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%
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DIGITAL WORKFLOW SYSTEMS IN EMERGENCY DEPARTMENTS: A SOCIO-TECHNICAL ANALYSIS OF STAFF EFFICIENCY AND WELL-BEING
Background: The rapid digitization of healthcare has transformed the Emergency Department (ED) into a complex socio-technical system. While Digital Workflow Systems (DWS), including Electronic Health Records (EHR) and Clinical Decision Support Systems (CDSS), aim to optimize operational metrics, their impact on the cognitive ecosystem of healthcare professionals is often overlooked. This article conducts a socio-technical analysis of the dichotomy between IT-driven efficiency and staff well-being. Methods: Employing a hybrid systematic–narrative review approach underpinned by the SEIPS 2.0 framework, this study synthesizes literature published between 2018 and 2025. The analysis focuses on identifying how poorly designed interfaces contribute to systemic failures within the ED work system. Results: The findings reveal that interface design flaws significantly contribute to "technostress," cognitive overload, and moral injury among staff. The review identifies a "productivity paradox" where digital tools, intended to assist clinical workflows, instead become primary sources of professional burnout. Conclusion: To address these challenges, the paper proposes a framework for resilient, human-centric design. It emphasizes the critical need for integrating cognitive ergonomics and explainable AI into future ED information systems to ensure both patient safety and operator well-being.
Copyright (c) 2026 Beata Szreder, Joanna Ślusarczyk, Piotr Pietrzyk, Natalia Stanek, Patrycja Krawczyk, Maja Łapaj, Aleksandra Jagiełło, Zuzanna Noweta, Milena Lewicka, Tamara Chodań https://creativecommons.org/licenses/by/4.0
EFFECTS OF ANABOLIC-ANDROGENIC STEROIDS ON MENTAL HEALTH - COMPREHENSIVE REVIEW
This review summarizes current information on the mechanisms and adverse outcomes of anabolic-androgenic steroid (AAS) usage. Chronic use of AAS induces significant structural and functional changes in the brain, especially in the prefrontal cortex, hippocampus, and amygdala, through monoaminergic and GABAergic dysregulation, alterations in the tryptophan-kynurenine pathway, and neuroinflammation. Moreover, abuse of AAS causes remodeling of fronto-limbic circuits, as well as suppression of the hypothalamic-pituitary-gonadal (HPG) axis. Clinically, excessive AAS consumption is associated with psychotic, depressive, and anxiety-related symptoms, cognitive decline, and increased aggressive behaviors.
Mental Health, Anabolic-Androgenic Steroids, Psychiatry, Neuroinflammation
Copyright (c) 2026 Mateusz Kosowski, Wiktor Śliwiński, Karolina Zarówna, Daniel Chołuj, Jakub Marciniak, Jakub Mazur, Weronika Pura, Dominika Matecka https://creativecommons.org/licenses/by/4.0
IMPACT OF COMMON CHRONIC DISEASES ON SEMEN QUALITY: A NARRATIVE REVIEW
Background. Chronic diseases, including obesity, type 2 diabetes, cardiovascular diseases, and autoimmune conditions, represent a significant threat to male fertility. These conditions disrupt testicular homeostasis through interconnected pathophysiological mechanisms, leading to the deterioration of semen parameters and sperm genomic integrity. Aim. This narrative review aims to analyze the impact of common chronic diseases on semen quality and to discuss the integrated molecular and systemic mechanisms underlying male infertility in these clinical conditions. Material and methods. A narrative review of current scientific literature was conducted, focusing on clinical and experimental studies regarding the effects of metabolic, cardiovascular, autoimmune, renal, and hepatic disorders on male reproductive functions. Key pathomechanisms, including oxidative stress, inflammation, and hormonal dysregulation, were analyzed. Results. Five primary pathways leading to testicular dysfunction were identified: (1) oxidative stress causing lipid peroxidation and decreased sperm motility; (2) chronic inflammation disrupting the blood-testis barrier; (3) HPG axis dysregulation leading to hypogonadism; (4) endothelial dysfunction impairing testicular microcirculation and thermoregulation; and (5) sperm DNA damage. It was shown that patients with diabetes, hypertension, and inflammatory joint diseases exhibit significantly lower sperm concentration, volume, and motility compared to control groups. Conclusions. Chronic diseases exert a multidirectional, negative impact on semen quality, and the degree of fertility impairment often correlates with disease activity and stage. Management of metabolic and cardiovascular health, along with inflammatory control, is crucial for preserving male reproductive potential.
Male Infertility, Semen Quality, Chronic Diseases, Oxidative Stress, Metabolic Syndrome
Copyright (c) 2026 Wiktor Śliwiński, Dominika Matecka, Jakub Mazur, Daniel Chołuj, Weronika Pura, Karolina Zarówna, Mateusz Kosowski, Jakub Marciniak https://creativecommons.org/licenses/by/4.0
THE ROLE OF HORMONAL AND NON-HORMONAL MARKERS IN ASSESSING PERINATAL STRESS AND ITS CLINICAL IMPLICATIONS
Background: Prenatal and perinatal stress activates the maternal and fetal HPA axis, releasing biomarkers that can cross the placenta. In high concentrations, these substances may lead to congenital malformations, preterm labor, or intrauterine growth restriction (IUGR). Despite their potential, endogenous biomarkers are not yet part of standard gynecological diagnostics. Aim: This paper analyzes recent reports on hormonal and non-hormonal perinatal stress biomarkers to evaluate their application in assessing health risks for mothers and fetuses. Material and Methods: This literature review examines clinical trials and observational studies from the late 20th and early 21st centuries. It focuses on laboratory techniques such as ELI-SA, HPLC, and radioimmunoassay used to measure stress markers in maternal serum, cord blood, amniotic fluid, and urine. Results: Studies show that copeptin levels rise significantly during fetal hypoxia and IUGR, aiding ultrasonographic differentiation. Maternal cortisol levels correlate negatively with birth weight and increase the risk of infants being small for gestational age (SGA). ACTH and CRH serve as indicators of HPA axis maturity and predictors of preterm birth. Regarding non-hormonal markers, malondialdehyde and 8-isoprostane are sensitive indicators of oxidative stress linked to preeclampsia. Furthermore, elevated proinflammatory cytokines (IL-1, IL-6, IL-8, TNF-alpha) are closely associated with intrauterine infections and the onset of preterm labor. Conclusions: Perinatal stress biomarkers offer significant prognostic value for identifying risks of preterm labor and developmental pathologies. While cortisol currently has the greatest clinical utility, copeptin and malondialdehyde are noted for their stability and potential for routine screening. Further clinical trials are necessary to integrate these markers into standard obstetric care.
Perinatal Stress, Biomarkers, HPA Axis, Cortisol, Copeptin, Oxidative Stress, Preterm Labor
Copyright (c) 2026 Daniel Chołuj, Wiktor Śliwiński, Jakub Marciniak, Jakub Mazur, Mateusz Kosowski, Weronika Pura, Karolina Zarówna, Dominika Matecka https://creativecommons.org/licenses/by/4.0
HORMONAL THERAPY IN HIGH-GRADE SEROUS OVARIAN CARCINOMA: A REVIEW OF CURRENT EVIDENCE
Ovarian cancer remains one of the leading causes of cancer-related mortality among women worldwide. The most common histological subtype is high-grade serous ovarian carcinoma (HGSOC), which accounts for approximately 70-80% of epithelial cases and is characterized by profound genomic instability, nearly universal TP53 mutations, and a high propensity for recurrence. While the standard of care - comprising maximal cytoreductive surgery, platinum-based chemotherapy, and maintenance with poly (ADP-ribose) polymerase PARP inhibitors or anti-angiogenic agents- has improved outcomes, long-term prognosis for advanced disease remains poor. Hormonal therapy (HT) has emerged as a clinically relevant treatment option for selected patients with recurrent ovarian cancer, particularly in oestrogen receptor (ER)- positive tumours. Agents such as Tamoxifen and aromatase inhibitors (AIs), including Letrozole, Anastrozole, and Exemestane, demonstrate reproducible clinical benefit rates of 25-45%, primarily through disease stabilisation. Recent real-world cohort data (2025) and ongoing prospective trials- notably the phase III ENGOT-ov54/Swiss-GO-2/MATAO trial (NCT04111978) - represent critical steps towards establishing evidence-based endocrine therapy in HGSOC. This review evaluates the biological rationale for targeting the ER and progesterone receptor (PR) pathways, critically appraises current and emerging clinical evidence, discusses combination strategies with CDK4/6 inhibitors, PI3K/mTOR inhibitors, and PARP inhibitors, and highlights the unmet need for biomarker-driven patient selection.
High-Grade Serous Ovarian Carcinoma, Hormonal Therapy, Oestrogen Receptor, Aromatase Inhibitors, Tamoxifen, MATAO Trial, CDK4/6 Inhibitors, Letrazole
Copyright (c) 2026 Agnieszka Zaręba, Dawid Juszkiewicz, Krzysztof Kiełczewski, Barbara Fetner, Magdalena Dłużewska, Zuzanna Gebert, Ivanna Ilkiv, Agata Kucharska, Konrad Adler, Patrycja Stanowska https://creativecommons.org/licenses/by/4.0
IMPACT OF AIR POLLUTION ON ATHLETIC PERFORMANCE AND HEALTH: A COMPREHENSIVE REVIEW
Air pollution represents a major global health challenge and has been increasingly recognized as an important environmental factor influencing respiratory and cardiovascular function as well as athletic performance. During exercise, elevated minute ventilation and oral breathing increase inhaled pollutant dose and modify particle deposition patterns within the respiratory tract. Particulate matter (PM₂.₅ and PM₁₀), nitrogen oxides, ozone, sulfur dioxide, and carbon monoxide are among the most relevant pollutants affecting exercise physiology. Inhaled pollutants may induce oxidative stress, systemic inflammation, endothelial dysfunction, and autonomic imbalance. Biological effects are mediated through reactive oxygen species generation, inflammatory cytokine activation, and potential translocation of ultrafine particles across the alveolar-capillary barrier. In athletes, these mechanisms may lead to transient reductions in pulmonary function, bronchial hyperresponsiveness, decreased maximal oxygen uptake (VO₂max), and impaired exercise performance. Although short-term exposure may cause acute functional impairment, regular physical activity remains beneficial for health. Monitoring air quality, adjusting training intensity, and optimizing exercise timing are recommended preventive strategies. Further prospective studies are needed to evaluate long-term exposure effects on athletic adaptation and cardiovascular outcomes.
Air Pollution, Athletic Performance, Health Effects, Particulate Matter, Endurance Exercise
Copyright (c) 2026 Ewa Sobolewska, Daniel Markowski, Magdalena Baranowska, Julia Dziaman, Viktoria Kretschmer, Wiktor Daniszewski, Jakub Rodziewicz, Patryk Kondracki https://creativecommons.org/licenses/by/4.0
AI-ASSISTED DEMENTIA CARE: A REVIEW OF EFFECTIVENESS AND ETHICAL CHALLENGES
Background: Dementia affects more than 57 million people worldwide and remains one of the most disabling and least treatable syndromes associated with aging. Given the lack of a pharmacological cure, there is significant interest in utilizing artificial intelligence to improve both the accessibility and quality of care. At present, AI-powered tools are applied in three main areas: early diagnosis through neuroimaging analysis, non-pharmacological management of behavioral symptoms with social robots, and continuous safety monitoring using smart home and wearable technologies. Objective: This review synthesizes peer-reviewed evidence from PubMed published between 2015 and 2025, evaluating the practical impacts of AI tools in dementia care and examining the moral challenges associated with their use in populations experiencing progressive cognitive decline. Key Findings: Deep learning techniques applied to brain MRI have demonstrated diagnostic validity for Alzheimer's disease that equals or exceeds the performance of specialist clinicians. However, questions remain regarding their effectiveness across diverse populations. Robotic companions, such as the PARO seal robot, have been shown to reduce agitation and depression in individuals with dementia and to significantly decrease the use of psychotropic medications. Observation technologies improve safety and alleviate caregiver anxiety, but they also introduce surveillance practices that may compromise the individual dignity and autonomy of those they are intended to protect. Conclusions: AI provides significant clinical benefits in dementia care; however, these advantages are inseparable from the ethical conditions governing its use.
Dementia, Alzheimer's Disease, Artificial Intelligence, PARO, Social Robots
Copyright (c) 2026 Wiktoria Dybizbańska, Karolina Dziki, Agnieszka Burzej, Maciej Komenda, Julia Szklarska-Komenda, Katarzyna Garncarz, Aleksandra Marek, Krzysztof Jamroch, Mateusz Kacalak, Zofia Nowakowska https://creativecommons.org/licenses/by/4.0
THE USE OF MODIFIED T LYMPHOCYTES (CAR-T AND CAR-Treg) AS A STRATEGY FOR RESTORING IMMUNOLOGICAL TOLERANCE IN SEVERE FORMS OF SYSTEMIC LUPUS ERYTHEMATOSUS AND SYSTEMIC SCLEROSIS – ANALYSIS OF EFFICACY AND SAFETY IN THE LIGHT OF THE LATEST CLINICAL TRIALS - REVIEW
In recent years, there has been rapid progress in cell therapies based on modified T cells, particularly CAR-T and CAR-Treg technologies, which show promise in the treatment of severe autoimmune diseases. Systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) are diseases characterized by profound dysregulation of the immune system, leading to chronic inflammation and multiorgan damage. Despite the use of conventional immunosuppressive therapies, a significant proportion of patients remain refractory to treatment, justifying the search for new therapeutic strategies. The aim of this review is to analyze the efficacy and safety of CAR-T and CAR-Treg cells in the context of the latest clinical trials published between 2024 and 2026. Particular attention was paid to the immunological mechanisms underlying the action of these therapies, their ability to “reset” the immune system, and their impact on long-term disease remission. Available clinical data indicate that B-cell-targeted CAR-T therapy (e.g., CD19) can lead to deep and long-lasting remission in patients with refractory SLE through the elimination of autoreactive cell populations and the restoration of the immune repertoire (Wang et al., 2025; Xu et al., 2025). At the same time, new strategies utilizing CAR-Treg cells are emerging, aimed at restoring immune tolerance without systemic immunosuppression. Despite promising results, this therapy is associated with potential risks, such as cytokine release syndrome or neurotoxicity, although in recent studies their incidence appears to be limited (Zhou et al., 2024; Wang et al., 2025). In summary, CAR-T and CAR-Treg therapies represent a breakthrough in the treatment of severe autoimmune diseases; however, their widespread use requires further research on safety, accessibility, and the optimization of therapeutic protocols.
CAR-T, CAR-Treg, Systemic Lupus Erythematosus, Systemic Sclerosis, Immunotherapy, Immune Tolerance, Autoimmune Diseases
Copyright (c) 2026 Patrycja Szczygielska, Sylwia Hejna, Weronika Smutkiewicz, Weronika Teterycz, Wiktoria Goździejewska, Łukasz Jaworek, Gabriela Zimka, Krystian Bjorgen, Lilianna Jasińska, Magdalena Roman https://creativecommons.org/licenses/by/4.0
GUT MICROBIOTA AS A KEY REGULATOR OF THE GUT–BRAIN AXIS AND METABOLISM IN THE PATHOGENESIS OF PSYCHIATRIC AND METABOLIC DISORDERS: A NARRATIVE REVIEW
The gut microbiota has emerged as a central regulator of the gut–brain axis and systemic metabolism, playing a pivotal role in the development of both psychiatric and metabolic disorders. This review synthesizes current evidence from peer-reviewed studies indexed in PubMed to elucidate the mechanisms linking gut microbiota dysbiosis with disease pathogenesis. A structured literature review was conducted, focusing on studies published between 2004 and 2025. Evidence indicates that alterations in microbial composition and function are associated with depression, anxiety, autism spectrum disorders, obesity, type 2 diabetes, and metabolic syndrome. Mechanistically, the gut microbiota influences host physiology through neural, endocrine, immune, and metabolic pathways, including modulation of neurotransmitters, short-chain fatty acids, and inflammatory mediators. The review highlights shared biological pathways between psychiatric and metabolic disorders, emphasizing chronic inflammation and metabolic dysregulation. Emerging therapeutic strategies, including microbiota-targeted interventions such as probiotics, prebiotics, dietary modifications, and fecal microbiota transplantation, demonstrate promising clinical potential. However, heterogeneity in study designs and individual microbiome variability remain significant challenges. This review underscores the importance of integrative, multidisciplinary research and supports the gut microbiota as a novel therapeutic target.
Gut Microbiota, Gut–Brain Axis, Dysbiosis, Inflammation, Psychiatric Disorders, Metabolic Syndrome
Copyright (c) 2026 Weronika Teterycz, Wiktoria Goździejewska, Łukasz Jaworek, Gabriela Zimka, Krystian Bjorgen, Lilianna Jasińska, Magdalena Roman, Martyna Lipiarz, Michał Niespodziewański, Patrycja Szczygielska, Sylwia Hejna https://creativecommons.org/licenses/by/4.0
DIGITAL HEALTH INTERVENTIONS IN TYPE 2 DIABETES: A NARRATIVE REVIEW OF PATIENT ENGAGEMENT, SELF-MANAGEMENT, AND BARRIERS TO ADOPTION
Research objective: The aim of this paper was to present the role of digital health interventions in the treatment of type 2 diabetes, with a particular focus on their impact on patient engagement, self-management, clinical outcomes, and barriers related to their implementation Methods: This study was conducted as a narrative review. The literature search was performed using PubMed and Google Scholar databases. Articles published between 2020 and 2026 were included, with priority given to systematic reviews, meta-analyses, and selected original studies concerning adult patients with type 2 diabetes. Results: Digital health interventions can improve glycemic control, with the most consistent effect being a reduction in glycated hemoglobin (HbA1c). They also support patient engagement and self-management by facilitating regular monitoring, improving adherence, and promoting healthier behaviors. The most effective interventions were those combining data monitoring with feedback and professional support. At the same time, several barriers to implementation were identified, including limited digital literacy, technological usability issues, costs, access inequalities, and insufficient integration with healthcare systems. Conclusion: Digital health interventions represent a valuable supplement to type 2 diabetes treatment. Their effectiveness depends not only on the technology itself, but also on the quality of implementation, integration with medical care, and adaptation to patients’ individual needs.
Type 2 Diabetes, Digital Health, Telemedicine, Glycemic Control, Self-Management
Copyright (c) 2026 Anna Maria Kowalska, Aleksandra Kuls, Aleksandra Zofia Sobol, Bogusław Pabis, Justyna Maria Wiktorowicz, Martyna Kadłubańska, Nicole Bulińska, Zofia Sinczak, Sonia Zembrzuska, Stanisław Bajerski https://creativecommons.org/licenses/by/4.0
PANCREATIC SURGERY - CANCER, CHRONIC PANCREATITIS, ACUTE PANCREATITIS, INNOVATIVE SURGICAL METHODS
Pancreatic surgery is one of the most technically demanding fields of abdominal surgery due to the complex anatomy of the pancreas and its proximity to major vascular structures. Pancreatic cancer, often diagnosed at an advanced stage, carries a poor prognosis, and surgical resection combined with systemic therapy remains the only potentially curative option for a limited group of patients. Postoperative complications remain common despite advances in perioperative care. Chronic pancreatitis leads to irreversible structural damage and severe pain, frequently requiring surgical intervention tailored to morphological changes. In acute pancreatitis, management focuses on early severity assessment, intensive supportive therapy, and minimally invasive treatment of complications. Ongoing development of modern techniques—including minimally invasive, robotic, and ablative procedures—has contributed to gradual improvement in outcomes and reduction of postoperative morbidity.
Pancreatic Surgery, Pancreatic Cancer, Chronic Pancreatitis, Acute Pancreatitis, Pancreaticoduodenectomy, Distal Pancreatectomy, Minimally Invasive Surgery, Robotic Surgery, Irreversible Electroporation, Mesopancreas, Postoperative Complications
Copyright (c) 2026 Aleksandra Romanowska, Paweł Arkadiusz Malmur, Weronika Biaduń-Mućko, Kinga Rogowska-Borettini, Maria Wysieńska, Piotr Jóźwiak, Adam Rybak https://creativecommons.org/licenses/by/4.0
SPINAL CORD STIMULATION (SCS): TECHNICAL ASPECTS AND NEW DIRECTIONS
Introduction and purpose: Spinal cord stimulation (SCS) is a well-established implantable neuromodulation therapy for chronic pain. Over the last decade, the field has evolved rapidly due to the diversification of stimulation waveforms, expanded programming capabilities, and the emergence of data-driven paradigms such as ECAP-controlled closed-loop systems. This review aims to present SCS as a medico-technical system by summarizing key mechanisms of neuromodulation, core elements of system architecture, clinical indications and selection principles, and technological directions. Materials and methods: A comprehensive literature search was performed using PubMed, BioMed Central, Scopus, and Google Scholar to identify relevant studies on spinal cord stimulation. The search included the following keywords and their combinations: spinal cord stimulation, SCS, neuromodulation, chronic pain, failed back surgery syndrome, and complex regional pain syndrome. Results: Evidence supports that SCS analgesia arises from both segmental spinal mechanisms and supraspinal modulation, with waveform-dependent differences in sensory and affective pain processing. Modern SCS platforms integrate leads, IPG, and telemetry/programming layers, enabling multipolar field shaping and increasingly incorporating sensing channels for objective biomarkers (e.g., ECAP) and real-time dose stabilization. Indications remain centered on PSPS/FBSS and CRPS, with expanding applications across selected neuropathic pain syndromes. Conclusion: SCS is transitioning from conventional open-loop neuromodulation toward biomarker-driven, adaptive, and remotely supported therapy. Future progress is likely to be shaped by closed-loop architectures, improved sensing and telemetry, and computational approaches enabling more consistent outcomes and scalable personalization.
Spinal Cord Stimulation, Neuromodulation, Chronic Pain, Neuropathic Pain, High-Frequency Stimulation, Pain Management
Copyright (c) 2026 Julia Wilanowska, Jędrzej Sztajura, Wiktoria Mikulska, Kamila Tasior https://creativecommons.org/licenses/by/4.0
PREVENTION AND MANAGEMENT OF SYSTEMIC COMPLICATIONS ARISING FROM POOR ORAL HYGIENE: CURRENT STATE OF KNOWLEDGE
Introduction: Oral health is increasingly recognized as a critical component of overall health and well-being. Poor oral hygiene, particularly dental caries and periodontal disease, has been linked not only to local oral conditions but also to systemic complications, including cardiovascular disease, type 2 diabetes mellitus, respiratory infections, adverse pregnancy outcomes, and neurodegenerative disorders. This review aims to provide a comprehensive overview of the prevention and management of systemic complications arising from poor oral hygiene, summarizing current evidence on biological mechanisms, disease associations, and preventive strategies. Materials and Methods: A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar to identify studies investigating the relationship between oral hygiene, periodontal disease, and systemic health outcomes. Keywords included: oral hygiene, periodontal disease, systemic diseases, cardiovascular disease, diabetes, adverse pregnancy outcomes, respiratory disease, neurodegenerative disease, and oral-systemic link. Conclusion: Evidence indicates that oral health is essential for maintaining physical, mental, and social well-being. Preventive dental care, including early detection and management of caries, periodontal disease, and malocclusion, reduces disease progression, systemic complications, and psychosocial burden. Equitable access to dental services is critical, as limited access exacerbates health disparities and worsens outcomes. Integrating oral healthcare within comprehensive health systems and emphasizing prevention can improve individual and population-level health and quality of life.
Oral Hygiene, Periodontal Disease, Cardiovascular Disease, Diabetes, Preventive Dentistry, Health Promotion
Copyright (c) 2026 Katarzyna Nycz, Jędrzej Sztajura https://creativecommons.org/licenses/by/4.0
NEUROSURGICAL TECHNOLOGIES IN MENTAL HEALTH CARE: SOCIETAL, WELL-BEING, AND PUBLIC POLICY IMPLICATIONS
Introduction and purpose: Neurosurgery, traditionally focused on life-saving and functional preservation, also profoundly impacts mental integrity due to its direct interaction with the brain. Psychiatric neurosurgery, including deep brain stimulation and advanced stereotactic techniques, actively modulates dysfunctional neural circuits in treatment-resistant psychiatric disorders. This review examines how such interventions influence personality, cognition, and social functioning, highlighting their evolving role as evidence-based therapeutic options that extend beyond conventional clinical outcomes. Materials and methods: The literature search was performed using PubMed, Scopus, Web of Science, and Google Scholar. Keywords included: “psychiatric neurosurgery”, “deep brain stimulation”, “DBS”, “vagus nerve stimulation”, “VNS”, “auricular vagus nerve stimulation”, “aVNS”, “stereotactic neurosurgery”, “treatment-resistant depression”, “major depressive disorder”, “obsessive-compulsive disorder”, “OCD”, “treatment-resistant psychiatric disorders”, “personality changes”, “cognitive changes”, “neuropsychiatric outcomes”, “quality of life”, “social functioning”, “employment”, “cost-effectiveness”, and “caregiver burden”. Conclusion: Psychiatric neurosurgery, including deep brain stimulation and vagus nerve stimulation, demonstrates significant clinical and socioeconomic benefits for patients with treatment-resistant psychiatric disorders. Beyond symptom reduction, these interventions can restore cognitive and emotional functioning, enhance quality of life, improve social integration, and facilitate professional reintegration. Additionally, they alleviate caregiver burden and may reduce long-term healthcare costs. While current evidence supports the safety and efficacy of these approaches, optimal targeting strategies, patient selection, and long-term outcomes require further research. Overall, psychiatric neurosurgery represents a transformative therapeutic option, bridging clinical treatment with broader psychosocial and economic impact.
Psychiatric Neurosurgery, Deep Brain Stimulation, Vagus Nerve Stimulation, Treatment-Resistant Psychiatric Disorders, Personality and Cognitive Changes, Quality of Life
Copyright (c) 2026 Justyna Karliczek, Natalia Kitala, Julia Knap, Jędrzej Sztajura https://creativecommons.org/licenses/by/4.0
CLINICAL IMPACT OF DEPRESSION ON TREATMENT OUTCOMES IN RHEUMATOID ARTHRITIS: A LITERATURE REVIEW
Depression is a common comorbidity in rheumatoid arthritis, however we still don't know enough about how it affects treatment outcomes. This systematic review aims to assess the clinical influence of depression on disease activity, remission rates, pharmacological treatment response, patient-reported outcomes, and treatment adherence behaviour in individuals with rheumatoid arthritis. A thorough literature review was performed using PubMed, Scopus and Web of Science. We focused on studies published from 2020 to 2026 that evaluated depressive symptoms through validated instruments and reported at least one treatment-related outcome. The results consistently indicated that comorbid depression correlated with greatly elevated composite disease activity scores. It was mostly influenced by subjective rather than objective components. Patients exhibiting depressive symptoms were less likely to attain remission and demonstrated diminished responses to both conventional synthetic and biologic disease-modifying antirheumatic drugs. Depression was also found to be a strong independent predictor of worse health-related quality of life, more pain, more functional disability and less adherence to treatment. These findings underscore the necessity for regular depression screening in rheumatology practice and advocate for the incorporation of mental health interventions into the management of rheumatoid arthritis to enhance treatment outcomes.
Arthritis, Rheumatoid, Depression, Treatment Outcome, Medication Adherence, Patient Reported Outcome Measures
Copyright (c) 2026 Maciej Błaszczak, Wiktoria Leja, Katarzyna Latalska, Zeeshan Zulfiqar, Jakub Kot, Katarzyna Czechowicz, Maciej Szczupaj, Andżelika Pastuszak , Konrad Borkowski , Jakub Rudnicki https://creativecommons.org/licenses/by/4.0
PERIOPERATIVE ANESTHETIC MANAGEMENT IN PATIENTS WITH HEART FAILURE: FROM RISK ASSESSMENT TO HEMODYNAMIC OPTIMIZATION, INTEGRATING FUNCTIONAL CAPACITY ASSESSMENT AND EXERCISE PREHABILITATION – A NARRATIVE REVIEW
Background: Heart failure (HF) increases perioperative complications and mortality in patients undergoing non-cardiac surgery. Both heart failure with reduced ejection fraction and preserved ejection fraction increase cardiovascular risk and require perioperative management. Aim: This review summarizes evidence on perioperative anesthetic management in patients with HF undergoing non-cardiac surgery, focusing on risk assessment, medical therapy optimization, intraoperative hemodynamic management, fluid therapy, postoperative monitoring and impact of exercise on recovery. Materials and Methods: This narrative review included PubMed-indexed studies published between 2021 and 2026. ESC consensus statements, randomized trials, and large cohort studies were analyzed to summarize practical recommendations for perioperative management of HF. Results: Preoperative evaluation should include clinical assessment, natriuretic peptide measurement, and echocardiography. Optimization of medical therapy and euvolemia is essential. During surgery, maintaining MAP ≥ 65 mmHg, careful fluid therapy, and early vasopressor use may reduce myocardial injury. Conclusions: Perioperative management of patients with heart failure should include risk assessment, prehabilitation, hemodynamic control, multidisciplinary care, and functional capacity evaluation to improve short-term outcomes.
HF, HFrEF, HFpEF, Perioperative Care, Hemodynamic Monitoring, Quality of Care
Copyright (c) 2026 Paula Żak, Patrycja Pietraszkiewicz, Inez Michalska, Zuzanna Korbel, Katarzyna Pinkowska, Zuzanna Taciak, Filip Glista, Anna-Maria Grzeczka, Mikołaj Jaszowski, Agnieszka Dąbrowska, Weronika Nawrocka https://creativecommons.org/licenses/by/4.0
ESTABLISHED AND EMERGING BIOMARKERS OF INFLAMMATION IN RHEUMATOID ARTHRITIS: A LITERATURE REVIEW
Background and Objective: Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by persistent inflammation, progressive joint damage, and systemic consequences contributing to increased morbidity and mortality. Although conventional biomarkers are fundamental for diagnosis and disease activity assessment, their prognostic accuracy remains limited. This review aimed to summarize current evidence on emerging inflammatory biomarkers in RA, with emphasis on their prognostic value and translational relevance for personalized disease management. Methods: A structured literature search was conducted in major scientific databases, covering English-language publications from 2014 to March 2025. Studies were selected according to predefined inclusion criteria to identify clinically relevant data on novel inflammatory biomarkers in RA. Results: Emerging biomarkers, including novel autoantibodies, 14-3-3η protein, calprotectin, selected cytokines, adipokines, circulating microRNAs, and hematological inflammatory indices, provide complementary insights into immune dysregulation and systemic inflammation. Several markers are associated with radiographic progression, extra-articular involvement, and treatment response. Multibiomarker disease activity scores represent an integrative approach linking molecular pathways with clinical assessment and risk stratification. Conclusions: Integration of conventional and emerging biomarkers may enhance prognostic precision and support precision medicine strategies in RA. However, robust prospective validation and cost-effectiveness analyses are required before routine clinical implementation.
Rheumatoid Arthritis, Inflammatory Biomarkers, Prognostic Markers, microRNA, Adipokines, Autoantibody
Copyright (c) 2026 Katarzyna Czechowicz, Aleksandra Stępień, Julia Radziwiłko, Kacper Curzytek, Andżelika Pastuszak, Grzegorz Czepiel, Urszula Marzec, Wiktoria Leja, Maciej Błaszczak , Katarzyna Latalska https://creativecommons.org/licenses/by/4.0
ORAL MANIFESTATIONS OF AMYLOIDOSIS AS AN EARLY INDICATOR OF THE DISEASE - A LITERATURE REVIEW
Introduction and Purpose: Amyloidosis is a rare group of diseases characterized by the irreversible extracellular deposition of insoluble amyloid fibrils in various organs and tissues. Treatment should begin as early as possible, immediately following diagnosis. Therefore, clinicians should be aware of the disease’s characteristic features, including those visible in the oral cavity- which will be the focus of this article. While systemic manifestations are often emphasized, changes in the oral cavity can serve as early- and sometimes the first- indicators of the disease. The aim of this article is to present the most relevant and recent scientific reports from the past ten years regarding oral manifestations of amyloidosis, highlight their diagnostic value, and emphasize the role of the dental professionals in the multidisciplinary approach to early detection and patient care. Description of the State of Knowledge: Recent literature highlights a broad range of oral manifestations in amyloidosis, including macroglossia, nodular lesions, hemorrhagic changes, and chronic ulcers- some of which may appear without systemic symptoms. Histopathological biopsy with Congo red staining remains the gold standard for confirming amyloid deposits. Case reports increasingly show that oral findings can prompt systemic evaluation, leading to earlier diagnosis and management. This underscores the importance of dental professionals in recognizing subtle signs and initiating appropriate referrals. Conclusions: Oral signs of amyloidosis can be the first clue to a systemic disease. Recognizing the type and location of lesions helps assess whether the disease is localized or systemic. Early diagnosis may improve outcomes- and in some cases, even save the patient’s life.
Amyloidosis, Oral Manifestations, Oral Cavity Symptoms, Oral Health, Oral Cavity Mucosa
Copyright (c) 2026 Kinga Popielarska, Michał Borowski, Anna Maria Zakrzewska, Julia Aleksandra Leśniak, Natalia Maria Leśniak, Julia Agnieszka Michalak, Klaudia Elżbieta Niwińśka, Klaudia Martyna Patrzykąt, Aleksander Midera, Monika Augustyn https://creativecommons.org/licenses/by/4.0
IRRITABLE BOWEL SYNDROME - PATHOGENESIS, EPIDEMIOLOGY, TREATMENT
Irritable bowel syndrome (IBS) is a common disorder of gut–brain interaction characterized by recurrent abdominal pain and altered bowel habits, including diarrhea, constipation, or mixed patterns. Despite its significant impact on quality of life and healthcare systems, IBS remains underdiagnosed. Diagnosis is based on the Rome IV criteria, which emphasize symptom patterns rather than structural abnormalities. The pathogenesis of IBS is multifactorial and not fully understood, involving low-grade intestinal inflammation, immune activation, alterations in the gut microbiota, and dysregulation of the gut–brain axis, as well as psychological factors such as stress, anxiety, and depression. Epidemiological data show substantial global variation in IBS prevalence, influenced by geographic, methodological, and diagnostic differences. Recent meta-analyses estimate a global prevalence of approximately 14%, with higher rates observed in women and individuals experiencing psychological distress. Post-infectious IBS is also increasingly recognized, with a significantly elevated risk following acute gastroenteritis. Management of IBS requires a multidisciplinary and individualized approach. First-line strategies include patient education, dietary modifications, and stress management. Pharmacological treatments are selected based on the predominant symptom subtype, with options including antibiotics such as rifaximin for IBS-D and laxatives or secretagogues for IBS-C. Increasing attention has been given to microbiota-targeted therapies, including probiotics and fecal microbiota transplantation. Dietary interventions, particularly the low FODMAP diet, have shown effectiveness in reducing global IBS symptoms, although long-term adherence requires careful supervision. Overall, advances in research and treatment strategies offer promising prospects for improving symptom control, patient outcomes, and disease awareness.
IBS, Irritable Bowel Syndrome, Gut-Brain
Copyright (c) 2026 Dominika Walczak, Karolina Niewola, Kamil Arciszewski, Natalia Hariasz , Karolina Orda, Jakub Szumiło, Klaudia Kasperska, Mariana Markiv, Michał Słowik, Paweł Stenzel https://creativecommons.org/licenses/by/4.0
THE ROLE OF THE SKIN MICROBIOME IN THE DEVELOPMENT OF DERMATOLOGIC DISEASES: CURRENT STATE OF EVIDENCE (2020–2025)
Background: The cutaneous microbiome is a sophisticated ecosystem essential for skin homeostasis and immune regulation. Between 2020 and 2025, research transitioned from simple taxonomic mapping toward functional metagenomics, highlighting the microbiome's role as a dynamic modifier of dermatologic pathology. This review synthesizes recent evidence on microbial involvement in inflammatory skin diseases and evaluates emerging therapeutic interventions. Methods: A narrative synthesis was performed via a targeted PubMed search for literature published from January 2020 to December 2025. Following the screening of 171 abstracts, 33 high-impact studies focusing on functional metagenomics, "multi-omic" integration, and microbiome-targeted therapies were selected for in-depth analysis. Results: In atopic dermatitis (AD), the correlation between Staphylococcus aureus dominance and barrier degradation remains the most robust evidence of clinically significant dysbiosis. In psoriasis, localized microbial shifts are intrinsically linked to Th17/IL-23 axis activation. Acne vulgaris pathogenesis is increasingly attributed to specific virulent Cutibacterium acnes phylotypes rather than absolute abundance. In seborrheic dermatitis, the synergistic interaction between Malassezia fungi and bacterial commensals drives inflammatory signaling. Precision interventions, including strain-targeted probiotics, postbiotics, and skin microbiome transplantation (SMT), demonstrate mechanistic rationale and early-phase feasibility. Conclusions: Emerging evidence suggests a potential transition in dermatological therapeutics from broad-spectrum antimicrobial suppression toward targeted ecological restoration. However, this approach remains largely investigational and requires validation through rigorous clinical trials. Future progress depends on standardized sampling protocols and the application of machine learning to identify "microbial endotypes," enabling the development of personalized, microbiome-based therapeutic strategies.
Skin Microbiome, Dysbiosis, Precision Medicine, Metagenomics, Probiotics
Copyright (c) 2026 Julia Glińska, Filip Witowicz, Wiktoria Waldon, Weronika Spychalska, Kornelia Kaźmierkiewicz-Makanga , Maksymilian Bogacz, Aleksandra Krawczyk, Paulina Sumlet, Maria Gofron, Michał Duliński https://creativecommons.org/licenses/by/4.0
BERBERINE IN METABOLIC DISORDERS: THE “NATURE’S OZEMPIC” PHENOMENON - A NARRATIVE REVIEW
Background: Metabolic disorders, particularly type 2 diabetes and obesity, represent one of the greatest public health challenges of the 21st century. In response to the limitations and side effects of conventional pharmacotherapy, many patients are seeking natural alternatives. Berberine, a traditional medicinal plant compound, has become increasingly popular on social media under the label “Nature’s Ozempic.” Objective: This narrative review provides a comprehensive synthesis of berberine in metabolic disorders. It examines its molecular mechanisms, clinical evidence, safety profile, pharmacological interactions, and the public health consequences of its rapid rise on social media. Methods: A targeted literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar. Priority was given to randomised controlled trials, meta-analyses, mechanistic studies, and recent publications analysing social media trends. The articles published between 2009 and 2026 were primarily included. Main Findings: Berberine acts through multiple pathways, most notably AMPK activation, modulation of the gut microbiota, and anti-inflammatory effects. Clinical studies show mild but consistent improvements in glycemic control, insulin sensitivity, and lipid parameters, particularly in patients with type 2 diabetes or metabolic syndrome. Its impact on body weight and visceral fat is generally limited. Short-term safety is acceptable, with mainly mild gastrointestinal side effects, although potential interactions with cytochrome P450 enzymes and P-glycoprotein have been documented. Conclusions: Berberine may serve as a useful adjunctive option in selected patients, but it cannot replace standard therapies such as metformin or statins. Its growing popularity on social media has encouraged widespread self-medication, raising concerns about safety and unrealistic expectations. Larger, longer-term, and more diverse studies are needed to define its true clinical value and long-term safety.
Berberine, Metabolic Syndrome, Nutraceuticals, Social Media, “Nature’s Ozempic”
Copyright (c) 2026 Emilia Lenkiewicz, Alicja Maciejewska, Monika Stępińska, Marta Omiecińska, Maja Kaczor, Weronika Trynkiewicz, Zuzanna Rybka, Julia Żak, Karolina Dąbrowska, Jakub Winiarczyk https://creativecommons.org/licenses/by/4.0
DIGITAL INTERVENTIONS IN PSYCHODERMATOLOGY: NAVIGATING MENTAL HEALTH RISKS AND SOCIAL ISOLATION IN ACNE VULGARIS
Background: Acne vulgaris is a chronic dermatological disease that, beyond its visible cutaneous manifestations, exerts a significant negative impact on psychological well-being. Clinical evidence demonstrates that the persistent nature of this inflammatory condition is directly associated with a heightened susceptibility to clinical depression, anxiety, and body dysmorphic disorder (BDD). This inherent link between skin health and mental state necessitates a comprehensive, integrated approach to patient care. Objective: This narrative review first aims to illuminate the profound psychological dimensions of acne vulgaris—particularly the emotional distress and social isolation experienced by patients. Subsequently, it critically evaluates the role of modern digital health interventions (mHealth, teledermatology, artificial intelligence) in managing this burden and analyzes the dual impact of social media on patients' psychosocial functioning. Methods: A systematic literature search was conducted across primary scientific databases, leading to the selection of 23 peer-reviewed articles. The incorporated studies specifically focused on the psychiatric toll of inflammatory skin diseases, the clinical efficacy of remote care, and the societal implications of emerging digital phenomena in dermatology. Results and Discussion: The synthesized evidence indicates that structured digital tools—most notably internet-delivered cognitive behavioral therapy (ICBT) and mobile applications grounded in self-regulation theory—effectively improve clinical outcomes while restoring patients’ sense of personal control over their condition. Furthermore, while the diagnostic accuracy of artificial intelligence (AI) models continues to evolve, their integration introduces a standardized, data-driven assessment. This emotionless baseline can assist patients in rationalizing their distorted self-image. However, the modern social media landscape exerts a distinctly paradoxical influence. While grassroots initiatives like the "acne positivity" movement actively combat social isolation by fostering peer-support networks, these platforms simultaneously expose vulnerable users to unrealistic aesthetic standards that can exacerbate dysmorphic symptoms. Additionally, this environment is frequently saturated with unverified medical information, predominantly driven by influencers promoting pseudoscientific therapies. Conclusions: To optimize psychodermatological care, healthcare systems must adopt hybrid ("blended care") treatment models that seamlessly integrate traditional in-person consultations with remote digital monitoring, thereby preserving the fundamental physician-patient relationship. Furthermore, the industry requires stricter regulatory oversight of commercial medical applications. It is equally critical to train diagnostic AI algorithms on highly diverse datasets encompassing all skin phototypes to prevent algorithmic bias. Finally, the medical community must establish a proactive online presence to actively counter digital misinformation.
Psychodermatology, Acne Vulgaris, Digital Health, Telemedicine, Artificial Intelligence, Social Media
Copyright (c) 2026 Aleksandra Maciejewska-Gaskoń, Alicja Maciejewska, Monika Stępińska, Marta Omiecińska, Maja Kaczor, Weronika Trynkiewicz, Zuzanna Rybka, Julia Żak, Emilia Lenkiewicz, Karolina Dąbrowska, Jakub Winiarczyk https://creativecommons.org/licenses/by/4.0
THE RISE OF DIGITAL SELF-DIAGNOSIS: TECHNOLOGICAL INNOVATION AND ITS SOCIAL AND HEALTHCARE SYSTEM IMPLICATIONS
The rapid expansion of digital health technologies has transformed how people seek, interpret, and use medical information. Tools supporting self-diagnosis—such as online symptom checkers, AI-based chatbots, wearable biosensors, and mobile health applications—are now widely used across healthcare systems. This review examines the clinical, ethical, and societal implications of these developments. A structured search of PubMed/MEDLINE, Google Scholar, and the Cochrane Library identified peer-reviewed studies published between 2010 and 2025 evaluating consumer-oriented diagnostic technologies. Eligible studies addressed diagnostic performance, behavioral outcomes, regulation, health literacy, and equity. Due to methodological heterogeneity, results were synthesized narratively. Evidence suggests that digital self-diagnosis tools provide several benefits, including improved access to health information, earlier symptom assessment, triage support, and greater patient engagement. These advantages may be particularly important in resource-limited settings and during periods of healthcare system strain. However, notable concerns remain. Diagnostic accuracy varies considerably, and triage advice may be overly cautious or occasionally inappropriate. Additional risks include increased health anxiety, exposure to misinformation, data privacy issues, and the potential to exacerbate existing social inequalities. Moreover, the current evidence base is uneven, with limited real-world validation and insufficient research on long-term behavioral and professional impacts. Digital self-diagnosis represents a lasting structural change rather than a temporary trend. Its effective integration into healthcare systems will require stronger regulatory oversight, greater investment in digital health literacy, and interdisciplinary research addressing clinical effectiveness, ethical governance, and equity. Careful management is necessary to ensure that technological innovation strengthens—rather than undermines—the quality and fairness of medical care.
Digital Health, Self-Diagnosis, Symptom Checkers, Artificial Intelligence, Mhealth, Wearable Devices
Copyright (c) 2026 Marta Omiecińska, Monika Stępińska, Alicja Maciejewska, Maja Kaczor, Weronika Trynkiewicz, Zuzanna Rybka, Julia Żak, Emilia Lenkiewicz, Karolina Dąbrowska, Jakub Winiarczyk https://creativecommons.org/licenses/by/4.0
THE ROLE OF SMALL INTESTINAL BACTERIAL OVERGROWTH IN THE PATHOGENESIS, MANAGEMENT AND QUALITY OF LIFE IN PATIENTS WITH IRRITABLE BOWEL SYNDROME – A LITERATURE REVIEW
Background: Small intestinal bacterial overgrowth (SIBO) contributes significantly to the pathogenesis and symptom severity of irritable bowel syndrome (IBS). It is associated with microbial dysbiosis, abnormal intestinal gas fermentation, altered motility, and systemic metabolic and neurocognitive effects, including brain fogginess. Diagnostic uncertainty and lack of a universally accepted gold standard complicate clinical management. Aim: This review synthesizes current evidence on disease mechanisms, diagnostic challenges, therapeutic strategies, and the impact on patient quality of life in SIBO-associated IBS. Methods: A literature search was conducted in PubMed, Scopus, and Google Scholar for full-text articles published between 2000 and 2025. Clinical studies, systematic reviews, and meta-analyses addressing pathophysiology, diagnostics, and treatment outcomes were included. Results: Microbial dysbiosis exacerbates gastrointestinal symptoms through excessive gas production and disrupted motility. Patients frequently report cognitive impairments, including brain fogginess, alongside gastrointestinal distress. Targeted therapy with nonabsorbable antibiotics provides significant symptom relief and improves functional capacity. Persistent diagnostic challenges underscore the need for standardized breath testing and microbial assessments to guide management. Conclusion: Incorporating specific microbial diagnostics into routine gastroenterological practice is essential for optimizing treatment in SIBO-associated IBS. Recognizing the multifaceted impact of bacterial overgrowth enables clinicians to implement targeted therapies, address both intestinal and systemic consequences, and improve long-term patient outcomes.
SIBO, Irritable Bowel Syndrome, Treatment, Quality of Life, Bioengineering, Artificial Intelligence
Copyright (c) 2026 Karolina Dąbrowska, Emilia Lenkiewicz, Alicja Maciejewska, Monika Stepinska, Marta Omiecińska, Maja Kaczor, Weronika Trynkiewicz , Zuzanna Rybka , Julia Żak , Jakub Winiarczyk https://creativecommons.org/licenses/by/4.0