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.
EMERGING THERAPEUTIC AND DIGITAL INNOVATIONS IN CYSTIC FIBROSIS: A COMPREHENSIVE REVIEW
Cystic fibrosis (CF) is an autosomal recessive, multisystem genetic disorder caused by mutations in the CFTR gene, leading to defective chloride transport across epithelial surfaces. Historically associated with early mortality, CF care has transformed over the last decade due to CFTR modulator therapies that target the underlying protein defect, significantly improving pulmonary function, reducing exacerbations, and enhancing quality of life. Concurrently, digital health technologies such as telemedicine, remote monitoring, artificial intelligence (AI) facilitated predictive tools, and wearable sensors are reshaping care delivery. Additionally, advances in gene therapy and personalized medicine hold potential for future curative approaches. This review synthesizes current evidence on CFTR modulators, emerging therapeutic strategies, the integration of digital health in CF care, and the psychosocial and economic challenges that persist. We provide a holistic perspective on how these developments collectively advance CF management, and we highlight ongoing research directions to further improve outcomes.
Cystic Fibrosis, CFTR Modulators, Gene Therapy, Digital Health, Quality of Life
Copyright (c) 2026 Gabriela Mroczka, Paulina Łobaza, Idalia Myszor, Michał Madej, Maria Kubacka, Lucjan Kocemba, Sylwia Nycz-Jucha, Brygida Pinkowicz, Piotr Rachwał, Barbara Nowak-Misiąg https://creativecommons.org/licenses/by/4.0
EFFICACY AND SAFETY OF ORAL JANUS KINASE INHIBITORS FOR ATOPIC DERMATITIS: A NARRATIVE REVIEW
Introduction: Atopic dermatitis (AD) is a common chronic inflammatory skin disease characterized by eczematous lesions and intense pruritus, which severely impacts patients’ quality of life. While recent advances such as biologic therapies (e.g., dupilumab) have improved AD management, many patients still experience inadequate disease control, persistent itch, or treatment side effects. The Janus kinase/ signal transducer and activator of transcription (JAK-STAT) signaling pathway has emerged as a key driver of AD’s inflammatory process, making it a promising therapeutic target for new treatments. Purpose: The aim of this paper was to evaluate the efficacy and safety of oral JAK inhibitor therapies in moderate-to-severe AD. The review synthesizes clinical trial findings for three agents - upadacitinib, abrocitinib, and baricitinib - with a focus on disease-severity endpoints, itch reduction, speed of therapeutic response, long-term disease control, and adverse-event profiles. It also examines how these therapies address previously unmet needs in AD care, including rapid relief of pruritus and treatment options for patients who do not achieve satisfactory outcomes with existing systemic therapies. Methodology: A narrative literature review was conducted using Google Scholar and PubMed, focusing on clinical trials, extension studies, and meta-analyses published up to 2025 that examined oral JAK inhibitors for AD. Key sources include Phase III randomized controlled trials (RCTs) and their long-term extensions, head-to-head studies comparing JAK inhibitors with biologic therapy, and relevant guidelines. Data on efficacy endpoints (EASI, vIGA-AD, pruritus scores), onset of action, durability of response, and adverse events were extracted and synthesized to present an integrated overview of each drug’s performance and safety. Conclusions: Oral JAK inhibitors offer rapid and substantial control of skin lesions and pruritus in moderate-to-severe atopic dermatitis. Their distinct efficacy and safety profiles support personalized systemic therapy. Evidence to date indicates that JAK inhibitors are suitable for long-term management with standard monitoring. Future research should clarify their optimal place in the therapeutic algorithm, including direct comparisons and real-world outcomes.
Atopic Dermatitis, JAK Inhibitors, Upadacitinib, Abrocitinib, Baricitinib, Eczema, Pruritus, Targeted Therapy, Cytokine, Review
Copyright (c) 2026 Piotr Szczepański, Justyna Kącikowska, Oliwia Grzelak, Oliwia Bolek, Magdalena Majkowska, Maria Fengier, Weronika Kuśmierczyk, Krzysztof Rogulski, Katarzyna Sordyl, Jakub Trzaskowski https://creativecommons.org/licenses/by/4.0
SARCOPENIA – CURRENT KNOWLEDGE AND CLINICAL CHALLENGES
Introduction: Sarcopenia, defined as the progressive loss of muscle mass and strength, is one of the primary threats to the functional independence of older adults. With global population aging and an increasing burden of chronic diseases, the clinical relevance of this condition continues to grow. Despite rising awareness, sarcopenia remains underdiagnosed and undertreated, leading to a decline in quality of life, a higher risk of falls, hospitalizations, complications, and increased mortality. Aim of the Study: The aim of this study is to provide a comprehensive review of current knowledge on sarcopenia, including its definition, pathophysiology, epidemiology, risk factors, diagnostic criteria, and therapeutic and preventive strategies. Methodology: A literature search was conducted using PubMed, Google Scholar, and ScienceDirect for publications from 2005 to 2025. The review included peer-reviewed studies, clinical trials, systematic reviews, and international guidelines (EWGSOP2, ICFSR, GLIS) related to the definition, diagnosis, and management of sarcopenia. Only peer-reviewed articles published in English were included, while non-peer-reviewed materials, conference abstracts, and case reports without broader applicability were excluded. Conclusions: Sarcopenia is a complex and increasingly prevalent condition that requires early diagnosis and a comprehensive, multidisciplinary approach. Effective management relies primarily on resistance training, adequate protein intake, and correction of nutritional deficiencies, while pharmacological options remain limited. Particular attention should be directed to secondary sarcopenia, and routine screening in at-risk populations is essential to reduce functional decline and adverse health outcomes.
Sarcopenia, Aging, Muscle Loss, Geriatrics, Prevention, Diagnosis, Physical Activity
Copyright (c) 2026 Mateusz Kacalak, Zofia Nowakowska, Julia Szklarska-Komenda, Maciej Komenda, Wiktoria Dybizbańska, Aleksandra Marek, Agnieszka Burzej, Krzysztof Jamroch, Karolina Dziki, Katarzyna Garncarz https://creativecommons.org/licenses/by/4.0
SURGICAL MANAGEMENT OF BENIGN PROSTATIC HYPERPLASIA: A CONTEMPORARY NARRATIVE REVIEW OF TURP, HOLEP, THULEP, AND AQUABLATION
Background: Benign prostatic hyperplasia (BPH) remains one of the most common causes of lower urinary tract symptoms in aging men. Surgical intervention is required when medical therapy becomes insufficient, and recent technological advancements have introduced several minimally invasive alternatives to traditional transurethral resection of the prostate (TURP). This review provides a contemporary comparison of TURP, holmium laser enucleation (HoLEP), thulium laser enucleation (ThuLEP), and Aquablation. Methods: A narrative review was conducted using a structured PubMed search with the query: "Benign Prostatic Hyperplasia" AND (TURP OR HoLEP OR ThuLEP OR Aquablation) AND "minimally invasive surgery". A total of 43 studies published between 1993 and 2025 were screened, and 15 met the inclusion criteria. Data on perioperative outcomes, functional results, complications, and retreatment rates were extracted and synthesized qualitatively. Results: TURP remains an effective reference procedure but presents higher bleeding risk, longer catheterization, and increased rates of sexual dysfunction compared with modern alternatives. HoLEP demonstrated superior symptom improvement, reduced blood loss, and durable efficacy across all prostate sizes. ThuLEP showed comparable functional outcomes and strong hemostatic performance. Aquablation offered robot-assisted precision with reduced thermal injury and favorable preservation of ejaculatory function, particularly in larger prostates. Each technique demonstrated clinically meaningful improvements in LUTS and urinary flow, with minimally invasive modalities generally offering more favorable perioperative profiles. Conclusions: Contemporary evidence supports the growing use of HoLEP, ThuLEP, and Aquablation as effective and often superior alternatives to TURP. Surgical selection should be individualized based on prostate size, patient comorbidities, sexual function priorities, and surgeon expertise. Further high-quality comparative studies are warranted.
Benign Prostatic Hyperplasia, Turp, HoLep, ThuLEP, Aquablation, Minimally Invasive Surgery
Copyright (c) 2026 Stanisław Jurkowski, Konrad Zieliński, Jagoda Józefczyk, Karolina Ganczar, Paweł Buć, Karolina Buć, Mikołaj Zalewski, Marianna Rudzińska, Łukasz Krzystek, Michał Mazurek https://creativecommons.org/licenses/by/4.0
ANIFROLUMAB IN THE TREATMENT OF SYSTEMIC LUPUS ERYTHEMATOSUS - A LITERATURE REVIEW
Introduction and objective: Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease characterised by a diverse clinical course and multifactorial aetiology. Improvement in treatment has been significant in recent years. Current treatment is primarily based on glucocorticosteroids and immunosuppressive drugs that cause numerous side effects and have limited efficacy in a significant number of patients. Anifrolumab therapy is a new treatment option in SLE. The aim of this review is to describe its characteristics, mechanisms of action, and therapeutic effects. Review methods: A literature review was conducted using scientific publications, focusing primarily on those published between 2017 and 2025. The PubMed and Google Scholar databases were used for the search. Publications in English and Polish that met thematic and substantive criteria were analyzed. Ultimately, 32 publications were included in the review Brief description of the state of knowledge: Anifrolumab is a modern monoclonal antibody that blocks the type I interferon pathway, one of the key mechanisms in the pathogenesis of SLE. A significant reduction in disease activity, improvement in joint and skin symptoms, and a reduction in glucocorticosteroid use can be achieved. Summary: Anifrolumab represents a novel approach in the treatment used in moderate to severe forms of SLE. This drug improves skin and joint symptoms, reduces disease activity, and reduces used doses of corticosteroids. It is well-tolerated and has a rapid therapeutic effect. It improves patients' quality of life. However, its safety in use in children, pregnant and breastfeeding women is unknown.
Interferon Type I, Monoclonal Antibodies, Autoimmune Diseases, Pharmacokinetics, Systemic Lupus Erythematosus
Copyright (c) 2026 Dawid Nowicki, Paulina Małyszczak, Małgorzata Muszyńska, Julia Surowaniec, Katarzyna Karaś, Sylwia Mroszczyk https://creativecommons.org/licenses/by/4.0
THE INFLUENCE OF THE SMARTPHONES ON THE DEVELOPMENT OF POSTURE AND MUSCLE DISORDERS IN THE HEAD AND NECK AREA BY CHILDREN AND YOUTH
The rapid proliferation of smartphones has transformed the lifestyle of modern youth, offering constant access to communication, entertainment, and information. However, this convenience is accompanied by growing concerns about its negative effects on posture and musculoskeletal health. A growing body of research indicates that excessive smartphone use contributes to postural abnormalities, particularly forward head posture (FHP), rounded shoulders, and increased cervical muscle tension among children and adolescents (López-de-Uralde-Villanueva et al., 2023; Alotaibi & Alsaadi, 2022; Areeudomwong et al., 2021). Systematic reviews and meta-analyses confirm that prolonged screen exposure and sedentary behavior are associated with neck and shoulder pain, muscle fatigue, and impaired postural control (López-de-Uralde-Villanueva et al., 2023; Hegazy et al., 2020). Biomechanical studies show that sustained head flexion during smartphone use increases cervical load exponentially — up to 27 kg of additional pressure on the spine when the neck is flexed at 60° (Kim & Kim, 2015). These changes may contribute to the development of “text neck syndrome,” characterized by chronic neck pain, stiffness, and muscle imbalance (Damasceno et al., 2018; Xie et al., 2020). The problem intensified during the COVID-19 pandemic, when remote learning and restricted physical activity significantly increased screen time (Cakir et al., 2022). This review summarizes current evidence on the impact of smartphone use on posture and musculoskeletal health in children and adolescents, exploring biomechanical mechanisms, behavioral risk factors, and possible preventive strategies.
Smartphone Use, Children And Adolescents, Forward Head Posture, Neck Pain, Musculoskeletal Disorders, Text Neck Syndrome
Copyright (c) 2026 Jakub Rusek, Karolina Piatikow, Michał Szalach, Mateusz Jasiński, Aleksandra Żywicka, Małgorzata Kuczek, Kamila Mozga, Justyna Tasior https://creativecommons.org/licenses/by/4.0
PSEUDOANEURYSM OF THE LEFT VENTRICULAR APEX AFTER TRANSFEMORAL TRANSCATHETER AORTIC VALVE IMPLANTATION PROCEDURE – CASE REPORT
Aortic stenosis represents one of the most prevalent degenerative valvular defects in the aging population. The advent of Transcatheter Aortic Valve Implantation (TAVI) has facilitated the effective treatment of high-risk patients who were previously disqualified from surgery. While this minimally invasive method significantly reduces the risk of perioperative complications compared to traditional surgery, it does not entirely eliminate them. The occurrence of life-threatening mechanical complications following TAVI is uncommon but requires immediate recognition. This study aims to present a rare case of an iatrogenic left ventricular pseudoaneurysm following a transfemoral procedure. This report details the case of a 73-year-old female patient with severe aortic stenosis and multiple comorbidities who underwent elective TAVI via transfemoral access. During the procedure, a stiff guidewire was positioned in the left ventricle. Although the implantation was technically successful, routine diagnostic imaging on the first postoperative day revealed an abnormality. Based on the patient's clinical condition, transthoracic echocardiography (TTE), and a subsequent contrast-enhanced Computed Tomography (CT) scan, a pseudoaneurysm of the left ventricular apex with active bleeding into the pericardial sac was confirmed. The patient required urgent conversion to classical cardiac surgery. The left ventricular perforation was successfully repaired via median sternotomy, which resulted in the patient's recovery, albeit with a prolonged hospitalization. Bleeding complications remain one of the most common causes of surgical reoperation following TAVI. Such events have been demonstrated to significantly impact the risk of mortality and extend the overall duration of hospitalization. Formed apical pseudoaneurysms represent a particularly rare complication. in the literature, such cases are predominantly described in the context of transapical access, which necessitates traversing the heart wall. However, this case highlights that iatrogenic perforation of the ventricle by the guidewire can also occur during transfemoral access. Routine postoperative imaging is crucial for the early detection and successful management of this life-threatening condition.
Pseudoaneurysm, Transcatheter Aortic Valve Replacement, Aortic Valve Stenosis, Case Report, Bleeding, Reoperation
Copyright (c) 2026 Robert Kasza, Lidia Ziętek https://creativecommons.org/licenses/by/4.0
THE ROLE OF VITAMIN D IN PATHOGENESIS AND PREVENTION OF CARDIOVASCULAR DISEASES - A LITERATURE REVIEW
Introduction: Cardiovascular diseases remain the leading cause of mortality worldwide, and its incidence is increasing with the population aging. A growing number of studies indicate that vitamin D deficiency, which is common in the global population, may play an important role in the pathogenesis of cardiovascular diseases by influencing inflammatory processes, oxidative stress, the renin-angiotensin-aldosterone system, calcium-phosphate metabolism, and endothelial function. As a result, vitamin D has become the subject of intensive analysis regarding its potential impact on the prognosis of patients with hypertension, heart failure, atherosclerosis, diabetes, and arrhythmias. Aim of the study: The aim of the study was to present the current state of knowledge on the association between vitamin D deficiency and the risk and management of cardiovascular diseases, as well as to evaluate the role of vitamin D supplementation in the prevention and treatment of these diseases. Material and methods: This paper provides a review of the literature including current experimental, observational, and randomized controlled studies on vitamin D metabolism, the significance of 25(OH)D deficiency, pathophysiological mechanisms, and the effects of supplementation. Included publications present the impact of vitamin D on endothelial function, oxidative stress, atherosclerosis, the neurohormonal system, glucose metabolism, and the risk of arrhythmia. Results and Conclusions: A review of the literature indicates that vitamin D deficiency is associated with an increased risk of hypertension, heart failure, type 2 diabetes, atherosclerosis, and cardiac arrhythmias, including atrial fibrillation. The mechanisms of this effect include the action of VDR receptors in cardiomyocytes and vascular cells, modulation of the inflammatory response, reduction of oxidative stress, and regulation of the RAA system. Observational data suggest potential benefits of vitamin D supplementation, especially in high-risk groups, but large randomized clinical trials do not conclusively confirm that routine vitamin D administration reduces the number of major cardiovascular events in the general population. It is therefore necessary to individualize supplementation and conduct further well-designed studies to identify populations that may benefit most from therapy.
Vitamin D, Cardiovascular Diseases, Vitamin D Deficiency, Atherosclerosis, Supplementation, Cardiovascular Risk
Copyright (c) 2026 Natalia Jankowska, Adrianna Świerzyńska, Tomasz Puszkiel, Aleksandra Simlat, Aleksandra Cieciora, Angelika Szwaj, Ilona Mariańska-Wiśniewska, Julia Surowiec, Małgorzata Kawiorska, Mateusz Cieciora https://creativecommons.org/licenses/by/4.0
LIVING WITH UNCERTAINTY: GENERALIZED ANXIETY DISORDER AND PSYCHOSOCIAL STRESSORS DURING THE COVID-19 PANDEMIC
Background: The COVID-19 pandemic created an unprecedented global environment of uncertainty, acting as a profound catalyst for Generalized Anxiety Disorder (GAD). This crisis fundamentally shifted the psychological landscape, revealing that the primary driver of distress was not merely the biological threat of the virus, but a pervasive "certainty deficit" that overwhelmed both individual and systemic coping mechanisms. Methods: This narrative review synthesizes seminal cognitive models of anxiety with contemporary empirical evidence to examine how pandemic-related psychosocial stressors and intolerance of uncertainty (IU) influenced GAD trajectories. A systematic search was conducted across major academic databases, integrating classical theoretical frameworks with peer-reviewed articles and institutional reports published between 2020 and 2026, with a specific focus on the Polish clinical landscape. Results: The synthesis reveals that IU acted as the primary cognitive mediator of anxiety, frequently outweighing the direct fear of viral infection. Social isolation, economic instability, and digital overload, manifested as "doomscrolling," were identified as critical triggers for pathological worry. In Poland, young adults and healthcare workers exhibited the highest vulnerability, with symptoms persisting well into the post-pandemic era. This "long-tail" effect of anxiety is further complicated by secondary behavioral shifts, including documented increases in maladaptive coping strategies such as altered substance use patterns and social withdrawal. Conclusions: Addressing the persistent "mental health debt" requires a paradigm shift in clinical practice. Future interventions must prioritize uncertainty tolerance training and the permanent integration of resilient, digitally-enabled health solutions to ensure a robust safety net for vulnerable populations in the face of future global crises.
Generalized Anxiety Disorder, COVID-19, Intolerance of Uncertainty, Psychosocial Stressors, Poland, Systematic Review
Copyright (c) 2026 Martyna Susek, Amadeusz Furmanek https://creativecommons.org/licenses/by/4.0
IRON DEFICIENCY WITHOUT ANEMIA IN ATHLETES: IMPLICATIONS FOR PERFORMANCE, HEALTH, AND TRAINING
Objectives: This review synthesizes current evidence regarding the impact of IDNA on athletic performance. It also covers physiological mechanisms, diagnostic strategies, as well as potential nutritional and training implications. Methods: The literature search was conducted in the PubMed database. The search terms were related to iron deficiency, iron status, non-anemic states, athletes, performance, and endurance. Athletes with low iron stores and normal hemoglobin concentrations were the subject of this study, which included original research and reviews. Studies consisting of iron deficiency anemia (IDA) or non-athletic populations were excluded from the paper. A narrative synthesis was performed. Key Findings: IDNA is a common condition among athletic populations, which can be associated with reduced aerobic capacity. Affected athletes have a decreased probability of achieving high VO₂-based performance thresholds. Therefore, athletes should be seasonally screened for IDNA using ferritin with CRP. Diagnostic accuracy can be improved by selective use of transferrin saturation and soluble transferrin receptor (sTfR). Iron supplementation efficacy depends on the severity of iron deficiency. Performance benefits are most consistent in individuals with ferritin levels below 20 µg/L. Conclusions: Endurance performance and training efficiency are especially at risk of being negatively affected by IDNA. The research shows that athletes at a higher risk of IDNA should be advised to conduct regular screening. Moreover, there is a lack of analysis focused on ferritin cut-offs and intervention protocols that would benefit athletic populations.
Iron Deficiency, Athletes, Non-Anemic, Ferritin, Aerobic Performance
Copyright (c) 2026 Oliwia Jerzyńska, Aleksandra Lisowska, Bartosz Nowak, Maria Nowakowska, Maria Sierant, Aleksandra Kowalewska-Kurek, Constancia Esther Guy, Martyna Rożek, Miszela Kałchurska, Mateusz Gural https://creativecommons.org/licenses/by/4.0
INTELLIGENT DIAGNOSTICS IN ENDOCRINOLOGY: THE POTENTIAL OF ARTIFICIAL INTELLIGENCE IN THE DETECTION AND EVALUATION OF THYROID NODULES
Advancements in artificial intelligence (AI) havesignificantly influenced the development of diagnostic tools in medicine, including endocrinology.Thyroid nodules are a prevalent clinical occurrence, and their accurate evaluation about malignancy risk is essential for treatment decisions. Conventional diagnostic techniques, like ultrasonography and fine-needle aspiration biopsy (FNAB),although effective, are burdened with subjectivity and limited availability of specialists.This article discusses the contemporary applications of artificial intelligence, including machine learning and deep learning algorithms, in the detection, classification, and evaluation of thyroid nodules utilizing ultrasound pictures and clinical data. The text compares the performance of AI models with expert evaluations and examines the possible advantages of their application in clinical practice, including enhanced diagnostic accuracy, standardized assessments, and decreased time to diagnosis.Despite the promising research findings, additional efforts are required to validate models in extensive populations and to integrate AI systems with current clinical protocols. Artificial intelligence possesses the potential to support as a substantial aid in the diagnosis of thyroid disorders; nevertheless, its comprehensive implementation necessitates the evaluation of ethical, legal, and organizational factors. Aim of the study: The aim of this article is to assess the role of artificial intelligence in the diagnosis of thyroid nodules, with particular emphasis on the use of machine learning (ML) and deep learning (DL) algorithms in the analysis of ultrasound images, cancer risk classification, and clinical decision support. The article aims to compare the effectiveness of AI-based systems with radiological assessment performed by specialists and to discuss the potential benefits and limitations of implementing these technologies in endocrinology practice. Materials and methods: A review of the literature available in the PubMed and Google Scholar databases was performed, using the key words: “Artificial Intelligence”, “AI”, “Thyroid Nodules”, “Fine Needle Aspiration Biopsy”, “FNAB”, “TIRADS”.
Copyright (c) 2026 Agnieszka Kasprzak, Angelika Malec, Katarzyna Oświeczyńska, Agnieszka Zaleszczyk, Patrycja Jędrzejewska-Rzezak https://creativecommons.org/licenses/by/4.0
THE IMPACT OF DIGITAL COGNITIVE REHABILITATION TOOLS ON THE SOCIAL INTEGRATION OF PEOPLE WITH BRAIN INJURIES
Traumatic brain injury (TBI) is a major global health concern, frequently resulting in persistent cognitive impairments that limit social integration and quality of life. Social integration—defined as meaningful participation in interpersonal relationships, employment, and community life—is strongly influenced by deficits in memory, attention, executive functioning, and social cognition. While traditional cognitive rehabilitation has demonstrated clinical benefits, its accessibility and long-term sustainability are often constrained by cost, resource demands, and reliance on in-person delivery. In recent years, digital cognitive rehabilitation tools, including mobile applications, virtual reality (VR), and tele-rehabilitation platforms, have emerged as promising alternatives that enable scalable, adaptive, and home-based interventions. This narrative review synthesizes current evidence on the impact of digital cognitive rehabilitation on social integration following TBI, with attention to clinical outcomes, socio-economic implications, and technological barriers. Findings suggest that digital interventions are effective in improving core cognitive domains and may indirectly enhance social functioning by supporting communication, self-efficacy, motivation, and participation in daily activities. VR-based approaches, in particular, offer ecologically valid environments that facilitate the transfer of cognitive gains to real-world social contexts. Economic evidence indicates that digital rehabilitation is often cost-effective or cost-saving, reducing healthcare system burden and supporting return-to-work outcomes. However, direct evidence linking digital cognitive rehabilitation to measurable social integration outcomes remains limited, and significant barriers persist related to digital access, usability, literacy, and ethical considerations. Future research should prioritize participation-level outcomes, long-term follow-up, and inclusive implementation strategies to maximize the social and societal benefits of digital rehabilitation after brain injury.
Brain Injury, Digital Cognitive Rehabilitation, Virtual Reality, Social Integration
Copyright (c) 2026 Miszela Kałachurska, Martyna Rożek, Constancia Esther Guy, Maria Nowakowska, Aleksandra Lisowska, Bartosz Nowak, Oliwia Jerzyńska, Maria Sierant, Aleksandra Kowalewska-Kurek, Mateusz Gural https://creativecommons.org/licenses/by/4.0
MULTIDISCIPLINARY MANAGEMENT OF AWAKE AND SLEEP BRUXISM: A LITERATURE REVIEW
Introduction: Bruxism is currently understood as a range of jaw muscle activities and teeth contact that occur during sleep and/or wakefulness. Awake bruxism can be distinguished from sleep bruxism based on differences in etiology, comorbidities, and the spectrum of muscle activity and clinical manifestations. Although the exact cause of bruxism remains unclear, it is considered to be multifactorial. This article aims to highlight both awake and bruxism and explore various approaches to their management. Aim of the Study: The aim of this article is to review current knowledge on awake and sleep bruxism and increase awareness of its multidisciplinary management. Materials and Methods: A literature review was conducted using the PubMed and Google Scholar databases. The following keywords were used in various combinations: "bruxism," "awake," "sleep" "management," "treatment," and "oral health." Fourty four relevant articles published between 2001 and 2025 were selected for analysis. Results: The most common current approaches to managing awake and sleep bruxism include occlusal splints, mandibular advancement devices, cognitive-behavioral therapy (CBT), biofeedback therapy, mindfulness techniques, self-awareness and self-regulation strategies, physical therapy (such as physiotherapy, exercise, and dry needling), botulinum toxin injections, and non-steroidal anti-inflammatory drugs (NSAIDs) for pain exacerbation. Conclusion: Bruxism and its associated symptoms can significantly affect patients' quality of life. Early identification and appropriate management can help reduce facial muscle soreness, headaches, and general fatigue and pathological tooth wear.
Awake, Sleep, Bruxism, Treatment, Symptoms, Oral Health, Management
Copyright (c) 2026 Aleksandra Karolak, Jakub Michał Lichoń, Mateusz Józef Goldyn, Ewa Wietrzykowska, Piotr Trojan, Andrzej Wydrych, Patryk Pindlowski, Agata Karasiewicz, Maja Kuklo, Marta Kras https://creativecommons.org/licenses/by/4.0
THE IMPACT OF BODY MASS INDEX ON TIME TO FULL FUNCTIONAL RECOVERY FOLLOWING TOTAL HIP ARTHROPLASTY: A SYSTEMATIC LITERATURE REVIEW
Obesity represents a growing global health challenge with significant implications for orthopedic surgery outcomes. Total hip arthroplasty (THA) is one of the most common and successful procedures for treating end-stage hip osteoarthritis. The influence of high body mass index (BMI) on postoperative functional recovery requires our attention due to the seriousness of this issue. This systematic literature review aimed to evaluate the impact of BMI on time to full functional recovery following primary total hip arthroplasty, examining evidence from Polish and international studies. Outcomes assessed included Harris Hip Score (HHS), Hip disability and Osteoarthritis Outcome Score (HOOS), gait analysis parameters, complication rates, and time to functional independence. Based on the studies analyzed, it can be observed that elevated BMI primarily contributes to an increased risk of perioperative complications and revision surgeries. Short-term functional recovery (<6 months) showed small differences favoring non-obese patients, but these differences remained below minimal clinically important difference thresholds. By 6-12 months post-surgery, functional gains were comparable between obese (BMI ≥30 kg/m²) and non-obese patients. Obese patients demonstrated significant improvements in gait speed and hip range of motion, with functional gains comparable irrespective of BMI. However, morbidly obese patients (BMI ≥35 kg/m²) experienced higher revision rates (7.99% vs 2.75%, p<0.0001) and increased complication rates. Postoperative complications including surgical site infections (11.83% vs 4.30%, p=0.05) and prolonged hospital stays (7.6±2.1 vs 5.4±1.7 days, p<0.001) were significantly elevated in obese patients.
Body Mass Index, Obesity, Total Hip Arthroplasty, Functional Recovery, Rehabilitation Outcomes, Harris Hip Score
Copyright (c) 2026 Maciej Osuch, Maja Osuch, Olga Tatarata, Martyna Jaciubek, Carmena Luty, Amanda Abramowicz, Magdalena Rumin, Anna Kiełboń, Zuzanna Olga Reklewska, Kornelia Domagała https://creativecommons.org/licenses/by/4.0
FAST, PREDICTABLE, REVERSIBLE: A COMPREHENSIVE REVIEW OF REMIMAZOLAM
Remimazolam is a new, ultra–short-acting benzodiazepine whose unique chemical structure—the introduction of an ester moiety into the benzodiazepine core—enables rapid hydrolysis by non-specific tissue esterases to an inactive metabolite (CNS7054). This modification, analogous to that used in remifentanil, ensures an exceptionally rapid onset and equally rapid offset of sedation, organ-independent metabolism, and a highly predictable pharmacokinetic profile. The drug is intended exclusively for intravenous administration, which—according to the summary of product characteristics—eliminates gastrointestinal absorption and avoids the first-pass effect. Pharmacodynamically, remimazolam exerts its sedative effect through allosteric enhancement of the inhibitory action of GABA at the GABA-A receptor. Remimazolam may be administered as a bolus or continuous infusion, and its dosing varies depending on the indication, country, patient condition, and concomitant medications. Compared with midazolam, it is characterized by a faster onset, deeper sedative effect, and shorter duration of action. In comparison with propofol, remimazolam does not shorten recovery time but offers a more favorable safety profile—it significantly less frequently causes post-induction hypotension, bradycardia, respiratory depression, or injection pain. An additional advantage is the availability of a specific antidote—flumazenil. Although remimazolam reduces the risk of postoperative nausea and vomiting (PONV) compared with inhalational anesthetics, it may be associated with a higher incidence of vomiting when compared directly with propofol. However, the drug may offer benefits in terms of postoperative patient comfort. Methodology: This review paper is based on data derived from peer-reviewed scientific articles and reports published in recognized databases and journals, including PubMed, Clinical Pharmacokinetics, and Anaesthesiology Intensive Therapy. It includes clinical studies and review articles published between 2015 and 2025 in English or Polish.
Remimazolam, Benzodiazepines, GABA-A, Procedural Sedation, General Anesthesia, Propofol
Copyright (c) 2026 Agata Juchniewicz, Jakub Sapikowski, Julita Jagodzińska, Maria Janiszewska, Martyna Grześkowiak, Iga Kuba, Jakub Idziński, Anna Lubomska, Mikołaj Góralczyk https://creativecommons.org/licenses/by/4.0
THE ROLE OF THE ANESTHESIOLOGIST IN THE MANAGEMENT OF CRITICALLY ILL SEPTIC PATIENTS: A CLINICAL LITERATURE REVIEW
Sepsis and septic shock are acute, life threatening syndromes in which infection triggers widespread organ dysfunction and rapid clinical deterioration, demanding fast, coordinated action from multiple specialties. In patients who require surgical source control, the anesthesiologist becomes central to perioperative management, because decisions made in the operating room directly influence perfusion, oxygen delivery, and the safety of the procedure. This review focuses on the anesthesiologist’s tasks before, during, and after surgery, with particular attention to how sepsis alters usual anesthetic practice. In unstable patients, careful evaluation of organ failure, cautious choice and dosing of induction drugs (often favoring ketamine or etomidate rather than propofol), advanced monitoring with individually tailored fluid therapy, lung protective ventilation, and timely escalation to vasopressor support are all essential to reduce perioperative risk. Current Surviving Sepsis Campaign recommendations underline that effective source control should be achieved as early as possible, ideally within the first 6 hours from recognizing sepsis, which places anesthesiologists in a key position to balance the urgency of surgery with the need for initial resuscitation. A solid grasp of sepsis pathophysiology and its hemodynamic consequences is therefore fundamental for anesthesiologists involved in the care of these critically ill patients.
Sepsis, Septic Shock, Anesthesia Management, Critically Ill Patients, Perioperative Care, Hemodynamic Monitoring
Copyright (c) 2026 Maja Osuch, Maciej Osuch, Olga Tatarata, Martyna Jaciubek, Carmena Luty, Amanda Abramowicz, Magdalena Rumin, Anna Kiełboń, Zuzanna Olga Reklewska, Kornelia Domagała https://creativecommons.org/licenses/by/4.0
IS OBESITY PHARMACOTHERAPY A LIFETIME COMMITMENT? A STRUCTURED REVIEW OF WEIGHT REGAIN AND STRATEGIES FOLLOWING INCRETIN CESSATION
Background: The 2026 World Health Organization (WHO) guidelines formalize a major shift in metabolic medicine by characterizing obesity as a chronic, progressive, and relapsing neuroendocrine disease. While innovative incretin-based medical technologies - specifically GLP-1 and dual GIP/GLP-1 receptor agonists - have achieved weight-loss magnitudes previously reserved for invasive metabolic surgery, the long-term durability of these outcomes after treatment cessation remains a formidable socio-clinical challenge. Objective: This structured narrative review synthesizes contemporary evidence regarding weight-loss maintenance, the biological drivers of regain, and the systemic barriers to treatment persistence following the discontinuation of incretin-based therapies. Methods: A comprehensive search of major bibliographic databases (2011–2026) was conducted, integrating data from randomized withdrawal trials (STEP and SURMOUNT programs), large-scale meta-analyses, and diverse real-world evidence (RWE). Results: Evidence indicates that statistically significant weight regain can emerge as early as 8 weeks post-discontinuation, with substantial recovery of lost weight typical within 12 months. This rebound is primarily mediated by a biological “energy gap” of approximately 120 kcal per kilogram lost, driven by a combination of adaptive thermogenesis (reduced energy expenditure) and heightened orexigenic signaling. Crucially, real-world data reveal a significant "persistence gap," with 50–67% of patients discontinuing therapy within the first year due to economic barriers, global supply instabilities, and tolerability issues. Conclusions: Effective obesity management requires a transition from short-term interventions to a lifelong "chronic care continuum." Future strategies must prioritize the preservation of fat-free mass, implement intensified monitoring protocols (specifically the 25% regain threshold), and promote a systemic reframing of pharmacotherapy as a permanent metabolic stabilizer rather than a transient cure.
Obesity, Incretin-Based Therapies, Weight Regain, Chronic Care, GLP-1 Receptor Agonists
Copyright (c) 2026 Kornelia Domagała, Amanda Dolores Abramowicz, Magdalena Rumin, Olga Tatarata, Maja Osuch, Maciej Osuch, Anna Kiełboń, Martyna Jaciubek, Carmena Luty, Zuzanna Olga Reklewska https://creativecommons.org/licenses/by/4.0
COMPARISON OF MORTALITY AND POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH CLIPPED RUPTURED VS. UNRUPTURED INTRACRANIAL ANEURYSMS
Introduction: Intracranial aneurysm (IA) is a weakening of a cerebral vessel that can lead to rupture and subarachnoid hemorrhage (SAH). Ruptured IAs account for about 85% of SAH cases, with high complication risks. Unruptured intracranial aneurysms (UIAs) are increasingly diagnosed due to advanced imaging techniques, with treatment options including clipping or coiling. The aim of the study was to compare mortality and the incidence of complications in patients after intracranial aneurysm clipping, with a distinction between previously ruptured and unruptured aneurysms. Materials and methods: This retrospective study analyzed patients who underwent cerebral aneurysm clipping between 2022 and 2025 at the Clinical Department of Neurosurgery of the University Clinical Center named after Prof. K. Gibiński, Medical University of Silesia in Katowice, Poland. Data on sex, age, aneurysm location, status (ruptured/unruptured), and complications were collected. Statistical analysis used chi-square and Fisher's exact tests (p < 0,05). Results: The study included 61 patients, with 46 females (75,41%) and 15 males (24,59%). Of the aneurysms, 46 (75,41%) were unruptured and 15 (24,59%) ruptured. Postoperative complications occurred in 21 patients (34,43%), including transient paresis, aphasia, and stroke. Three patients (4,92%) died. Chi-square and Fisher's tests showed no statistically significant differences in complications (p = 0,08) and mortality (p = 0,15) between ruptured and unruptured groups. Conclusions: Postoperative complications were more common in ruptured aneurysms, though no statistical significance was found. The overall mortality rate was low, and no significant difference in mortality was observed between ruptured and unruptured aneurysms.
Intracranial Aneurysm, Aneurysm Clipping, Postoperative Complications Ruptured Aneurysm
Copyright (c) 2026 Jędrzej Sztajura, Małgorzata Gola, Paweł Jaksik, Mikołaj Dymek https://creativecommons.org/licenses/by/4.0
SLEEP DISTURBANCES AND OPTIMIZATION IN NIGHT-SHIFT WORKERS - A LITERATURE REVIEW
Sleep is a fundamental biological process essential for physical recovery, cognitive performance, metabolic regulation, hormonal balance, and mental health. Night and rotating shift workers constitute a high-risk population for sleep disturbances due to chronic circadian misalignment, irregular sleep-wake schedules, and elevated occupational stress. This narrative review synthesizes current evidence on sleep physiology, specific sleep disorders, and the acute and chronic health consequences of shift work, integrating insights from occupational health and sports recovery research. Shift work is consistently associated with altered sleep architecture, reduced slow-wave and REM sleep, and conditions such as Shift Work Sleep Disorder and social jet lag, leading to impaired vigilance, increased error risk, and mood dysregulation. Long-term exposure to night work is linked to adverse cardiometabolic outcomes, including hypertension, obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease, as well as disrupted eating behaviors and unfavorable meal timing. Emerging evidence also indicates neurological consequences such as accelerated brain aging, cognitive decline, and increased vulnerability to neurodegenerative and seizure disorders. Additionally, hormonal dysregulation involving melatonin, cortisol, sex hormones, and circadian clock gene expression may contribute to reproductive disturbances, immune dysfunction, and increased cancer risk. The review further discusses organizational- and individual-level interventions, including optimized shift scheduling, strategic light exposure, napping, sleep hygiene, meal timing, physical activity, and cognitive-behavioral strategies, highlighting practical approaches to mitigate sleep disturbances and improve health and performance among night-shift workers.
Shift Work, Circadian Misalignment, Sleep Disturbances, Night Shift Workers, Cardiometabolic Health, Sleep Optimization
Copyright (c) 2026 Jakub Roszak, Oliwia Sójkowska-Sławińska, Anna Leśniewska, Patryk Macuk, Michał Gniedziejko, Paulina Bernecka, Bartosz Michał Skorupski, Natalia Strumnik https://creativecommons.org/licenses/by/4.0
THE ROLE OF VITAMIN B12 IN THE DIET – IMPACT ON THE BODY. A LITERATURE REVIEW
Vitamin B12 is a key chemical compound for human health, involved in processes such as homocysteine methylation, DNA synthesis, and mitochondrial function. We present current knowledge on the causes and clinical significance of hypervitaminosis B12 and discuss cobalamin deficiency and excess in selected risk groups: pregnant women, vegetarians and vegans, athletes, and the elderly. Aim of the study: The aim of the study is to assess the impact of vitamin B12 on the functioning of the human body. The analysis focuses on the role of vitamin B12 in the proper functioning of the nervous, hematopoietic, and cardiovascular systems. Furthermore, the study determines the effects of vitamin B12 deficiency and excess in the diet. Material and methods: A literature review was conducted from the PubMed and Google Scholar databases. Key phrases as “vitamin B12”, “cobalamin”, “vitamin B12 deficiency” and “excess vitamin B12” were used. Results and conclusions: Vitamin B12 plays a crucial role in the proper functioning of the human body, influencing the nervous, hematopoietic, and cardiovascular systems. Symptoms such as fatigue, anemia, and impaired concentration have been observed among individuals with vitamin B12 deficiency. The analysis revealed a significant correlation between vitamin B12 supplementation and bodily function. Therefore, it can be concluded that adequate levels of vitamin B12 in the diet are crucial for maintaining health.
Vitamin B12, Cobalamin, Vitamin B12 Deficiency, Excess Vitamin B12
Copyright (c) 2026 Aleksandra Simlat, Angelika Szwaj, Aleksandra Cieciora, Adrianna Świerzyńska, Natalia Jankowska, Mateusz Cieciora, Małgorzata Kawiorska, Julia Surowiec, Ilona Mariańska-Wiśniewska, Tomasz Puszkiel https://creativecommons.org/licenses/by/4.0
VITAMIN D3 IN THE PATHOGENESIS AND CLINICAL COURSE OF MULTIPLE SCLEROSIS: A COMPREHENSIVE REVIEW OF CURRENT EVIDENCE (2015–2026)
Multiple sclerosis (MS) is a chronic immune-mediated demyelinating disease of the central nervous system characterized by inflammatory activity, neuroaxonal degeneration, and progressive neurological disability. Over the past decade, converging epidemiological, genetic, and mechanistic evidence has positioned vitamin D3 as a biologically plausible environmental determinant influencing MS susceptibility and potentially modulating disease course. This comprehensive review synthesizes peer-reviewed literature published between 2015 and 2026, including Mendelian randomization analyses, large-scale genomic studies, randomized controlled trials, and contemporary meta-analyses. Independent Mendelian randomization studies consistently demonstrate that genetically determined lower circulating 25-hydroxyvitamin D concentrations increase the risk of MS, supporting a causal role in disease susceptibility. In contrast, randomized supplementation trials in established relapsing–remitting MS report heterogeneous and generally modest effects on relapse rates, MRI activity, and disability progression. Emerging data from early-stage disease, including clinically isolated syndrome, suggest a potential stage-dependent benefit. Collectively, current evidence indicates that vitamin D functions primarily as a susceptibility modifier and early immunological regulator rather than a definitive disease-modifying therapy in established MS. Future research should prioritize early-life exposure, genotype-informed stratification, and long-term clinical outcomes to clarify the translational potential of vitamin D optimization in multiple sclerosis.
Multiple Sclerosis, Vitamin D3, Mendelian Randomization, MRI Activity, Randomized Controlled Trials, Neuroimmunology
Copyright (c) 2026 Martyna Jaciubek, Maja Osuch, Maciej Osuch, Olga Tatarata, Carmena Luty, Amanda Abramowicz, Magdalena Rumin, Anna Kiełboń, Zuzanna Olga Reklewska, Kornelia Domagała https://creativecommons.org/licenses/by/4.0
THE ROLE OF SLEEP QUALITY IN CARDIOMETABOLIC HEALTH: MECHANISMS AND CLINICAL EVIDENCE – A NARRATIVE REVIEW
Background: Sleep quality is increasingly recognized as a fundamental pillar of health, recently emphasized in the American Heart Association’s “Life’s Essential 8”. However, the multidimensional pathways linking sleep-such as duration, continuity, and regularity to metabolic and cardiovascular function remain complex. Objective: This narrative review synthesizes clinical evidence and biological mechanisms connecting multidimensional sleep health with cardiometabolic outcomes, including metabolic syndrome, type 2 diabetes, coronary heart disease, and the newly defined Cardiovascular-Kidney-Metabolic (CKM) syndrome. Methods: Peer-reviewed publications from 2018-2025 were analyzed, including prospective cohort studies, randomized controlled trials, meta-analyses, and scientific statements. Mechanisms involving inflammation, autonomic regulation, neuroendocrine activity, epigenetic modifications, and gut microbiota were evaluated. Results: Poor sleep quality and irregular sleep patterns consistently correlate with increased metabolic dysregulation, obesity, and Major Adverse Cardiovascular Events (MACE). Recent findings link inadequate sleep with advanced CKM stages and accelerated epigenetic aging. Interventional studies show that extending sleep duration can reduce energy intake and support weight loss, although improvements in insulin sensitivity remain inconsistent. Conclusions: Sleep quality is a modifiable and clinically relevant determinant of cardiometabolic health. A multidimensional assessment of sleep-not limited to duration-offers improved risk stratification and highlights potential avenues for preventive interventions.
Sleep Quality, Cardiometabolic Health, Metabolic Syndrome, Cardiovascular-Kidney-Metabolic Syndrome, Gut Microbiota, Epigenetic Aging, Sleep Extension
Copyright (c) 2026 Aleksandra Iwona Włodarczyk, Norbert Grabias, Jędrzej Piotrowski, Paulina Jarząbek, Maria Rajkowska, Julia Weronika Mieszkowska, Radosław Gryko, Bernard Myszewski, Anna Kinga Tejchma, Łukasz Dominik Woźniak
SIMULATION-BASED TEAM TRAINING IN EMERGENCY MEDICINE: A REVIEW OF INNOVATIVE EDUCATIONAL TECHNOLOGIES AND THEIR IMPACT ON CLINICAL PERFORMANCE
Background: Simulation-based team training (SBTT) is increasingly applied in emergency medicine (EM) to enhance interprofessional collaboration and non-technical skills within high-acuity, time-critical scenarios in the emergency department. Effective teamwork—encompassing communication, leadership, situational awareness, and coordination—is critical for patient safety. Evidence on SBTT remains heterogeneous, particularly regarding clinical outcomes and adoption of emerging technologies. Methods: This narrative review synthesizes literature from PubMed, Scopus, and Google Scholar (1984–2025) on SBTT in EM. Eligible studies included systematic and narrative reviews, randomized and non-randomized studies, and qualitative reports. Data extraction focused on simulation modalities, educational strategies, non-technical skill development, and reported effects on team performance and clinical outcomes. Results: SBTT has been shown to improve communication, leadership, situational awareness, and coordination across diverse contexts and modalities, including low- and high-fidelity manikins, virtual reality, and augmented reality. Pilot applications of artificial intelligence have shown potential for adaptive scenarios, individualized feedback, and performance analytics, although evidence in EM remains limited. SBTT also supports workflow efficiency, protocol adherence, and simulated clinical performance. However, data linking training to sustained behavioral change and patient-level outcomes remain limited. Conclusions: SBTT constitutes a valuable educational approach for interprofessional EM teams, fostering non-technical skills and team-based competencies. Its effectiveness relies on structured pedagogy, standardized frameworks, and high-quality debriefing rather than technological fidelity alone. Integration of innovative technologies may enhance scalability and individualized learning. Further longitudinal and multicenter research is required to clarify SBTT’s impact on clinical practice, patient outcomes, and sustainable implementation within EM training programs.
Simulation-Based Education, Emergency Medicine, Team Training, Innovative Educational Technologies, Non-Technical Skills, Clinical Performance
Copyright (c) 2026 Kinga Lubomska, Daria Julia Makowska-Woszczyk, Patrycja Jagura, Julia Groszewska, Michał Romaniuk, Agata Rapior, Jan Romaniuk, Agata Mytych, Marta Dziedziak, Łukasz Nosek
THE ANTIDEPRESSANT EFFECTS OF PHYSICAL ACTIVITY: NEUROBIOLOGICAL MECHANISMS AND PSYCHOSOCIAL MECHANISMS
Background: Depression is a leading cause of disability worldwide, affecting millions and imposing significant personal, social, and economic burdens. While pharmacological and psychotherapeutic interventions are standard treatments, physical activity has emerged as a promising complementary or alternative strategy. Methods: A comprehensive literature review was conducted of peer-reviewed studies published between 2000 and 2025, including randomized controlled trials, meta-analyses, and observational research. Populations examined included adolescents, adults, and older adults. Data extraction focused on depressive symptom outcomes, exercise modalities, intervention duration and intensity, and underlying neurobiological and psychosocial mechanisms. Results: Evidence consistently indicates that regular physical activity, particularly aerobic and combined aerobic–resistance exercise, produces moderate to large reductions in depressive symptoms. Mechanistically, exercise enhances brain-derived neurotrophic factor (BDNF) expression, modulates monoaminergic neurotransmission, regulates the hypothalamic–pituitary-adrenal (HPA) axis, and reduces systemic inflammation. Psychosocial benefits, including behavioral activation, increased self-efficacy, and social engagement, further support sustained mood improvement. Combined interventions often yield the greatest effect, integrating biological, psychological, and social pathways. Conclusion: Physical activity is a safe, accessible, and effective intervention for depression, with benefits extending beyond symptom reduction to improved cognitive function, stress resilience, and overall well-being. Incorporating structured exercise into standard treatment protocols may optimize clinical outcomes and support long-term mental health across diverse populations.
Exercise, Depression, Antidepressant Effects, Neurobiology, Mental Health
Copyright (c) 2026 Amadeusz Furmanek, Martyna Susek, Mariusz Suchcicki
CHRONIC STRESS AS A MODULATOR OF THE IMMUNE SYSTEM: NEUROENDOCRINE MECHANISMS, IMMUNOLOGICAL PATHWAYS AND CLINICAL CONSEQUENCES - A LITERATURE REVIEW
Chronic stress is a significant factor influencing human immune system functioning. Prolonged activation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system leads to hormonal and immunological dysregulation (Glaser & Kiecolt-Glaser, 2005; Segerstrom & Miller, 2004). Consequently, immune cells become less sensitive to glucocorticoids, cytokine balance is disrupted, and the organism remains in a state of chronic low-grade inflammation. These changes increase susceptibility to infections, delay wound healing, weaken vaccine responses, and may exacerbate the course of chronic diseases, including autoimmune and inflammatory disorders (Segerstrom & Miller, 2004; Alotiby, 2024). This review presents current data from clinical and immunological studies published between 2000 and 2025. Molecular and cellular mechanisms are discussed, including HPA axis dysfunction, excessive sympathetic activity, cytokine profile alterations, and changes in innate and adaptive immunity. Attention is given to populations particularly vulnerable to chronic stress and the clinical consequences of these dysregulations (Katz et al., 2025; Chan et al., 2023; Bolton, 2024). The review also considers strategies to mitigate stress-related immune impairment, such as mindfulness and meditation, regular physical activity, cognitive-behavioral therapy, and sleep hygiene improvement (Black & Slavich, 2016; Creswell et al., 2012; Carlson et al., 2007; Nieman & Wentz, 2019). Understanding these mechanisms may support clinical practice by enabling better identification of high-risk patients and the implementation of effective interventions.
Chronic Stress, Immune System, HPA Axis, Cytokines, Inflammation, Immunosuppression
Copyright (c) 2026 Martyna Susek, Amadeusz Furmanek, Anna Wawrzeczko, Maciej Jakubiec, Mariusz Suchcicki
THE SIGNIFICANCE OF SLEEP DISTURBANCES IN THE CLINICAL AND PSYCHOSOCIAL PRESENTATION OF DEPRESSION - NARRATIVE LITERATURE REVIEW
Background: Sleep disturbances are highly prevalent in depressive disorders and are increasingly recognized as both core symptoms and risk factors. Insomnia, hypersomnia, fragmented sleep, and circadian rhythm disruptions—including social jetlag—contribute to the onset, severity, and persistence of depressive symptoms, while impairing cognitive, emotional, and psychosocial functioning. Methods: A narrative literature review was conducted using PubMed, Web of Science, and Scopus, focusing on peer-reviewed studies published between 2000 and 2025. Studies examining subjective and objective measures of sleep in adult populations with depressive disorders were included, with emphasis on clinical presentation, functional outcomes, and treatment response. Results: Sleep disturbances are associated with greater depressive symptom severity, earlier onset of illness, impaired psychosocial functioning, and poorer response to treatment. Insomnia is the most common disturbance, while circadian misalignment, including social jetlag, is particularly relevant in adolescents, shift workers, and evening chronotypes. Mechanistic evidence links sleep disturbances to mood dysregulation through HPA axis disruption, inflammation, and altered melatonin secretion. Sleep-focused interventions, such as cognitive-behavioral therapy for insomnia, structured sleep schedules, and light therapy, improve both sleep quality and depressive outcomes, and enhance responsiveness to pharmacological treatments. Conclusion: Sleep disturbances are integral to the clinical and psychosocial presentation of depression. Early identification and targeted management of insomnia, hypersomnia, and circadian misalignment should be incorporated into routine care to optimize symptom control, functional outcomes, and long-term prognosis.
Sleep Disturbances, Depression, Insomnia, Major Depressive Disorder
Copyright (c) 2026 Martyna Susek, Amadeusz Furmanek, Mariusz Suchcicki, Karol Krupiniewicz
UNDERSTANDING BURNOUT AND MAJOR DEPRESSIVE DISORDER: A NARRATIVE REVIEW OF DIAGNOSTIC OVERLAP AND IMPLICATIONS
Background: Occupational burnout and Major Depressive Disorder (MDD) share overlapping symptoms, including fatigue, sleep disturbances, cognitive impairments, and reduced motivation. Despite these similarities, burnout is primarily context-specific to occupational settings, whereas MDD affects global functioning. Differentiating the two is critical for accurate diagnosis and effective intervention. Methods: This narrative review synthesizes literature, integrating empirical studies, meta-analyses, longitudinal research, and psychometric assessments. Databases included PubMed, Frontiers in Psychology and Google Scholar. Instruments examined include the Maslach Burnout Inventory (MBI), Burnout Inventory (OLBI), Burnout Assessment Tool (BAT), PHQ-9, and HADS. Data were analyzed for symptom overlap, psychosocial and occupational determinants, neurobiological mechanisms, and clinical implications. Results: Both conditions exhibit fatigue, sleep disruption, cognitive dysfunction, and reduced motivation; however, burnout is situational, while MDD involves pervasive impairment. Chronic occupational stress may progress to MDD in vulnerable individuals. Neurobiological studies indicate shared HPA axis dysregulation, though MDD presents more systemic alterations. Psychometric analyses reveal moderate-to-strong correlations between burnout and depression measures, demonstrating partial conceptual overlap without redundancy. Additional theoretical perspectives explore whether burnout represents a subtype or prodrome of depression. Conclusions: Accurate differentiation between burnout and MDD is essential for treatment planning. Burnout may respond to organizational and environmental interventions, whereas MDD requires pharmacological and psychotherapeutic approaches. Longitudinal monitoring, multidimensional assessment, and preventive strategies are recommended to mitigate progression from burnout to depression and optimize clinical outcomes.
Occupational Burnout, Major Depressive Disorder, Fatigue, Cognitive Impairment, Psychosocial Factors, Sleep Disturbances
Copyright (c) 2026 Martyna Susek, Amadeusz Furmanek
CHRONIC LOW BACK PAIN: IS THE MIND THE MISSING KEY TO QUALITY OF LIFE? A NARRATIVE REVIEW OF PSYCHOLOGICAL DETERMINANTS OF HEALTH-RELATED QUALITY OF LIFE
Introduction and aim: Chronic low back pain (CLBP) is a highly prevalent musculoskeletal condition and a major contributor to disability worldwide. Its impact extends beyond physical symptoms, affecting emotional well-being, daily functioning and overall health-related quality of life (HRQoL). Increasing evidence suggests that psychological factors play a central role in shaping outcomes in CLBP. This narrative review summarises and critically discusses recent evidence (2022-2025) on the relationship between psychological factors and HRQoL in adults with CLBP, with particular emphasis on depression, anxiety, pain catastrophizing, kinesiophobia and self-efficacy. Methodology: A literature search was conducted in PubMed, Web of Science, Scopus, Google Scholar and the Cochrane Library. Original studies evaluating psychological factors in relation to pain, disability or HRQoL in adults with CLBP were included. Thirteen studies met the inclusion criteria, including cross-sectional and longitudinal designs, randomised controlled trials, one mediation analysis and one systematic review. Results: CLBP was consistently associated with impaired HRQoL across physical, emotional and social domains. Older age and female sex were linked with greater disability and lower HRQoL. Depression and anxiety showed the strongest associations with reduced well-being and long-term functional decline. Pain catastrophizing was negatively associated with HRQoL and increased risk of symptom generalisation. Kinesiophobia was linked with functional deficits and mediated treatment-related improvements. Self-efficacy was associated with better psychological outcomes, although its responsiveness to intervention varied across studies. Conclusions: Psychological factors are key determinants of HRQoL in patients with CLBP. Integrating psychological assessment into multidisciplinary care may improve quality of life and long-term management.
Chronic Low Back Pain, Psychological Factors, Health-Related Quality of Life, Biopsychosocial Model, Chronic Pain
Copyright (c) 2026 Natalia Rosół, Natalia Kruszewska, Natalia Ziółkowska, Michał Cholewiński, Paweł Szajewski, Alicja Pełszyk, Agata Pluta, Justyna Kącikowska, Daria Marciniak, Justyna Łapicka
ACROMEGALY: CURRENT MANAGEMENT AND THE EMERGING ROLE OF ORAL PALTUSOTINE
Introduction and aim: Acromegaly is a chronic endocrine disorder caused by sustained excess secretion of growth hormone and insulin-like growth factor I, leading to significant morbidity and increased mortality if inadequately treated. Transsphenoidal surgery remains the primary therapeutic approach; however, a substantial proportion of patients fail to achieve durable biochemical remission and require long-term medical therapy. Injectable somatostatin receptor ligands are effective but are associated with treatment burden, variable biochemical responses, and impaired quality of life. The aim of this review was to summarize current management strategies for acromegaly and to evaluate the emerging role of paltusotine, a novel orally administered somatostatin receptor agonist. Materials and Methods: This narrative review was based on a structured analysis of published clinical trials, extension studies, and review articles evaluating the pharmacological properties, clinical efficacy, and safety of paltusotine in patients with acromegaly. Results: Available evidence indicates that paltusotine provides effective suppression of growth hormone secretion and reduction of insulin-like growth factor I levels with once-daily oral administration. Clinical studies demonstrate maintenance of biochemical control in patients previously treated with injectable therapies, as well as efficacy in selected untreated individuals. Paltusotine was generally well tolerated, with predominantly mild gastrointestinal adverse events and elimination of injection-related complications. Conclusions: Paltusotine represents a promising oral alternative to injectable somatostatin receptor ligands, with the potential to reduce treatment burden, improve adherence, and maintain biochemical control. Further long-term and real-world studies are needed to fully define its role in routine clinical practice.
Acromegaly, Paltusotine, Somatostatin, Lanreotide, Octreotide
Copyright (c) 2026 Justyna Całka, Monika Kowalska, Katarzyna Ścibisz, Dominika Zdobylak, Karolina Ollik, Kamil Harenza, Anita Zięba, Michał Domin, Mateusz Taranowicz, Olga Kowalczyk
THE EFFICACY OF EPLEY MANEUVER IN TREATING BENIGN PAROXYSMAL POSITIONAL VERTIGO
Benign paroxysmal positional vertigo (BPPV) constitutes the most common cause of peripheral vertigo, significantly reducing patients' quality of life. The Epley maneuver is considered the gold standard treatmen, though its effectiveness depends on many factors, and recurrences remain a significant clinical problem. Objective: Systematic evaluation of the effectiveness of the Epley maneuver in treating BPPV based on current literature, including factors influencing treatment efficacy and recurrence rates. Materials and methods: A systematic review was conducted according to PRISMA guidelines. We analyzed 32 studies (including 17 RCTs, 5 meta-analyses and 10 cohort studies) from 1990-2025, identified in PubMed, Cochrane Library and Embase databases. Inclusion criteria comprised: confirmed BPPV diagnosis, use of the Epley maneuver, and efficacy assessment. Case reports and studies without control groups were excluded. Results: The average effectiveness of the Epley maneuver is 85-90% after the first session for posterior canal BPPV [7,13]. Factors reducing effectiveness: age >65 years (70% vs 90%; p<0.05) [3], delayed treatment (>7 days: 75% vs 90%; p<0.01) [6,15], coexisting diabetes/migraine [15,16]. Recurrences occur in 30-50% of patients within one year [17,18]. Technique modifications (e.g., changed rotation angle) increase effectiveness to 95% (p=0.04) [14]. Conclusions: The Epley maneuver remains a highly effective method for treating BPPV, but requires individualization in elderly patients and those with comorbidities. Further research is needed on strategies to reduce recurrences and standardize protocols.
BPPV, Peripheral Vertigo, The Epley Maneuver
Copyright (c) 2026 Kamil Rajczyk, Dominika Błonka, Janina Pohrybieniuk, Maria Irena Grys, Filip Kochański, Karolina Wołk, Aleksandra Jaskulska, Jan Pietrzak, Magdalena Bartold, Magda Skudzińska
THE IMPACT OF SLEEP ON MENTAL HEALTH: A COMPREHENSIVE REVIEW ACROSS THE LIFESPAN
Background: Sleep plays a crucial role in mental health throughout life. Disrupted, insufficient, or irregular sleep has been linked to adverse emotional, cognitive, and psychological outcomes from childhood through older adulthood. Early identification and intervention may mitigate long-term consequences of sleep disturbances. Methods: A narrative review of peer-reviewed literature published between 2015 and 2025 was conducted using PubMed and Google Scholar. The review focused on sleep duration, sleep quality, circadian disruption, and their associations with mental health outcomes across different age groups. Results: Across all life stages, poor sleep was consistently linked to higher risks of depression, anxiety, cognitive impairments, and subclinical psychotic symptoms. Vulnerability was particularly pronounced in adolescents, young adults, and older adults. The relationship between sleep and mental health appeared to be bidirectional, with sleep disturbances both contributing to and resulting from psychiatric symptoms. Interventions focused on improving sleep, such as sleep hygiene programs and Cognitive Behavioral Therapy for Insomnia, were shown to enhance sleep quality and alleviate a range of mental health difficulties. Conclusion: Sleep is a modifiable and clinically significant factor for mental health. Integrating sleep assessment and interventions into routine mental health care, along with public education and population-level strategies, may substantially enhance mental well-being across the lifespan.
Sleep, Mental Health, Sleep Deprivation, Sleep Hygiene, Psychiatric Disorders
Copyright (c) 2026 Patrycja Jagura, Julia Groszewska, Michał Romaniuk, Agata Rapior, Kinga Lubomska, Daria Makowska-Woszczyk, Agata Mytych, Jan Romaniuk, Łukasz Nosek, Marta Dziedziak
EMERGING DIGITAL TECHNOLOGIES IN MONITORING ENDOCRINE DISORDERS: CONTINUOUS GLUCOSE MONITORING SYSTEMS AND ARTIFICIAL INTELLIGENCE IN THE DIAGNOSIS OF POLYCYSTIC OVARY SYNDROME
Introduction and objective: Endocrine disorders affect the regulation of metabolic processes and are often associated with disturbances in glucose and hormonal homeostasis. In recent years, digital tools have increasingly contributed to the diagnosis and monitoring of metabolic diseases. Technological advancements have introduced continuous glucose monitoring (CGM) for patients with diabetes, as well as artificial intelligence (AI) algorithms to support the assessment of hormonal and imaging parameters in the diagnosis of PCOS. Despite these advances, studies on patients with diabetes using CGM who are simultaneously diagnosed with PCOS remain limited. AI-based diagnostic tools show promising accuracy in detecting PCOS characteristics through hormonal profiles and ultrasound imaging. The aim of this review is to summarize current evidence on CGM systems and AI in the evaluation and diagnosis of endocrine disorders, focusing on diabetes and PCOS. Methods: This narrative review analyzed literature from 2019–2025 and one earlier publication using PubMed and Google Scholar, focusing on CGM, AI, and diagnostic approaches in endocrine disorders. Results: CGM provides valuable insight into glucose variability and metabolic patterns in diabetes, but evidence for its use in patients with concurrent PCOS is limited. AI-based tools demonstrate high accuracy in identifying PCOS features, especially through hormonal profiling and ultrasound analysis. Conclusion: Digital technologies such as CGM and AI offer promising opportunities to improve the evaluation and management of endocrine disorders, particularly in women with PCOS. Larger, standardized studies are needed to validate clinical utility and support integration into routine care.
Endocrine Disorders, Diabetes, Polycystic Ovary Syndrome (PCOS), Continuous Glucose Monitoring (CGM), Artificial Intelligence (AI), Metabolic Health
Copyright (c) 2026 Aleksandra Ćwirko-Godycka, Nikola Murawska, Michalina Chodór, Aleksandra Tomaszewska, Kinga Karczewska, Sonia Mojzyk, Maciej Kokoszka, Aleksandra Mierniczek, Natalia Dymel, Ryszard Feret
DIAGNOSTIC UNCERTAINTY IN SPORTS MEDICINE: CHALLENGES IN THE INTERPRETATION OF CORTISOL TESTING
Background: Cortisol is a key hormone of the hypothalamic-pituitary-adrenal (HPA) axis and plays an essential role in the stress response. In physically active individuals, exercise-induced cortisol elevations are common; however, cortisol testing is often used in the evaluation of Overtraining Syndrome (OTS) despite uncertain diagnostic value and potential for misinterpretation in clinical practice. Material and methods: A structured literature search of PubMed and Google Scholar (1998–2025) was conducted using terms related to cortisol, exercise, overtraining, hypercortisolism and HPA-axis function. Human studies, systematic reviews, meta-analyses and major endocrine guidelines were included. Results: Cortisol responses to exercise are highly variable and influenced by training load, intensity, duration and individual factors. In athletes with suspected OTS, resting and dynamic cortisol measurements show inconsistent results with significant overlap compared to healthy athletes and non-athletic controls. Diagnostic accuracy is further limited by methodological heterogeneity, diurnal variation and biological variability. Numerous non-training factors, including sleep disturbance, psychological stress, illness, medications and endocrine disorders, can elevate cortisol to levels similar to exercise-related responses, increasing diagnostic uncertainty. Conclusions: Cortisol lacks sufficient specificity and sensitivity to serve as an independent diagnostic marker of OTS. Elevated cortisol in athletes should be interpreted within a comprehensive clinical context. Cortisol testing may provide supportive information but should not be used in isolation to diagnose overtraining or guide clinical or training-related decisions.
Cortisol Testing, Overtraining Syndrome, Sports Medicine, Hypercortisolism, Physically Active Individuals, Stress Response
Copyright (c) 2026 Gabriela Bajor, Wiktoria Jurczyk-Florkiewicz, Zofia Gniadek, Agata Pszczółka, Joanna Kozak, Kacper Melka, Mikołaj Szulewski, Aleksandra Salagierska, Patrycja Machno, Patryk Matuszczak
ORAL MUCOSAL CHANGES IN COELIAC DISEASE, DIABETES MELLITUS, AND INFLAMMATORY BOWEL DISEASES – A SYSTEMATIC REVIEW
Background: The oral cavity is sometimes referred to as a “diagnostic window” of systemic health, as even subtle systemic disturbances can manifest as changes in the oral mucosa. Coeliac disease, diabetes mellitus, and inflammatory bowel diseases (IBD) are chronic conditions that frequently present with oral mucosal lesions, which may precede or accompany the classical symptoms of these diseases. Aim: To systematically review and compare the oral mucosal changes reported in coeliac disease, diabetes mellitus, and IBD. The most common clinical manifestations are characterized, potential pathophysiological mechanisms are discussed, and the relevance of oral findings for early recognition and monitoring of these systemic diseases is evaluated. Materials and Methods: A systematic literature search was conducted in PubMed and Google Scholar using combinations of English keywords (including “oral mucosa,” “oral manifestations,” “coeliac disease,” “diabetes mellitus,” “inflammatory bowel disease,” “Crohn’s disease,” “ulcerative colitis,” “aphthous ulcers,” “xerostomia,” “oral microbiome,” and “oral–gut axis”). A total of 37 relevant peer-reviewed articles (clinical studies and reviews) were identified and analyzed. Results: The most frequently described oral manifestations in these conditions include recurrent aphthous stomatitis, inflammatory and atrophic changes of the tongue (such as geographic tongue and atrophic glossitis), angular cheilitis, xerostomia, and recurrent opportunistic infections (especially oral candidosis). In coeliac disease, oral lesions (aphthae, glossitis, cheilitis) and dental enamel defects often occur, sometimes even years before diagnosis, and tend to improve after the introduction of a strict gluten-free diet. Diabetes is associated with salivary gland dysfunction leading to dry mouth, elevated salivary glucose, and immune dysfunction – factors that contribute to candidosis, poor wound healing, burning mouth sensations, and an increased incidence of oral ulcers. IBD (Crohn’s disease and ulcerative colitis) can produce a broad spectrum of oral changes: Crohn’s disease in particular is characterized by specific granulomatous lesions (such as persistent lip swelling, mucosal “cobblestoning,” and deep linear ulcers) as well as nonspecific lesions (recurrent aphthae, pyostomatitis vegetans, glossitis, cheilitis). Oral manifestations of IBD are more common in Crohn’s disease and in pediatric patients and can precede intestinal symptoms or correlate with intestinal disease activity. Conclusions: Oral mucosal changes represent an important extraintestinal component of coeliac disease, diabetes, and IBD. They can serve as early warning signs of these disorders or indicators of disease activity and control. Recognition of characteristic oral lesions by dentists and physicians is crucial, as it can expedite diagnosis and prompt timely management (e.g. initiation of a gluten-free diet in coeliac disease or improved glycemic control in diabetes). Regular oral examinations should be an integral part of the care of patients with these conditions. Interdisciplinary collaboration – especially between dentists, gastroenterologists, and diabetologists – is essential for early detection, comprehensive monitoring, and improved patient outcomes.
Coeliac Disease, Diabetes Mellitus, Inflammatory Bowel Disease, Oral Mucosa, Oral Manifestations
Copyright (c) 2026 Ryszard Feret, Natalia Dymel, Krzysztof Feret, Michalina Chodór, Maciej Kokoszka, Aleksandra Tomaszewska, Kinga Karczewska, Sonia Mojzyk, Aleksandra Mierniczek, Aleksandra Ćwirko-Godycka, Nikola Murawska
STEM CELL–BASED MYOCARDIAL REGENERATION AFTER INFARCTION: MOLECULAR MECHANISMS, TRANSLATIONAL CHALLENGES, AND EMERGING BIOTECHNOLOGICAL INNOVATIONS
Myocardial infarction (MI) remains a major global health burden, driving substantial healthcare costs and long-term societal impact due to progressive heart failure and reduced quality of life. Conventional therapies improve survival but do not restore lost myocardial tissue. Stem cell–based cardiac regeneration represents a disruptive biomedical innovation situated at the intersection of biotechnology, translational medicine, and health systems transformation. This review examines contemporary regenerative strategies—including mesenchymal stromal cells, induced pluripotent stem cells, and cardiac progenitor cells—with emphasis on their underlying molecular mechanisms and technological advancements. Particular attention is given to exosome engineering, gene-modified stem cells, biomaterial-assisted delivery systems, hydrogel scaffolds, and tissue-engineered cardiac patches. Evidence from preclinical and clinical studies indicates functional improvements mediated predominantly through paracrine signaling, angiogenic stimulation, and immunomodulatory regulation rather than direct cardiomyocyte replacement. However, technological scalability, manufacturing standardization under GMP conditions, safety concerns, regulatory frameworks, and cost-effectiveness remain critical barriers to widespread implementation. The integration of regenerative cardiology with bioengineering, nanotechnology, and precision medicine may enable more sustainable and accessible therapeutic models. By situating stem cell–based cardiac repair within a broader innovation ecosystem, this review highlights both the transformative potential and the systemic challenges associated with next-generation cardiovascular therapies.
Stem Cell Therapy, Cardiac Regeneration, Regenerative Biotechnology, Exosome Engineering, Tissue Engineering, Translational Medicine
Copyright (c) 2026 Amanda Abramowicz, Maja Osuch, Maciej Osuch, Olga Tatarata, Martyna Jaciubek, Carmena Luty, Anna Kiełboń, Zuzanna Olga Reklewska, Kornelia Domagała, Magdalena Rumin
BEYOND TRIPTANS: SYSTEMATIC REVIEW FOCUSING ON THE EFFICACY AND SAFETY PROFILE OF CGRP RECEPTOR ANTAGONISTS IN MIGRAINE MANAGEMENT
Background: Despite the availability of traditional pharmacotherapies, including triptans and nonsteroidal anti-inflammatory drugs (NSAIDs), clinical value is often limited by suboptimal efficacy, significant cardiovascular contraindications, and the risk of medication-overuse headache (MOH). This study aims to evaluate the clinical efficacy and safety of rapidly developing calcitonin gene-related peptide (CGRP) receptor antagonists named ‘gepants’. Material and methods: A systematic review of scientific literature was performed to evaluate the efficacy of novel antimigraine agents. A structured search of the PubMed database was conducted using keywords including "migraine", "gepant", and "CGRP receptor antagonists." Emphasis was placed on clinical trials, RCTs, and meta-analyses, supplemented by references to neurological textbooks to provide clinical context. Results: Analysis of clinical data indicates that daily administered gepants reduce mean monthly migraine days (MMDs) compared to placebo in preventive treatment model. Furthermore, gepants proved their efficacy in acute migraine treatment, providing pain relief and the absence of the most bothersome symptoms (MBS). Multiple studies evaluating novel gepants have reported safety profiles comparable to placebo. In addition, gepants do not exert vasoconstrictive effects, making them a viable candidate for triptan-unsuitable patients or those who had documented adverse events (AEs) of traditional oral preventive medications (OPMs). Conclusions: Novel CGRP receptor antagonists represent a significant advancement in migraine therapy. By providing high tolerability and efficacy without the risk of MOH, hepatotoxicity or cardiovascular events, gepants emerge as a transformative option for both acute relief and prophylaxis in adult triptan-unsuitable patients suffering from migraine.
Migraine, CGRP Receptor Antagonists, Rimegepant, Gepants, Atogepant, Zavegepant
Copyright (c) 2026 Mikołaj Szulewski, Gabriela Bajor, Zofia Gniadek, Joanna Kozak, Aleksandra Salagierska, Kacper Melka, Patrycja Machno, Patryk Matuszczak, Agata Pszczółka, Wiktoria Jurczyk-Florkiewicz
INVESTIGATING LONG-TERM SIDE EFFECTS OF SNRI: VENLAFAXINE, DULOXETINE, DESVENLAFAXINE, MILNACIPRAN, AND LEVOMILNACIPRAN ANTIDEPRESSANTS TREATMENT IN PATIENTS DIAGNOSED WITH DEPRESSION
Depression is a prevalent mental health disorder affecting approximately 4% of the global population. Pharmacological management commonly involves the use of serotonin–norepinephrine reuptake inhibitors (SNRIs), including venlafaxine, duloxetine, desvenlafaxine, milnacipran, and levomilnacipran. Although these agents are effective in alleviating depressive symptoms, their prolonged use raises concerns regarding long-term safety. Clinical guidelines recommend antidepressant (AD) therapy for at least six months following symptom remission after the first episode of major depression; however, in practice, treatment duration often extends for years. Extended exposure to SNRIs has been associated with both common short-term adverse effects—such as weight gain, appetite changes, and sexual dysfunction—and less understood long-term outcomes, including metabolic, cardiovascular, and skeletal complications. The objective of this study is to systematically evaluate existing literature on the long-term side effects of SNRI therapy in patients diagnosed with depression. By synthesizing current evidence, this review aims to enhance understanding of the risk profile associated with chronic SNRI use and inform safer clinical practices.
Antidepressants, SNRI, Serotonin–Norepinephrine Reuptake Inhibitors, Selective Serotonin Reuptake Inhibitors, SSRI, Depression, Long Term Side Effects, Adverse Effects, Venlafaxine, Duloxetine, Desvenlafaxine, Milnacipran, Levomilnacipran
Copyright (c) 2026 Olivia Grygorcewicz, Marta Czachorowska, Franciszek Szweda, Tomasz Poczwardowski, Adrianna Kaczmarek, Katarzyna Anna Kowalska, Jakub Tomasz Latos, Marcin Chwalczuk, Marta Koneczna, Karolina Alicja Krystyniak, Kinga Augustyniak
INTERVENTIONS TARGETING IMPAIRED FASTING GLUCOSE: A COMPREHENSIVE REVIEW OF STRATEGIES TO PREVENT TYPE 2 DIABETES
Objective: Impaired Fasting Glucose (IFG), a state of prediabetes characterized by elevated fasting glucose levels, signifies a significantly increased risk of developing Type 2 Diabetes Mellitus (T2D) and associated cardiovascular complications. This comprehensive review systematically analyzes evidence from original research, including Randomized Controlled Trials (RCTs), prospective and retrospective cohort studies, and single- and multi-center implementation experiences, to evaluate the effectiveness and translation challenges of interventions targeting IFG progression. Methods: A targeted literature search was conducted across major medical databases, focusing on human intervention studies published between 2000 and 2025. Included articles were categorized based on intervention type (Intensive Lifestyle Intervention [ILI] or pharmacological) and study design, with an emphasis on T2D incidence rate reduction as the primary outcome. Key Findings: The analysis confirms that ILI, focused on diet, physical activity, and achieving moderate weight loss (5–7%), remains the most efficacious long-term strategy, demonstrating superior and sustained T2D risk reduction (e.g., 58% in the Diabetes Prevention Program) (Diabetes Prevention Program Research Group, 2002); (Tuomilehto et al., 2001). Metformin therapy serves as a critical, cost-effective pharmacological alternative, particularly for high-risk subgroups (e.g., younger individuals, high BMI). Translational studies, including retrospective and multi-center experiences, highlight significant barriers to real-world implementation, such as low sustained adherence and scalability challenges within diverse populations. Conclusion: Effective T2D prevention in individuals with IFG necessitates early, risk-stratified intervention. While ILI is the gold standard, future strategies must focus on developing tailored, technologically-supported, and scalable programs to overcome implementation barriers and maximize population-level health impact.
Copyright (c) 2026 Marzena Swojnóg, Zuzanna Dobrakowska, Radosław Swędrak, Jakub Klepacz https://creativecommons.org/licenses/by/4.0
EMERGING TRENDS AND FUTURE PERSPECTIVES ON CONTINUOUS MONITORING (E.G. CGM, REMOTE ECG) FOR OPTIMIZING TREATMENT ADHERENCE AND QUALITY OF LIFE IN PATIENTS WITH CHRONIC CONDITIONS
Background: The escalating prevalence of chronic non-communicable diseases (NCDs), including diabetes mellitus, cardiovascular diseases, and neurodegenerative disorders, presents a significant challenge to global healthcare systems. The traditional paradigm of episodic, reactive care is increasingly proving insufficient. Consequently, a digital transformation is underway, characterized by the adoption of Continuous Monitoring (CM) technologies such as Continuous Glucose Monitoring (CGM), remote Electrocardiography (ECG), and wearable biosensors. Objectives: This narrative review aims to provide a comprehensive overview of emerging trends in continuous monitoring technologies from 2020 to 2025. Specifically, it evaluates the impact of these technologies on treatment adherence and Quality of Life (QoL), analyzes the integration of Artificial Intelligence (AI) and Digital Twins, and identifies sociotechnical barriers to widespread implementation. Methodology: A rigorous narrative review was conducted based on a systematic search of high-impact literature. Thirty two key studies, including systematic reviews, meta-analyses, and technical frameworks, were synthesized to explore the intersection of technological innovation (IoMT, AI) and social science dimensions (behavioral change, patient empowerment, and equity). Results: Current evidence indicates that CM technologies significantly improve clinical outcomes, including HbA1c reduction in diabetes and decreased hospital readmission rates for heart failure. However, the impact on QoL is bidirectional: while fostering empowerment and safety, continuous surveillance can also induce anxiety and symptom preoccupation. Novel frameworks like Digital Twins and AI-driven predictive analytics offer promising avenues for personalized medicine but raise ethical and privacy concerns. Conclusion: Continuous monitoring serves as a critical enabler of proactive health management. Future advancements must prioritize user-centered design, interoperability, and equitable access to realize the full potential of these technologies in improving societal health and well-being.
Continuous Monitoring, CGM, Remote ECG, Treatment Adherence, Quality of Life, Artificial Intelligence, Digital Twins, Chronic Disease Management
Copyright (c) 2026 Maria Rajkowska, Bernard Myszewski, Aleksandra Włodarczyk, Norbert Grabias, Jędrzej Piotrowski, Paulina Jarząbek, Julia Weronika Mieszkowska, Radosław Gryko, Anna Kinga Tejchma, Łukasz Dominik Woźniak
INNOVATIVE TECHNOLOGIES IN THE DIAGNOSIS AND TREATMENT OF INFERTILITY: A COMPREHENSIVE REVIEW
Infertility is increasingly recognized as a condition affecting diverse populations and one that requires advanced medical and technological approaches to support effective diagnosis and treatment. In recent years, significant progress in medical sciences and digital technologies has refined the ways infertility is assessed and managed. Contemporary diagnostic methods now include high-resolution imaging, hormonal and genetic testing, microbiome evaluation, and immunological analysis. These advancements enable clinicians to identify reproductive disorders with greater precision. Artificial intelligence (AI) and robotic systems further support clinical decision-making by improving embryo selection, predicting treatment outcomes, and standardizing laboratory procedures. Advances in assisted reproductive technologies (ART) have expanded therapeutic options for patients who previously had limited chances of achieving pregnancy. Although technology plays a crucial role in modern infertility care, patient experiences and psychological well-being remain equally important, as treatment can be both emotionally and physically demanding. This review summarizes current knowledge on innovative technologies used in the diagnosis and treatment of infertility and highlights how the continued development of these methods enhances clinical outcomes and patient care.
Infertility, Assisted Reproductive Technologies, IVF, ICSI, Artificial Intelligence, Digital Twins, Genetic Testing, Microbiome, Reproductive Medicine, Laboratory Automation
Copyright (c) 2026 Zuzanna Dobrakowska, Marzena Swojnóg, Radosław Swędrak, Jakub Klepacz https://creativecommons.org/licenses/by/4.0
INNOVATIVE TECHNOLOGIES IN PEDIATRIC SURGERY: CLINICAL APPLICATIONS, EDUCATIONAL IMPACT, AND SOCIAL IMPLICATIONS
Background: Rapid technological progress has significantly transformed pediatric surgery, introducing innovative tools that influence not only clinical outcomes but also education, healthcare organization, and the social experience of patients and their families. Objective: This narrative review aims to synthesize current evidence on innovative technologies used in pediatric surgery, with particular emphasis on their clinical applications, educational value, and broader social implications. Methods: A comprehensive literature review was conducted using major scientific databases, including PubMed, Scopus, and Web of Science. Peer-reviewed articles published between 2015 and 2025 were analyzed, focusing on technologies such as three-dimensional (3D) printing, robotic-assisted surgery, augmented and virtual reality (AR/VR), simulation-based training, artificial intelligence (AI), and telemedicine. Results: Innovative technologies have demonstrated substantial benefits in pediatric surgery, including improved preoperative planning, enhanced surgical precision, reduced perioperative stress, and better training outcomes for surgeons. Three-dimensional printing and AR/VR facilitate personalized surgical planning and family education, while robotic platforms and AI-based tools offer potential improvements in minimally invasive procedures and decision-making. Simulation-based training contributes to patient safety, and telemedicine supports postoperative care and continuity of treatment. Conclusions: Innovative technologies are reshaping pediatric surgery beyond technical performance, affecting social, educational, and ethical dimensions of care. Future research should focus on long-term outcomes, cost-effectiveness, and equitable access to technological advancements.
Pediatric Surgery, Innovative Technologies, Robotic Surgery, 3D Printing, Artificial Intelligence, Virtual Reality
Copyright (c) 2026 Agnieszka Walczak, Magdalena Domisiewicz, Kacper Domisiewicz
CHONDROMALACIA PATELLAE: ETIOLOGY, DIAGNOSIS, AND TREATMENT – A NARRATIVE REVIEW
Chondromalacia patellae (CMP) is a degenerative disorder of the hyaline cartilage of the patella, forming part of the patellofemoral joint. Due to its key role in joint biomechanics, CMP commonly manifests as anterior knee pain and functional limitation, which can significantly impair patients’ quality of life. Early and accurate diagnosis, along with appropriate treatment, is crucial due to the very limited regenerative capacity of articular cartilage. This narrative review analyses current evidence regarding the etiology, diagnostic approaches, and treatment options for CMP, including conservative management, regenerative therapies (autologous chondrocyte implantation and mesenchymal stem cell therapy), and surgical interventions. A comprehensive literature search of the PubMed database (2010–2025) was performed, prioritising meta-analyses, systematic reviews, and randomised controlled trials relevant to the topic. CMP represents a complex degenerative condition requiring an integrated clinical and imaging-based approach. Magnetic resonance imaging is highlighted as the primary non-invasive diagnostic modality, while evidence supporting regenerative therapies remains promising but limited. Early recognition and tailored management strategies are essential to prevent disease progression and improve long-term functional outcomes.
Chondromalacia Patellae, Patellofemoral Joint, Anterior Knee Pain, Magnetic Resonance Imaging, Conservative Treatment, Surgical Treatment
Copyright (c) 2026 Jan Romaniuk, Michał Romaniuk, Julia Groszewska, Daria Julia Woszczyk, Agata Rapior, Kinga Lubomska, Patrycja Jagura, Agata Mytych, Marta Dziedziak, Łukasz Nosek
THE PSYCHEDELIC RENAISSANCE: A SYSTEMATIC REVIEW OF PSILOCYBIN AND LSD IN THE TREATMENT OF PSYCHIATRIC DISORDERS
The escalating global burden of mental health disorders, coupled with the stagnation of innovation in traditional monoaminergic pharmacotherapy (e.g., SSRIs), has precipitated a critical need for novel therapeutic paradigms. This article presents a comprehensive systematic review of the so-called "Psychedelic Renaissance," focusing on the clinical resurgence of classical serotonergic hallucinogens: psilocybin and Lysergic Acid Diethylamide (LSD). The review adopts an interdisciplinary structure to evaluate the efficacy, safety, and societal implications of these compounds. Firstly, the paper traces the historical evolution of psychedelics from indigenous sacramental use, through the research proliferation of the 1950s, to the prohibitive legislation of the late 20th century. Secondly, it delineates the neurobiological mechanisms of action, specifically 5-HT2A receptor agonism and the disintegration of the Default Mode Network (DMN), which correlates with the alleviation of rigid cognitive patterns in depression and anxiety. Thirdly, the review synthesizes data from contemporary clinical trials demonstrating significant therapeutic potential in Treatment-Resistant Depression (TRD), end-of-life existential distress, and substance use disorders. Unlike standard pharmacological reviews, this paper also analyzes the distinct psychotherapeutic framework ("set and setting"), integration processes, and socio-economic factors, including cost-effectiveness and access equity. The findings suggest that psychedelic-assisted therapy represents a transformative shift from chronic symptom management to rapid, episodic curative interventions, provided that regulatory and ethical challenges are adequately addressed.
Copyright (c) 2026 Jakub Klepacz, Radosław Swędrak, Marzena Swojnóg, Zuzanna Dobrakowska https://creativecommons.org/licenses/by/4.0