International Journal of Innovative Technologies in Social Science
e-ISSN: 2544-9435 DOI: 10.31435/rsglobal_ijitss OCLC Number: 1036501433 Founding Support: RS Global Sp. z O.O., Poland Operating Publisher: SciFormat Publishing Inc., Canada Subject area: Social Sciences Submission to publication: 59 days Acceptance rate: 55%
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles. CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
TOXIC EPIDERMAL NECROLYSIS (LYELL SYNDROME): CURRENT INSIGHTS INTO PATHOGENESIS, CLINICAL FEATURES, AND MANAGEMENT STRATEGIES
Introduction and objectives: Toxic epidermal necrolysis (TEN) is a rare, life-threatening disease of the skin and mucous membranes. It is characterised by extensive desquamation of the epidermis, severe systemic involvement and a high mortality rate. Despite its rarity, it poses a significant clinical challenge due to its rapid progression and the risk of serious complications. The aim of this study was to present the current state of knowledge regarding the etiology, pathogenesis, clinical presentation and treatment strategies for TEN. Methods: A narrative review was conducted using PubMed and Google Scholar databases. Publications from 2010 to 2026 were included. Key findings: TEN is most often drug-induced and affects the skin and mucous membranes, with a high risk of mortality. Current evidence points to a key role for cytotoxic immune responses, particularly CD8+ T cells and granzyme B, in the pathogenesis of this disease. The cornerstone of treatment remains rapid discontinuation of the causative agent and intensive supportive care. However, immunomodulatory therapies are increasingly recognized as adjunctive treatment options. Conclusions: Despite advances in understanding the pathogenesis of TEN, this disease is still associated with high mortality and risk of severe complications. Early diagnosis, prompt discontinuation of the causative agent, and supportive care are crucial to improving prognosis. Further research into targeted therapies and the development of uniform standards for clinical management remain essential.
Toxic Epidermal Necrolysis, Stevens-Johnson Syndrome, Drug Hypersensitivity, SCORTEN, Keratinocyte Apoptosis, Supportive Care
Copyright (c) 2026 Natalia Nałęcz, Zuzanna Jankowska https://creativecommons.org/licenses/by/4.0
BURNOUT SYNDROME AMONG HEALTHCARE PROFESSIONALS: A NARRATIVE REVIEW OF EPIDEMIOLOGY, CLINICAL CONSEQUENCES, AND INTERVENTIONS
Background: Burnout is a syndrome arising from chronic, poorly managed workplace stress and is characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. It is highly prevalent among healthcare professionals and has been recognized by the World Health Organization as an occupational phenomenon. Aim: This narrative review summarizes current evidence on the epidemiology, risk factors, clinical consequences, and management of burnout among healthcare professionals, with particular attention to its impact on patient care and safety. Methods: We reviewed recent international literature, including epidemiological studies, systematic reviews, and intervention trials addressing burnout in physicians, nurses, and allied health workers. Results: Burnout affects a substantial proportion of healthcare workers, with reported prevalence exceeding 50% among physicians and approximately one-third among nurses. Frequently reported risk factors include excessive workload, long working hours, insufficient staffing, limited organizational support, and short sleep duration, whereas supportive work environments and individual resilience appear protective. Burnout is consistently associated with increased medical errors, reduced quality of care, lower adherence to safety protocols, and comorbid mental health problems. Organization-directed interventions are generally more effective than individual approaches alone, although combined strategies appear most beneficial. Conclusions: Burnout is a prevalent occupational phenomenon with important consequences for both clinicians and patients. Effective mitigation requires system-level interventions addressing work organization and leadership, complemented by individual support, together with further research in underrepresented populations and settings.
Copyright (c) 2026 Jakub Mazur, Mateusz Kosowski, Jakub Marciniak, Daniel Chołuj, Karolina Zarówna, Weronika Pura, Dominika Matecka, Wiktor Śliwiński https://creativecommons.org/licenses/by/4.0
EVENING BLUE LIGHT EXPOSURE AND SLEEP QUALITY: MECHANISMS, CONSEQUENCES, AND PREVENTIVE STRATEGIES — A NARRATIVE REVIEW
Background: Blue light exposure from digital devices has become a prevalent environmental factor affecting circadian rhythms and sleep quality. Objective: This review aims to evaluate the physiological mechanisms, sleep disturbances, and psychological consequences associated with evening blue light exposure. Methodology: A narrative synthesis of current literature was conducted, focusing on the effects of short-wavelength light (400-500 nm) on melatonin suppression, sleep architecture, and related health outcomes. Results: Evidence suggests that artificial blue light is an important contributing factor to delayed sleep onset, reduced sleep duration, and impaired sleep efficiency. Furthermore, growing evidence indicates that circadian disruption and evening screen exposure are associated with poorer mood outcomes and digital eye strain. Conclusions: While blue light-filtering technologies offer limited objective benefits, behavioral and environmental interventions—such as limiting evening screen time—remain the most effective preventive strategies to mitigate the adverse effects of digital device use.
Blue Light, Sleep Quality, Sleep Disturbances
Copyright (c) 2026 Weronika Pura, Karolina Zarówna, Dominika Matecka, Mateusz Kosowski, Daniel Chołuj, Jakub Marciniak, Jakub Mazur, Wiktor Śliwiński https://creativecommons.org/licenses/by/4.0
FRAILTY SYNDROME IN CLINICAL NEUROLOGY: A COMPREHENSIVE REVIEW OF NERVOUS SYSTEM PATHOPHYSIOLOGY, PROGNOSIS IN SELECTED CONDITIONS, AND SOCIO-TECHNOLOGICAL PERSPECTIVES
Background: Neurological conditions are now the leading cause of disability worldwide. Frailty syndrome, defined as a multisystemic state of physiological impairment, often predicts clinical outcomes more accurately than chronological age. Objective: This review examines the molecular pathophysiology of neuro-frailty, its prognostic significance in acute ischemic stroke, multiple sclerosis (MS), and Parkinson’s disease (PD), as well as the integration of emerging diagnostic technologies. Methodology: A comprehensive review of English-language articles published from 2001 to 2026 in PubMed, Scopus, and Cochrane was conducted. Grey literature and animal studies were excluded from the analysis. The synthesis focused on meta-analyses and human-based research connecting artificial intelligence diagnostics, fluid biomarkers, and clinical neurology. Results: Neuro-frailty is associated with the phenomenon of inflammaging, the secretory ageing-associating phenotype (SASP), and progressive mitochondrial dysfunction. The presence of pre-existing frailty also elevates the risk of unfavorable functional recovery (mRS > 2) in acute phase of ischaemic stroke by 3.11 times. In MS, ongoing neurodegeneration accelerates biological ageing, often resulting in premature frailty. The sarcopenia-frailty axis in Parkinson’s disease affects over 35% of patients and significantly increases the risk of recurrent falls. Modern diagnostic methods now enable objective and precise quantification of this impairment. Conclusions: Frailty is a dynamic clinical condition that is possible to reverse. The transition from age-based metrics to AI-powered biological screening enables a personalized approach to care by clinicians. These targeted strategies are essential for maintaining neurological functions and reducing socio-economic consequences of ageing.
Frailty Syndrome, Clinical Neurology, Neurodegeneration, Inflammaging, Ageing Society, Digital Health
Copyright (c) 2026 Katarzyna Michta, Zuzanna Lechowska, Zuzanna Kafara, Agnieszka Kafara, Dominika Jurczak, Julia Koronczok-Matusiak , Donata Kowalczyk, Wiktoria Król, Konrad Kulka, Rafał Szarek https://creativecommons.org/licenses/by/4.0
ARTIFICIAL INTELLIGENCE FOR PERSONALIZED POST-STROKE REHABILITATION: SOCIAL, ETHICAL, AND CLINICAL IMPLICATIONS
Objectives: Stroke is one of the leading causes of mortality and long-term disability worldwide. Recent advances in artificial intelligence (AI) have created new possibilities for improving the individualization and effectiveness of post-stroke rehabilitation. This narrative review aims to summarize current applications of AI in post-stroke rehabilitation and to discuss associated opportunities and limitations. Methods: A narrative review was conducted using PubMed and Google Scholar databases. The analysis focused on stroke, post-stroke rehabilitation, and the use of AI in the rehabilitation process. Publications from 2000 and early 2026 were included. Key Findings: The reviewed literature indicates that AI-based technologies may support stroke rehabilitation through improved treatment personalization, outcome prediction, continuous patient monitoring, and remote delivery of therapy. Machine learning algorithms, AI-enabled wearable devices, and computer vision techniques facilitate more detailed function assessment of motor and cognitive performance. In addition robotic rehabilitation systems, virtual and augmented reality environments may enhance patient engagement and support functional recovery. However, clinical implementation remains limited due to insufficient validation in large randomized trials, lack of standardization, data privacy issues, ethical and regulatory concerns, and unequal access to advanced technologies. Conclusions: AI has the potential to contribute to more personalized and data-driven approaches in post-stroke rehabilitation. Nevertheless, its integration into routine clinical practice requires further high-quality clinical studies, interdisciplinary collaboration, and the development of ethical and regulatory frameworks to ensure safe and effective implementation.
Artificial Intelligence (AI); Stroke; Neurorehabilitation; Telerehabilitation; Wearable Devices
Copyright (c) 2026 Zuzanna Jankowska, Natalia Nałęcz https://creativecommons.org/licenses/by/4.0
SCREEN-BASED LEISURE VS LIFE SATISFACTION IN ADULTS - A NARRATIVE REVIEW
Objectives: This narrative review aimed to synthesize evidence on how leisure (non‑work) screen-based activities—such as TV viewing, internet use, smartphone, social media, and gaming—relate to life satisfaction and broader well‑being in adults, and to explore potential age differences and mechanisms. Methods: A literature search was conducted in the PubMed and Google Scholar databases. Eligible studies examined adult populations, leisure screen use, and subjective life satisfaction or well‑being, with higher-evidence designs prioritized. In total, 16 studies with heterogeneous designs were included and narratively synthesized. Key Findings: Total leisure screen time showed null or slightly negative associations with life satisfaction and related outcomes, detrimental especially when use exceeded 2–3 h/day or displaced physical or social activity. Excessive use was also correlated with poorer subjective well‑being, self‑rated health, body satisfaction, self‑control, and sleep. Associations varied by age, type, and quality of use, with some studies finding that younger adults were vulnerable to social media use downsides, while older adults benefited from online use for social connection purposes. Screen experiences that felt meaningful or socially connective to the user were neutral or positively related to well‑being, whereas passive TV viewing and some social media patterns were more consistently unfavorable. Experimental and modeling work suggested that reducing recreational screen time or reallocating it to physical activity may improve mood and psychological well‑being. Conclusions: Adult leisure screen use is highly prevalent and, in higher, more passive forms, is modestly linked to lower life satisfaction. However, effects depend on dose, content, and context, and can be neutral or beneficial when screen activities feel meaningful, social, or goal-oriented. Encouraging intentional screen use, balanced with fulfilling offline leisure, as well as conducting more causal research on specific screen behaviors, may help support adult life satisfaction.
Screen-Time, Screen-Based Leisure, Digital Media, Life Satisfaction, Well-Being, Adults
Copyright (c) 2026 Sabina Kolawa, Julia Pilecka, Jędrzej Wojciechowski, Wojciech Markiewicz, Natalia Ostruszka, Arnold Borowiec, Maria Marusińska, Michał Karpiński, Wiktoria Czyż, Michał Parzniewski https://creativecommons.org/licenses/by/4.0
NEUROMODULATION IN PEDIATRIC OBSESSIVE-COMPULSIVE DISORDER: A SYSTEMATIZED NARRATIVE REVIEW EMPHASIZING SEVERE AND TREATMENT-RESISTANT PRESENTATIONS
Objective: Pediatric obsessive-compulsive disorder (OCD) is usually managed with cognitive-behavioral therapy with exposure and response prevention and selective serotonin reuptake inhibitors, yet a subset of patients remains severely symptomatic. This review evaluates the pediatric evidence for transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS) and deep brain stimulation (DBS), with emphasis on severe or treatment-resistant OCD. Methods: We conducted a systematic narrative review of English-language literature published between 2015 and 2025. Searches were performed in PubMed/MEDLINE and Google Scholar and supplemented by reference-list screening. Eligible sources included pediatric or adolescent clinical studies, case reports, protocols and implementation-relevant ethical or developmental literature concerning TMS, tDCS, or DBS for OCD. Results: Twenty-eight records were included. Pediatric evidence was sparse and heterogeneous, with few controlled data and limited follow-up. TMS was the most frequently described modality and was supported mainly by observational studies, case reports, and extrapolation from adult OCD literature. One sham-controlled adolescent tDCS trial reported improvement in both active and sham groups, without clear between-group superiority. No prospective pediatric DBS trials for primary OCD were identified; available evidence was limited to isolated cases, comorbid neuropsychiatric cohorts, and stakeholder or ethics studies. Conclusions: Current evidence does not support routine neuromodulation for pediatric OCD. TMS appears closest to cautious clinical translation in specialist settings, whereas tDCS should remain research-focused. DBS should be restricted to exceptional, severe, treatment-refractory cases under multidisciplinary review, robust ethical oversight and developmentally appropriate consent or assent procedures.
Obsessive-Compulsive Disorder; Child; Adolescent; Transcranial Magnetic Stimulation; Transcranial Direct Current Stimulation; Deep Brain Stimulation
Copyright (c) 2026 Laura Mikuła, Julia Sposób , Justyna Strycharczuk, Wiktoria Wiśniewska, Wiktoria Jarosiewicz, Aleksandra Kowalewska-Kurek, Katarzyna Kowalska, Daria Krzyżanowska https://creativecommons.org/licenses/by/4.0
CHRONIC LOW BACK PAIN: A REVIEW OF DIAGNOSTIC ALGORITHMS, PATHOPHYSIOLOGICAL MECHANISMS, AND EVIDENCE-BASED MANAGEMENT IN PRIMARY CARE
Background and Objectives: This narrative review aims to evaluate the systemic challenges in managing Chronic Low Back Pain (CLBP) and establish an evidence-based operational framework for primary care. Methods: Utilizing data synthesized from landmark epidemiological reports, functional neuroimaging studies, and guidelines from the National Institute for Health and Care Excellence (NICE) and the American College of Physicians (ACP), the analysis focused on diagnostic triage, routine imaging stewardship, and the neurobiology of pain chronicity. Findings: Findings indicate that the traditional biomedical model drives an "iatrogenic paradox," where over-medicalization and premature imaging induce a nocebo-driven labeling effect, worsening long-term disability. True chronicity is predominantly mediated by central sensitization, nociplastic pathways, and psychosocial yellow flags rather than structural spinal abnormalities. Consequently, clinical assessment must prioritize a "three-bucket" diagnostic triage and validated risk stratification over incidental pathoanatomical findings. Conclusions: Addressing the escalating global burden of CLBP requires a decisive paradigm shift toward a biopsychosocial, stepped-care model. Primary care physicians must act as rigorous gatekeepers against low-value medicalization, instead prioritizing patient education, early reassurance, and active, tailored exercise therapy. Future strategies should emphasize clinical phenotyping and implementation science to effectively bridge the gap between research evidence and routine primary care practice.
Chronic Low Back Pain, Biopsychosocial Model, Iatrogenic Paradox, Evidence-Based Medicine, Rehabilitation, Primary Care
Copyright (c) 2026 Patryk Obajtek, Sylwia Sanakiewicz, Mikołaj Dubiel, Michał Bochenek https://creativecommons.org/licenses/by/4.0
SECONDARY PAPILLARY THYROID CARCINOMA IN A NON-IRRADIATED PEDIATRIC LEUKEMIA SURVIVOR: CRITICAL IMPLICATIONS FOR ADVANCED NURSING SURVEILLANCE AND LONG-TERM SURVIVORSHIP PARADIGMS
Objectives: This case study aims to document an extraordinary instance of early-onset secondary papillary thyroid carcinoma (PTC) in a non-irradiated pediatric survivor of acute lymphoblastic leukemia (ALL) and to evaluate its implications for advanced oncology nursing surveillance models. Methods: A descriptive, retrospective single-patient case study design was utilized. Clinical data, including multi-agent chemotherapy dosing protocols (ALL-IC BFM 2009), diagnostic radiologic logs, pre-operative thyroid function assays, and high-resolution ultrasonography parameters, were critically reviewed alongside post-operative histopathological data. Key Findings: A 3.5-year-old boy achieved molecular remission from B-cell ALL after exclusive chemotherapy, without any cranial or cervical irradiation. Remarkably, only 36 months post-primary diagnosis, proactive nursing physical palpation during a routine follow-up incidentally detected a firm cervical mass. High-resolution ultrasonography and fine-needle aspiration biopsy confirmed a metastatic classical variant of PTC (pT1bN1bM0). The patient successfully underwent a total thyroidectomy and modified cervical lymphadenectomy, achieving stable clinical remission over an 18-month longitudinal observation period. Conclusions: Secondary metastatic PTC can manifest exceptionally early in pediatric leukemia survivors, completely independent of prior exposure to ionizing radiation. This rapid oncogenesis challenges radiation-centric surveillance paradigms. To prevent diagnostic delays, we recommend the integration of regular, standardized manual thyroid palpation into routine nursing assessments for all pediatric oncology survivors. Future research must prioritize multi-center registries and routine molecular profiling to define chemotherapy-induced genotoxic thresholds and uncover underlying somatic-germline interactions in very young cohorts.
Pediatric Acute Lymphoblastic Leukemia, Papillary Thyroid Carcinoma, Secondary Primary Malignancy, Nursing Surveillance, Survivorship Care, Cytotoxic Genotoxicity
Copyright (c) 2026 Patryk Obajtek, Sylwia Sanakiewicz, Mikołaj Dubiel, Julia Jasińska, Aleksandra Gródek, Dominik Iskrzyński, Aleksandra Bułat, Wiktoria Dubiel, Julia Iglantowicz https://creativecommons.org/licenses/by/4.0
DIGITAL HEALTH INNOVATIONS IN CONTEMPORARY HEALTHCARE
Contemporary healthcare systems face severe strains due to aging populations, rising chronic disease rates, and workforce shortages. This review of scientific literature from 2015 to 2025 evaluates how Digital Health innovations address these structural challenges. The digital transformation, anchored by electronic medical records, e-prescriptions, and patient portals-has significantly reduced administrative burdens and medical errors. Furthermore, advancements in Artificial Intelligence, Big Data, and the Internet of Medical Things (IoMT) have enhanced diagnostic accuracy and enabled proactive, home-based care through Remote Patient Monitoring (RPM). Clinical evidence indicates that RPM alone reduces hospitalization rates by 27% and lowers overall system expenditures. Despite persistent barriers such as digital exclusion, data privacy concerns, and algorithmic bias, the responsible integration of these digital solutions remains essential for building efficient, accessible, and sustainable patient-centered healthcare systems.
Digital Health; Telemedicine; Artificial Intelligence; Remote Patient Monitoring
Copyright (c) 2026 Maria Sierant, Aleksandra Kowalewska-Kurek, Maria Nowakowska, Miszela Kałachurska, Bartosz Nowak, Martyna Rożek, Mateusz Gural, Kamila Zmysłowska https://creativecommons.org/licenses/by/4.0
HYPERTENSIVE DISORDERS IN PREGNANCY: FROM PATHOGENESIS TO CLINICAL MANAGEMENT
Hypertension in pregnancy combines several conditions, such as chronic hypertension, gestational hypertension, unclassified hypertension before delivery, and preeclampsia. According to WHO data, preeclampsia complicates 3-8% of pregnancies and contributes significantly to maternal and neonatal mortality. In recent years, hypertension in pregnancy has been diagnosed more and more frequently, which is associated with the prevalence of conditions such as diabetes, metabolic syndrome, dyslipidemia, and obesity, but also with the increasing average age of women becoming pregnant. The following article discusses the diagnosis, prevention, and non-pharmacological and pharmacological treatment of this condition. The authors also highlight the role of lifestyle modifications during the preconception period in preventing maternal and fetal complications. The safety of pharmacotherapy for both women and newborns is also discussed. In women with preeclampsia, magnesium sulfate should be used to reduce the risk of eclampsia by more than half. The following article is a review of the diagnosis and treatment of hypertensive disorders occurring during pregnancy.
Hypertension, Pregnancy, Preeclampsia, Treatment
Copyright (c) 2026 Maria Sierant, Kornelia Tyczka, Zofia Cepowska, Maria Nowakowska https://creativecommons.org/licenses/by/4.0
THE IMPACT OF CIGARETTE SMOKING ON SEMEN QUALITY AND MALE FERTILITY: A REVIEW OF CURRENT EVIDENCE
Male infertility represents a major global health concern, with lifestyle-related factors increasingly recognised as contributors to lowering reproductive potential. Cigarette smoking is one of the most significant modifiable risk factors affecting male fertility due to the presence of toxic compounds capable of inducing oxidative stress, DNA damage, and impaired spermatogenesis. This literature review summarises current evidence published in articles regarding the impact of cigarette smoking and alternative nicotine products on semen quality and male fertility. The reviewed studies consistently demonstrated that smoking is associated with reduced semen volume, sperm concentration, total sperm count, and motility, alongside increased sperm DNA fragmentation and epigenetic alterations. Oxidative stress emerged as the central pathogenic mechanism, reinforced by mitochondrial dysfunction, abnormal DNA methylation, reduced antioxidant capacity, and formation of DNA adducts. Conventional semen analysis may underestimate smoking-related fertility impairment, as molecular and epigenetic abnormalities may persist despite apparently normal semen parameters. Smoking cessation was consistently associated with improvements in semen quality, particularly in sperm concentration and total sperm count, with longer abstinence producing greater recovery. Alternative nicotine products, including e-cigarettes, snus, and hookah, were also linked to adverse reproductive effects, although their degree of toxicity may differ from that of conventional cigarettes. Overall, current evidence supports smoking cessation as an important intervention for improving male reproductive health and highlights the need for further research into molecular markers of fertility impairment beyond routine semen analysis.
Cigarette Smoking, Male Infertility, Semen Quality, Public Health
Copyright (c) 2026 Katarzyna Bednarczuk, Aleksandra Irena Skuza, Marta Góral, Dominik Fidorowicz, Daniel Sagan, Katarzyna Helena Sergiel, Rafał Siedlecki , Emilia Torbacka, Magda Downar-Zapolska, Agnieszka Mikłaszewicz https://creativecommons.org/licenses/by/4.0
RHINITIS MEDICAMENTOSA: PATHOPHYSIOLOGY, CLINICAL MANIFESTATIONS, AND CURRENT MANAGEMENTS STRATEGIES
Background: Rhinitis medicamentosa (RM) is a non-allergic condition caused by the prolonged use of topical nasal decongestants. Despite its prevalence, it remains frequently underdiagnosed in clinical practice. Objectives: This review synthesizes current knowledge on the pathophysiology, diagnostic criteria, and multifaceted treatment approaches for RM. Methods: A comprehensive literature search was conducted across PubMed (up to 2026) focusing on alpha-adrenergic agonist-induced mucosal changes and therapeutic interventions. Results: Chronic administration of sympathomimetics, such as xylometazoline, leads to adrenoceptor downregulation, secondary vasodilation, and permanent mucosal remodelling. Clinical presentation is characterized by rebound congestion and tachyphylaxis. Management centers on immediate or tapered decongestant cessation, supplemented by intranasal corticosteroids. In refractory cases involving turbinate hypertrophy, surgical intervention (e.g., conchoplasty) remains a definitive option. Conclusions: RM represents a significant clinical challenge. Increasing clinical awareness and patient education regarding the risk of decongestant overuse are crucial for prevention and successful long-term outcomes.
Rhinitis Medicamentosa, Nasal Decongestants, Rebound Congestion, Turbinate Hypertrophy, Intranasal Corticosteroids, Drug-Induced Rhinitis
Copyright (c) 2026 Monika Kałwak, Patryk Dłubis, Sviatlana Filitaryna, Monika Wiatr, Magda Marciniak, Cezary Orzechowski, Michał Gutowski, Wojciech Wojas, Justyna Żabicka, Kinga Lichtarska, Aleksandra Foryś https://creativecommons.org/licenses/by/4.0
IRRITABLE BOWEL SYNDROME – NEW PERSPECTIVE
Background: IBS is a worldwide chronic gastrointestinal tract disorder. The challenges in treatment include unknown causes, non-specific symptoms, lack of precises testing, diagnosis based on ruling out other ailments. New therapies and probiotics show promise in improving the now available treatments and alleviating symptoms in a more precise manner based on IBS type. The understanding of the gut-brain axis as the basis of novel therapies shows promise in further implementation of more efficient treatment. Aim: This narrative review analysis the new therapeutical possibilities and probiotic influence on IBS treatment and the gut-brain axis. Material and methods: A search of relevant research databases was conducted to identify eligible papers. Results: Management of IBS is still on insufficient level. Some studies showed the opportunities arising from the implementation of prostaglandines or even locally acting agonist of opioid receptors. Probiotics also play an important role. On the other hand, the pathophysiology of the disease and the interactions between hormones and cytokines still recuire further studies. Conclusions: IBS is a complex medical condition, the usage of probiotics and other novel therapeutic agents may alleviate the severity of the disease.
Irritable Bowel Syndrome (IBS), Gut Microbiota, Gut-Brain Axis, Pathophysiology, Probiotics
Copyright (c) 2026 Joanna Kulpa, Kornelia Tyczka, Marcin Szczepanik, Maria Nowakowska, Jakub Senko, Zofia Suchanek https://creativecommons.org/licenses/by/4.0
OCULAR INJURIES IN PICKLEBALL: CLINICAL EVIDENCE, INJURY SURVEILLANCE, PROTECTIVE TECHNOLOGY, AND PREVENTION - A NARRATIVE REVIEW
Pickleball participation has expanded rapidly, while evidence on ocular and orbital injury remains dispersed across case reports, emergency-department surveillance, computational modelling, and prevention research. This narrative review aimed to synthesize the epidemiology, mechanisms, clinical spectrum, management, and prevention of pickleball-related eye injury, with particular attention to injury-surveillance methods and protective technology. PubMed/MEDLINE, Google Scholar, publisher databases, reference lists, and authoritative safety documents were searched through July 17, 2026. Direct pickleball evidence was prioritized, and studies from related racket sports were used as indirect context. Reported injuries range from corneal abrasion and traumatic iritis to hyphema, angle recession, lens or intraocular-lens displacement, retinal tears and detachment, traumatic glaucoma, eyelid laceration, and orbital fracture. Mechanism estimates depend on case definition: direct ball impact predominates in detailed globe-injury reports and one manually reviewed surveillance analysis, whereas broader eye, face, and head datasets identify a larger contribution from falls and paddle contact. Finite-element modelling supports the plausibility of damage to the angle, zonules, vitreous, and retina, but current models remain simplified. Dedicated protective-eyewear use is limited, and direct effectiveness data in pickleball are unavailable. Prevention therefore requires a combined approach involving certified eyewear, acceptable product design, player education, facility practices, and improved exposure-based surveillance.
Pickleball; Ocular Trauma; Injury Surveillance; Protective Eyewear; Sports Technology; Injury Prevention
Copyright (c) 2026 Alicja Maj, Karol Knysak, Maja Piątek, Michał Jastrzębski, Aleksandra Hejnosz, Mateusz Szczerba, Krystyna Wilkowska, Wojciech Kaczorowski, Maciej Karol Michałowski, Maria Sudomir, Julia Strumińska-Szularz https://creativecommons.org/licenses/by/4.0
THE SOCIO-ECONOMIC AND CLINICAL BURDEN OF BACTERIAL BIOFILM IN CHRONIC WOUND MANAGEMENT: A SOCIO-TECHNICAL REVIEW OF ADVANCED NURSING PROTOCOLS AND COST-MITIGATION TECHNOLOGIES
Aim: To analyze the clinical and socio-economic impact of bacterial biofilm on chronic wound healing stagnation and to evaluate the efficacy of structured, nurse-led biofilm-disruption protocols within the TIMERS framework, focusing on contemporary cost-mitigation technologies and healthcare resource allocation. Methodology: A comprehensive narrative review of literature published between January 2010 and March 2026 was performed across PubMed, CINAHL, and the Polish Main Medical Library (GBL). Methodological quality and structural reporting were evaluated using the Scale for the Assessment of Narrative Review Articles (SANRA) guidelines to ensure systematic rigor. Results: Bacterial biofilm represents a critical biological barrier present in the majority of non-healing wounds, driving a disproportionate socio-economic burden where approximately 30% of unresolved cases consume over 70% of specialized healthcare resources. Advanced nursing interventions incorporating specialized monofilament debridement technologies, surfactant-based cleansing protocols (e.g., polihexanide), and real-time bedside fluorescence imaging significantly enhance biofilm disruption compared to conventional saline irrigation. Discussion: Implementing structured wound management strategies mitigates the economic strain on public health systems by reducing long-term nursing hours, minimizing hospitalization frequencies, and optimizing material costs. The integration of advanced wound care technologies redefines nursing competencies, requiring interdisciplinary coordination and systematic clinical frameworks. Conclusions: Transitioning from reactive to proactive, technology-driven wound care protocols managed by specialized nursing staff is essential to alleviate both clinical stagnation and systemic economic pressures.
Biofilms; Chronic Wounds; Nursing Practice; Socio-Economic Burden; TIMERS Framework; Medical Technology
Copyright (c) 2026 Mikołaj Dubiel, Patryk Obajtek, Sylwia Sanakiewicz, Aleksandra Kwiatkowska, Dominik Woźniak, Karolina Zygoń-Komendarczyk https://creativecommons.org/licenses/by/4.0
BRUXISM IN HIGH PSYCHOPHYSICAL LOAD POPULATIONS: THE ROLE OF DIGITAL DIAGNOSTIC TECHNOLOGIES IN ATHLETES AND DANCERS - A NARRATIVE REVIEW
Background and Objective: Professional athletes and dancers operate under extreme psychosocial and physical demands, predisposing them to stress-related motor behaviors, notably awake and sleep bruxism. This review explores the neurobiological and epidemiological links between high-stress environments and bruxism, evaluating how innovative diagnostic technologies can bridge existing gaps in real-world clinical and ecological assessment. Methods: A narrative review of recent literature (2020-2026) was conducted using databases such as PubMed, Scopus, and Google Scholar. The analysis included systematic reviews, meta-analyses, observational studies, and research on technological innovations, with particular emphasis on electromyography (EMG), ecological momentary assessment (EMA), and machine learning-based diagnostic systems. Key Findings: Evidence demonstrates that stress acts as a primary neurobiological trigger for bruxism, significantly affecting athletic performance and, potentially, dancer well-being while contributing to craniofacial pain and physical injuries. While direct literature isolating dancers is an emerging niche, clear parallels with elite athletes may represent the high-risk nature of these professions. Crucially, the adoption of Ecological Momentary Assessment (EMA) and AI-enhanced wearable sensors (EMG) has significantly enhanced patient-reported and instrumental diagnostics, offering continuous, non-invasive data collection that captures real-world behavioral patterns and daily psychophysical load. Conclusions: Because bruxism heavily impacts high-load populations, leveraging smartphone-based diaries and smart wearable systems is essential. These innovative technologies not only enhance diagnostic accuracy but also empower healthcare providers and coaches to deploy timely psychological and physical interventions, safeguarding performers' holistic health. Furthermore, this synthesis has broader implications for public health strategies and digital health integration in high-performance populations.
Bruxism, Athletes, Dancers, Digital Health, Ecological Momentary Assessment, Wearable Technology
Copyright (c) 2026 Paula Kaczmarczyk, Mateusz Balicki, Marta Krężołek, Alicja Palus, Oliwia Zynek, Tomasz Arkuszyński, Julia Dobrowolska, Kornel Pawlak, Marcin Stępiński, Filip Kamyszek https://creativecommons.org/licenses/by/4.0
THE ROLE OF BRACHYTHERAPY IN THE TREATMENT OF NON-MELANOMA SKIN CANCERS: A NARRATIVE REVIEW
Background. Basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC) are the two most frequent malignancies worldwide, and their incidence continues to rise with the ageing of the population. Although surgical excision remains the gold standard, radiotherapy — including brachytherapy — constitutes a valuable alternative in selected clinical situations, particularly in elderly patients and in tumours located in cosmetically or functionally sensitive areas. Aim. This narrative review aims to define the role of brachytherapy in the treatment of non-melanoma skin cancers, with emphasis on currently used techniques (surface, contact, mould-based, and interstitial methods, including Leipzig- and Valencia-type applicators and electronic brachytherapy), as well as on indications, patient selection, efficacy, and safety profile. Methods. The PubMed/MEDLINE and Google Scholar databases were searched for English-language publications, and 44 articles published between 2011 and 2025 were included and analysed descriptively. Conclusions. The available literature indicates that brachytherapy is an effective treatment strategy for selected non-melanoma skin cancers, providing high local control rates (reported between 71% and 99%), good cosmetic outcomes, and low toxicity. High dose conformity and effective sparing of healthy tissue make brachytherapy a valuable component of multidisciplinary skin cancer care.
Brachytherapy, Skin Cancer, Basal Cell Carcinoma, Squamous Cell Carcinoma, Radiotherapy, Skin Cancer Treatment
Copyright (c) 2026 Natalia Bogumiłło, Krzysztof Mirkowski, Dawid Żuraw, Magdalena Kijowska, Karolina Klusek, Katarzyna Kulszo, Martyna Rynkowska, Magda Kowaleczko, Maciej Wiśniecki, Bartłomiej Baszun https://creativecommons.org/licenses/by/4.0
MACHINE LEARNING IN PREDICTION OF SEPSIS IN INTENSIVE CARE UNITS: A LITERATURE REVIEW OF ALGORITHMIC MODELS AND CLINICAL IMPLEMENTATION
Background. Sepsis continues to be among the leading causes of in-hospital death, accounting for around 11 million deaths globally in 2017 and pooled ICU mortality of nearly 42% (Rudd et al., 2020; Fleischmann-Struzek et al., 2020). The chance of survival decreases with each additional hour of delay in starting effective antibiotic treatment (Kumar et al., 2006), and standard screening tools, including SIRS and qSOFA, are known to overlook a meaningful share of cases (Raith et al., 2017). Models trained on routinely captured EHR data have therefore been put forward as a means of recognising patients at risk well before overt deterioration. Objective. To bring together the peer-reviewed evidence published between 2015 and 2025 on machine-learning algorithms for predicting sepsis in adult ICU patients, with attention to model architecture, prospective validation and the regulatory status of systems that have actually reached the bedside. Methods. A PRISMA 2020-aligned narrative review (Page et al., 2021) covering MEDLINE, Scopus, Web of Science, Embase and IEEE Xplore from January 2015 to March 2025. Reporting quality was checked against TRIPOD+AI (Collins et al., 2024) and risk of bias with PROBAST (Wolff et al., 2019). Seventy-three studies met the inclusion criteria. Results. Gradient-boosted trees, LSTM networks and transformer-based models reach internal AUROCs of about 0.83 to 0.94, while qSOFA and SIRS sit between 0.69 and 0.76 (Henry et al., 2015; Nemati et al., 2018). TREWS was associated with an 18.7% relative drop in adjusted in-hospital sepsis mortality (Adams et al., 2022); the only published randomised trial of an ML sepsis predictor, InSight, lowered mortality from 21.3% to 8.96% in a small ICU cohort (Shimabukuro et al., 2017); COMPOSER showed a 17% relative reduction at the bedside (Boussina et al., 2024). By contrast, the widely deployed Epic Sepsis Model achieved an external AUROC of only 0.63 (Wong et al., 2021). Two AI sepsis diagnostics have so far cleared the FDA: Sepsis ImmunoScore (De Novo DEN230036, 2024) and TriVerity (510(k) K241676, 2025). Conclusions. On the whole ML models discriminate sepsis better than traditional scores, but uneven outcome definitions, training-set bias, alert fatigue and patchy external validation still limit how far the gains travel between centres. Prospective trials reported to TRIPOD+AI standards, together with explicit equity audits, will be needed before ML sepsis prediction can be treated as routine care.
Sepsis; Machine Learning; Intensive Care; TREWS; Epic Sepsis Model; COMPOSER; Sepsis ImmunoScore; PRISMA
Copyright (c) 2026 Michal Parzniewski, Natalia Ostruszka, Maria Marusińska, Michał Karpinski, Wiktoria Czyż, Sabina Kolawa, Wojciech Markiewicz, Arnold Borowiec, Julia Pilecka, Jędrzej Wojciechowski https://creativecommons.org/licenses/by/4.0
PREGNANCY PLANNING AND PHARMACOTHERAPY FOR PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)
Background: SLE is an intriguing topic of research, given the severity of the disease and the impact in can have on a pregnant body is why this analysis and future research can help to better the understanding on how to improve patients' healthcare. Aim: This narrative review analysis the current available treatment methods for patients with SLE and the risks of SLE and pregnancy. Material and methods: A search of relevant research databases was conducted to identify eligible papers. Results: More research needs to be conducted to improve the understanding and improve SLE treatment in pregnant patients. Conclusions: SLE is a complex condition the variety of symptoms and risks factors in pregnancy are why new methods of treatment, improved specialist care and novel therapies are vital in its treatment.
Systemic Lupus Erythematosus (SLE), Lupus Nephritis (LN), Antiphospholipid Syndrome (APS), Pregnancy, Antiphospholipid Antibodies
Copyright (c) 2026 Maria Nowakowska, Jakub Senko, Zofia Suchanek, Kornelia Tyczka, Marcin Szczepanik, Joanna Kulpa https://creativecommons.org/licenses/by/4.0
BARRIERS AND FACILITATORS TO ACCESSING PSYCHOTHERAPY AMONG ADOLESCENTS IN PUBLIC HEALTH SYSTEMS: A SYSTEMATICALLY INFORMED NARRATIVE REVIEW
Background: Access to psychotherapy among adolescents in public health systems remains a significant challenge despite the growing burden of youth mental health disorders. Individual, family, service, and system-level factors influence whether adolescents initiate and sustain engagement with treatment. Objectives: To synthesize evidence on barriers and facilitators to accessing psychotherapy among adolescents within publicly funded or subsidized health systems and to identify multilevel determinants relevant to equitable service delivery. Methods: A systematically informed narrative review was conducted following PRISMA 2020 conventions. PubMed, Scopus, and the Cochrane Library were searched for studies published between 2015 and December 2025 on psychotherapy access among children and adolescents within public health systems. Qualitative, quantitative, and mixed-methods studies reporting barriers or facilitators to access or engagement were included and synthesized narratively using a four-level individual, family, service, and system framework. Results: Twenty studies met the inclusion criteria. Structural barriers, including long waiting times, limited specialist availability, geographic distance, and fragmented service coordination, were the most consistently reported obstacles. Stigma and cultural or linguistic mismatch further hindered engagement, particularly among migrant and minority populations, while limited mental health literacy and parental non-acceptance were key family-related barriers. Key facilitators included strong therapeutic relationships, active family support, school-based delivery, telehealth, and culturally adapted care models. Conclusions: Access to adolescent psychotherapy is shaped by interacting multilevel determinants. Reducing inequities requires coordinated strategies addressing structural barriers and psychosocial factors. Future research should adopt standardized definitions of access and prioritize underserved populations and low-resource settings.
Adolescent Mental Health; Psychotherapy Access; Barriers to Care; Facilitators of Care; Public Health Systems; Mental Health Services
Copyright (c) 2026 Maja Śmigielska, Joanna Jarzębska, Damian Grusiecki, Zuzanna Waszak, Jakub Marek Baran https://creativecommons.org/licenses/by/4.0
SMALL INTESTINAL MICROBIAL OVERGROWTH (SIBO, IMO, AND SIFO) IN THE PATHOGENESIS AND MANAGEMENT OF IRRITABLE BOWEL SYNDROME
Background. Irritable Bowel Syndrome (IBS) is a complex functional disorder characterized by abdominal pain and altered bowel habits. Small Intestinal Bacterial Overgrowth (SIBO) is increasingly recognized as a key pathogenetic factor, shifting the understanding of IBS toward a micro-organic basis. IBS is viewed as a heterogeneous condition with distinct phenotypes: microbiota-driven, post-infectious (PI-IBS), centrally mediated, and genetic variants. Aim. To evaluate the role of SIBO, Intestinal Methanogen Overgrowth (IMO), and Small Intestinal Fungal Overgrowth (SIFO) in IBS pathogenesis, focusing on prevalence, mechanisms, and targeted therapy. Material and methods. A literature review was performed using PubMed and Scopus (2000 - 2025). The analysis included 45 sources, including meta-analyses, systematic reviews, and clinical guidelines (Rome IV, Polish Society of Gastroenterology). Results. Meta-analyses indicate that IBS patients are nearly five times more likely to test positive for SIBO than healthy individuals (OR 4.7). Hydrogen-producing bacteria are linked to diarrhea (IBS-D), while methane delays transit, correlating with constipation (IBS-C). Proposed mechanisms include excessive fermentation gas, bile acid deconjugation, and increased intestinal permeability. SIFO is found in 25% of refractory cases. Targeted eradication particularly with rifaximin achieves symptom resolution, with 48% of treated patients no longer meeting Rome criteria. However, diagnostic inconsistencies in breath tests remain a subject of clinical controversy. Conclusions. SIBO and IMO represent treatable pathomechanisms in a subset of IBS patients, supporting a transition to personalized, mechanism-based management. Identifying these phenotypes is essential for optimizing targeted antimicrobial and prokinetic therapy. Individualized diagnostics are crucial for managing the micro-organic subtype of this complex syndrome.
IBS, SIBO, IMO, Dysbiosis, Microbiome, SIFO
Copyright (c) 2026 Julia Danieluk, Natalia Adamaszek, Michał Gliński, Urszula Kacprzak, Dominika Dołęga-Mostowska, Julia Sochowska, Agnieszka Buczkowska, Laura Stochaj, Michalina Flejszman, Justyna Wójcik https://creativecommons.org/licenses/by/4.0
IMMUNOPATHOGENESIS OF OCULAR MANIFESTATIONS OF GRANULOMATOSIS WITH POLYANGIITIS AND POTENTIAL TARGETS FOR NOVEL BIOLOGICAL THERAPIES
Granulomatosis with polyangiitis (GPA) is a phenotypically heterogeneous form of ANCA-associated vasculitis characterized by two partially overlapping processes: extravascular granulomatous inflammation and necrotizing vasculitis of small- and medium-sized vessels. This dual pathobiology is particularly relevant in ocular disease, where some manifestations primarily reflect active vasculopathy and endothelial injury, whereas others result from locally destructive granulomatous inflammation extending from the sinonasal tract, orbit, sclera, and ocular adnexa. Ocular involvement is reported in approximately one quarter to one third of patients in contemporary pooled analyses, with higher rates in ophthalmology-based cohorts and in head-and-neck–limited disease. The most common manifestations include scleritis, episcleritis, orbital inflammatory mass or pseudotumor, peripheral ulcerative keratitis, and lacrimal system involvement; optic neuropathy, retinochoroidal inflammation, and visual loss are less frequent but potentially sight-threatening. The immunopathogenesis of ophthalmic GPA involves dysregulated B- and T-cell responses, ANCA-mediated neutrophil activation, neutrophil extracellular trap formation, complement amplification, and local tissue-destructive programs mediated by macrophages, plasma cells, fibroblasts, and matrix metalloproteinases. Rituximab remains the best-established biologic therapy, particularly for vasculitic ocular manifestations and peripheral ulcerative keratitis, although granulomatous orbital lesions may be relatively treatment-resistant. Future therapeutic strategies should target BAFF/APRIL/BCMA/TACI signaling, CD38-positive plasma cells, IL-6/IL-6R, IL-21/Tfh/ICOS pathways, Th17/IL-23 signaling, C5a/C5aR-mediated complement activation, NETosis, and monocyte-driven tissue invasion. A layered therapeutic approach combining control of ANCA-dependent inflammation with suppression of local granulomatous tissue destruction may be especially promising, although ocular-specific randomized trials remain lacking.
Granulomatosis With Polyangiitis, Ocular Involvement, ANCA-Associated Vasculitis, Immunopathogenesis, Biological Therapy
Copyright (c) 2026 Maria Kiełbus, Julia Oziębło, Magdalena Kijowska, Karolina Klusek, Michał Batory, Jakub Jakubowski, Karol Kraska, Nadzieja Krasucka, Aleksandra Zynkowska, Aleksandra Magdalena Skrzyniarz https://creativecommons.org/licenses/by/4.0
COMPARATIVE CLINICAL OUTCOMES OF FARICIMAB VERSUS AFLIBERCEPT IN DIABETIC MACULAR EDEMA: A FOCUSED REVIEW
This manuscript presents a focused narrative review with systematic literature identification of comparative evidence on faricimab versus aflibercept in adults with diabetic macular edema. The review prioritized randomized phase III evidence and selected only clinically decisive extension, post hoc, and real-world studies published from 2022 through 2025. The predefined PICO was: adults with DME; intervention faricimab; comparator aflibercept; outcomes best-corrected visual acuity, central subfield thickness, injection burden and durability, and safety. The core evidence base consisted of the YOSEMITE and RHINE randomized trials and their 2-year follow-up, supplemented by FDA regulatory documents and a small number of directly relevant post hoc and real-world studies. At year 1, faricimab achieved noninferior visual gains versus aflibercept in both trials, with numerically greater reductions in central subfield thickness. At year 2, visual acuity remained comparable, whereas anatomic outcomes and durability continued to favor faricimab, especially in the treat-and-extend arm, in which more than 60% of patients were on every-16-week dosing and approximately 80% were on every-12-week-or-longer dosing by week 96. Safety was broadly similar across randomized arms, although postmarketing retinal vasculitis warnings require continued pharmacovigilance. Direct real-world head-to-head evidence remained sparse; available switch studies suggest benefit primarily in selected aflibercept-refractory eyes. Overall, the present evidence supports faricimab as a clinically relevant alternative to aflibercept in DME when durability and anatomic control are prioritized, but not as a superior agent for letter gain alone.
Diabetic Macular Edema; Faricimab; Aflibercept; YOSEMITE; RHINE; Durability
Copyright (c) 2026 Karol Kraska, Nadzieja Krasucka, Aleksandra Zynkowska, Aleksandra Magdalena Skrzyniarz, Maria Kiełbus, Julia Oziębło, Magdalena Kijowska, Karolina Klusek, Michał Batory, Jakub Jakubowski https://creativecommons.org/licenses/by/4.0
IMPACT OF MODERN DIETARY HABITS ON ORAL HEALTH IN CHILDREN: A NARRATIVE REVIEW
Introduction. Dental caries remains the most prevalent chronic disease of childhood worldwide. In recent decades, children's dietary patterns have shifted toward increased consumption of sugar-sweetened beverages, ultra-processed foods, and frequent snacking, raising concerns about their impact on oral health. Aim. To examine the impact of modern dietary habits on oral health outcomes in children, integrating epidemiological patterns, mechanistic insights, and preventive strategies. Material and Methods. A literature search was conducted across PubMed, Scopus, and Google Scholar for English-language studies examining dietary habits and oral health in children aged 0–18 years. Studies were selected based on relevance to contemporary dietary patterns and pediatric oral health outcomes, with priority given to publications from the last 20 years. A total of 27 studies met the inclusion criteria and were included in the review. Results. Frequent consumption of sugar-sweetened beverages and sugary snacks was consistently associated with higher caries prevalence across age groups and geographic settings. Ultra-processed food consumption was associated with poorer diet quality and indirect caries risk, though direct oral health evidence remains limited. Nutrient-dense diets were associated with reduced caries incidence, particularly when combined with oral hygiene education in school-based programs. Socioeconomic factors, including low parental education and limited access to preventive care, significantly moderated these associations. Conclusions. Modern dietary habits are consistently associated with poorer oral health outcomes in children, with the strongest evidence for sugar-sweetened beverages and dental caries. Integrated interventions combining dietary guidance, oral hygiene education, and targeted support for high-risk populations are needed to reduce the pediatric caries burden. Future prospective studies with standardized measures are warranted to strengthen the causal evidence base.
Dental Caries, Children, Dietary Habits, Sugar-Sweetened Beverages, Ultra-Processed Foods, Oral Health, Narrative Review
Copyright (c) 2026 Hanna Krupa, Ewa Stopa, Emilia Miśkiewicz, Natalia Borek, Julia Gałązka, Zofia Wieczorek , Magdalena Kędrak, Dominik Stanisławski, Wiktoria Jabłońska-Trzosek , Jakub Pochwalski https://creativecommons.org/licenses/by/4.0
TYPE 2 DIABETES MELLITUS: PATHOPHYSIOLOGY, DIAGNOSTICS, AND CONTEMPORARY THERAPEUTIC STRATEGIES. A REVIEW
Type 2 diabetes mellitus (T2DM) remains one of the dominant clinical challenges in modern medicine. According to the 11th edition of the IDF Diabetes Atlas (2025), 589 million adults currently suffer from this condition, and it is estimated that by 2050, the number of patients will increase by 46%, reaching 853 million. This paper reviews current knowledge on the pathogenesis of T2DM, which includes peripheral insulin resistance, the progressive loss of pancreatic beta-cell mass alongside secondary impairment of their secretory function, and systemic inflammation. Diagnostic criteria are presented in accordance with the 2025 PTD (Diabetes Poland) guidelines, including recommendations for screening and the identification of high-risk groups. A fundamental part of the study is devoted to modern pharmacotherapy, with a particular focus on SGLT-2 inhibitors and GLP-1 receptor agonists as drugs with documented cardioneproprotective effects. Furthermore, the role of metabolic surgery and the importance of comprehensive, multidisciplinary care in the prevention and treatment of organ-related complications are discussed.
Type 2 Diabetes Mellitus, Insulin Resistance, SGLT-2 Inhibitors, GLP-1 Agonists, Cardiovascular Complications, Renal Complications
Copyright (c) 2026 Dominik Wiater, Kacper Szkodziński, Inga Jakubczyk, Jagoda Maternia, Aleksandra Łoś, Karolina Majowicz-Czaszyńska, Wiktoria Pempuś, Nikola Król, Barbara Tomaszek, Aleksandra Blok, Gabriela Płodzień https://creativecommons.org/licenses/by/4.0
THE ROLE OF INNOVATIVE TELEMEDICINE TECHNOLOGIES IN DIABETES CARE: A NARRATIVE REVIEW OF METABOLIC, BEHAVIORAL, AND SOCIAL OUTCOMES
Introduction: Diabetes mellitus remains a major public health challenge worldwide, requiring continuous monitoring, long-term treatment, and active patient participation. Recent advances in telemedicine, continuous glucose monitoring systems, mobile health applications, and artificial intelligence have created new opportunities for remote and personalized diabetes management. Aim: This narrative review evaluated the impact of telemedicine and digital health technologies on metabolic control, treatment adherence, self-management behaviors, and psychosocial outcomes among adults with type 1 and type 2 diabetes mellitus. Materials and Methods: A narrative review of the literature was conducted using keywords in the PubMed database. Recent studies involving adult patients with type 1 and type 2 diabetes were analyzed. Attention was paid to outcomes related to glycated hemoglobin (HbA1c), continuous glucose monitoring metrics, treatment adherence, patient engagement, self-management, and quality-of-life indicators. Results: Most reviewed studies demonstrated that telemedicine interventions significantly improved glycemic control, particularly by reducing HbA1c levels. Digital care models incorporating continuous glucose monitoring increased Time in Range and reduced hyperglycemic exposure. Telemedicine was also associated with improved adherence to treatment recommendations, greater patient engagement, enhanced self-management competencies, and positive psychosocial outcomes, including improved quality of life and reduced diabetes-related distress. The greatest benefits were observed in patients with poor baseline metabolic control and in programs integrating remote monitoring with structured educational support. Conclusions: Telemedicine represents an effective and innovative complement to conventional diabetes care. Digital health technologies facilitate personalized disease management, improve patient participation in therapeutic processes, and may contribute to more accessible and sustainable healthcare delivery.
Diabetes Mellitus, Telemedicine, Telemonitoring, Digital Health, Continuous Glucose Monitoring, Innovative Healthcare Technologies
Copyright (c) 2026 Aleksandra Wojtera, Nina Urantówka, Aleksandra Karolina Węglarz, Patrycja Anna Borowiecka, Jagoda Anna Adamarczuk, Jacek Głuski, Aleksandra Anna Miciak, Karina Barbara Kaszowska, Tomasz Piotr Dąbrowski, Karolina Kaczmarz-Chojnacka, Jakub Buziak https://creativecommons.org/licenses/by/4.0
ADVANCED BIOMATERIAL PLATFORMS FOR CHRONIC WOUND CARE: SMART DRESSINGS, 3D BIOPRINTING, AND 4D RESPONSIVE TECHNOLOGIES
Chronic non-healing wounds constitute a significant health concern and impose a substantial financial burden on healthcare systems. This creates a pressing need for advanced solutions capable of improving therapeutic efficacy. The aim of this review article is to analyze the current state of knowledge regarding the application of smart dressings and 3D and 4D bioprinting technologies in the treatment of chronic wounds. The methodology was based on a critical review and synthesis of scientific literature in the fields of biomaterials engineering and regenerative medicine. Contemporary hydrogel-based matrices integrated with biosensors and machine learning algorithms effectively transform passive mechanical wound protection into an automated system for monitoring the wound microenvironment and actively responding to its changes. Concurrently, 3D bioprinting techniques enable precise architectural reconstruction of tissues and the fabrication of grafts tailored to the unique size, shape, and depth of individual injuries. Although smart dressing technologies, 3D and 4D bioprinting are undergoing intensive development, additional preclinical and clinical studies are required to establish their safety and efficacy profiles, which is a prerequisite for the development of national regulatory standards.
3D Bioprinting, Chronic Wounds, Smart Dressings, 4D Printing
Copyright (c) 2026 Nadzieja Krasucka, Jakub Jakubowski, Michał Batory, Karolina Klusek, Magdalena Kijowska, Julia Oziębło, Maria Kiełbus, Aleksandra Magdalena Skrzyniarz, Aleksandra Zynkowska, Karol Kraska https://creativecommons.org/licenses/by/4.0
THE ROLE OF ELECTROCARDIOGRAPHY IN THE DIAGNOSIS AND MONITORING OF FABRY DISEASE: A COMPREHENSIVE REVIEW
Anderson-Fabry disease (FD) is a rare, X-linked lysosomal storage disorder in which the progressive accumulation of globotriaosylceramide (Gb3) leads to widespread multi-organ damage, with cardiac involvement serving as the primary cause of mortality. This comprehensive review aims to summarize the current state of knowledge regarding the clinical application of electrocardiography (ECG) as a pivotal and cost-effective tool in the management of patients with FD. The paper systematically categorizes ECG findings across the various stages of the disease's progression. Early stages are typically characterized by a shortened PR interval and increased QRS complex voltages, which frequently manifest prior to the development of structural changes identifiable through echocardiography. In the more advanced stages of the disease, the predominant features include signs of left ventricular hypertrophy (LVH), ST-segment depressions, and deep T-wave inversions, which often mimic the presentation of hypertrophic cardiomyopathy or myocardial ischemia. Furthermore, this review discusses the evolution of conduction disturbances, including atrioventricular blocks and atrial fibrillation, while emphasizing the absolute necessity of Holter monitoring for effective arrhythmia risk stratification. The impact of enzyme replacement therapy (ERT) on the stabilization of ECG patterns is evaluated, indicating that early clinical intervention is crucial for the prevention of irreversible electrical remodeling. In conclusion, despite the ongoing development of advanced imaging modalities, the standard 12-lead ECG remains a fundamental and indispensable tool that shortens the diagnostic odyssey and allows for the precise monitoring of treatment efficacy in Fabry disease.
Fabry Disease, Electrocardiography, PR Interval, Left Ventricular Hypertrophy, Arrhythmia, Screening
Copyright (c) 2026 Jakub Jakubowski, Karol Kraska, Nadzieja Krasucka, Aleksandra Zynkowska, Aleksandra Skrzyniarz, Maria Kiełbus, Julia Oziębło, Magdalena Kijowska, Karolina Klusek, Michał Batory https://creativecommons.org/licenses/by/4.0
THERAPY FOR ALZHEIMER’S DISEASE - FOCUS ON LECANEMAB
Alzheimer’s disease (AD) is a chronic, progressive neurodegenerative disorder and the leading cause of dementia worldwide, with prevalence increasing due to population aging. It is characterized by cognitive decline, functional impairment, and significant public health burden. Pathophysiology involves a complex interplay of amyloid-β (Aβ) accumulation, tau pathology and neuroinflammation. Despite extensive research, current pharmacological management of Alzheimer’s disease relies primarily on symptomatic therapies and does not alter the underlying neurodegenerative process. The aim of this review is to summarize the current state of knowledge on therapeutic strategies for AD, with particular emphasis on lecanemab, a recombinant humanized antibody characterized by their selectivity for soluble Aβ oligomers. We discuss its mechanism of action, clinical evidence from recent randomized controlled trials assessing its efficacy and safety. In this review, lecanemab is not only addressed in the context of established and widely used therapies but also alongside novel treatments currently being tested. Lecanemab represents a significant step towards disease-modifying therapy for AD as it reduces brain amyloid. Although the available results are promising, current evidence suggests that monotherapeutic interventions targeting a single pathological mechanism may be insufficient to completely stop or reverse disease progression underscoring the need for further research to optimize therapeutic outcomes.
Alzheimer’s Disease; Lecanemab; Amyloid-Beta; Disease-Modifying Therapy
Copyright (c) 2026 Mikołaj Jońca, Gabriela Majchrowicz, Natasza Kurys, Weronika Piekarska, Szymon Litke , Katarzyna Gołacka https://creativecommons.org/licenses/by/4.0
APPLICATIONS OF VIRTUAL REALITY TECHNOLOGY IN PSYCHIATRY – A REVIEW
Virtual reality (VR) is a promising tool supporting diagnostics and therapy in psychiatry, aligning with the Health 4.0 paradigm of personalized healthcare. This review synthesizes the available scientific evidence on VR applications in psychiatry, with particular emphasis on therapeutic mechanisms, clinical effectiveness, and identification of research gaps. The strongest empirical evidence concerns VR exposure therapy (VRET) in the treatment of anxiety disorders, where the effectiveness of VRET is comparable to in vivo exposure (Suso-Ribera et al., 2019). In the case of post-traumatic stress disorder, graded exposure based on the patient's responses has been shown to be a key moderator of effectiveness, yielding significant therapeutic effects (Heo and Park, 2022). In psychotic disorders, automated VR interventions reduce agoraphobic avoidance (Freeman et al., 2022), while in social phobia, optimal results are achieved by combining VRET with cognitive-behavioral interventions (Tan et al., 2025). The neurobiological mechanisms of therapeutic change are based on amygdala activation and modulation of the medial prefrontal cortex and hippocampus, enabling extinction of the fear response. However, generalization of learned responses beyond the virtual context remains a key challenge (Freeman, 2017). Personalization of interventions using artificial intelligence is in the early stages of development (Bergsnev and Sánchez Laws, 2026). From a clinical perspective, VR is characterized by high acceptability and low dropout rates. Further development of the field requires comparative studies with active interventions, standardization of the sense of presence measurement, and validation of tools for measuring social attitudes toward VR therapy. Integrating VR with traditional therapeutic methods, rather than replacing them, seems to be the most justifiable path forward for this field.
Virtual Reality, Psychiatry, Exposure Therapy, VRET, Anxiety Disorders, PTSD
Copyright (c) 2026 Wiktor Rybicki, Radosław Dutczak, Aleksandra Sobieska, Alicja Korpacka, Patrycja Mularczyk, Mateusz Okoń, Zuzanna Lecyk, Alicja Gawlik, Małgorzata Lubowiecka https://creativecommons.org/licenses/by/4.0
THE IMPACT OF DEVELOPMENTAL ENAMEL DEFECTS ON QUALITY OF LIFE AND PSYCHOSOCIAL ASPECTS IN MINOR PATIENTS WITH MIH, AMELOGENESIS IMPERFECTA, AND DENTAL FLUOROSIS
Developmental enamel defects (DEDs) constitute a clinically significant group of conditions with multifactorial etiology. Beyond their structural and functional consequences — including dentinal hypersensitivity, increased susceptibility to caries, and mechanical fragility — developmental enamel defects significantly reduce oral health-related quality of life (OHRQoL) in the pediatric population. The aim of this literature review was to characterize three distinct developmental enamel defects — molar-incisor hypomineralization (MIH), dental fluorosis, and amelogenesis imperfecta (AI) — and to evaluate their impact on OHRQoL in minor patients. Between March and May 2026, the PubMed and Google Scholar databases were searched, with inclusion limited to English-language publications. All three conditions were associated with reduced OHRQoL through aesthetic compromise, diminished self-esteem, and social avoidance. In MIH, patients face difficulties achieving effective anesthesia and demonstrate a pronounced tendency toward carious lesions. Fluorosis negatively affects self-perception among those affected. AI is associated with psychological distress and social withdrawal. Prosthetic rehabilitation and aesthetic treatment improve OHRQoL in patients with developmental enamel defects. Aesthetic dental treatment in this group should be regarded as a preventive intervention against depression and social exclusion, rather than merely a cosmetic procedure.
Developmental Enamel Defects, MIH, Fluorosis, Amelogenesis Imperfecta, OHRQoL, Pediatric Dentistry
Copyright (c) 2026 Monika Maria Szerszeń, Maria Torchalska, Martyna Smogór https://creativecommons.org/licenses/by/4.0
THE ROLE OF NURSING ASSESSMENT IN DIAGNOSING INTESTINAL MALROTATION: A CASE REPORT
Intestinal malrotation is a congenital anomaly of the gastrointestinal tract that is most commonly diagnosed during the neonatal period. Delayed presentation beyond infancy is uncommon and may result in significant diagnostic challenges, particularly in children with complex genetic disorders. This case describes a 4-year-old girl with Edwards syndrome (Trisomy 18) whose atypical presentation of intestinal malrotation created a demanding clinical situation for the multidisciplinary healthcare team. The patient was admitted to the pediatric surgical department with coffee-ground vomiting and a one-week history of constipation. Due to severe developmental impairment and limited communication abilities associated with her genetic condition, the assessment of symptoms relied heavily on careful clinical observation. The nursing team played a crucial role in the diagnostic process through comprehensive assessment, including pain evaluation using the FLACC scale, continuous monitoring of vital signs, and detailed observation of the frequency and characteristics of emesis. These findings raised suspicion of a high-level intestinal obstruction and prompted further diagnostic investigations. Although the initial abdominal X-ray suggested a diaphragmatic hernia, surgical exploration revealed intestinal malrotation with volvulus consistent with Ladd’s syndrome. This case highlights the importance of advanced nursing assessment, clinical vigilance, and interdisciplinary collaboration in recognizing rare surgical emergencies and ensuring patient safety in children with significant communication barriers and complex healthcare needs.
Nursing Assessment, Pediatric Nursing, Intestinal Malrotation, Edwards Syndrome
Copyright (c) 2026 Sylwia Sanakiewicz, Patryk Obajtek, Mikołaj Dubiel, Julia Jasińska, Aleksandra Gródek, Dominik Iskrzyński, Aleksandra Bułat, Wiktoria Dubiel, Julia Iglantowicz https://creativecommons.org/licenses/by/4.0
EXERCISE-INDUCED GASTROINTESTINAL SYMPTOMS IN ENDURANCE ATHLETES: MECHANISMS, PREVENTION, AND MANAGEMENT – A NARRATIVE REVIEW
Background: Gastrointestinal (GI) symptoms are common among endurance athletes and may impair performance, particularly during prolonged, high-intensity exercise in hot environments or under conditions of dehydration. These disturbances are collectively referred to as Exercise-Induced Gastrointestinal Syndrome (EIGS). Objective: This review summarizes current evidence on the epidemiology, pathophysiological mechanisms, consequences, and prevention strategies for EIGS in endurance athletes. Methods: A narrative review of the literature was conducted, focusing on the prevalence of GI symptoms during endurance exercise, the underlying mechanisms of EIGS—including splanchnic hypoperfusion, epithelial barrier disruption, ischemia-reperfusion injury, mechanical stress, nutritional factors, and neuroendocrine responses—and evidence-based prevention and management strategies. Results: GI symptoms affect approximately 30–50% of endurance athletes, with the highest prevalence reported in marathon, ultra-endurance, and triathlon events. EIGS results from the interaction of reduced splanchnic blood flow, hyperthermia, epithelial injury, and nutritional and mechanical stress, leading to increased intestinal permeability, inflammation, impaired fluid and nutrient absorption, dehydration, and reduced athletic performance. Hypertonic carbohydrate intake, high-FODMAP foods, and nonsteroidal anti-inflammatory drug use may increase symptom risk. Individualized nutrition and hydration strategies, gut training, and low-FODMAP dietary approaches in susceptible athletes may reduce symptom severity. Conclusions: EIGS is a multifactorial condition driven by interacting circulatory, thermal, mechanical, nutritional, and neuroendocrine stressors. Although no single intervention completely prevents GI symptoms, individualized fueling strategies and gut training appear to be the most effective current approaches. Further research is needed to optimize prevention and identify factors underlying individual susceptibility.
Gastrointestinal Symptoms; Endurance Sports; Exercise-Induced Gastrointestinal Syndrome; Intestinal Permeability; Splanchnic Blood Flow; Gut Training
Copyright (c) 2026 Karolina Przybysz, Luiza Stadnik, Alicja Kozłowska, Nicol Szerenos, Adela Dzwonkowska, Daria Trocka, Natalia Zienkiewicz, Jarosław Rachoń, Jakub Dzwonkowski, Natalia Woroniecka https://creativecommons.org/licenses/by/4.0
ARTIFICIAL INTELLIGENCE IN DERMATOLOGY: OPPORTUNITIES, LIMITATIONS, ETHICAL CHALLENGES AND HEALTH EQUITY – A NARRATIVE REVIEW
Background: Artificial intelligence (AI) has become a promising tool in dermatology that could improve diagnostic accuracy, optimize clinical workflows, and expand access to dermatological care. Recent advances in machine learning and deep learning have enabled the development of highly accurate image-analysis systems, particularly for the diagnosis of skin lesions. However, the implementation of AI in clinical practice is accompanied by important ethical, legal, and equity-related challenges. Objective: This narrative review aims to summarize the current evidence regarding the applications of artificial intelligence in dermatology, with particular emphasis on its potential to improve healthcare accessibility, support teledermatology, and promote health equity while addressing existing limitations and ethical concerns. Methods: A narrative review of the literature was conducted using PubMed, PubMed Central, and Google Scholar. Peer-reviewed articles published in English between 2017 and 2025 were included. The literature was selected using keywords related to artificial intelligence, dermatology, skin cancer, teledermatology, and health equity. Results: The reviewed literature demonstrates that AI has achieved high diagnostic performance in the recognition of various skin diseases, particularly malignant skin lesions, and may significantly improve access to dermatological services through teledermatology and decision-support systems. Nevertheless, challenges including algorithmic bias, limited representation of diverse skin phototypes in training datasets, data privacy concerns, and insufficient regulatory frameworks remain substantial barriers to widespread implementation. Conclusions: Artificial intelligence has the potential to transform dermatological care by enhancing diagnostic efficiency and improving healthcare accessibility. However, its successful integration into clinical practice requires diverse and representative datasets, robust ethical and legal standards, and continued human oversight to ensure safe, equitable, and patient-centered healthcare.
Artificial Intelligence, Dermatology, Health Equity, Skin Cancer, Teledermatology, Deep Learning
Copyright (c) 2026 Adela Dzwonkowska, Jakub Dzwonkowski, Alicja Kozłowska, Karolina Przybysz, Jarosław Rachoń, Luiza Stadnik, Nicol Szerenos, Daria Trocka, Natalia Woroniecka, Natalia Zienkiewicz https://creativecommons.org/licenses/by/4.0
DELIVERING MULTIMODAL PREHABILITATION IN THE NEOADJUVANT WINDOW BEFORE ESOPHAGOGASTRIC CANCER SURGERY: HOME-BASED MODELS, DIGITAL HEALTH, AND IMPLEMENTATION – A NARRATIVE REVIEW
Esophagectomy and gastrectomy for esophagogastric cancer are among the most physiologically demanding oncological operations and carry high rates of postoperative morbidity. Because neoadjuvant chemotherapy or chemoradiotherapy now precedes surgery in most patients with locally advanced disease, the preoperative interval offers an opportunity to intervene through multimodal prehabilitation, combining aerobic and resistance exercise, inspiratory muscle training, nutritional optimization, and psychological support. This narrative review synthesizes the rationale and current evidence for prehabilitation during the neoadjuvant window and, in particular, examines how it can be delivered in practice. Prehabilitation consistently improves preoperative functional capacity and respiratory muscle strength, and inspiratory muscle training is associated with fewer postoperative pulmonary complications, although effects on overall morbidity, length of stay, and mortality remain inconsistent. Beyond efficacy, the review foregrounds delivery and implementation: supervised hospital-based programmes are resource-intensive and geographically limiting, whereas home-based and digitally supported models — using smartphone applications, wearable sensors, and telehealth contact — offer a scalable alternative, with early evidence that home-based delivery may be comparable to supervised care. Technology-enabled prehabilitation raises its own questions of access and equity, including digital literacy and connectivity, that determine whether it narrows or widens existing disparities. Prehabilitation timed to the neoadjuvant window is a biologically plausible, feasible, and low-risk strategy to improve preoperative fitness; its translation into routine esophagogastric cancer care now depends as much on delivery model, technology, and implementation as on defining optimal clinical content, and standardized, adequately powered trials are needed to confirm benefit.
Prehabilitation; Telemedicine; Mobile Health; Esophagectomy; Neoadjuvant Therapy; Health Services Accessibility
Copyright (c) 2026 Natalia Zienkiewicz, Jarosław Rachoń, Adela Dzwonkowska, Jakub Dzwonkowski, Alicja Kozłowska, Daria Trocka, Karolina Przybysz, Luiza Stadnik, Natalia Woroniecka, Nicol Szerenos https://creativecommons.org/licenses/by/4.0
OPTIMIZING PROSTATE CANCER DIAGNOSTICS: CAN BIOMARKERS DECREASE THE BURDEN OF OVER-INVESTIGATION?
The foundation of current prostate cancer diagnostics still remains the interpretation of total PSA (tPSA) results, but it is an imperfect test due to its low specificity and diagnostic ambiguities in patients within the "gray zone," meaning patients with a result of (2.0/4.0–10.0 ng/mL). This fact leads to many cases of "overdiagnosis" and an excess of unnecessarily performed biopsies. This article summarizes the diagnostic value of blood-based biomarkers and tests (PHI, 4Kscore, Stockholm3) as well as urine-based ones (SelectMDx and ExoDx). These tests achieve high AUC values (0.76–0.88) and a high negative predictive value (up to 98%) in detecting clinically significant prostate cancer (csPCa, GG ≥ 2), underscoring their advantage over traditional methods. Combining them with multiparametric MRI allows for a 30–65% reduction in unnecessary biopsies while maintaining high oncological safety for the patient. Despite promising results, the high costs of individual tests, lack of reimbursement, and absence of full standardization in international urological guidelines remain a continuous challenge and a hurdle to their introduction into daily practice.
Prostate Cancer, Biomarkers, Biopsy, Multiparametric MRI (mpMRI), Prostate Health Index (PHI), 4Kscore, Stockholm3, ExoDx, SelectMDx
Copyright (c) 2026 Mikolaj Kurczynski, Aleksandra Suszczyńska, Angelika Wiatr, Ksenia Jakubiak, Julia Witkowska, Ewa Wojtanowska, Aleksandra Pietrucień, Monika Krasoń https://creativecommons.org/licenses/by/4.0
SLEEP AND PHYSICAL RECOVERY METHODS IN SPORT: A NARRATIVE REVIEW
Recovery is a fundamental component of athletic training and performance. Appropriate recovery strategies support physiological adaptation, reduce fatigue, and decrease the risk of injury. Among the various recovery approaches used in sport, sleep and physical recovery methods are the most commonly applied by athletes and coaches. The aim of this narrative review was to evaluate the role of sleep and selected physical recovery methods in post-exercise recovery. A literature search was conducted using electronic databases, including PubMed and Google Scholar. Original studies, systematic reviews, meta-analyses, and narrative reviews related to sleep, cold-water immersion, massage, stretching, and foam rolling were analyzed. Current evidence indicates that sleep is the most important recovery factor, as it directly influences hormonal regulation, immune function, glycogen restoration, protein synthesis, cognitive performance, and overall adaptation to training. Adequate sleep has been associated with improved reaction time, endurance, concentration, and reduced injury risk. In contrast, physical recovery methods appear to be effective mainly in reducing delayed onset muscle soreness and perceived fatigue, while their influence on physiological recovery mechanisms remains limited. Methods such as cold-water immersion, massage, stretching, and foam rolling may improve subjective recovery and readiness for subsequent exercise sessions. The findings suggest that sleep should be prioritized as the primary recovery strategy, whereas physical recovery methods should be considered complementary interventions. A combined recovery approach may provide the greatest benefits for athletic performance and long-term adaptation.
Sleep; Recovery; Sport Performance; Cold-Water Immersion; Massage; Foam Rolling
Copyright (c) 2026 Wiktor Nesterak, Julia Suchecka, Izabela Szubert, Jakub Lamorski, Gabriela Stępień, Karolina Chudecka, Michał Chylewski, Katarzyna Józwa, Aleksandra Kędzierska, Urszula Przewoźna https://creativecommons.org/licenses/by/4.0
THE NEUROBIOLOGICAL AND IMMUNOLOGICAL BASIS OF THE CO-OCCURRENCE OF ENDOMETRIOSIS WITH DEPRESSION AND ANXIETY: A SYSTEMATIC REVIEW
Introduction: Endometriosis is a chronic, oestrogen-dependent inflammatory condition affecting approximately 10% of women of reproductive age worldwide. In addition to its well-documented gynaecological symptoms, endometriosis is increasingly associated with psychiatric disorders, particularly depression and anxiety disorders. The neurobiological and immunological mechanisms underpinning this comorbidity remain poorly understood. Objective: This systematic review aims to synthesise current data on the neurobiological, neuroendocrine and immunological mechanisms linking endometriosis to depression and anxiety disorders, taking into account additional psychiatric symptoms such as sleep disorders, post-traumatic stress disorder (PTSD) and sexual dysfunction. Methods: A systematic search of the PubMed/MEDLINE database was conducted to identify articles published between January 2008 and March 2026, using predefined search terms relating to endometriosis, mental health, neuroinflammation and immune dysregulation. Study selection was carried out in accordance with the PRISMA 2020 guidelines. Studies analysing the association between endometriosis and psychiatric outcomes, or investigating the underlying biological mechanisms, were included. Results: Thirty studies met the inclusion criteria. The data consistently indicate elevated rates of depression (prevalence 9.8-98.5 per cent) and anxiety (11.5-87.5 per cent) in women with endometriosis compared with the general population. Key mechanisms identified include: dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis; systemic and central neuroinflammation mediated by pro-inflammatory cytokines (IL-1beta, IL-6, TNF-alpha), oestrogen-induced neurotransmitter imbalances, central sensitisation, oxidative stress and gut-brain axis dysfunction. Conclusions: The relationship between endometriosis and psychiatric disorders is bidirectional and mediated by combined neuroendocrine-immunological pathways. These findings highlight the need for integrated, multidisciplinary management strategies that take into account both the somatic and psychological dimensions of endometriosis.
Endometriosis, Depression, Medication, Neuroinflammation, Hypothalamic-Pituitary-Adrenal Axis, Cytokines
Copyright (c) 2026 Julia Wawerska, Martyna Grzywacz, Bartosz Okliński, Maciej Kisielewski, Mateusz Zugaj, Weronika Wrzosek, Rafał Ejsner, Marta Rząsa, Balbina Tybulczuk, Bartłomiej Markowski https://creativecommons.org/licenses/by/4.0
HYPOTHYROIDISM AND HASHIMOTO'S THYROIDITIS AS MIGRAINE COMORBIDITIES: EPIDEMIOLOGY, MECHANISMS, AND THERAPEUTIC IMPLICATIONS - A NARRATIVE REVIEW
Background: Both migraine and hypothyroidism are prevalent chronic conditions, predominantly affecting women. A growing body of evidence suggests a bidirectional comorbid relationship between these two conditions, yet the magnitude and directionality of this association remain insufficiently characterized. Objective: To review published evidence on the association between hypothyroidism (including subclinical hypothyroidism and Hashimoto's thyroiditis) and migraine or headache outcomes in humans, and to evaluate the therapeutic implications of thyroid hormone replacement. Methods: A systematic search of PubMed (n = 141) and Cochrane (n = 16) databases was conducted for studies published from January 1990 to 2025. After title/abstract screening and full-text eligibility assessment, 17 studies were included. Included study designs comprised cross-sectional studies, case-control studies, cohort studies, and one quasi-randomized placebo-controlled trial. Results: The prevalence of hypothyroidism in migraine patients consistently exceeded general population estimates. Subclinical hypothyroidism was identified in a significantly higher proportion of migraine patients compared to controls. Patients with chronic migraine showed substantially higher rates of hypothyroidism than those with episodic migraine. Hashimoto's thyroiditis was associated with migraine chronification and increased migraine days per month. Levothyroxine treatment significantly reduced headache frequency, severity, and disability in patients with comorbid subclinical hypothyroidism and migraine. Genetic evidence supported shared biological pathways. Conclusion: Hypothyroidism and Hashimoto's thyroiditis are meaningful comorbidities in migraine patients. Routine thyroid function screening is warranted in patients with refractory or progressive migraine. Levothyroxine treatment may yield clinically significant headache reduction.
Migraine; Hypothyroidism; Hashimoto's Thyroiditis; Subclinical Hypothyroidism; Levothyroxine; Narrative Review
Copyright (c) 2026 Aleksandra Kędzierska, Karolina Chudecka, Michał Chylewski, Katarzyna Józwa, Jakub Lamorski, Urszula Przewoźna, Gabriela Stępień, Izabela Szubert, Julia Suchecka, Wiktor Nesterak https://creativecommons.org/licenses/by/4.0
ATYPICAL KAWASAKI DISEASE IN AN INFANT: A CASE STUDY OF DIAGNOSTIC CHALLENGES AND DISCHARGE AGAINST MEDICAL ADVICE
Objective: This case study evaluates the diagnostic difficulties and socio-medical challenges encountered during the sequential hospitalization of an 11-month-old infant with atypical Kawasaki disease (AKD). Methods: A retrospective review of medical records, laboratory values, imaging studies, and documented clinical interactions was conducted at a regional hospital. Results: The patient initially presented with isolated acute febrile cervical lymphadenopathy. A recent routine Varicella immunization was noted in the medical history. The clinical trajectory was confounded by early corticosteroid exposure for airway stridor and a congenital bicuspid aortic valve with an associated dilated ascending aorta, leading to the initial exclusion of Kawasaki disease. Upon readmission with delayed periungual desquamation and borderline left anterior descending coronary artery Z-scores, a diagnosis of incomplete vasculitis was established, and intravenous immunoglobulin (IVIG) therapy (total 1.65 g/kg) was completed. However, during both admissions, the patient’s parents demanded immediate discharge against medical advice (DAMA) upon observing temporary symptomatic relief, equating clinical improvement with full recovery. Conclusion: Incomplete clinical criteria and co-existing structural cardiac anomalies can cause significant diagnostic delays in infant vasculitis. Furthermore, this case suggests that parental interpretation of early symptomatic improvement may contribute to DAMA decisions, highlighting the need for highly specific risk communication regarding invisible cardiovascular complications.
Atypical Kawasaki Disease, Pediatric Vasculitis, Discharge Against Medical Advice (DAMA), Health Communication, Patient Compliance
Copyright (c) 2026 Mikołaj Dubiel, Mateusz Kałwik, Iga Klepacz, Aleksandra Lorent, Dominika Groth, Martyna Rykowska https://creativecommons.org/licenses/by/4.0
GENERATIVE ARTIFICIAL INTELLIGENCE AND LARGE LANGUAGE MODELS IN EMERGENCY MEDICINE: A NARRATIVE REVIEW
The integration of generative artificial intelligence (AI) and large language models (LLMs) into healthcare has accelerated dramatically, with emergency medicine emerging as a particularly dynamic yet challenging domain for clinical deployment. This comprehensive narrative review synthesizes contemporary literature to examine current clinical applications, critical safety considerations, implementation scalability and governance, and future research priorities surrounding generative AI in acute care settings. We examine the current clinical applications, critical safety considerations, implementation scalability and governance, and future research priorities for generative AI in acute care settings. Current emergency medicine applications span automated documentation via ambient clinical intelligence systems, clinical decision support for triage and diagnostic prediction, patient communication tools including discharge summary generation, and multilingual data extraction supporting care transitions. Despite promising efficiency gains - including documented reductions in clinician burnout from 50.6% to 29.4% and modeled documentation time savings of up to 7.1 hours per shift cycle - substantial safety concerns persist, with hallucination rates ranging from 26% to 36% across automated pipelines and systematic misclassification in high-acuity triage tasks. We address automation bias (26% increased risk) and data privacy and governance risks, and identify algorithmic equity as a critical research priority. We conclude that while generative AI holds transformative potential to reduce clerical burden and augment clinical reasoning, its successful deployment in emergency medicine requires rigorous attention to clinical safety, health equity, workflow integration, and human‑factors considerations.
Generative Artificial Intelligence, Large Language Models, Emergency Medicine, Clinical Decision Support, Ambient Clinical Intelligence, Patient Safety
Copyright (c) 2026 Klaudia Kwolek, Wiktoria Laskowska , Marcel Pilarek , Sebastian Ożga, Monika Roszkowska , Michał Furtak , Szymon Janczarski, Dominika Sarna, Łukasz Wąs, Piotr Tryczyński https://creativecommons.org/licenses/by/4.0
IMPACT OF THE COVID-19 PANDEMIC ON THE MENTAL HEALTH OF CHILDREN AND ADOLESCENTS - A REVIEW OF THE LITERATURE
The coronavirus pandemic was one of the most unique challenges faced by humanity, which did not influence only the physical functioning of the world but also its psychological state. Children and adolescents were especially prone to experiencing adverse impacts due to the disruption caused by the pandemic in terms of education, social contacts, daily routine, and availability of mental health resources. The current narrative literature review highlights current findings about the effects of the coronavirus pandemic on the psychological state of children and adolescents with a specific emphasis on risks, protective factors, and outcomes. A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar was conducted for peer-reviewed studies, systematic reviews, and meta-analyses published between 2020 and 2025. Consistent results show there is an observed increase in mental health issues among people during and following the pandemic, in terms of anxiety, depression, loneliness, sleep disorders, emotional regulation problems, and behavioral issues. From a meta-analysis of the available literature, it is evident that the rates of depressive and anxiety symptoms are almost twice compared to before the pandemic. Adolescents, females, those suffering from other psychological issues, and disadvantaged children from economically challenged backgrounds were determined as the most vulnerable populations. Main risk factors include school closure, social isolation, family pressure, financial insecurity, and excessive use of electronic gadgets. On the other hand, there are protective factors that mitigate some of the adverse effects, including parental guidance, consistent routines, mental health treatment, and effective coping mechanisms. It is important for mental health professionals and policymakers to learn from previous experiences as a way to prevent similar impacts in future crises.
COVID-19; Children; Adolescents; Mental Health; Anxiety; Depression
Copyright (c) 2026 Anna Maria Szeszko, Weronika Maria Czernek , Magdalena Cichorzewska, Martyna Płachta , Rafał Marcin Wojtan, Małgorzata Lubowiecka https://creativecommons.org/licenses/by/4.0
CHRONIC INFLAMMATORY LESIONS OF THE GROIN IN A PATIENT WITH SCHIZOPHRENIA DURING LONG-TERM POLYPHARMACOTHERAPY: A POTENTIAL ADVERSE EFFECT OF ANTIPSYCHOTIC DRUGS
Objective: This paper presents a case report of a patient with recurrent skin lesions of probable drug-induced etiology. The study highlights the importance of considering adverse drug reactions. Methods: A detailed clinical interview, medical documentation, and the patient’s pharmacological treatment were analyzed, with particular emphasis on the potential adverse effects of the medications used. The analysis included an assessment of the temporal relationship between the administered drugs and the occurrence of skin lesions, as well as the exclusion of other possible causes, including infectious etiologies. Particular attention was paid to the possibility of a drug-induced nature of the observed lesions. Key Findings: A patient with long-standing schizophrenia receiving extensive polypharmacotherapy developed chronic inflammatory lesions in the groin area. Comprehensive diagnostic evaluation excluded infectious causes, indicating a probable drug-induced etiology of the lesions. This case highlights the importance of considering adverse drug reactions and polypharmacotherapy in the diagnostic process of chronic skin lesions. Conclusions: By presenting this case, we aim to emphasize that chronic skin lesions in patients undergoing long-term polypharmacotherapy may most likely be drug-induced, particularly after infectious causes have been excluded. In clinical practice, careful attention should be paid to the medications the patient is taking, as well as to potential drug interactions and adverse effects. With appropriate medical supervision, however, the condition may remain stable and well controlled.
Schizophrenia, Antipsychotic Drugs, Skin Lesions, Polypharmacotherapy, Drug-Induced Hyperhidrosis
Copyright (c) 2026 Kaja Nieradka, Krystyna Klahs, Maciej Muraszko-Kuźma, Patryk Twardy, Weronika Wagner, Jakub Białożyt, Anna Dębniak, Maciej Gutarowicz, Patryk Modelewski, Michał Armatys https://creativecommons.org/licenses/by/4.0
SLEEP–WAKE RHYTHM DISORDERS IN CHILDREN AND ADOLESCENTS: NEUROPSYCHIATRIC CONSEQUENCES
Background: Sleep is a key determinant of psychomotor and cognitive development in children and adolescents. Increasing exposure to evening blue light, irregular sleep schedules, and lifestyle factors contribute to circadian misalignment and sleep–wake rhythm disorders, which are increasingly recognized as clinically relevant in pediatric mental health. Objective: To summarize current evidence on neuropsychiatric consequences of sleep–wake rhythm disorders in children and adolescents and to outline major contributing factors and management strategies. Methods: A narrative review of the literature was conducted using PubMed and selected full-text publications, with emphasis on studies published within the last 10 years addressing sleep physiology, circadian regulation, and neuropsychiatric outcomes of sleep disturbances in pediatric populations. Results: Circadian rhythm sleep–wake disorders, particularly delayed sleep–wake phase disorder, are common during adolescence and are driven by pubertal circadian phase delay, evening light exposure, and behavioral sleep restriction. Sleep–wake rhythm disruption is associated with internalizing symptoms, including anxiety and depression, and evidence supports a bidirectional relationship between sleep disturbances and mental disorders. Sleep problems are also frequent in attention-deficit/hyperactivity disorder and may exacerbate executive dysfunction, impulsivity, irritability, and behavioral dysregulation. Experimental and translational findings suggest that sleep loss during sensitive developmental periods may affect limbic functioning and synaptic plasticity, potentially contributing to long-term neurodevelopmental vulnerability. Conclusions: Sleep–wake rhythm disorders represent modifiable risk factors for adverse neuropsychiatric outcomes in youth. Early identification, sleep hygiene, chronotherapy, and appropriately timed melatonin may improve sleep timing and daytime functioning and should be integrated into clinical practice and preventive strategies.
Sleep Wake Disorders, Circadian Rhythm, Adolescent, Child, Sleep Deprivation, Insomnia, Attention Deficit Disorder With Hyperactivity, Anxiety Disorders Depressive Disorder, Melatonin
Copyright (c) 2026 Aleksandra Kowalewska-Kurek, Katarzyna Kowalska , Hanna Grygorcewicz, Laura Mikuła, Justyna Strycharczuk https://creativecommons.org/licenses/by/4.0
RECENT ADVANCES IN AUTOPHAGY AND VESICLE TRAFFICKING IN PANCREATIC DISEASES: MOLECULAR MECHANISMS AND SELECTIVE AUTOPHAGY PATHWAYS
Autophagy is a key lysosome-dependent degradation pathway essential for maintaining cellular homeostasis, particularly in the highly secretory pancreas. This review summarizes recent advances in autophagy, selective autophagy, and vesicle trafficking in pancreatic physiology and disease. We focus on the dual role of autophagy, which can support cellular protection and organelle quality control, but also contribute to pathology when dysregulated. We highlight emerging molecular mechanisms linking autophagy with vesicle trafficking systems, including membrane remodeling, organelle contact sites, and key regulators such as VMP1 and Beclin-1. In addition, we discuss the role of autophagy in pancreatic inflammation and cancer, emphasizing its context-dependent function. Finally, we outline recent translational approaches targeting autophagy-related pathways, including pharmacological and genetic strategies, with potential diagnostic and therapeutic relevance in pancreatic diseases.
Autophagy; Pancreas; Vesicle Trafficking; Selective Autophagy; Cellular Homeostasis; Pancreatitis; Pancreatic Cancer
Copyright (c) 2026 Jakub Motor, Michał Hajt, Dastin Misiaszek, Anna Wolszczak, Alicja Graczyk, Weronika Martynowska, Piotr Ciecierski, Natalia Grabowska, Zofia Parol https://creativecommons.org/licenses/by/4.0
ADOLESCENT BODY DYSMORPHIC DISORDER IN THE MODERN SOCIAL LANDSCAPE: A REVIEW OF CURRENT LITERATURE
Background and Aim: Body Dysmorphic Disorder (BDD) is a debilitating psychiatric condition that is increasingly affecting adolescents, largely exacerbated by the modern digital and social landscape. The aim of this article is to provide a comprehensive review of the current literature regarding the psychosocial risk factors, severe consequences, and diagnostic screening tools associated with adolescent BDD. Methodology: A narrative review of the current literature was conducted. The analysis synthesized recent studies, clinical guidelines, and theoretical papers focusing on the intersection of adolescent BDD, digital environments, peer dynamics, psychiatric risks, and diagnostic practices. Results: The reviewed literature indicates that social media exposure, peer dynamics, and bullying (including cyberbullying) serve as primary risk factors that trigger and intensify BDD symptoms in youth. The analysis also highlights severe psychosocial threats, demonstrating a concerning correlation between untreated adolescent BDD, self-injurious behaviors, and suicidality. Furthermore, the review identifies and evaluates the most effective, evidence-based screening scales currently recommended for early detection of the disorder. Conclusion: The modern social landscape significantly amplifies the risk and severity of BDD among adolescents. Due to the high risk of severe, life-threatening outcomes, there is an urgent need for heightened clinical awareness and the routine implementation of standardized screening protocols by healthcare professionals and educators to ensure early identification and intervention.
Body Dysmorphic Disorder (BDD), Adolescents, Dysmorphophobia, Social Media, Digital Body Image, Cyberbullying
Copyright (c) 2026 Julia Paczyna, Maria Jędryka, Oliwia Wróblewska, Jakub Majewski, Małgorzata Witaszczyk, Zofia Hałabuda, Alicja Benecka, Iwona Kawka-Bryk https://creativecommons.org/licenses/by/4.0
GLOBAL HEALTH SECURITY: INNOVATIVE THERAPEUTIC AND DIAGNOSTIC APPROACHES AGAINST NIPAH VIRUS - A DISTANT DANGER OR A REAL THREAT?
Background: Nipah virus (NiV) is an emerging zoonotic paramyxovirus causing severe respiratory distress and devastating neurological complications. Given its high fatality rates and human-to-human transmission, NiV holds significant epidemic potential, prompting the World Health Organization to designate it a priority pathogen. Aim: This review synthesizes current knowledge on the molecular virology, pathogenesis, clinical manifestations, and therapeutic strategies of NiV infection. Material and methods: We analyzed literature from PubMed and Google Scholar, including observational studies, trials, and reviews focusing on the clinical symptoms, diagnostic mechanisms, and molecular virology of NiV. Results: NiV enters cells via highly conserved ephrin-B2/B3 receptors and employs sophisticated immune evasion strategies. We focus on central nervous system (CNS) invasion, detailing how NiV breaches the blood-brain barrier via direct endothelial infection and a leukocyte-mediated "Trojan horse" mechanism. Clinically, NiV induces rapidly progressive acute encephalitis with profound brainstem dysfunction. The virus's unique capacity for persistence often causes delayed-onset or relapsing neurological sequelae, frequently leaving survivors with irreversible cognitive impairments. We address diagnostic complexities, emphasizing the prognostic value of electroencephalography and neuroimaging, alongside rigorous molecular and serological testing. Finally, we review the current frontier of clinical management, including experimental small-molecule antivirals, neutralizing monoclonal antibodies, and next-generation vaccines. Conclusions: Further research into NiV neuroinvasion is essential to develop targeted neuroprotective interventions, improve patient outcomes, and mitigate this severe global health threat.
Nipah Virus, Encephalitis, Zoonoses, Central Nervous System Infections, Global Health
Copyright (c) 2026 Barbara Fetner, Magdalena Dłużewska, Dawid Juszkiewicz, Krzysztof Kiełczewski, Agnieszka Zaręba, Agata Kucharska, Konrad Adler, Patrycja Stankowska, Zuzanna Gebert, Ivanna Ilkiv https://creativecommons.org/licenses/by/4.0
VOICE AND COUGH AS DIGITAL BIOMARKERS (2025–2026): LINGUISTIC EQUITY, PRIVACY, AND THE PROMISE OF ACOUSTIC DIAGNOSTICS IN GLOBAL HEALTH
Recent advances in artificial intelligence and mobile sensing have renewed interest in the human voice and cough as non-invasive, low-cost biomarkers of disease. While respiratory, neurological, and psychiatric applications have shown moderate-to-high diagnostic accuracies in classification studies, the translation of these tools from proof-of-concept into routine clinical practice remains incomplete. This narrative review synthesizes the 2025–2026 literature across five domains: (a) the biophysiological foundations that make voice and cough acoustically informative, (b) clinical evidence spanning respiratory, neurodegenerative, mental-health, cardiometabolic, pediatric, and laryngeal use cases, (c) the growing body of work on linguistic equity and structural bias in speech-based systems, (d) privacy and adversarial security concerns specific to voice as biometric data, and (e) deployment prospects in low- and middle-income countries, with tuberculosis screening as the most advanced use case. The analysis reveals that no single disease domain has reached the level of large-scale, independently validated deployment, though respiratory and laryngeal applications are closest. Structural language bias—particularly against speakers of tonal languages—remains a first-order obstacle, and current speaker de-identification systems demonstrably leak identity information. These findings point to three conditions for responsible scale-up: methodological standardization, inclusive multilingual datasets, and governance frameworks that treat voice data as sensitive biometric medical information.
Voice Biomarkers, Cough Analysis, Digital Health, Linguistic Equity, Privacy, Global Health
Copyright (c) 2026 Wiktor Adamiec, Damian Danilczuk, Jerzy Buszko, Michał Dyś, Nicol Baran, Marta Bajkowska-Piterak, Przemysław Piterak, Monika Szlachta-Gubernat, Adrianna Buż https://creativecommons.org/licenses/by/4.0
LEFT VENTRICULAR GLOBAL LONGITUDINAL STRAIN FOR EARLY DETECTION OF ANTHRACYCLINE-INDUCED CARDIOTOXICITY IN ADULT BREAST CANCER PATIENTS: A SYSTEMATIC REVIEW
Introduction: Anthracycline-based chemotherapy remains an important component of breast cancer treatment, but its use is limited by the risk of cardiotoxicity, including subclinical left ventricular dysfunction and cancer therapy-related cardiac dysfunction. Conventional monitoring based on left ventricular ejection fraction may detect myocardial injury relatively late. Left ventricular global longitudinal strain (LV GLS), assessed by speckle-tracking echocardiography, has emerged as a more sensitive parameter for identifying early myocardial impairment. This systematic review summarizes current evidence on the role of LV GLS in the early detection of anthracycline-induced cardiotoxicity in adult breast cancer patients. Methods: A systematic literature review was performed using PubMed/MEDLINE. The search strategy combined terms related to breast cancer, anthracyclines, global longitudinal strain, speckle-tracking echocardiography, and cardiotoxicity. Original English-language studies focused on adult breast cancer patients receiving anthracycline-based chemotherapy and undergoing strain echocardiographic assessment were considered eligible. After title, abstract, and full-text screening, seven studies were included in the qualitative synthesis. Results: The included studies consistently suggested that LV GLS detects subclinical myocardial dysfunction earlier than conventional left ventricular ejection fraction assessment in breast cancer patients treated with anthracyclines. Several studies reported early impairment in myocardial deformation parameters during or shortly after chemotherapy, even in the presence of preserved ejection fraction. The reviewed evidence also indicated that changes in GLS may have diagnostic and prognostic relevance for subsequent cardiotoxicity and later decline in cardiac function. More recent studies additionally supported the value of integrating GLS with other echocardiographic parameters in the assessment of cancer therapy-related cardiac dysfunction. Conclusions: LV GLS appears to be a sensitive and clinically useful echocardiographic marker for the early detection of anthracycline-induced cardiotoxicity in adult breast cancer patients. Its use may improve identification of subclinical cardiac dysfunction before a measurable decline in left ventricular ejection fraction occurs. Further studies are needed to clarify optimal cutoff values, monitoring intervals, and the role of GLS within standardized cardio-oncology surveillance protocols.
Breast Cancer; Anthracyclines; Cardio-Oncology; Left Ventricular Global Longitudinal Strain; Speckle-Tracking Echocardiography
Copyright (c) 2026 Tomasz Mainka, Emil Sergejuk, Wojciech Kotlarski, Klaudia Magdalena Kotlarska https://creativecommons.org/licenses/by/4.0
DIASTOLIC DYSFUNCTION AS AN EARLY INDICATOR OF ANTHRACYCLINE-INDUCED CARDIOTOXICITY IN BREAST CANCER PATIENTS: A SYSTEMATIC REVIEW
Introduction: Breast cancer is one of the most common malignancies worldwide, and anthracyclines remain a cornerstone of its treatment. However, their use is associated with the risk of cardiotoxicity, which may lead to subclinical myocardial injury, progressive ventricular dysfunction, and heart failure. Although left ventricular ejection fraction is still widely used in routine surveillance, it often decreases relatively late. Therefore, increasing attention has been directed toward diastolic dysfunction as a possible earlier marker of anthracycline-induced cardiac injury. Methods: A systematic review was conducted using the PubMed database. The search strategy included the terms “breast cancer” OR “breast neoplasms,” “anthracycline” OR “doxorubicin” OR “epirubicin,” and “diastolic dysfunction” OR “diastolic function.” The search was limited to studies published between 2010 and 2026, written in English, and conducted in humans. A total of 43 records were identified. After title and abstract screening, 15 full-text articles were assessed for eligibility. Fourteen studies met the inclusion criteria and were included in the final qualitative synthesis. Results: The reviewed studies showed that anthracycline therapy was associated with worsening of conventional and tissue Doppler indices of diastolic function, including E/A ratio, deceleration time, e′ velocity, and E/e′ ratio, often despite preserved left ventricular ejection fraction. Several studies also demonstrated abnormalities in more advanced echocardiographic markers, such as diastolic strain rate, diastolic strain time, left atrial strain, and intrinsic wave velocity propagation. In longitudinal analyses, early diastolic dysfunction was associated with later worsening of global longitudinal strain, decline in left ventricular ejection fraction, or subsequent cancer therapy-related cardiac dysfunction. Conclusions: Diastolic dysfunction appears to be a clinically relevant and potentially early marker of anthracycline-induced cardiotoxicity in breast cancer patients. Its earlier recognition may support closer cardio-oncology surveillance, improve risk stratification, and help identify patients who may benefit from earlier specialist evaluation and consideration of cardioprotective strategies before overt systolic dysfunction develops. Further prospective studies are needed to determine which diastolic parameters are the most sensitive and clinically useful in routine practice.
Breast Cancer; Anthracycline Cardiotoxicity; Diastolic Dysfunction; Echocardiography; Cardio-Oncology; Early Detection
LEFT ATRIAL MECHANICS ASSESSED BY SPECKLE-TRACKING ECHOCARDIOGRAPHY IN ADULT PATIENTS UNDERGOING HEMODIALYSIS: A SYSTEMATIC REVIEW
Introduction: Cardiovascular disease remains the leading cause of morbidity and mortality in patients with end-stage renal disease undergoing maintenance hemodialysis. In this population, conventional echocardiographic parameters may not fully detect early atrial dysfunction or adequately reflect the complex hemodynamic effects of recurrent volume shifts. Speckle tracking echocardiography has emerged as a promising tool for the assessment of left atrial mechanics, including reservoir, conduit, and contractile function. Methods: This systematic review was conducted in accordance with the PRISMA framework. A PubMed/MEDLINE search was performed using predefined terms related to left atrial strain, left atrial mechanics, speckle-tracking echocardiography, hemodialysis, and end-stage renal disease. Studies were eligible if they included adult patients undergoing maintenance hemodialysis and assessed left atrial deformation using speckle-tracking echocardiography. Seven studies met the inclusion criteria and were included in the qualitative synthesis. Results: Across the included studies, left atrial strain was consistently impaired in adult hemodialysis patients and was associated with markers of diastolic dysfunction, elevated filling pressures, atrial remodeling, and dialysis-related loading changes. Left atrial reservoir strain emerged as the most clinically informative parameter and demonstrated independent prognostic value for major adverse cardiovascular events and mortality in prospective studies. In addition, impaired left atrial deformation and strain rate were associated with an increased risk of paroxysmal atrial fibrillation. Conclusions: Left atrial mechanics assessed by speckle-tracking echocardiography appear to provide clinically relevant information in adult patients undergoing hemodialysis. Left atrial strain may serve as a sensitive imaging biomarker of subclinical cardiovascular dysfunction and may improve cardiovascular risk stratification in this population. However, further prospective multicenter studies are required to standardize methodology and confirm the role of left atrial strain in routine clinical practice.
Hemodialysis; End-Stage Renal Disease; Echocardiography; Speckle-Tracking; Left Atrium
THE INFLUENCE OF PREBIOTIC AND PROBIOTIC ON THE SMALL INTESTINAL BACTERIAL OVERGROWTH (SIBO)
Background: SIBO is a significant and growing problem in the XXI century. Patients suffer from symptoms that inconvenience their everyday life. Despite numerous trials existing SIBO treatment does not fully alleviate patients’ symptoms. Prebiotics and probiotics have proved and widely recognized benefits for gut health, which could be influential for SIBO treatment and for more severe disorders like cirrhosis. Aim: This narrative review synthesizes evidence on the influence of prebiotics and probiotics on human health, especially in SIBO. Material and methods: A search of relevant research databases was conducted to identify eligible papers. Results: Many studies showed that supplementation of prebiotics and probiotics may alleviate the prevalence and severity of SIBO symptoms. Correlation of those therapeutic agents, especially probiotics with antibiotics like rifaximin may bring additional benefits. However, further multi-center studies are required. Conclusions: Prebiotics and probiotics may be an important factor in the SIBO therapeutic path.
SIBO, Probiotics, Prebiotics, Saccharomyces, Bifidobacterium, Lactobacillus
Copyright (c) 2026 Marcin Szczepanik, Jakub Senko, Kornelia Tyczka, Joanna Kulpa, Zofia Suchanek https://creativecommons.org/licenses/by/4.0
CAR-T CELL THERAPY IN ONCOLOGY AND RHEUMATOLOGY
Background: CAR-T cell therapy is a highly personalized form of treatment. it involves modifying T cells extracted from the patients white blood cells during cell collection. Genetic modification of said T cells allows for the extraction of chimeric antigen receptor (CAR), which are later multiplied and infused into the recipients organism. The use of such a highly personalized method yields promising results in both oncology and hematology where relapses and the severity of conditions require precise therapy. Aim: This narrative analysis aims to summarize and explore the present-day application of CAR-T cell therapy, currently held trials and possibilities for future therapy development in the fields of oncology and rheumatology. Material and methods: A search of relevant research databases was conducted to identify eligible papers. Results: CAR-T cell therapy shows promising results due to its mechanism of genetical modifications of patients’ own T-cells, thus allowing them to recognize surface antigens present on cancer cells and reduce symptoms and long-term consequences of autoimmune diseases. However, its use still is limited, and more research needs to undergo to better utilize CAR-T cell therapy. Conclusions: The use of CAR-T cell therapy in oncology and rheumatology is promising however, further studies are needed to assess its efficiency and safety.
CAR-T Cell Therapy, Hematologic Cancers, Solid Tumors, Systemic Lupus Erythematosus (SLE), Antisynthetase Syndrome
Copyright (c) 2026 Kornelia Tyczka, Marcin Szczepanik, Maria Nowakowska, Jakub Senko, Joanna Kulpa, Zofia Suchanek https://creativecommons.org/licenses/by/4.0
WHY SARCOPENIC OBESITY IS THE STRATEGIC INTERSECTION? – A NARRATIVE REVIEW
Sarcopenic obesity has emerged as a significant clinical and public health concern due to the simultaneous presence of decreased skeletal muscle mass and increased adipose tissue accumulation. This condition represents a complex metabolic state that combines the adverse consequences of both sarcopenia and obesity, leading to deterioration of physical function and metabolic health. The purpose of this review is to analyze current scientific evidence regarding the epidemiology, pathophysiological mechanisms, diagnostic challenges, and clinical consequences of sarcopenic obesity, as well as potential therapeutic and preventive strategies. A narrative review of studies published between 2000 and 2025 using PubMed, Scopus, and Web of Science was conducted. The findings indicate that sarcopenic obesity is associated with aging, metabolic dysregulation, and lifestyle-related factors such as physical inactivity and inadequate nutrition. Chronic low-grade inflammation, insulin resistance, hormonal alterations, and mitochondrial dysfunction play key roles in its development. Sarcopenic obesity has been associated with an increased risk of cardiovascular diseases, type 2 diabetes, frailty, disability, and mortality. The condition remains underdiagnosed due to the lack of standardized diagnostic criteria and limitations of traditional indicators such as body mass index. Effective management requires a multidisciplinary approach combining resistance exercise, nutritional interventions, and lifestyle modifications. Understanding its mechanisms may improve prevention and clinical management in aging populations.
Sarcopenic Obesity; Sarcopenia; Aging; Body Composition; Metabolic Disorders
Copyright (c) 2026 Michał Słowik, Jędrzej Świercz, Kamil Arciszewski, Natalia Hariasz, Karolina Orda, Dominika Walczak, Jakub Szumiło, Klaudia Kaspersk, Mariana Markiv, Paweł Stenzel https://creativecommons.org/licenses/by/4.0
TREATMENT OF KERATOSIS PILARIS: A NARRATIVE LITERATURE REVIEW OF TOPICAL, PROCEDURAL, AND VARIANT-SPECIFIC THERAPIES
Keratosis pilaris (KP) is a common disorder of follicular keratinization characterized by keratotic perifollicular papules with variable erythema and, in some patients, dyspigmentation. Although benign, KP may generate substantial cosmetic concern and psychosocial burden. Therapeutic management remains challenging because available interventions often produce incomplete and temporary improvement, and the evidence base is limited by small sample sizes, heterogeneous study designs, short follow-up, and inconsistent outcome measures. This narrative literature review synthesizes current evidence on treatment of KP, emphasizing topical keratolytics, retinoids, anti-inflammatory agents, laser- and light-based therapies, and emerging approaches. A separate section addresses keratosis pilaris atrophicans (KPA) and keratosis pilaris rubra faciei/rubra (KPRF/KPR), which warrant a distinct therapeutic approach because erythema, inflammation, and scarring risk may predominate over texture alone. Overall, treatment is difficult and rarely curative; however, a careful, phenotype-directed, stepwise approach can yield clinically meaningful improvement in roughness, erythema, and pigmentary change. Aim: The purpose of this review is to present a comprehensive overview of the therapeutic approaches used in the treatment of keratosis pilaris. It outlines the roles of topical agents, procedural therapies, and emerging interventions, and reviews both commonly used treatments with broader clinical experience and newer or less well-established modalities supported by limited evidence. It also addresses variant-specific management of keratosis pilaris rubra/rubra faciei and keratosis pilaris atrophicans, in which erythema, inflammation, and scarring risk may influence treatment selection. Material and methods: A literature search was conducted in PubMed and Google Scholar using the keywords “keratosis pilaris,” “keratosis pilaris rubra faciei,” and “treatment.” Additional relevant articles were identified through reference screening. Original studies, review articles, and other clinically relevant sources on therapeutic approaches and treatment outcomes were considered for this narrative review. Conclusions: Keratosis pilaris and its erythematous variants can be challenging to treat, currently available therapies may provide meaningful clinical improvement, particularly when selected according to the predominant phenotype and patient-specific concerns. Further high-quality studies are needed to refine treatment strategies and strengthen the evidence base for individualized management.
Keratosis Pilaris, Keratosis Pilaris Rubra Faciei, Keratosis Pilaris Atrophicans, Follicular Keratosis, Topical Therapy, Keratolytics, Retinoids, Laser Therapy, Light-Based Therapy, Nd:YAG Laser, Pulsed Dye Laser, Intense Pulsed Light
Copyright (c) 2026 Tomasz Mróz, Paula Biernat, Dagmara Cybulska, Klaudia Cybulska, Anna Czerwińska, Jeremi Morka, Michał Sobczak https://creativecommons.org/licenses/by/4.0
CARDIOVASCULAR BENEFITS OF GLP-1 RECEPTOR AGONISTS: EVIDENCE FROM CARDIOVASCULAR OUTCOMES TRIALS (CVOTs)
Cardiovascular disease remains the leading cause of morbidity and mortality among patients with type 2 diabetes mellitus (T2DM). In recent years, glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as an important therapeutic class capable of providing cardiovascular benefits beyond glycemic control. This review aimed to evaluate the current evidence regarding the cardiovascular effects of GLP-1RAs, with particular emphasis on findings from major cardiovascular outcome trials (CVOTs). A narrative review of randomized controlled trials, meta-analyses, and contemporary clinical guidelines was conducted. Major CVOTs evaluating lixisenatide, liraglutide, semaglutide, exenatide, albiglutide, dulaglutide, oral semaglutide, and efpeglenatide were analyzed with respect to major adverse cardiovascular events (MACE), cardiovascular mortality, stroke, myocardial infarction, heart failure, and renal outcomes. The available evidence demonstrates that several GLP-1RAs significantly reduce cardiovascular risk in patients with T2DM. Liraglutide, semaglutide, dulaglutide, albiglutide, and efpeglenatide consistently showed reductions in MACE, while meta-analyses confirmed favorable effects on cardiovascular mortality, all-cause mortality, and stroke. Additional benefits included improved renal outcomes and clinically meaningful weight loss. Recent evidence from the SELECT trial further suggests that cardiovascular protection may extend to individuals with overweight or obesity without diabetes. In conclusion, GLP-1 receptor agonists have evolved from glucose-lowering agents into therapies with established cardioprotective properties. Their ability to improve cardiovascular outcomes and reduce cardiometabolic risk supports their central role in contemporary diabetes management and cardiovascular prevention strategies.
GLP-1 Receptor Agonists; Type 2 Diabetes Mellitus; Cardiovascular Outcomes; Cardiovascular Disease; Obesity; Semaglutide
Copyright (c) 2026 Nicol Szerenos, Natalia Woroniecka, Daria Trocka, Alicja Kozłowska, Karolina Przybysz, Luiza Stadnik, Natalia Zienkiewicz, Jarosław Rachoń, Adela Dzwonkowska, Jakub Dzwonkowski https://creativecommons.org/licenses/by/4.0
OBESITY AS A FACTOR AFFECTING COGNITIVE FUNCTIONS: NEUROBIOLOGICAL AND METABOLIC MECHANISMS – A REVIEW OF CURRENT EVIDENCE
Obesity has been increasingly recognized as a potential modifiable risk factor for cognitive dysfunction and dementia. Accumulating evidence indicates that excess adiposity is associated with impairments in multiple cognitive domains, particularly executive function, attention, processing speed, and, to a lesser extent, memory. The strongest and most consistent associations are observed in midlife obesity, suggesting a life-course effect of prolonged metabolic exposure on brain health. This narrative review synthesizes current epidemiological, neuroimaging, mechanistic, and interventional evidence linking obesity with cognitive outcomes. Structural and functional brain alterations associated with obesity include reduced gray matter volume, white matter integrity disruption, and altered connectivity within key cognitive networks such as frontoparietal and hippocampal circuits. Proposed biological mechanisms include chronic low-grade systemic inflammation, insulin resistance with impaired central glucose metabolism, cerebrovascular dysfunction, oxidative stress, adipokine imbalance, and gut–brain axis alterations. The relationship between obesity and cognition is further modified by age, adiposity distribution, metabolic health status, genetic susceptibility, and lifestyle factors, indicating substantial inter-individual heterogeneity. Emerging interventional evidence suggests that cognitive impairment associated with obesity may be at least partially reversible, particularly following lifestyle modification, multidomain interventions, bariatric surgery, and pharmacological treatments targeting metabolic pathways; however, long-term randomized controlled data remain limited. Overall, obesity should be considered a heterogeneous and potentially modifiable risk factor for cognitive decline, with early metabolic intervention representing a promising strategy for preserving long-term cognitive health.
Obesity, Cognitive Dysfunction, Dementia, Insulin Resistance, Neuroinflammation, Executive Function, Metabolic Syndrome, Brain Aging, Adiposity, GLP-1 Receptor Agonists
Copyright (c) 2026 Daria Trocka, Natalia Woroniecka, Nicol Szerenos, Alicja Kozłowska, Karolina Przybysz, Luiza Stadnik, Natalia Zienkiewicz, Jarosław Rachoń, Adela Dzwonkowska, Jakub Dzwonkowski https://creativecommons.org/licenses/by/4.0
HORMONALLY INDUCED GINGIVAL ENLARGEMENT: FOCUS ON EPULIS - A NARRATIVE REVIEW
Gingival enlargement and epulis are common reactive lesions of the oral cavity with a multifactorial aetiology. While dental plaque is considered the primary initiating factor, systemic hormonal influences play a significant modulatory role in their development and clinical expression. This narrative review aims to summarise current evidence regarding the effects of sex steroid hormones on gingival enlargement and epulis, with particular emphasis on pregnancy-associated lesions and hormonal fluctuations throughout life. A literature search was conducted using PubMed and Google Scholar, focusing on studies investigating the effects of oestrogen and progesterone on periodontal tissues. The available evidence indicates that sex hormones influence inflammatory responses, vascular function, immune activity, microbial composition, and connective tissue metabolism within the periodontium. The findings suggest that hormonal changes do not directly initiate gingival disease but act as modifying factors that increase tissue susceptibility to local irritants, particularly dental plaque. Understanding these mechanisms is essential for improving prevention and clinical management of hormonally influenced gingival conditions.
Gingival Enlargement, Epulis, Pregnancy Tumour, Oestrogen, Progesterone, Periodontium
Copyright (c) 2026 Aleksandra Suszczyńska, Ewa Wojtanowska, Marcin Mazur, Julia Kozicka, Angelika Wiatr, Patryk Ziomek, Natalia Tomoń https://creativecommons.org/licenses/by/4.0
ALGORITHMIC DISINFORMATION IN HIGHER EDUCATION: TOWARDS A COMMUNICATION MODEL FOR EXPLAINING THE PRODUCTION AND DISSEMINATION OF FAKE NEWS IN DIGITAL UNIVERSITY ENVIRONMENTS
In recent years, digital university environments have undergone a profound transformation due to the increasing reliance on digital platforms and recommendation algorithms for accessing and disseminating information. This shift has contributed to the emergence of new forms of information disorder, most notably algorithmic disinformation. The research problem lies in the limited number of studies that have addressed the mechanisms of fake news production and dissemination within higher education from a communication perspective that explains the role played by algorithms in reshaping information and knowledge flows within the university environment. This study aims to develop a communication model that explains the relationship between digital algorithms and the production and dissemination of fake news in digital university environments, as well as to analyze its implications for knowledge construction among higher education students. The study adopts a descriptive-analytical approach supported by a critical review of recent scientific literature, along with a synthetic approach to integrate relevant concepts and theoretical models related to information disorder, algorithmic governance, and digital communication. The expected findings indicate that recommendation, ranking, and personalization algorithms do not play a neutral role in information dissemination; rather, they contribute to amplifying attention-grabbing content, reinforcing information bubbles, and reproducing fake news within digital university environments, thereby affecting the quality of knowledge and students’ attitudes toward digital information. Furthermore, the study proposes a communication model that explains the stages through which algorithmic disinformation passes, from content production to its re-dissemination within the academic community. This provides a theoretical framework that can be utilized in future research and in the design of university policies that promote information integrity and digital verification skills.
Algorithmic Disinformation; Fake News; Higher Education; Digital University Environments; Digital Communication; Algorithmic Governance; Information Integrity
Copyright (c) 2026 Nassima Sahnoune https://creativecommons.org/licenses/by/4.0
MOBILE HEALTH APPLICATIONS FOR MEDICATION ADHERENCE IN CHRONIC DISEASE MANAGEMENT: A REVIEW OF EFFECTIVENESS, BEHAVIOURAL MECHANISMS, AND SOCIOECONOMIC BARRIERS
Medication non-adherence is a major challenge in modern healthcare, with approximately half of patients with chronic conditions failing to take medications as prescribed and global economic costs exceeding US$100 billion annually in the United States alone. Mobile health (mHealth) applications, of which over 97,000 are currently available on commercial platforms, offer a scalable approach to supporting adherence behaviours. This narrative review synthesises evidence published between 2018 and 2025 on the effectiveness of mHealth applications in chronic disease management, the behavioural mechanisms underpinning observed effects, and the socioeconomic barriers shaping equitable access, with particular attention to the European context. Peer-reviewed literature was identified through structured searches of MEDLINE, Scopus, and the Cochrane Library. Recent meta-analyses demonstrate consistent, moderate improvements in adherence, with pooled mean differences of 0.57 on the 8-item Morisky Medication Adherence Scale (95% CI 0.33–0.80) and absolute improvements of 15–20% on percentage-based measures across hypertension, type 2 diabetes, HIV, cardiovascular disease, and other chronic conditions. Effectiveness is mediated by reminder mechanisms, self-monitoring, social-support features, gamification, and educational content informed by behaviour change theory. However, populations with the highest baseline non-adherence — older adults, individuals with low health literacy, those of lower socioeconomic status, and patients in low- and middle-income countries — remain underserved by current applications, reflecting a persistent digital health equity gap. Within the European Union, the German Digital Health Applications framework and the forthcoming European Health Data Space provide important precedents for statutory reimbursement and interoperable digital health infrastructure.
mHealth; Medication Adherence; Chronic Disease; Behaviour Change; Digital Health Equity; European Health Data Space
IMPACT OF ENVIRONMENTAL AIR POLLUTION ON ALLERGIC RHINITIS SEVERITY AND QUALITY OF LIFE IN ADULTS: A NARRATIVE REVIEW
Air pollution is recognized as one of the leading environmental determinants of human health. It has been associated with a growing burden of respiratory diseases worldwide. Allergic rhinitis (AR), a chronic inflammatory disorder of the upper airways, may be susceptible to the effects of environmental pollutants. This narrative review aimed to summarize current evidence regarding the impact of air pollution on allergic rhinitis severity, disease control, and quality of life in adults. A literature search was conducted using the PubMed database. Relevant publications were identified using combinations of the keywords with priority given to recent systematic reviews, meta-analyses, observational studies, clinical investigations, and international clinical guidelines. The reviewed evidence consistently demonstrated positive associations between exposure to ambient air pollutants and allergic rhinitis outcomes. Particulate matter (PM2.5 and PM10), nitrogen dioxide (NO₂), ozone (O₃), and sulfur dioxide (SO₂) were most frequently associated with increased symptom severity, poorer disease control, and reduced quality of life. Particulate matter showed the strongest and most consistent relationship with allergic rhinitis burden. Proposed biological mechanisms include oxidative stress, epithelial barrier dysfunction, chronic inflammation, and immune dysregulation. In conclusion, air pollution represents an important and potentially modifiable determinant of allergic rhinitis severity and quality of life. Improving air quality and reducing individual exposure to environmental pollutants may contribute to better disease control and reduced burden of allergic respiratory diseases, highlighting the importance of both clinical and public health interventions.
Allergic Rhinitis; Air Pollution; Particulate Matter; Oxidative Stress; Quality of Life; Environmental Exposure
OVERVIEW OF THE MAIN FUNGAL INFECTIONS IN HUMANS
Human fungal infections (mycoses) represent a rapidly growing public health concern worldwide. Although many fungi exist as environmental saprophytes or harmless commensals, a substantial number of species can cause disease ranging from superficial skin infections to severe invasive disease with high mortality. The global rise in immunocompromised patient populations, combined with increasing antifungal resistance, contributes to the expanding burden of fungal disease. This review summarizes the major categories of human mycoses, key etiological agents, clinical manifestations, diagnostic challenges, and current therapeutic strategies. Recent advances in diagnostics, antifungal development, and molecular epidemiology are discussed, with emphasis on emerging pathogens and evolving resistance profiles.
Human Mycoses, Fungal Infections, Invasive Fungal Disease, Dermatophytosis, Candidiasis, Aspergillosis, Antifungal Resistance, Emerging Fungal Pathogens, Subcutaneous Mycoses, Endemic Mycoses
Copyright (c) 2026 Kinga Rogowska-Borettini, Klaudia Arciszewska, Aleksandra Padkowska, Jakub Maciej Pieniążek, Mateusz Dobosz, Julia Kajszczak, Aleksandra Romanowska, Weronika Biaduń-Mućko, Paweł Arkadiusz Malmur, Aleksandra Rak https://creativecommons.org/licenses/by/4.0
TECHNOLOGIES SUPPORTING ORAL HEALTH IN PATIENTS WITH PARKINSON’S DISEASE: CURRENT SOLUTIONS AND FUTURE POSSIBILITIES. A NARRATIVE REVIEW
Parkinson's disease (PD) is associated with progressive motor and non-motor impairments that substantially compromise oral self-care and contribute to poor oral health outcomes. Although conventional preventive strategies have been established, they remain largely static and insufficiently adapted to disease progression or individual patient needs. This narrative review aimed to examine current and emerging technologies that may support oral healthcare in individuals with PD and to identify future directions for technology-assisted dental care. A narrative literature review was conducted using PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library. Relevant publications addressing oral health, Parkinson's disease, assistive technologies, digital health, teledentistry, wearable sensors, and mobile health applications were identified and synthesized qualitatively. The available technologies were grouped into four domains: functional compensation technologies, behavioral and cognitive support systems, monitoring and feedback technologies, and integrated digital health platforms. Current evidence indicates that assistive devices, wearable sensors, smartphone-based applications, and telemedicine platforms may improve functional independence, behavioral adherence, and remote healthcare delivery. However, most technologies were developed for general Parkinson's disease management rather than for oral healthcare, resulting in predominantly indirect benefits for oral hygiene. A substantial gap remains between motor function monitoring and technologies providing direct support for daily oral hygiene practices. Future research should prioritize the development of integrated, patient-centered digital platforms combining neurological monitoring, teledentistry, caregiver support, and personalized oral hygiene interventions. Such multidisciplinary approaches may improve oral health outcomes and quality of life in the growing population of individuals living with Parkinson's disease.
Parkinson’s Disease, Oral Hygiene, Assistive Technology, Digital Health, Teledentistry, Neurodegenerative Disorders
Copyright (c) 2026 Wiktoria Jabłońska-Trzosek, Natalia Borek, Julia Gałązka, Emilia Miśkiewicz, Hanna Krupa, Ewa Stopa, Zofia Wieczorek, Magdalena Kędrak, Dominik Stanisławski, Jakub Pochwalski https://creativecommons.org/licenses/by/4.0
GUT MICROBIOTA AS A REGULATOR OF FEMALE REPRODUCTIVE HEALTH AND EXERCISE ADAPTATION: MECHANISTIC AND CLINICAL PERSPECTIVES
Introduction: The gut microbiota regulates host metabolism, immune function and endocrine signaling. In women, it may affect reproductive health through estrogen metabolism, inflammation and metabolic homeostasis. Physical activity also modifies microbiota composition, with potential effects on adaptation, recovery and performance. Aim: This review summarized evidence on gut microbiota in female reproductive health and exercise adaptation, with emphasis on mechanisms and implications in physically active women. Materials and Methods: A narrative review was conducted using PubMed, Web of Science and Scopus. Studies from 2012–2024 were included, especially reviews, meta-analyses and observational studies on gut microbiota, estrobolome, reproductive disorders, exercise and female athletes. Results: Gut microbiota influences estrogen metabolism through the estrobolome and may affect systemic estrogen levels and reproductive function. Dysbiosis has been associated with PCOS and endometriosis, mainly through metabolic dysfunction and chronic low-grade inflammation. Physical activity may increase microbial diversity and short-chain fatty acid production, supporting metabolic efficiency and anti-inflammatory effects. Excessive exercise may im-pair intestinal barrier integrity and increase gastrointestinal symptoms, especially in athletes. Hormonal fluctuations, contraceptive use and energy availability may further modify microbiota composition. Conclusions: Gut microbiota appears to link reproductive physiology and exercise adaptation in women. Current evidence supports associations between microbiota, hormonal regulation and metabolic function, but causal relationships remain unclear. Further longitudinal and interventional studies are needed to clarify mechanisms and support personalized strategies for female health and sports performance.
Gut Microbiota; Estrobolome; Female Reproductive Health; Exercise; Female Athletes; PCOS; Endometriosis
Copyright (c) 2026 Małgorzata Świderska, Julita Papińska, Jakub Buziak, Magdalena Lengier, Patrycja Małyszek, Franciszek Cezary Pastuszak, Szymon Świstak, Natalia Powęska, Szymon Zych, Julia Pielacha https://creativecommons.org/licenses/by/4.0
MUSCLE TENSION DYSPHONIA AMONG PROFESSIONAL VOICE USERS: CURRENT DIAGNOSTIC AND THERAPEUTIC APPROACHES
Background: Muscle Tension Dysphonia (MTD) is a common functional voice disorder characterized by excessive laryngeal and paralaryngeal muscle activity during phonation. The disorder negatively affects vocal quality, communication, occupational functioning, and quality of life. Aim: This narrative review summarizes current evidence regarding the pathophysiology, epidemiology, diagnosis, and treatment of Muscle Tension Dysphonia. Material and methods: A PRISMA-informed narrative literature review was conducted using PubMed, Scopus, and Web of Science databases. Publications from 2003–2025 concerning functional dysphonia, laryngeal muscle tension, diagnostic methods, psychosocial factors, and voice therapy were analyzed. Results: Current evidence indicates that MTD is a multifactorial disorder associated with excessive laryngeal tension, maladaptive vocal behaviors, occupational voice overuse, stress, and impaired respiratory-phonatory coordination. Diagnostic assessment should include perceptual voice evaluation, videolaryngostroboscopy, acoustic analysis, and patient-reported outcome measures. Behavioral voice therapy remains the primary evidence-based treatment. Manual circumlaryngeal therapy, semi-occluded vocal tract exercises, respiratory retraining, and psychosocial interventions may additionally improve clinical outcomes. Conclusions: MTD is a complex biopsychosocial disorder requiring individualized and interdisciplinary management. Further high-quality studies are necessary to standardize diagnostic criteria and optimize therapeutic protocols.
Muscle Tension Dysphonia; Functional Voice Disorder; Voice Therapy; Laryngeal Tension; Dysphonia; Vocal Rehabilitation
Copyright (c) 2026 Jakub Buziak, Julita Papińska, Szymon Bojanowski, Katarzyna Cencelewicz, Patrycja Bździuch, Paulina Miciuda, Aleksandra Wojtera, Patrycja Małyszek, Franciszek Cezary Pastuszak, Magdalena Lengier https://creativecommons.org/licenses/by/4.0
HEART RATE ZONE-BASED TRAINING IN THE ERA OF WEARABLE TECHNOLOGIES: CARDIOVASCULAR ADAPTATIONS AND DIGITAL HEALTH IMPLICATIONS
Purpose of research: Heart rate zone-based training is increasingly delivered through wearable technologies, mobile applications and digital health platforms. These tools make cardiovascular monitoring accessible to athletes and physically active individuals, but their interpretation requires physiological and technological understanding. The aim of this review was to evaluate cardiovascular adaptations associated with training across different heart rate zones and to discuss the role of wearable technologies in digital exercise monitoring. Research materials and methods: A narrative review was conducted using peer-reviewed studies, systematic reviews, meta-analyses, randomized trials and scientific statements concerning heart rate zones, wearable devices, exercise intensity, VO₂max, lactate threshold, heart rate variability and endurance training. Basic results: Low-intensity zones mainly improve aerobic efficiency, endothelial function and parasympathetic modulation. Moderate-intensity zones support sustainable cardiac output and lactate clearance. High-intensity zones stimulate VO₂max and maximal cardiac output, but excessive exposure may increase autonomic stress. Wearables improve access to real-time monitoring, although device accuracy and data interpretation remain important limitations. Conclusions: Heart rate zone-based training is most useful when wearable-derived data are interpreted alongside physiological thresholds, perceived exertion and recovery markers.
Heart Rate Zones; Wearable Technologies; Digital Health; Cardiovascular Adaptations; Heart Rate Variability; Exercise Monitoring
Copyright (c) 2026 Szymon Świstak, Szymon Zych, Natalia Powęska, Franciszek Cezary Pastuszak, Patrycja Małyszek, Małgorzata Świderska, Magdalena Lengier, Jakub Buziak, Julita Papińska, Julia Pielacha https://creativecommons.org/licenses/by/4.0
HEALTH BENEFITS, PHYSIOLOGICAL RESPONSES, AND INJURY RISKS ASSOCIATED WITH PADEL PRACTICE: A NARRATIVE REVIEW
Background. Padel is a rapidly growing racket sport with intermittent activity, repeated strokes, frequent direction changes, and doubles-based tactical interaction. Its accessibility and social character make it a promising leisure-time activity, but increasing participation raises injury-prevention concerns. Aim. This narrative review summarizes evidence on health benefits, physiological responses, and injury risks in padel. Material and methods. Peer-reviewed padel articles were identified mainly through PubMed and screening of relevant reviews and studies. Evidence was synthesized thematically. Results. Padel may support physical activity and improve selected fitness components, especially in youth and non-professional players, including strength, agility, lateral movement, cardiorespiratory capacity, and body composition. Physiological studies show moderate cardiovascular intensity, repeated high-intensity actions, and autonomic stress. Early evidence suggests acute inflammatory, myokine-related, and cognitive responses, but data are mainly from small acute studies. Injuries are common, especially tendinous and muscular injuries affecting the elbow, shoulder, knee, ankle, lower leg, and lower back. Risk appears multifactorial and may be influenced by exposure, player level, equipment, footwear, court surface, warm-up habits, wellness, and supervision. Conclusions. Padel is an accessible activity with promising health and fitness benefits, but it also presents a relevant injury burden. Participation should be supported by warm-up, progressive load management, strength and conditioning, appropriate equipment, wellness monitoring, and early symptom management. Future research should prioritize standardized injury surveillance, prospective risk-factor studies, randomized interventions, biomechanical analyses, and padel-specific prevention and rehabilitation trials.
Padel; Racket Sports; Health Promotion; Injury Risk; Prevention; Rehabilitation
Copyright (c) 2026 Franciszek Cezary Pastuszak, Małgorzata Świderska, Szymon Świstak, Patrycja Małyszek, Magdalena Lengier, Szymon Zych, Julita Papińska, Julia Pielacha, Natalia Powęska, Jakub Buziak https://creativecommons.org/licenses/by/4.0
HIGH-INTENSITY INTERVAL TRAINING AND MODERATE-INTENSITY AEROBIC EXERCISE FOR GENERALIZED ANXIETY DISORDER: A NARRATIVE LITERATURE REVIEW
Background: Anxiety disorders, including Generalised Anxiety Disorder (GAD), represent a leading global health burden. First-line treatments - pharmacotherapy and cognitive behavioural therapy - carry notable limitations including side-effects, high cost, and limited accessibility. High-Intensity Interval Training (HIIT) and Moderate-Intensity Continuous Training (MICT) have emerged as potential adjunctive interventions. Aim of the study: To synthesise and critically evaluate available evidence on the effects of HIIT and MICT on anxiety symptom severity in individuals with GAD. Material and methods: A narrative review of PubMed, Google Scholar, and PsycINFO (2009–2025) was conducted. Eligible sources included RCTs, systematic reviews, meta-analyses, and mechanistic studies addressing exercise interventions and anxiety outcomes. Results: Both HIIT and MICT produce significant reductions in anxiety, comorbid depression, and somatic symptoms across clinical and non-clinical samples, with higher exercise intensity generally associated with greater benefit. In clinically diagnosed GAD, HIIT yielded approximately twice the effect size of lower-intensity training. However, MICT outperformes HIIT in certain subgroups. Baseline anxiety severity emerges as a key moderator of response. Conclusions: HIIT holds potential as a first-line complementary treatment for GAD. MICT remains a valuable alternative for specific subgroups. Adequately powered, long-term head-to-head RCTs directly comparing HIIT and MICT in clinically diagnosed GAD are needed.
Generalised Anxiety Disorder; High-Intensity Interval Training; Moderate-Intensity Continuous Training; Aerobic Exercise; Exercise Intensity; Anxiety; Mental Health
Copyright (c) 2026 Patrycja Małyszek, Julita Papińska, Magdalena Lengier, Małgorzata Świderska, Franciszek Pastuszak, Szymon Zych, Szymon Świstak, Natalia Powęska, Jakub Buziak, Julia Pielacha https://creativecommons.org/licenses/by/4.0
PATHOGENESIS, DIAGNOSIS, AND TREATMENT OF SYSTEMIC SCLEROSIS – AN INTEGRATIVE REVIEW OF THE CURRENT APPROACHES
Systemic sclerosis is a rare autoimmune connective tissue disorder marked by immunological dysregulation, vasculopathy, and progressive fibrosis of the skin and internal organs, resulting in considerable morbidity and mortality. The disease results from a complex interaction between genetic susceptibility, epigenetic modifications, environmental triggers, endothelial dysfunction, and aberrant immune responses. These mechanisms promote persistent inflammation, stimulation of fibroblasts and abundant extracellular matrix deposition, eventually causing irreversible tissue fibrosis and organ dysfunction. The diagnosis is based on clinical manifestations, supported by specific antibodies detection, capillaroscopy, and appropriate functional and imaging tests. To facilitate diagnosis, the American College of Rheumatology/European League Against Rheumatism issued guidelines in 2013, enabling earlier diagnosis and more accurate prognostic assessment. Although no curative therapy is currently available, treatment has advanced considerably and focuses on suppressing disease activity, slowing fibrosis, and preventing organ complications. Current therapeutic strategies include immunosuppressive agents, biologic therapies, antifibrotic drugs, and targeted vasodilator treatments tailored to individual organ involvement. Emerging approaches, such as JAK-STAT pathway inhibitors, CAR-T cell therapy, and stem cell transplantation, may further improve long-term outcomes in selected patients. Despite substantial progress in understanding disease mechanisms and expanding therapeutic options, systemic sclerosis remains a clinically heterogeneous disorder requiring early diagnosis, multidisciplinary management, and individualized treatment to optimize survival and quality of life.
Systemic Sclerosis, Fibrosis, Vasculopathy, Autoantibodies, Immunosuppressants
Copyright (c) 2026 Olaf Krawczyk, Wojciech Kopyciński, Norbert Krawczyk, Piotr Wilczkowski, Natalia Krzysztofek, Monika Kamela, Katarzyna Boszczyk, Małgorzata Grzybowska, Adrianna Baran, Aleksandra Palka https://creativecommons.org/licenses/by/4.0
BRAIN FOG IN POST-COVID SYNDROME: MECHANISMS OF MICROCLOT FORMATION, BBB DISRUPTION, AND NEUROINFLAMMATION
Background: Post-COVID syndrome (PCS) is characterized by persistent symptoms following infection, most notably "brain fog." Affecting approximately 5-15% of individuals in recent vaccinated cohorts-and up to 30% in early pandemic studies-brain fog significantly impairs professional, educational, and daily functioning. Its underlying biological mechanisms remain unclear, partly due to heterogeneous case definitions and study designs. Methods: We conducted a narrative, hypothesis-driven review of PubMed, Web of Science and Scopus from 2019 to January 2026, focusing on human mechanistic studies of PCS-related cognitive dysfunction. Findings: Several human cohorts describe persistence of SARS-CoV-2 spike antigen in plasma months after infection. Studies associate this with three overlapping pathways: (1) formation of fibrin amyloid microclots with impaired fibrinolysis in vitro; (2) increased blood-brain barrier permeability linked to elevated MMP-9 and oxidative stress markers in blood and CSF; and (3) sustained microglial and astrocytic reactivity with elevated cytokines. Evidence is largely cross-sectional and mechanistic data derive mostly from small studies. The specificity and causal role of microclots in post-COVID syndrome remain contested in recent reviews. Interpretation: We outline a testable integrative model in which microvascular injury, blood-brain barrier disruption and neuroinflammation may contribute to persistent cognitive symptoms in PCS. The model remains hypothetical, as current data are largely cross-sectional and derive partly from in vitro work. Longitudinal studies with biomarker stratification are needed before mechanism-based interventions can be evaluated.
Post-COVID Syndrome; Brain Fog; Blood-Brain Barrier; Neuroinflammation; Microclots; Fibrin Amyloid
Copyright (c) 2026 Szymon Skrzypek, Natalia Skórka, Bartosz Wójtowicz, Jakub Jasionka, Karolina Skórka, Oliwia Żmuda, Weronika Skrzypek, Magdalena Chrościńska-Krawczyk https://creativecommons.org/licenses/by/4.0
CLINICAL EFFICACY AND ADVERSE EFFECTS OF AEROBIC EXERCISE ON ANXIETY DISORDERS
Introduction: The number of people diagnosed with anxiety disorders is steadily rising, both in Europe and worldwide. This is serious problem, as these disorders significantly impar daily functioning and reduce quality of life. The ability to manage anxiety is crucial for healthy functioning in society. A growing body of research indicates that regular aerobic exercise can be an effective tool for reducing anxiety symptoms. Aim: The aim of this study is to review the literature on anxiety disorders, their pathophysiology, and complications, and to describe the mechanisms by which aerobic exercise influences their development. Methods and materials: A review of the literature available in the PubMed database was conducted using key search terms. Conclusions: Aerobic exercise may be effective treatment for anxiety. It can enhance the effects of medication, but the evidence is still limited. Larger studies, improved methodology and longer-term follow-up of patient groups are needed. Exercise works better than rest. In healthy individuals, as well as those who have experienced trauma or have PTSD, a short session of aerobic exercise reduced anxiety and fear more effectively than lying down and resting. Even a small amount of physical activity helps reduce anxiety disorders.
Anxiety Disorders, Aerobic Exercise, Generalized Anxiety Disorder (GAD), Post-Traumatic Stress Disorder (PTSD)
Copyright (c) 2026 Wiktor Zawadziński, Karolina Szamocka, Tomasz Kuliński, Kinga Mehal, Weronika Martyna Pielich, Michalina Bąk, Natalia Balicka-Dworczak, Natalia Siusta, Karolina Stróżyk, Kamil Malinowski https://creativecommons.org/licenses/by/4.0
EXERCISE-INDUCED LARYNGEAL OBSTRUCTION IN ATHLETES: AN UNDERRECOGNIZED CAUSE OF EXERTIONAL DYSPNEA, DIAGNOSTIC CONFUSION WITH ASTHMA, AND IMPAIRED EXERCISE TOLERANCE - A NARRATIVE REVIEW
Background: Exertional dyspnea is a clinically relevant symptom in athletes, particularly during high-intensity exercise. Although asthma and exercise-induced bronchoconstriction are commonly considered in this context, exercise-induced laryngeal obstruction (EILO) is represents an important upper-airway cause of exertional breathlessness that may remain underdiagnosed. Its symptomatic overlap and possible coexistence with lower-airway disease may contribute to diagnostic confusion, ineffective treatment and impaired sport participation. Aim: The aim of this narrative review was to synthesize current evidence on EILO in athletes, with emphasis on clinical presentation, diagnostic confusion with asthma and exercise-induced bronchoconstriction, effects on exercise tolerance, and available diagnostic and therapeutic strategies. Methods: A targeted literature review of peer-reviewed publications concerning EILO, inducible laryngeal obstruction, exertional respiratory symptoms in athletes, asthma, exercise-induced bronchoconstriction, continuous laryngoscopy during exercise and treatment strategies was performed. Evidence was synthesized narratively and organized into clinically relevant thematic sections. Results: EILO is characterized by transient narrowing of the laryngeal airway during exercise, usually under conditions of high ventilatory demand. Symptoms typically occur during peak exercise and may include inspiratory dyspnea, throat tightness, noisy breathing or stridor. The available literature indicates that EILO is clinically relevant among adolescents and athletes, particularly in symptomatic and referral-based cohorts. Because symptoms may mimic or coexist with asthma and exercise-induced bronchoconstriction, objective assessment of both upper- and lower-airway function is often required. Continuous laryngoscopy during exercise remains the current diagnostic reference standard. Management is usually conservative and may include education, speech therapy, breathing retraining, physiotherapy and inspiratory muscle training, while surgery is reserved for selected severe supraglottic cases. Conclusions: EILO should be considered in athletes with persistent, unexplained or atypical exertional dyspnea, especially when symptoms are predominantly inspiratory, occur during peak exercise and respond inadequately to asthma-directed treatment. Early recognition and objective assessment may reduce diagnostic delay, limit ineffective management and support maintenance of exercise tolerance, training quality and sport participation.
Exercise-Induced Laryngeal Obstruction; Athletes; Exertional Dyspnea; Asthma; Exercise-Induced Bronchoconstriction; Continuous Laryngoscopy During Exercise; Sports Medicine
Copyright (c) 2026 Sara Elżbieta Czubak, Michalina Weronika Nieścioruk, Dominika Julia Kozdroń, Lena Głuszkiewicz, Alia Echtay Yarbou, Rami Mallah, Jan Szafranek, Julia Beata Woźniak, Jakub Marcel Korowicki https://creativecommons.org/licenses/by/4.0
PERCEIVED THERAPEUTIC BOND IN INTERACTIONS WITH MENTAL HEALTH CHATBOTS: A NARRATIVE REVIEW
Background: The rapid development of digital mental health interventions has led to the increasing use of AI-based chatbots as accessible alternatives or complements to traditional psychotherapy. While the therapeutic alliance is a well-established factor influencing treatment outcomes in conventional settings, its applicability to human–chatbot interactions remains unclear. Objective: This narrative review aims to examine existing evidence regarding the subjective experience of therapeutic bond in interactions with mental health chatbots and to explore its characteristics and potential clinical relevance. Methods: A narrative review of selected literature was conducted using databases such as PubMed and Google Scholar. Studies focusing on users’ subjective experiences and relational aspects of interaction with conversational agents were included. Results: Available evidence suggests that users can develop a form of therapeutic bond with mental health chatbots, characterized by perceived empathy, support, and emotional engagement. Both quantitative and qualitative studies indicate that users may attribute human-like qualities to chatbots and describe interactions in relational terms. However, the intensity and nature of this bond vary across individuals, with some users perceiving the interaction as purely instrumental. The bond appears to be limited in depth and may lack key features of traditional therapeutic relationships, such as reciprocity and genuine emotional responsiveness. Conclusions: Therapeutic bond in chatbot-based interventions may represent a distinct and simplified form of relational engagement shaped by the characteristics of human–AI interaction. Further research is needed to assess its long-term development and its relationship to clinical outcomes.
Mental Health, Therapeutic Alliance, Therapeutic Bond, Conversational Agents, Digital Mental Health Interventions, Human–AI Interaction
Copyright (c) 2026 Wojciech Markiewicz, Maria Marusińska, Michał Karpiński, Michał Parzniewski, Wiktoria Czyż, Sabina Kolawa, Natalia Ostruszka, Arnold Borowiec, Julia Pilecka, Jędrzej Wojciechowski https://creativecommons.org/licenses/by/4.0
EMOTIONAL STATE OF PREGNANT WOMEN: PSYCHOGENIC AND CLINICAL FACTORS, TREATMENT OPTIONS, AND PREDICTION USING ARTIFICIAL INTELLIGENCE – A NARRATIVE REVIEW
The aim of this study is to analyze the psychogenic and clinical factors influencing the emotional state of women during pregnancy and to discuss the possibilities for the treatment and prediction of mental disorders using artificial intelligence (AI). The article presents the physiological and psychosocial determinants of emotional functioning in pregnant women, with particular emphasis on risk factors for mood disorders, such as depression and anxiety. Contemporary therapeutic approaches utilized in the perinatal period are discussed, encompassing both medical methods and non-medical forms of psychological support. Special attention is devoted to the role of modern technologies—including machine learning algorithms, mobile applications, and chatbots—in the process of early disorder detection and mental health support for pregnant women. Furthermore, the significance of diagnostic tools, such as ultrasonography (USG) and cardiotocography (CTG), in monitoring fetal well-being is addressed, alongside their potential integration with AI-based systems. The literature review indicates that AI can serve as a significant supplement to traditional medical care, contributing to improved diagnostic quality, enhanced predictive capabilities and increased accessibility of support for pregnant women.
Pregnancy, Mental Health, Depression, Artificial Intelligence, Perinatal Care
Copyright (c) 2026 Inga Jakubczyk, Kacper Szkodziński , Jagoda Maternia , Aleksandra Łoś, Karolina Majowicz-Czaszyńska , Wiktoria Pempuś , Nikola Król, Barbara Tomaszek , Aleksandra Blok, Dominik Wiater, Gabriela Płodzień https://creativecommons.org/licenses/by/4.0
DEPRESSION IN ENDOMETRIOSIS: SHARED PATHOPHYSIOLOGICAL MECHANISMS AND CLINICAL IMPLICATIONS – A NARRATIVE REVIEW
Background: Endometriosis is a chronic inflammatory disease associated with substantial physical and psychological morbidity. Depression is common among affected women, and its relationship with endometriosis appears to extend beyond the psychological consequences of chronic pain alone. Methods: A structured narrative review of peer-reviewed literature was conducted using PubMed/MEDLINE, Scopus, and Google Scholar. Epidemiological, biological, psychosocial, and clinical evidence was synthesized qualitatively. Findings: Women with endometriosis report greater depressive symptom burden than healthy controls, although chronic pain contributes substantially to this association. Shared genetic susceptibility and inflammatory, neuroendocrine, hormonal, pain-processing, and tryptophan–kynurenine pathways may provide additional biological links, but direct evidence for several mechanisms remains limited. Chronic pelvic pain, infertility, fatigue, sleep disturbances, diagnostic difficulties, and stigma further contribute to psychological distress and impaired quality of life. Evidence for endometriosis-specific pharmacological treatment of depression is scarce, while preliminary studies suggest potential benefits from psychological interventions and multidisciplinary care. Conclusions: The relationship between endometriosis and depression is multifactorial and best understood within a biopsychosocial framework. Further longitudinal and interventional studies are needed to clarify causal mechanisms and evaluate targeted approaches to treatment.
Copyright (c) 2026 Alina Kozłowska, Mateusz Maciejewski https://creativecommons.org/licenses/by/4.0
EXPLORING THE POTENTIAL BIDIRECTIONAL RELATIONSHIP BETWEEN MIGRAINE AND DEPRESSION: A NARRATIVE REVIEW
Background: Migraine and depression frequently coexist, increasing disability and reducing quality of life. This review evaluated evidence on the direction and mechanisms of their relationship. Methods: A critical narrative review used targeted searches of PubMed, Scopus, and Google Scholar for English-language publications from January 2016 to June 2026, supplemented by landmark studies. Evidence was synthesised qualitatively according to study design and its ability to inform association, temporal direction, or causality. Results: Cross-sectional studies consistently associate migraine with depressive symptoms or reported depression. Prospective studies show temporal associations in both directions but do not establish causal bidirectionality. Mendelian randomisation has more often yielded estimates consistent with a potential influence of genetic liability to major depressive disorder on migraine risk than with the reverse pathway. Shared polygenic susceptibility and alterations in pain- and emotion-related neural systems, neurotransmitter and inflammatory signalling, stress regulation, sleep, anxiety, and functional impairment may contribute, but direct mechanistic evidence in clinically diagnosed comorbidity is limited. In a placebo-controlled trial, fremanezumab reduced monthly migraine days and depressive symptom scores in participants with a DSM-5-defined history of major depressive disorder and active symptoms; whether mood improvement was independent of reduced migraine burden remains uncertain. Conclusions: Reciprocal assessment and coordinated management are reasonable, although their comparative effectiveness remains unproven. CGRP-targeted prevention may improve migraine burden and depressive symptoms in selected patients but should not replace targeted depression treatment. Research should use verified diagnoses, clarify mechanisms and causal direction, and test whether treating either disorder modifies the other.
Migraine; Depression; Comorbidity; Bidirectional Association; Mendelian Randomisation; Shared Mechanisms
Copyright (c) 2026 Mateusz Maciejewski, Alina Kozłowska https://creativecommons.org/licenses/by/4.0
ODONTOGENIC SINUSITIS: CURRENT CONCEPTS IN DIAGNOSIS AND MULTIDISCIPLINARY MANAGEMENT
Background: Odontogenic sinusitis (ODS) is an increasingly recognized subtype of maxillary sinusitis caused by dental infections or dental procedures. It accounts for approximately 25–40% of chronic maxillary sinusitis cases and up to 70% of unilateral sinonasal disease. Despite its high prevalence, ODS remains underdiagnosed because of its nonspecific clinical presentation and the frequent absence of overt dental symptoms. Objective: This narrative review summarizes current evidence regarding the etiology, microbiology, diagnosis, and multidisciplinary management of ODS, with particular emphasis on the role of advanced imaging modalities and collaboration between dental and otolaryngology specialists. Methods: A narrative literature review was conducted using PubMed and Google Scholar. English-language studies involving human subjects, including systematic reviews, retrospective studies, and prospective studies, were included. Additional information was obtained from authoritative textbooks in oral surgery, otolaryngology, and head and neck anatomy. Results: The available evidence indicates that ODS most commonly results from periapical and periodontal infections or iatrogenic dental procedures, including implant placement and maxillary sinus augmentation. Accurate diagnosis requires correlation of clinical findings with nasal endoscopy and radiological imaging, particularly cone-beam computed tomography (CBCT). Successful management depends on elimination of the underlying odontogenic source combined with appropriate medical therapy and, when indicated, functional endoscopic sinus surgery (FESS). Current evidence supports a multidisciplinary approach as the cornerstone of effective treatment. Conclusions: ODS represents a common yet frequently overlooked cause of sinonasal disease. Early recognition, comprehensive radiological assessment, and close cooperation between dentists and otolaryngologists are essential for accurate diagnosis and optimal patient outcomes. Further prospective studies are needed to establish standardized diagnostic and therapeutic protocols.
Odontogenic Sinusitis; Chronic Rhinosinusitis; Cone-Beam Computed Tomography; Functional Endoscopic Sinus Surgery; Dental Implants; Multidisciplinary Management
Copyright (c) 2026 Patryk Ziomek, Aleksandra Suszczyńska, Natalia Tomoń, Marta Krama https://creativecommons.org/licenses/by/4.0
THE ROLE OF PAIN AS A RESPIRATORY STIMULANT: A CASE REPORT OF SUDDEN RESPIRATORY DEPRESSION FOLLOWING REGIONAL ANESTHESIA IN A PATIENT ON HIGH-DOSE OXYCODONE
This study provides a detailed case report of a 65-year-old patient with disseminated cancer who was receiving extremely high doses of oxycodone (2 g/day) for severe, uncontrolled pain. A suprascapular nerve block with bupivacaine provided almost immediate relief; however, after 25 minutes, it led to sudden respiratory arrest. This event necessitated urgent emergency medical intervention and ICU hospitalization. Clinical analysis ruled out local anesthetic systemic toxicity (LAST), identifying the physiological antagonism between nociception and the respiratory depressive effects of opioids as the cause. Pain, acting as a natural respiratory stimulant, masked the effects of severe oxycodone overdose. The block's analgesic effect abruptly removed this stimulus, resulting in apnea. The article discusses the underlying mechanisms and provides a differential diagnosis between tolerance and opioid-induced hyperalgesia (OIH). It emphasizes the importance of multimodal treatment, including ultra-low-dose naloxone, to prevent dose escalation. The findings indicate a critical need for hospitalizing patients requiring high analgesic doses for safe titration and the necessity of intensive monitoring during regional anesthesia in opioid-dependent individuals. Introduction: The aim of this paper is to present and analyze a rare but life-threatening complication: respiratory arrest following local anesthesia in an oncology patient receiving extremely high doses of opioids. The work highlights the physiological role of pain as an antagonist of opioid-induced respiratory depression. Methodology: A case of a 65-year-old male with disseminated cancer, treated with an extremely high dose of oxycodone (2 g/day), is described. Due to severe shoulder pain, a suprascapular nerve block was performed using 5 ml of 0.5% bupivacaine and methylprednisolone. A literature review was conducted to differentiate the causes of apnea, including the exclusion of Local Anesthetic Systemic Toxicity (LAST). Results: Pain subsided almost immediately following the procedure; however, after 25 minutes, the patient experienced sudden apnea requiring intubation and ICU hospitalization. Analysis excluded technical error and systemic toxicity (LAST) based on dosage and symptom dynamics. The most likely cause was the elimination of the painful stimulus, which previously stimulated the respiratory center and balanced the depressive effects of high-dose oxycodone.
Oxycodone, Bupivacaine, Respiratory Depression, Cancer Pain, Opioid-Induced Hyperalgesia (OIH), Regional Anesthesia
Copyright (c) 2026 Izabella Kula, Emilia Kucab, Anna Kołodziej, Kacper Szpanelewski , Radosław Kołodziej , Szymon Lulek , Jakub Klecha, Szczepan Półchłopek , Katarzyna Dziki , Joanna Ciemięga, Wiktor Adamiec , Damian Danilczuk https://creativecommons.org/licenses/by/4.0
DIGITAL TECHNOLOGIES IN TOBACCO CESSATION: A NARRATIVE REVIEW OF SMARTPHONE APPLICATIONS, WEB-BASED PROGRAMMES, AND AI CONVERSATIONAL AGENTS
Background: Tobacco smoking causes over eight million deaths annually and remains the leading preventable cause of disease worldwide (World Health Organization, 2023). Structural barriers limit access to counselling and pharmacotherapy, motivating the development of digital cessation tools across three modalities: smartphone applications, web-based programs, and AI conversational chatbots. Objective: This narrative review synthesises peer-reviewed evidence (2021–2026) on the efficacy, engagement, and equity of digital smoking-cessation interventions across these three modalities. Methods: PubMed and PMC were searched using MeSH and free-text terms for smoking cessation combined with smartphone applications, eHealth, SMS, chatbots, and artificial intelligence. Primary studies enrolled smokers aged ≥16 years reporting abstinence outcomes; secondary literature included systematic reviews, meta-analyses, and qualitative evaluations. Findings were synthesised thematically. Results: Smartphone apps combined with pharmacotherapy outperformed medication alone (OR 1.79, 95% CI 1.38–2.33; Guo et al., 2023), whereas standalone apps were non-significant. A 152-RCT network meta-analysis (Li et al., 2025) ranked personalized digital interventions above standard care (RR 1.86, 95% CI 1.54–2.24). AI chatbots showed early positive signals, including biochemically verified 6-month abstinence rates of 26.0% versus 18.8% under usual care (Olano-Espinosa et al., 2022). Engagement decay, self-reported outcomes, and limited population diversity were consistent weaknesses. Conclusions: Digital tools deliver clinically meaningful benefits when grounded in behavioural science frameworks and integrated with pharmacotherapy or human support. Future research needs to prioritise head-to-head comparisons, biochemically verified outcomes, equity-centred deployment, and moral governance for AI-delivered support.
Smoking Cessation; Digital Health; Smartphone Applications; mHealth; Chatbot; Artificial Intelligence
Copyright (c) 2026 Michal Karpinski, Maria Marusińska, Michał Parzniewski, Wiktoria Czyż, Sabina Kolawa, Natalia Ostruszka, Arnold Borowiec, Julia Pilecka, Jędrzej Wojciechowski, Wojciech Markiewicz https://creativecommons.org/licenses/by/4.0
PREHABILITATION IN PATIENTS AWAITING LIVER TRANSPLANTATION – A REVIEW OF CURRENT EVIDENCE
End-stage liver disease (ESLD) is associated with significant metabolic disturbances, including chronic inflammation, hypercatabolism, and impaired protein synthesis, which lead to the development of sarcopenia and frailty. These conditions are common among patients qualified for liver transplantation and represent independent risk factors for waitlist mortality, postoperative complications, and prolonged hospitalization. Prehabilitation, defined as a multimodal intervention including physical training, nutritional optimization, and psychological support, aims to improve the patient’s physiological reserve prior to surgery. The aim of this study was a systematic evaluation of the available evidence regarding prehabilitation in liver transplant candidates, with particular emphasis on its impact on physical performance and clinical outcomes. Available data indicate that prehabilitation improves performance parameters such as VO₂peak and the 6-minute walk distance. However, its impact on hard clinical endpoints, including mortality and postoperative complications, remains inconclusive. Prehabilitation appears to be a safe and potentially beneficial intervention, particularly in frail patients; however, further high-quality studies are required.
End-Stage Liver Disease, Liver Transplantation, Prehabilitation, Frailty, Sarcopenia, Physical Performance
Copyright (c) 2026 Tomasz Mruzek, Artur Marcysiak, Patrycja Mularczyk, Karolina Zawadzka, Magdalena Kiełbasiewicz, Wojciech Łysoniewski, Małgorzata Sikorska, Nina Polek, Julia Strumińska https://creativecommons.org/licenses/by/4.0
POLYPHARMACY IN THE GERIATRIC POPULATION: A COMPREHENSIVE SYSTEMATIC REVIEW OF EPIDEMIOLOGY, PATHOPHYSIOLOGY, CLINICAL CONSEQUENCES, AND PHARMACOTHERAPY OPTIMIZATION STRATEGIES
Population aging has become a major demographic and public health challenge worldwide. Increased life expectancy and advances in healthcare have led to a growing number of older adults living with multiple chronic diseases. Consequently, multimorbidity and polypharmacy have become increasingly common in geriatric practice. Polypharmacy is commonly defined as the regular use of five or more medications, while excessive polypharmacy refers to the use of ten or more drugs. Modern geriatric medicine emphasizes that the appropriateness of treatment is more important than the number of medications alone. Therefore, a distinction should be made between appropriate and inappropriate polypharmacy. Appropriate polypharmacy refers to evidence-based pharmacotherapy in which multiple medications are clinically justified and optimized to improve patient outcomes. Inappropriate polypharmacy occurs when medications without clear indications are prescribed, when therapeutic duplication exists, or when treatment risks outweigh benefits. Older adults are particularly vulnerable to adverse drug reactions because of age-related physiological changes, frailty, cognitive impairment, and multiple comorbidities. An important mechanism contributing to inappropriate polypharmacy is the prescribing cascade, in which adverse drug reactions are misinterpreted as new medical conditions, leading to additional prescriptions. This process increases the risk of drug–drug interactions, hospitalization, functional decline, and reduced quality of life. Symptoms such as dizziness, fatigue, falls, constipation, or cognitive impairment may often result from medication-related toxicity rather than normal aging. This systematic review summarizes the epidemiology, mechanisms, clinical consequences, and evidence-based strategies for optimizing pharmacotherapy in older adults, including medication review, deprescribing, interdisciplinary collaboration, and individualized patient-centered care.
Geriatric Medicine, Geriatric Pharmacology, Geriatric Population, Polypharmacy
Copyright (c) 2026 Justyna Słowik, Izabela Sieradzka, Katarzyna Wajda, Dorota Wikiera, Magdalena Pomykalska, Zuzanna Wnęk, Eryk Trela https://creativecommons.org/licenses/by/4.0
THE INFLUENCE OF DIET ON THE COURSE OF PSORIASIS WITH PARTICULAR EMPHASIS ON THE MEDITERRANEAN DIET: A LITERATURE REVIEW
Psoriasis is a chronic, immune-mediated inflammatory disease increasingly recognised as a systemic disorder linked to obesity, metabolic syndrome, and cardiovascular comorbidity. Because these comorbidities share an inflammatory and metabolic substrate that is sensitive to nutritional status, diet has attracted growing interest as a modifiable factor capable of shaping the clinical course of the disease. The objective of this review was to synthesise the current evidence on the relationship between dietary patterns, individual nutrients, and the severity of psoriasis, with particular attention to the Mediterranean diet as an integrated anti-inflammatory model. A review of the medical literature was conducted by searching the main biomedical databases and screening reference lists. The evidence indicates that overweight and obesity are consistently associated with greater disease severity and a poorer response to systemic and biologic therapies, whereas a low-calorie diet and weight loss reduce disease activity. Long-chain omega-3 fatty acids, dietary antioxidants, and polyphenol-rich foods have clear anti-inflammatory effects, while a gluten-free diet appears beneficial in patients with serological markers of gluten sensitivity. Higher adherence to the Mediterranean diet is repeatedly reported to be inversely associated with disease severity and with markers of systemic inflammation. Collectively, the evidence supports dietary modification, and a Mediterranean pattern in particular, as a rational and low-risk adjunct to standard pharmacological management, although the predominance of observational data underscores the need for adequately powered, prospective interventional trials.
Psoriasis; Mediterranean Diet; Nutrition; Inflammation; Dietary Intervention; Obesity
Copyright (c) 2026 Natalia Krzysztofek, Olaf Krawczyk, Piotr Wilczkowski, Wojciech Kopyciński, Norbert Krawczyk, Monika Kamela, Małgorzata Grzybowska, Katarzyna Boszczyk, Adrianna Baran, Aleksandra Palka https://creativecommons.org/licenses/by/4.0
NEW ERA IN DIABETES AND OBESITY TREATMENT - THE EFFECTS OF GLP-1R, GIPR AND GCGR TRIAGONISTS
Background: In recent years, the number of people affected by obesity or diabetes has increased dramatically. This growing prevalence resulted in an intensified interest in new methods to fight this problem. More and more drugs have emerged on the pharmaceutical market such as next-generation triagonists targeting glucagon-like peptide-1 (GLP-1R), glucose-dependent insulinotropic polypeptide (GIPR), and glucagon (GCGR) receptors. Aim of the study: This article reviews the information about the effects of GLP-1R, GIPR, GCCR with particular emphasis on it being an obesity treatment, as well as the mechanisms, safety and potential therapeutic effect. Scope of review: The goal of this review was to gather knowledge about the effect of GLP-1R, GIPR and GCGR triagonists in preexperimental and clinical studies. Results: In experimental models triagonists successfully restricted weight gain and prevented hyperglycemia through promoting energy use and thermogenesis via the GCGR component. Triagonist NN1706 has shown to induce dose-dependent weight loss in early stages of clinical trials, however they also triggered specific adverse effects such as second degree atrioventricular blocks. In contrast, Retratrutide has shown an unprecedented clinical efficacy in phase 2 trials. After 48 weekends of a 12 mg dosage there was a 24.2% mean body weight reduction, a result comparable to bariatric surgery. Moreover 72% of prediabetic patients reverted to normoglycemia. Across all cohorts the most common adverse effects were gastrointestinal symptoms and temporary heart rate elevations. Conclusion: GLP-1R/GIPR/GCGR triagonists represent a significant shift in obesity and type 2 diabetes mellitus (T2DM) management. Their effect extend beyond simple appetite suppression to accelerate Their synergism extends beyond simple appetite inhibition for example to increase lipid metabolism, reduce fatty liver disease and accelerate energy expenditure. Clinical implementation will depend on confirming long-term safety in patients ongoing the stage 3 trials. Further research is crucial to ensure the safety of this therapeutic option and confirm these findings.
Triple Receptor Agonists, GLP-1, GIP, Obesity Management, Weight Loss
Copyright (c) 2026 Michał Duliński, Krzysztof K. Gofron, Kornelia Kaźmierkiewicz-Makanga, Weronika Spychalska, Emilia Piotrowicz, Filip Witowicz, Julia Glińska, Aleksandra Krawczyk, Wiktoria Waldon, Paulina Sumlet https://creativecommons.org/licenses/by/4.0