trabecular microarchitecture. Hormonal disruptions associated with the Female Athlete Triad and Relative Energy Deficiency in Sport further impair bone metabolism in women. Sport-specific loading, early specialisation, low body mass index, and menstrual irregularities compound this risk. Conclusions. The excess stress fracture risk in female athletes is multifactorial. Effective prevention requires sex-specific screening for energy deficiency, menstrual health monitoring, and individualised training load management.
Copyright (c) 2026 Jakub Rudnicki, Maciej Szczupaj, Iga Michalicha, Wiktoria Leja, Maciej Błaszczak, Katarzyna Latalska, Andżelika Pastuszak, Konrad Borkowski, Jakub Kot, Zeeshan Zulfiqar https://creativecommons.org/licenses/by-nc-sa/4.0
Exercise-Induced Irisin and Its Role in Metabolic and Neurological Adaptations: A Narrative Review
Background. In the context of the increasing prevalence of metabolic and neurodegenerative disorders, growing attention has been directed toward biological factors mediating the beneficial effects of physical activity. Among them, irisin, a myokine released in response to muscle contraction, has emerged as a potential regulator of metabolic and neurological processes. Its role in inter-tissue communication and adaptation to exercise has become a subject of intensive research. Aim. The aim of this study was to summarize the current state of knowledge regarding exercise-induced irisin and its role in metabolic and neurological adaptations. Material and methods. A narrative review was conducted using the PubMed and Web of Science databases. The analysis included systematic reviews as well as experimental and clinical studies published between 2017 and 2026 focusing on the role of irisin in metabolism, nervous system function, and responses to physical activity. Results. Available evidence indicates that irisin is involved in the regulation of glucose and lipid metabolism, improvement of insulin sensitivity, and induction of browning of white adipose tissue. Additionally, irisin appears to exert neuroprotective effects by influencing brain-derived neurotrophic factors (BDNF), supporting neurogenesis and cognitive function. Physical activity, particularly its intensity, type, and duration, plays a key role in modulating circulating irisin levels. However, the findings across studies remain inconsistent, likely due to methodological differences and variability in study populations. Conclusions. Irisin may represent an important link between physical activity and its beneficial metabolic and neurological effects. Nevertheless, due to the heterogeneity of existing evidence, further well-designed studies are needed to better understand its mechanisms of action and potential clinical applications.
Copyright (c) 2026 Julia Anna Malec, Lidia Kulig, Zuzanna Winiarska, Weronika Maria Woźniak, Marcin Wieleba, Barbara Izabela Krupska, Magdalena Zapalska, Sara Steć, Eliza Wiercioch, Franciszek Włodarczyk https://creativecommons.org/licenses/by-nc-sa/4.0
The Effects of the Crohn's Disease Exclusion Diet on the Clinical Course of Inflammatory Bowel Diseases in Pediatric and Adult Populations
Introduction: Crohn's disease is a chronic inflammatory condition of the gastrointestinal tract and a major subtype of inflammatory bowel disease (IBD). Its multifactorial etiology involves genetic, immunological, and environmental factors, among which diet plays a key role in modulating gut microbiota and intestinal barrier function. Aim of the study: This narrative review aims to evaluate the role of dietary interventions in Crohn's disease, with particular emphasis on the effectiveness of the Crohn's Disease Exclusion Diet (CDED) in inducing and maintaining remission. Materials and methods: A comprehensive literature review was conducted using Google Scholar and scientific databases. The analysis included randomized controlled trials, prospective and retrospective studies, and experimental research focusing on the impact of dietary interventions, particularly CDED, on clinical outcomes in patients with Crohn's disease. Results: The reviewed studies indicate that CDED, especially when combined with partial enteral nutrition (PEN), is effective in inducing clinical remission and reducing inflammatory markers. Compared to exclusive enteral nutrition (EEN), CDED demonstrates better patient adherence and tolerability. Additionally, the diet positively influences gut microbiota composition and intestinal barrier integrity. Conclusions: CDED appears to be a promising dietary strategy in the management of Crohn's disease. However, despite encouraging results, further large-scale and long-term studies are required to confirm its effectiveness and establish its role in standard treatment guidelines.
Copyright (c) 2026 Agnieszka Woźniacka, Agnieszka Piechowicz , Sylwia Bryksy, Hanna Tymchenko, Aleksandra Marciszewska, Martyna Świątecka, Jakub Kaźmierczyk, Jakub Jopek, Michał Popczyk, Ewa Buczkowska https://creativecommons.org/licenses/by-nc-sa/4.0
Post-Exercise Passive Heat Exposure in Athletes - A Systematic Review of Recovery, Performance, and Adaptation
Background. Post-exercise passive heat exposure, including sauna bathing, infrared sauna, and hot-water immersion, has been proposed as a strategy to influence recovery, performance, and adaptation in sport, but the evidence remains heterogeneous. Purpose. To assess the effects of post-exercise passive heat exposure on recovery-, performance-, and adaptation-related outcomes in athletes and trained individuals. Methods. PubMed and Scopus were searched on 18 March 2026 and supplemented by citation tracking and manual reference screening. Eligible studies examined passive whole-body heat exposure after exercise, training, or competition. Linked reports were grouped. Findings were synthesized narratively, and a retrospective risk-of-bias assessment was performed. Results. Thirteen study programs were included. The most favorable pattern was observed in repeated endurance-oriented applications, particularly when passive heat appeared to support heat adaptation. Acute effects were mixed and outcome-specific, whereas evidence in team-sport, strength-, power-, and hypertrophy-related settings was limited and mostly neutral. Conclusion. Post-exercise passive heat exposure appears to have selective rather than general effects in athletes. Current evidence does not support broad claims of consistent benefit across athletic settings.
Copyright (c) 2026 Dawid Burda, Karolina Galas, Oliwier Adamczyk, Wiktoria Cebula, Julita Orankiewicz, Dominika Dusińska, Bartłomiej Błażej, Zuzanna Płomińska, Piotr Akonom, Julia Grabowska https://creativecommons.org/licenses/by-nc-sa/4.0