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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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 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
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
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 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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 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 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
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
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
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
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 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
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
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
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
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
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