International Journal of Innovative Technologies in Social Science

KIDNEY HEALTH IN SPORT: INVESTIGATING THE INFLUENCE OF CREATINE, CITRULLINE, L-ARGININE, BETA-ALANINE AND BRANCHED CHAIN AMINO ACIDS (BCAA) ON RENAL FUNCTION

Marta Korchowiec — 2025-07-10

Aims: The purpose of this review was to examine how five commonly used supplements, including creatine, citrulline, L-arginine, beta-alanine, and branched-chain amino acids (BCAAs), affect physical performance and kidney health. These compounds are widely consumed in the context of athletic training, yet their long-term safety with respect to renal function remains insufficiently defined.

Methodology: Relevant literature published between 1990 and 2024 was identified using PubMed, Scopus, and Google Scholar. The selection included studies describing the physiological effects and potential renal impact of each supplement.

State of Knowledge: Analysis of the available research suggests that creatine does not impair kidney function in healthy individuals. Citrulline is considered metabolically safe and may support renal health in specific contexts, although elevated concentrations in patients with reduced kidney function could indicate metabolic imbalance. L-arginine may be beneficial in acute clinical settings but shows potentially harmful effects when used long term, especially in older or chronically ill individuals. Beta-alanine has demonstrated safety and antioxidant properties that could protect kidney cells. In contrast, high or prolonged intake of BCAAs may contribute to insulin resistance and worsen renal outcomes in people with diabetes or hereditary kidney disorders.

Conclusions: When used appropriately by healthy individuals, these supplements are generally safe for kidney function. However, individual health status, dosage, and duration of use can significantly affect renal outcomes. BCAA supplementation, in particular, should be approached with caution in at-risk populations. More long-term studies are needed to fully assess the renal safety of these compounds in both athletic and clinical settings.

THERAPEUTIC CLIMBING IN REHABILITATION: A NARRATIVE REVIEW

Władysław Hryniuk — 2025-07-12

Introduction and objective: Climbing has recently emerged as a promising form of movement therapy, combining physical and psychological benefits. This review aims to provide a comprehensive overview of current evidence regarding the therapeutic application of sport climbing—particularly bouldering and top-rope climbing—in rehabilitation settings. It focuses on its use in treating postural defects, neurological disorders, psychiatric conditions, and developmental disorders in children.
Review methods: The review is based on studies retrieved from PubMed, Google Scholar, ResearchGate, and other scientific databases. Included materials comprise clinical and preclinical studies, randomized trials, case reports, and reviews related to the use of sport climbing in rehabilitation.
State of knowledge: Therapeutic climbing has demonstrated benefits across diverse clinical populations, including individuals with chronic low back pain, scoliosis, multiple sclerosis, Parkinson’s disease, traumatic brain injury, cerebral palsy, ADHD, and autism spectrum disorders. Reported outcomes include improved balance, coordination, muscle strength, proprioception, mood regulation, and cognitive function. Climbing is also associated with enhanced motivation and social integration. However, limitations remain, such as the lack of standardised protocols, a scarcity of high-quality RCTs, and limited long-term data.
Conclusion: Climbing integrates physical exertion, neuromotor coordination, and emotional engagement, making it a multifaceted rehabilitation tool. Its ability to promote neuroplasticity and whole-body engagement suggests significant untapped potential. Nonetheless, to validate its clinical utility and ensure safety, there is a need for robust, standardised research and structured implementation protocols supervised by qualified professionals.

UPPER LIMB INJURIES IN ESPORTS AND VIDEOGAMING – A NARRATIVE REVIEW OF PATHOLOGY, RISK FACTORS AND PREVENTION METHODS

Wiktor Chrzanowski — 2025-07-14

Objective: The growth of esports and videogaming has led to increased upper limb musculoskeletal complaints. This narrative review synthesizes literature on injury types, prevalence, risk factors, and management to guide prevention and management.

Methods: We searched PubMed and Google Scholar for English-language studies on esports and videogaming up to May 2025. Epidemiological surveys, case reports, and reviews were included if they addressed upper limb injuries. Data on prevalence, injury types (e.g., neuropathies, tendinopathies), potential pathology and risk factors, were extracted.

Key findings: Up to 70% of competitive gamers report wrist and hand pain; wrist pain appears in 6%–36% and hand pain in 5%–30%. Among those gaming > 2 hours/day, 34.8% had musculoskeletal disorders. Common injuries include RSIs such as carpal tunnel and ulnar neuropathies, tendinopathies (e.g., “gamer’s thumb”), and occasional fractures or lacerations. Risk factors include prolonged sessions (5–10 hours/day), high actions per minute (APMs) (500–600), non-ergonomic setups and obesity. Only 2% seek medical care and untreated injuries can limit performance, force time off or end careers.

Conclusions: Early detection and intervention are vital. Preventive measures include ergonomic optimization, regular breaks, ergonomic devices, and exercise. Educating players and involving sports medicine professionals can reduce injuries and improve gamer well-being.

ROCK CLIMBING AS A HEALTH-PROMOTING ACTIVITY: BENEFITS AND RISKS ACROSS POPULATIONS

Zuzanna Perlicka — 2025-07-14

Rock climbing has been steadily gaining popularity worldwide, particularly after its inclusion in the Olympic Games in 2020. As a physically and mentally demanding activity, it uniquely combines strength, endurance, balance, coordination, and problem-solving. This review aims to explore the physical and mental health benefits of recreational rock climbing, with a focus on outdoor settings, as well as the associated risk of injury. Current evidence indicates that climbing can enhance muscular strength, cardiovascular fitness, and body composition, especially among youth and young adults. Additionally, it has been linked to psychological benefits such as improved mood, stress relief, and greater overall well-being. Outdoor climbing, in particular, is associated with higher levels of enjoyment and satisfaction compared to indoor activity, which may promote long-term participation. However, climbing also presents a risk of injury, particularly chronic overuse injuries in the upper limbs, with elite climbers experiencing higher injury rates. Despite these risks, the overall findings support the role of rock climbing as a multidimensional, health-promoting activity. Further research is needed to better understand injury prevention and the long-term health impacts of climbing across different populations.

THE ROLE OF HIPPOTHERAPY IN THE REHABILITATION OF PATIENTS WITH SELECTED CENTRAL NERVOUS SYSTEM DISORDERS: A NARRATIVE REVIEW

Julia Kwiecińska — 2025-07-14

Introduction: Hippotherapy is an equine-assisted intervention gaining popularity to support the rehabilitation of patients with neurological disorders. By applying the horse’s rhythmic movement, it aims to improve motor function, postural control, and overall quality of life. In addition to traditional therapy with live animals, mechanical simulators are now also employed. Neurological conditions such as cerebral palsy, stroke, and multiple sclerosis often lead to functional impairments that may benefit from complementary therapies.

Aim: The aim of this review is to evaluate the effectiveness of hippotherapy in improving physical and psychosocial outcomes in patients with selected central nervous system disorders.

Review methods: All data were collected from publicly available sources. This article's databases were accessed via PubMed, Google Scholar, and other scientific databases in May 2025.

Conclusions: Hippotherapy appears to be an effective complementary method in the rehabilitation of patients with neurological disorders, offering improvements in motor function, balance, posture, and psychosocial well-being. Both traditional and simulator-based forms show therapeutic potential. However, variability in study quality, small sample sizes, lack of standardization, and high costs limit the strength of current evidence. Further high-quality research is needed to confirm its effectiveness and cost-efficiency in clinical practice.

THE INFLUENCE OF WATCHING FOOTBALL MATCHES ON ACUTE CARDIOVASCULAR EVENTS

Jacek Sitkiewicz — 2025-07-15

Introduction and Objective: Acute emotional stress with big football matches is recognized to precipitate cardiovascular events in some individuals. The purpose of this narrative review is to address the existing scientific evidence regarding the association of viewing football matches with the risk of cardiovascular events like myocardial infarction, arrhythmias, and sudden cardiac death.

Methods: The review was based on an extensive PubMed database search conducted in April 2025. Articles were graded on methodology, sample description, scope of study, and results reported. There were no restrictions on publication dates. English-language studies and applicable book chapters only were considered.

Conclusions: The studies indicate that emotionally charged matches - especially if spectators are strongly bonded or identify intensely with their team - can raise the risk of cardiovascular incidents, especially in men who have a background of cardiovascular illness. Population data are contentious, nevertheless, and additional confounding variables like alcohol consumption, smoking, and unhealthy diet might be involved. Healthy emotional reactions (e.g., victories) can be protective. The public health interventions should aim at reducing behaviour and offer emergency readiness in risk high-risk environments like stadiums or fan zones. The measures of public health should emphasize reducing risk behaviour and offer emergency preparedness in high-risk environments like stadiums.

THE IMPACT OF STRESS ON DECISION-MAKING AND PERFORMANCE IN ROCK CLIMBING: A LITERATURE REVIEW

Adam Borsuk — 2025-07-15

Introduction and purpose: Sport climbing, as a high-risk activity, provides a valuable framework for analyzing the impact of stress on decision-making processes. This paper aims to explore specific aspects of climbing that may influence cognitive processes and, consequently, the behavior of individuals engaged in this demanding sport discipline.

Material and methods: A thorough review of the literature available on PubMed and Google Scholar databases was conducted using following keywords: “rock climbing”, “lead climbing”, “top rope climbing”, “bouldering”, “stress”, “decision-making”

Conclusions: Stress significantly affects climbers' cognitive and physical performance, especially among less experienced individuals. However, psychological resilience, experience, and mental training can mitigate its negative impact. When properly managed, stress may even enhance performance and adaptability. Therefore, climbing training should include psychological preparation to improve decision-making, focus, and safety in high-risk conditions.

INNOVATIONS IN CERVICAL CANCER THERAPY: THE IMPACT OF IMMUNOTHERAPY ON HEALTH SYSTEMS AND EDUCATION

Paulina Redel — 2025-07-15

Cervical cancer is one of the most common genital malignancies in women worldwide, although its development is largely preventable through effective primary and secondary prevention programs. The main cause of the development of this cancer is chronic infection with oncogenic types of human papillomavirus (HPV), particularly types 16 and 18. The introduction of HPV vaccination and regular screening (cytology, HPV DNA testing) has significantly contributed to the decline in incidence in developed countries. Unfortunately, in many regions of the world, including Poland, vaccination and screening rates remain inadequate, resulting in a high incidence and death rate. The standard treatment for locally advanced cervical cancer is combination chemoradiotherapy, which combines radiotherapy with the simultaneous administration of cisplatin. In recurrent and metastatic cases, where radical treatment is not possible, systemic treatment is used - mainly chemotherapy based on a combination of cisplatin and paclitaxel, often with the addition of bevacizumab, an angiogenesis inhibitor. Advances in targeted therapies and immunotherapies (e.g., PD-1/PD-L1 checkpoint inhibitors) are opening up new therapeutic options, increasing the chances of prolonging survival and improving quality of life for patients with advanced disease. Numerous clinical trials are currently underway to evaluate the efficacy of new drugs and combination treatment strategies. There is also a growing emphasis on personalizing therapy based on molecular biomarkers. Effective control of cervical cancer requires an integrated approach - combining prevention, early detection, and access to modern treatments. The future of the fight against this cancer involves global implementation of HPV vaccination, expansion of screening programs, and development of precision systemic therapies. This review synthesizes the current state of knowledge, challenges, and new directions in the prevention, diagnosis, and treatment of cervical cancer.

UNDERSTANDING PRADER-WILLI SYNDROME: FROM MOLECULAR DIAGNOSIS TO THERAPEUTIC INNOVATIONS

Paulina Redel — 2025-07-16

Prader-Willi syndrome (PWS) is a rare, multisystem genetic disorder with an epigenetic basis, caused by a lack of paternal gene expression in the region of chromosome 15q11-q13. Key clinical manifestations include severe hypotonia early in life, hyperphagia leading to obesity, short stature, hypogonadism, cognitive impairment, and multiple endocrine disorders such as growth hormone deficiency, hypothyroidism, and central adrenal insufficiency. Hypothalamic dysfunction plays a central role in the pathogenesis of PWS, responsible for many somatic and behavioral symptoms, including disorders of satiety, temperature regulation, sleep, and emotion. Obesity and its complications - including type 2 diabetes and cardiovascular disease - are a major cause of morbidity and mortality in this group of patients. Molecular diagnosis is mainly based on DNA methylation analysis, which allows detection of all types of genetic alterations in PWS. Currently, there is no causal treatment for the syndrome, and effective management requires a multidisciplinary approach including hormonal treatment, strict dietary control, behavioral interventions, rehabilitation, and possibly pharmacotherapy and new therapeutic options such as GLP-1 agonists, topiramate, oxytocin, naltrexone-bupropion, and matfromin.

BIOLOGICAL THERAPY IN CHRONIC RHINOSINUSITIS WITH NASAL POLYPS: A LITERATURE REVIEW OF TREATMENT METHODS INCLUDING DUPILUMAB AND MEPOLIZUMAB

Malwina Wojtas — 2025-07-16

Introduction and purpose: Nasal polyps occur in chronic mucosal inflammation of the nasal cavity. Overgrown mucosa forms pale colored, smooth, lobular, poorly vascularized structures which expand into nasal cavity causing obstruction, nasal congestion and hyposmia. Corticosteroids used topically or systemically significantly improve patients’ quality of life by reducing the size of the polyps, however long-term steroid use is associated with systemic side effects. Sinus surgeries alleviate breathing problems, however sinonasal symptoms can reoccur even 3 years after the surgery. Recently introduced biological treatment such as mepolizumab or dupilumab, showed itself effective and safe. Studies show that patients treated with dupilumab or mepolizumab have lower risk of sinonasal symptoms reoccurrence.

The aim of this review is to investigate the treatment methods in chronic rhinosinusitis with nasal polyps and the potential of the new biological therapy.

Materials and methods: A literature review was conducted using databases including PubMed, Scopus and Google Scholar. Additionally, European position paper on rhinosinusitis and nasal polyps (2020) was used. Search terms included “chronic rhinosinusitis with nasal polyps”, “nasal polyposis”, “endoscopic sinus surgery”, “mepolizumab”, “dupilumab”.

Summary and Conclusions: Steroid therapy and endoscopic sinus surgery as a well-known form of therapies alleviate symptoms of chronic rhinosinusitis with nasal polyps although often do not offer sustain outcomes. New studies concerning biological therapy including dupilumab and mepolizumab suggest a potential breakthrough for patients. Reoccurrence rate was significantly lower, and symptom control enhanced due to biological therapeutics. Dupilumab and mepolizumab should be considered in CRSwNP treatment.

IMPACT OF RESISTANCE EXERCISE ON NEUROCOGNITIVE HEALTH AND SARCOPENIA IN THE ELDERLY

Sebastian Polok — 2025-07-16

Introduction: Sarcopenia (progressive muscle loss/weakness) and neurocognitive decline are serious, interrelated difficulties of aging, with shared pathophysiological pathways including inflammation and disrupted muscle-brain communication. Resistance exercise training (RET) counters sarcopenia and additionally may be beneficial for cognition via myokine release.

Methods: Systematic review (PubMed/Google Scholar) of the impact of RET on sarcopenia and neurocognitive health in adults aged ≥ 65 years was done. The search words were "resistance exercise", "sarcopenia", "neurocognitive health", and "elderly". Clinical studies, trials, meta-analyses, and RCTs after 2017 were included. After screening 348 records and applying exclusion criteria, 21 studies were analyzed.

Results: RET significantly improves sarcopenia, increasing muscle strength (e.g., knee extension SMD=1.26), mass (especially with protein supplementation), and physical function (e.g., gait speed SMD=1.28), reducing fall risk. RET also yields domain-specific cognitive improvements, most consistently in executive function and processing speed, that are coupled with hippocampal expansion and expanded functional connectivity. RET elevates neurotrophic factors (e.g., BDNF) and reduces inflammation (e.g., IL-6). Crucially, several studies demonstrate concurrent improvements in both cognition and muscle strength/function, with strength improvement being related to cognitive improvement (up to 40% mediation).

Discussion: RET provides two-fold protection through mechanisms like heightened protein synthesis, reduced inflammation, and neurotrophic support. Barriers include low adherence, access, and standardization of protocols (e.g., optimal dose: ≥2 sessions/week, 70–80% 1RM). Future research needs validated biomarkers, optimized protocols (including nutritional co-interventions), and high-quality RCTs on minimal effective doses and synergies.

Conclusions: RET is a robust, evidence-based intervention counteracting both sarcopenia and cognitive impairment in older adults, and promoting functional independence and healthy aging. The resolution of implementation concerns and outstanding research questions is necessary to maximize its public health impact.

REPAIRING GENES, RESTORING STRENGTH: THE PROMISE OF MODERN GENE THERAPY IN DUCHENNE MUSCULAR DYSTROPHY

Katarzyna Kozon — 2025-07-16

Introduction: Duchenne muscular dystrophy (DMD) is a severe X-linked neuromuscular disorder characterized by progressive muscle degeneration due to mutations in the dystrophin gene. Current treatments primarily focus on symptom management. Delandistrogene moxeparvovec is a gene therapy designed to deliver a shortened, functional version of the dystrophin gene, potentially modifying disease progression.

Aim of the study: To evaluate the clinical efficacy and safety of delandistrogene moxeparvovec in improving skeletal muscle function and physical performance in patients with DMD based on data from completed clinical trials.

Methodology: The analysis includes four published clinical trials involving ambulatory boys aged 4–8 years with confirmed dystrophin mutations. Primary outcomes focused on changes in the North Star Ambulatory Assessment (NSAA), while secondary endpoints included time to rise from the floor and the 10-meter walk/run test. Study designs ranged from open-label to randomized, double-blind trials. Adverse events and regulatory outcomes were also considered.

Conclusions: Delandistrogene moxeparvovec demonstrated variable improvements in motor function, with more pronounced benefits in younger age groups. Some trials showed statistically significant results, while others failed to meet primary endpoints. Adverse events, including serious complications, were reported. The therapy received FDA approval in 2023 and 2024 for defined patient subgroups, though some decisions were made despite inconclusive efficacy data.

BRIDGING THE GAP BETWEEN SEIZURE CONTROL AND QUALITY OF LIFE: STIRIPENTOL AND FENFLURAMINE IN DRAVET SYNDROME

Katarzyna Kozon — 2025-07-16

Dravet syndrome is a severe, early childhood epileptic encephalopathy, most often associated with a mutation in the SCN1a gene characterized by drug resistance and high neurological burden. For many years treatment was limited to non-specific antiepileptic drugs, but recently new, targeted therapies have appeared, which have significantly improved the prognosis of patients. Stiripentol, modulating GABAergic transmission, has been approved as an adjuctive treatment in the treatment of Dravet syndrome, showing a significant reduction in the frequency of seizures in combination with clobazam and valproic acid. In turn, fenfluramine, acting on serotonin receptors, among others, has proven also effective. Both drugs have been approved by the FDA and EMA, constitiuting a breakthrough in the treatment of Dravet syndrome Their introduction has significantly improved the quality of life of patients and opened up new perspectives in the treatment of developmental epilepsies.

FATIGUE FRACTURES IN RECREATIONAL AND PROFESSIONAL ATHLETES: RISK FACTORS, PREVENTION, AND RECOVERY STRATEGIES

Krzysztof Pietrzak — 2025-07-17

Objectives: In the review we synthesized current evidence on fatigue fractures in athletes to bridge pathophysiological mechanisms with clinical strategies for prevention, diagnosis, and recovery.

Methods: A comprehensive analysis incorporated epidemiological studies, biomechanical research, clinical trials, and meta-analyses examining risk factors, diagnostics, interventions, and rehabilitation protocols.

Key findings: Fatigue fractures arise from repetitive microdamage exceeding bone repair capacity, amplified by intrinsic factors (e.g., low bone mineral density, hormonal imbalances) and extrinsic triggers (training errors, nutritional deficiencies). Magnetic resonance imaging demonstrated 90-95% diagnostic sensitivity. Gradual training progression (acute:chronic workload ratio < 1.5) reduced injuries by 30-50%, while nutritional optimization (calcium 1200-1500 mg/day; vitamin D ≥ 30ng/mL) enhanced recovery by 40%. Female athletes with relative energy deficiency faced 4-fold higher risk, mitigated through hormone/nutrition strategies. Advanced therapies like teriparatide improved outcomes in complex cases.

Conclusions: Effective management requires multidisciplinary integration of sport-specific biomechanics, nutritional/hormonal optimization, phased rehabilitation, and individualized load monitoring, with tailored approaches for post-hiatus deconditioning and aging physiology.

HYPERBARIC OXYGEN THERAPY: MECHANISMS, CLINICAL APPLICATIONS, AND FUTURE DIRECTIONS

Małgorzata Wasilewska — 2025-07-17

Objective: To synthesize recent evidence (2020-2025) regarding Hyperbaric Oxygen Therapy (HBOT) mechanisms, effectiveness, safety, and new applications.

Methods: A systematic literature review was conducted (PubMed, Scopus, Web of Science, Cochrane) using the terms "hyperbaric oxygen therapy" and primary indications (e.g., diabetic foot ulcer, radiation injury), mechanisms (e.g., angiogenesis), and safety. Boolean operators were used to limit searches. Peer-reviewed literature (2020-2025) adhering to inclusion criteria was title/abstract screened, reviewed at full text, and data extracted. Narrative synthesis appraised findings.

Results: HBOT significantly improves diabetic foot ulcer healing (2.2 fold faster healing, 33-52% reduction in amputation risk) and radiation tissue injury (80% healing in osteoradionecrosis). HBOT reduces mortality in acute illnesses (e.g., 66% to 23% in Fournier's gangrene) and long-term sequelae in CO poisoning (50% reduction). Promising data are available for efficacy in post-stroke recovery, post-COVID cognitive dysfunction, Parkinson's, male infertility, and early femoral head necrosis. Side effects are rare (<5%) and typically minor (e.g., ear barotrauma).

Conclusions: HBOT is effective and safe for established indications such as radiation injury and chronic wounds. New applications in oncology and neurology are promising but require further verification. The future of research is optimization and availability.

BONE STRESS INJURIES IN RUNNERS - A HOLISTIC APPROACH

Alicja Toczyłowska — 2025-07-17

Objective: Bone stress injuries (BSIs), ranging from periosteal edema to stress fractures, are highly prevalent in runners due to repetitive loading exceeding bone adaptation capacity. Delayed diagnosis prolongs recovery. This review synthesizes current knowledge on BSI pathophysiology, risk factors, diagnosis, management, and prevention in runners, highlighting the complexity of the problem.

Methods: A literature review was conducted using publicly available sources accessed via PubMed and Scopus.

Key Findings: BSIs arise from an imbalance between microdamage accumulation and repair, influenced by biological and biomechanical factors. Magnetic resonance imaging (MRI) is the diagnostic gold standard, recommended after initial plain radiography. Management prioritizes conservative measures; surgery is reserved for high-risk fractures (e.g., prone to nonunion) or conservative failure. Prevention strategies include individualized training programs, nutritional optimization, and preparticipation screening.

Conclusions: Early diagnosis and a multidisciplinary approach—focusing on risk factor identification, timely intervention, treatment, and prevention—are crucial for reducing BSI incidence and accelerating recovery in runners. Further research is needed to validate novel treatments and standardize risk factor detection systems for injury prevention.

INTRA-ARTICULAR APPLICATION OF DIFFERENT TYPES OF INJECTIONS IN OSTEOARTHRITIS - LITERATURE REVIEW

Aleksandra Dzwonkowska — 2025-07-18

Osteoarthritis (OA) is a complex, multifactorial disease characterized by an imbalance in chondrocyte metabolism, which ultimately leads to the progressive breakdown of articular cartilage. This process results in chronic pain, joint stiffness, and a decline in overall joint function, severely affecting the patient’s quality of life. OA is one of the most common causes of disability worldwide and frequently affects weight-bearing joints like the knees, hips, and spine. While there is currently no effective cure for OA, treatment strategies are primarily focused on managing pain, alleviating inflammation, and improving joint mobility. The risk factors for developing OA are diverse and include obesity, advancing age, genetic predisposition, and lifestyle factors, such as physical activity levels and previous joint injuries. Diagnosis of OA is typically made through a combination of clinical assessment and imaging studies, with radiographic features such as joint space narrowing, osteophyte formation, and subchondral sclerosis serving as key indicators. Although a variety of treatments, from non-pharmacological interventions to pharmacological therapies and surgical procedures, are utilized, a definitive, long-term cure for OA remains out of reach. As a result, current research is increasingly focused on potential therapies, such as mesenchymal stem cells, hyaluronic acid, corticosteroids, and platelet-rich plasma, which aim to promote cartilage regeneration and repair without significant side effects. This review examines these treatments, evaluating their mechanisms of action, efficacy, safety, and limitations, and highlights current clinical guidelines, as well as the risks associated with their long-term use.

AN INTEGRATED APPROACH TO POLYCYSTIC OVARY SYNDROME: DIAGNOSIS, PHARMACOLOGICAL TREATMENT AND BEHAVIOURAL INTERVENTIONS

Aleksandra Dzwonkowska — 2025-07-18

Introduction and Objective: Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting women of all ages. PCOS is one of the most common causes of anovulatory infertility, affecting up to 47% of patients. This work aims to present diagnostic methods, the importance of lifestyle management, and treatment methods in women with PCOS.

Review Methods: A literature review was conducted using the PubMed database to identify relevant articles related to polycystic ovary syndrome (PCOS) using keywords: “Polycystic Ovary Syndrome”, “Polycystic Ovary Syndrome/diagnosis”, “Polycystic Ovary Syndrome/therapy”, “Phenotype”, “Infertility”, and “Life Style”.

Brief description of the state of knowledge: PCOS typically presents with hyperandrogenism, polycystic ovarian morphology, and oligoovulation. It also affects metabolism, body weight, cardiovascular and mental health. Diagnosis is based on the modified Rotterdam criteria, which require two of three conditions: oligo/amenorrhea, hyperandrogenism, or polycystic ovaries, while excluding similar disorders. Treatment should be individualized and address infertility, menstrual disturbances, or androgen-related symptoms. Lifestyle interventions, including diet, regular physical activity, and weight control, are the first-line strategy in PCOS management.

Summary: PCOS requires early diagnosis and individualized treatment tailored to the patient's symptoms and reproductive goals. Lifestyle modifications, including diet and physical activity, play a key role in improving hormonal balance, metabolic health, and fertility outcomes in affected women.

SPINAL INJURIES IN WEIGHTLIFTERS AND POWERLIFTERS: A NARRATIVE ANALYSIS

Alicja Toczyłowska — 2025-07-18

Introduction and Objective: The growing popularity of weightlifting and powerlifting has been accompanied by an increased incidence of spinal injuries, posing significant health and career risks for athletes. This narrative analysis aims to synthesize existing evidence to identify key risk factors, injury mechanisms, and the prevalence of spinal injuries across cervical, thoracic, and lumbar segments in these disciplines.

Review Methods: A narrative analysis was conducted using PubMed and Scopus databases. The study focused on peer-reviewed articles addressing spinal injuries, biomechanical factors, and injury prevention strategies in weightlifting and powerlifting. Limitations included variability in study quality, a limited number of targeted publications, and potential underreporting of injuries.

State of Knowledge: Spinal injuries predominantly affect the lumbar region (28–59% of cases), driven by extreme mechanical loads during exercises like the deadlift, with disc herniation and chronic pain as common outcomes. Thoracic injuries (1.7–44%) are less frequent but linked to myogelosis and spondylolisthesis, while cervical injuries are rare (1–3%) but include severe cases such as Jefferson fractures. Chronic pain, however, is prevalent across all segments, with 52% of weightlifters reporting annual cervical pain. Technical errors, training overload, and fatigue were identified as primary injury risk factors, contributing to 31% and 81% of cases, respectively.

Conclusion: Spinal injuries, particularly in the lumbar spine, remain a critical concern in weightlifting and powerlifting. Injury prevention should prioritize technique refinement, load management, and fatigue mitigation. Further high-quality studies are needed to address gaps in injury reporting and longitudinal outcomes.

SAFE SLEEP: A MODERN LOOK AT INSOMNIA MEDICATIONS FOR SENIORS

Katarzyna Krupa — 2025-07-18

Background. Insomnia is a common and burdensome condition in older adults, marked by difficulty falling or staying asleep, early awakenings, and non-restorative sleep. Its prevalence increases with age and is linked to cognitive decline, depression, falls, and reduced quality of life. Physiological aging and polypharmacy complicate treatment in this group.

Aim. This paper reviews current pharmacological options for managing insomnia in the geriatric population, focusing on efficacy, safety, and adherence to clinical guidelines.

Materials and Methods. A literature review was conducted using PubMed, Scopus, and Google Scholar. Sources included randomized controlled trials, systematic reviews, meta-analyses, observational studies, and guidelines published up to 2024. Keywords included “insomnia,” “elderly,” “pharmacological treatment,” “hypnotics,” and related terms. Only studies involving patients aged 65+ were analyzed. Data on efficacy, safety, dosing, duration, and guideline recommendations were extracted.

Analysis of Literature. Current guidelines prioritize non-pharmacological treatments. Pharmacotherapy may be considered when behavioral methods are ineffective or unavailable. Prolonged-release melatonin and low-dose doxepin offer the best safety-efficacy balance. Orexin receptor antagonists show promise but are not yet available in Poland. Sedating antidepressants like trazodone, mirtazapine, and mianserin may be cautiously used in patients with comorbid depression or anxiety. Z-drugs and benzodiazepines, despite their efficacy, pose significant risks such as falls, dependence, and cognitive decline. Antihistamines and antipsychotics are generally not recommended due to unfavorable safety profiles.

Conclusion. Pharmacological treatment of insomnia in older adults should be cautious and individualized. Non-drug therapies remain the first-line option. When medications are necessary, the safest agents should be used at the lowest effective doses for the shortest duration. Ongoing research is essential to expand safe therapeutic options.

LIVING WITH MENIERE’S DISEASE: HOW TO MANAGE THIS CHALLENGING BALANCE AND HEARING DISORDER

Agnieszka Floriańczyk — 2025-07-18

Meniere’s disease is a chronic inner ear disorder characterized by recurrent vertigo, fluctuating hearing loss, tinnitus, and aural fullness. Despite extensive research, its aetiology remains unclear, complicating treatment. This review summarizes current therapeutic strategies for Meniere’s disease, spanning non-pharmacological, pharmacological, intratympanic, and surgical interventions. Lifestyle modifications, such as salt restriction and increased water intake, offer initial symptom control, though evidence remains limited. Pharmacological therapies, including diuretics, betahistine, and piracetam, provide varying degrees of vertigo relief, with inconsistent outcomes for hearing and tinnitus. Intratympanic treatments—steroids and gentamicin—are effective for refractory cases; steroids offer hearing preservation, while gentamicin achieves superior vertigo control at the risk of ototoxicity. Surgical options, including endolymphatic sac shunt surgery, semicircular canal plugging, vestibular neurectomy, and labyrinthectomy, are reserved for intractable cases, with selection guided by disease severity and hearing status. Emerging therapies, such as vestibular rehabilitation and Coriolus versicolor supplementation, show potential in improving vestibular compensation and reducing oxidative stress and inflammation. While current treatments primarily aim to manage symptoms rather than resolving the underlying disorder, ongoing research may lead to more targeted and disease-modifying therapies.

SUZETRIGINE, A NEW SELECTIVE NaV1.8 INHIBITOR, AS A BREAKTHROUGH IN THE TREATMENT OF PAIN – A REVIEW ARTICLE

Małgorzata Krzyżanowska — 2025-07-18

Introduction and purpose: Pain, especially chronic, remains a major public health burden, often refractory to existing treatments and associated with significant individual and social costs. Recent advances in our understanding of voltage-gated sodium channels, particularly NaV1.8, have highlighted their pivotal role in nociceptive signal transmission in peripheral sensory neurons. Suzetrigine, a novel and highly selective NaV1.8 inhibitor, has emerged as a promising therapeutic candidate in this context.

Aim: This review aims to evaluate the efficacy, safety, and therapeutic potential of suzetrigine, a novel and selective NaV1.8 channel inhibitor, in pain management and to assess its role as a non-opioid alternative in modern pain treatment.

Materials and Methods: A comprehensive review of literature available in the PubMed database was performed. This process involved a thorough search of articles written in English containing the following key terms: “suzetrigine”, “selective voltage-gated sodium channels”, “pain”, “pain management”, “NaV1.8”. The gathered data was then scrupulously examined and analyzed.

Conclusion: Suzetrigine with its high NaV1.8 channel selectivity and robust acute pain efficacy may represent a breakthrough in analgesia and pain management strategies. By minimizing off-target effects commonly associated with non-selective sodium channel blockers, suzetrigine offers a compelling alternative to opioids in treatment of postoperative pain. Its role in chronic and neuropathic pain remains under active investigation, with promising but not yet definitive results.

THE ROLE OF TOCILIZUMAB IN TREATMENT OF COVID-19

Aleksandra Gradek — 2025-07-21

Introduction and Aim: COVID-19, especially severe in the elderly, causes symptoms ranging from mild to critical organ failure and death. Treatments have included chloroquine, hydroxychloroquine, and corticosteroids. Tocilizumab, a monoclonal antibody blocking the IL-6 receptor, offers a promising biological therapy by reducing inflammation and possibly lowering thrombosis risk in COVID-19 patients. The aim of this review is to summarize current evidence on tocilizumab’s mechanism and its role in treating SARS-CoV-2 infection.

Material and Methods: A PubMed literature search was conducted using terms: “tocilizumab in COVID-19”, “interleukin-6 in COVID-19”, “interleukin-6 blockade with tocilizumab”, and “COVID-19 and inflammation”. Filters included Free Full Text, Clinical Trial, Randomized Clinical Trial, within the last 10 years.

Results: Studies show that tocilizumab reduces inflammation, shortens hospitalization, and accelerates recovery in COVID-19 patients, especially those with respiratory failure not yet on mechanical ventilation. Additionally, tocilizumab exhibits anticoagulant effects, potentially reducing thrombosis risk.

Conclusion: Originally used for rheumatologic diseases, tocilizumab shows therapeutic potential in COVID-19 by lowering inflammation and reducing mechanical ventilation needs, improving clinical outcomes. However, inconsistent study results highlight the need for further large, well-designed clinical trials to confirm its efficacy and safety.

THE ROLE OF PHYSICAL EXERCISE IN REDUCING INFLAMMATION IN PATIENTS WITH SYSTEMIC SCLEROSIS

Aleksandra Gradek — 2025-07-21

Introduction and Aim: Systemic sclerosis (SSc) is a chronic, progressive disease that leads to multi-organ failure. In its pathogenesis, inflammation plays a significant role, particularly due to the reduced frequency of regulatory T cells that modulate this process. The aim of this paper was to analyze the available scientific evidence to determine how physical activity influences the reduction of inflammation and its relevance in the therapy of systemic sclerosis.

Results: Systemic sclerosis is associated with a chronic inflammatory state, as indicated by elevated inflammatory markers such as C-reactive protein and ferritin, which correlate with disease severity and symptom progression. Physical activity demonstrates potential in modulating inflammation by lowering inflammatory markers and improving overall bodily function. Regular, supervised exercise in patients with SSc yields measurable benefits, enhancing exercise capacity, muscle strength, quality of life and respiratory function.

Materials and Methods: During the writing of this paper, data analysis was conducted based on a review of available articles published in the PubMed database. The following combination of keywords was used: „sport in systemic sclerosis", „physical exercise in systemic sclerosis", "sport in systemic sclerosis”, „inflammation in systemic sclerosis” „inflammation and exercise”. The following filters were applied: Free full text, Clinical Trial, Randomized Clinical Trial and within the last 10 years.

Conclusion: Chronic inflammation in systemic sclerosis accelerates the development of complications, while regular, moderate physical activity under supervision can improve physical capacity, microcirculation, and reduce inflammatory symptoms. However, further research is necessary to confirm the beneficial effects of exercise as a therapeutic intervention in systemic sclerosis.

EXERCISE STRESS TESTING FOR EVALUATING SYNCOPE IN ATHLETES: A NARRATIVE REVIEW

Patryk Macuk — 2025-07-21

Objectives: Syncope in athletes presents a complex diagnostic challenge requiring systematic evaluation to differentiate benign neurally-mediated causes from potentially life-threatening cardiac conditions. Unrecognized cardiovascular disease in athletes can lead to sudden cardiac death, making accurate risk stratification essential for athlete safety and appropriate return-to-play decisions. We aim to provide a comprehensive synthesis of current evidence regarding the indications, protocols, diagnostic yield, and limitations of exercise stress testing in athletes presenting with syncope.

Methods: We conducted a narrative literature review of PubMed databases from 2004-2025, focusing on studies involving athletic populations and recent consensus statements from major cardiovascular and sports medicine organizations. Evidence was synthesized from observational studies, clinical guidelines, and expert consensus documents.

Key findings: Exercise stress testing is strongly recommended for all athletes with exertional syncope, with sport-specific, maximal-effort protocols yielding arrhythmic or ischemic findings in 15-25% of cases. Negative predictive values approach 95% when proper protocols are employed, significantly reducing the probability of exercise-induced life-threatening events, though residual risk remains. Current evidence supports individualized testing protocols rather than generic clinical protocols designed for ischemia detection. Integration with comprehensive clinical assessment, ECG, echocardiography, and risk factor evaluation optimizes diagnostic accuracy and clinical decision-making.

Conclusions: Sport-specific, effortful exercise stress testing serves as a pivotal diagnostic tool and safety gatekeeper in athletic syncope evaluation. When integrated within systematic algorithms it enables accurate risk stratification, specialist referral, and evidence-based return-to-play decisions. Future research should focus on protocol validation, long-term outcome studies, and integration of emerging technologies for further enhancement of diagnostic precision.

BEYOND RENAL FUNCTION: SYSTEMIC AND FUNCTIONAL ASPECTS OF CKD IN THE ELDERLY

Marcin Lampart — 2025-07-21

Chronic kidney disease is a significant contributor to increased morbidity, mortality and reduced quality of life, particularly in elderly individuals. As the greatest prevalence of CKD occurs in the oldest age group, the growing life expectancy and aging population suggest a continued rise in CKD incidence. The disease frequently coexists with other common conditions, such as hypertension, diabetes, heart failure complicating both diagnosis and treatment. Moreover, the cost of managing a dialysis-dependent population is substantial and is expected to rise.

The article aims to highlight the systemic nature of CKD, in which the progressive impairment of homeostatic function triggers a chronic inflammatory process. This leads to accelerated cellular aging, predominantly affecting blood vessels, heart, brain tissue, muscles and diminishing the remaining renal function.

The accumulation of uremic toxins, electrolyte imbalances and fluid overload impairs cognitive performance, reducing both functional capacity and adherence to medical treatment. Disruptions in phosphates-calcium metabolism contribute to mineral-bone disease. The loss of muscle and bone mass leads to reduced mobility and physical endurance, thereby increasing the risk of falls, injury, disability and death.

These factors are the main components of the Frailty Syndrome, for which CKD is a major underlying cause, a condition characterized by increased vulnerability to minor stressors and reduced ability to recovery and serious worsening of general health condition.

This review provides a comprehensive overview, pathophysiological mechanism, clinical manifestations, functional consequences and management strategies in elderly patients with CKD.

UNVEILING THE EXPANDING CLINICAL HORIZONS OF BOTULINUM TOXIN ACROSS MEDICAL SPECIALITIES

Katarzyna Herjan — 2025-07-22

Introduction: Originally identified for its potent neurotoxicity, botulinum toxin (BoNT) has been successfully repurposed into a highly versatile agent used across numerous medical specialities. Through targeted inhibition of acetylcholine release at neuromuscular synapses, BoNT induces localized, reversible muscle relaxation, effectively alleviating symptoms in a variety of neuromuscular and autonomic disorders.

Aim: This review aims to highlight the approved therapeutic uses of BoNT, its expanding applications, and the importance of proper technique and anatomical knowledge in maximizing efficacy and minimizing adverse events.

Materials and Methods: A comprehensive literature review was conducted to evaluate current therapeutic indications, mechanisms of action, safety profile, and emerging uses of BoNT.

Results: Approved therapeutic indications include dystonias, spasticity, chronic migraine, hyperhidrosis, bruxism, while growing evidence supports its emerging role in pain management, selected psychiatric disorders and certain cardiovascular conditions. In aesthetic medicine, BoNT remains primary non-surgical option for addressing dynamic facial lines and hyperfunctional musculature. The safty profile of BoNT remains favorable, however, the efficacy and safety of BoNT is strongly linked to appropriate dosing, product selection, formulation and precise injection technique, emphasizing the critical role of anatomical knowledge to maximize therapeutic benefit while minimizing adverse events.

Conclusion: Botulinum toxin has evolved from a potent neurotoxin to a valuable therapeutic agent across a broad range of medical disciplines. Its continued success depends on deep understanding of anatomy, product characteristics, and injection technique. Ongoing research into novel serotypes, delivery systems, and expanded indications will further solidify BoNT’s role as a cornerstone in both therapeutic and aesthetic practice.

MASTITIS IN LACTATING PATIENTS - A LITERATURE REVIEW

Kamila Krzewska — 2025-07-22

Abstract: Mastitis is a common and significant complication affecting breastfeeding women worldwide. It can substantially impact maternal health and infant feeding, frequently resulting in premature cessation of breastfeeding. If inadequately managed, mastitis can progress to more severe outcomes such as breast abscess, recurrent infection, or in rare cases, be mistaken for inflammatory breast cancer. Due to prevalence of the condition, potential complications and the need for effective treatment, mastitis still poses a big challenge for clinical practitioners.

Aim of the study: This review aims to summarize current knowledge on the etiology, clinical presentation and management of symptoms, which includes both pharmacological and nonpharmacological treatment of the condition.

Materials and Methods: A literature review was conducted focusing on the epidemiology, risk factors, clinical presentation, prevention and management strategies of mastitis in lactating women.

Results and conclusions: Mastitis in lactating women varies widely- ranging from around 3% to over 30% due to differences in diagnostic criteria, duration of follow-up, and type of population. It is characterized by breast pain, swelling, erythema, and can often be accompanied by systemic flu-like symptoms such as fever and malaise. Optimal management hinges on early recognition, combined with non-pharmacological strategies such as maintaining direct breastfeeding, correcting latch issues, providing adequate rest and hydration, completed by a pharmacological treatment that includes: use of non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and in confirmed or persistent bacterial cases- a targeted use of antibiotics.

BASILIXIMAB AND ANTI-THYMOCYTE GLOBULIN AS AN INDUCTION OF IMMUNOSUPPRESSION IN RECIPIENTS OF VASCULARIZED ORGAN TRANSPLANTS

Marcin Sawczuk — 2025-07-22

Introduction and Aim: The advancement of immunosuppressive therapy has significantly increased organ transplantations. Among immunosuppressive agents, basiliximab and anti-thymocyte globulin (ATG) are key in induction therapy. However, clear guidelines on when to use basiliximab alone, ATG alone, or their combination are lacking, posing clinical challenges. This study aims to review recent data on basiliximab and ATG use in induction therapy post-transplant.

Materials and Methods: A literature review was conducted using PubMed with keywords “basiliximab”, “ATG” and “immunosupression" including articles published up to September 2024, focusing on studies from the last two years. The review targeted information on their application in induction immunosuppression after vascularized organ transplantation, effects relative to organ type, and drug combinations.

Results: Basiliximab and ATG differ in efficacy and side effects. ATG is more effective in reducing acute rejection, especially in high-risk patients, but carries higher infection and hematologic risks. Basiliximab has a better safety profile, suitable for elderly or low-risk patients. Treatment should be individualized by age, immunological risk, and infection susceptibility. Steroid continuation after basiliximab induction improves outcomes, a benefit not clearly seen with ATG.

Conclusion: Induction therapy is advised for high-risk patients and certain transplants, mainly using ATG, Grafalon, or basiliximab. ATG may be a safe, effective alternative to basiliximab, which is preferred in older or comorbid patients. Limited data support ATG use in other transplants like pediatric heart transplants. Further multicenter trials and personalized therapy are needed.

ENDOMETRIOSIS AND VTE: A REVIEW OF THE EVIDENCE AND PATHOPHYSIOLOGICAL MECHANISMS

Julia Dura — 2025-07-22

Introduction and objective: Endometriosis is a chronic inflammatory condition affecting approximately 10% of women of reproductive age. Venous thromboembolism (VTE) is a major cause of mortality worldwide. Because the relationship between endometriosis and VTE is not well-defined, we conducted a review of studies that assessed the occurrence of VTE in women with endometriosis.

Review methods: A structured PubMed search was conducted to identify studies published between January 2015 and April 2025 assessing the risk of VTE in patients with endometriosis. Seven studies met the inclusion criteria after screening for relevance and exclusion of case reports.

Abbreviated description of the state of knowledge: Some large-scale studies suggest an elevated VTE risk in women with endometriosis, particularly in younger individuals, during pregnancy, or when using hormonal therapy. However, results vary due to differences in study design, diagnostic definitions, and confounder adjustment. Pathophysiologically, endometriosis-related inflammation, hormonal influences, and endothelial dysfunction may contribute to a prothrombotic state.

Summary: The association between endometriosis and VTE remains unclear; biologically plausible mechanisms and clinical patterns suggest it may be relevant in certain populations. Future research should focus on well-characterized, prospective studies. Clinicians should remain alert to thrombotic risk in women with endometriosis, especially when additional risk factors are present.

GLP-1 RECEPTOR AGONISTS IN METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE: THERAPEUTIC POTENTIAL AND CLINICAL CHALLENGES

Michał Bzoma — 2025-07-22

Introduction and Purpose: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), represents the most common chronic liver condition worldwide, strongly linked to obesity and type 2 diabetes. The more severe form, metabolic dysfunction-associated steatohepatitis (MASH), significantly increases risks of cirrhosis, hepatocellular carcinoma, and cardiovascular complications. Currently, effective pharmacological treatments are limited. This review aims to summarize current evidence on the potential role of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) as therapeutic agents for MASLD/MASH.

Description of the State of Knowledge: GLP-1 RAs, currently used to treat diabetes and obesity, show beneficial metabolic effects through appetite reduction, weight loss, and improved glycemic control. Recent studies indicate that GLP-1 RAs, particularly liraglutide and semaglutide, effectively reduce liver steatosis, hepatic inflammation, and liver enzymes. However, evidence regarding their effectiveness in reducing liver fibrosis remains unclear, highlighting the need for larger and longer studies.

Conclusions: GLP-1 RAs emerge as promising therapeutic options for MASLD and MASH due to their metabolic and hepatoprotective benefits. While preliminary findings support their use, particularly in reducing hepatic steatosis and inflammation, their role in fibrosis regression requires further validation. Future research, involving extensive clinical trials with broader patient populations and standardized dosing protocols, is essential to establish GLP-1 RAs as standard therapy for metabolic liver disease.

ARTIFICIAL SWEETENERS - AS SAFE AS THEY SEEM? IMPACTS ON GUT MICROBIOTA, METABOLISM, INFLAMMATION, CARDIOVASCULAR HEALTH AND SPORTS PERFORMANCE - A LITERATURE REVIEW

Monika Grudzień — 2025-07-25

For a considerable length of time, artificial sweeteners have been seen as safe dietary ingredients, promoting weight control and regulating blood sugar levels. However, a growing number of scientific studies are questioning their supposed biological neutrality. Current analyses suggest that some of these substances may affect the composition and function of the gut microbiota, which in turn may affect the immune system and play a role in the development of chronic inflammatory bowel diseases such as ulcerative colitis and Crohn's disease. There is growing evidence of a potential link between long-term intake of artificial sweeteners and the onset of insulin resistance and type 2 diabetes. In addition, it has been noted that frequent consumption of artificially sweetened beverages may be associated with an increased risk of stroke, cardiovascular disease and higher overall mortality, especially among overweight or obese postmenopausal women. These substances are commonly used in protein supplements, energy drinks and sports supplements, which may also affect important post-exercise recovery processes - including inflammation, insulin regulation, gut function and hydration status. These observations highlight the need for further interdisciplinary research into the long-term effects of artificial sweeteners on metabolic health and overall body function, especially in groups with high levels of consumption, such as people with metabolic syndrome and patients with type 2 diabetes.

THE IMPACT OF REHABILITATION ON THE QUALITY OF LIFE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

Aneta Rasińska — 2025-07-25

Introduction and Objective: Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory condition characterized by airflow limitation and persistent respiratory symptoms, significantly impairing patients’ quality of life. Pulmonary rehabilitation (PR) has emerged as a comprehensive intervention aimed at improving physical and psychological outcomes. This narrative review aims to synthesize current evidence on the impact of rehabilitation on quality of life among individuals with COPD.

Review Methods: A systematic search of recent literature was conducted using databases including PubMed, Scopus, and Web of Science. Peer-reviewed articles published within the last five years were selected based on relevance to pulmonary rehabilitation and quality of life outcomes in COPD. Both clinical trials and observational studies were included to provide a broad perspective.

State of Knowledge: Rehabilitation programs, encompassing exercise training, education, and psychosocial support, consistently demonstrate improvements in exercise capacity, dyspnea reduction, and health-related quality of life (HRQoL). Emerging evidence supports the integration of tele-rehabilitation as an accessible alternative, especially amid barriers such as pandemics or geographic limitations. The multidimensional benefits of rehabilitation extend beyond physical symptoms to include psychological well-being and social participation, highlighting its critical role in COPD management.

Conclusion: PR significantly enhances quality of life in patients with COPD by addressing physical, psychological, and social dimensions of the disease. Continued research is essential to optimize program delivery, including personalized approaches and remote interventions, to maximize patient outcomes.

TELECARE FOR THE ELDERLY: EFFECTIVENESS OF REMOTE MONITORING OF VITAL SIGNS IN HOME SETTINGS

Aneta Rasińska — 2025-07-25

Introduction and Objective: The growing aging population and increased prevalence of chronic diseases necessitate innovative healthcare approaches. Telecare—particularly remote monitoring of vital signs—has emerged as a promising method to support older adults in home environments. This review aims to evaluate the effectiveness of remote monitoring systems in improving health outcomes, safety, and independence among elderly individuals.

Review Methods: A narrative review methodology was used to synthesize current evidence from peer-reviewed articles published between 2018 and 2024. Major databases such as PubMed, Scopus, and Google Scholar were searched using targeted keywords. Articles included focused on the use of remote vital sign monitoring technologies in home-based care for individuals aged 60 and above.

State of Knowledge: The findings suggest that telecare technologies, including wearable sensors and connected health platforms, contribute to earlier detection of clinical deterioration, reduction in hospital readmissions, and enhanced patient engagement. Furthermore, remote monitoring improves medication adherence and enables continuous communication between patients and healthcare providers. Despite technological and ethical challenges, user satisfaction and acceptance remain generally high when systems are tailored to older users' needs.

Conclusion: Telecare with remote vital sign monitoring holds significant potential to support aging in place while reducing healthcare burdens. Integrating these technologies into standard care models can enhance elderly care quality, improve health outcomes, and increase autonomy. Further interdisciplinary research is needed to optimize implementation strategies and address remaining barriers to scalability and equity.

ARTIFICIAL INTELLIGENCE IN CHEST X-RAY DIAGNOSTICS OF PNEUMONIA: OPPORTUNITIES TO REDUCE MEDICAL ERRORS AND IMPROVE CLINICAL PRACTICE EFFICIENCY

Hanna Skarakhodava — 2025-07-25

Introduction and Purpose: Chest X-ray (CXR) interpretation forms the bedrock of pneumonia diagnosis, yet it remains susceptible to human error and significant variability, with documented error rates reaching up to 30%. Artificial intelligence (AI), particularly through advancements in deep learning, presents a powerful opportunity to enhance diagnostic accuracy, minimize errors, and optimize clinical workflows. This structured review offers a critical summary of AI-based approaches for pneumonia detection on CXRs, delving into their diagnostic metrics, performance comparisons, impact on workflow, and role in error reduction.

Material and Method: We conducted a systematic synthesis of peer-reviewed literature from key databases including PubMed, ScienceDirect, Nature, and MDPI. Our search encompassed multicenter studies, comparative trials involving radiologists, and reports on real-world clinical deployments. Inclusion criteria specifically mandated explicit reporting of sensitivity, specificity, area under the curve (AUC), time savings, detailed dataset characteristics, comprehensive error analysis, and workflow efficiency. Special attention was given to studies involving convolutional neural networks (CNNs—such as ResNet, DenseNet, CheXNet, and Mask R-CNN), multicenter validation, applications in "second-reader" modes and triage systems, and aspects of interpretability.

Results: AI-powered CXR solutions consistently demonstrate high diagnostic value, with AUCs typically ranging from 0.87 to 0.98, and achieving sensitivity/specificity rates of 90–98% and 80–99% respectively. Notably, FDA-cleared platforms exhibit an AUC of 0.976, sensitivity of 0.908, and specificity of 0.887. The CheXNet model achieved diagnostic accuracy on par with radiologists when evaluated on the ChestX-ray14 dataset. Stand-alone AI review systems can process CXRs and generate reports in a mere 3–5 seconds (a dramatic reduction from approximately 1 hour for manual interpretation), significantly accelerating turnaround times and enabling rapid patient triage. When implemented in a "second-reader" capacity, AI tools reduce missed consolidations by up to 98% and effectively elevate the diagnostic accuracy of non-radiologists to a level comparable with that of board-certified radiologists. Furthermore, validation studies across pediatric and multi-pathology cases show robust performance metrics, provided age-appropriate adjustments are applied. However, comprehensive explainability and seamless integration remain crucial for the widespread and sustained adoption of these technologies.

Conclusions: AI, when applied to CXR-based pneumonia detection, demonstrably improves clinical accuracy, expedites reporting, and significantly mitigates human diagnostic error. These benefits are particularly pronounced in high-throughput environments and resource-constrained settings. Future large-scale implementation will depend on transparent validation processes, continuous real-world monitoring, and strong partnerships with clinicians to foster trust, ensure diagnostic consistency, and ultimately achieve optimal patient outcomes.

THE KETOGENIC DIET VS. CIVILIZATIONAL DISEASES: A REVIEW OF ITS APPLICATIONS IN DIABETES, ALZHEIMER’S DISEASE, AND ONCOLOGY

Paulina Redel — 2025-07-25

The ketogenic diet (KD) - a high-fat, low-carbohydrate, and moderate-protein diet - is gaining increasing recognition as a potential strategy to help treat a variety of conditions, including cancer, type 2 diabetes, and neurodegenerative diseases such as Alzheimer's. KD's mechanisms of action are mainly based on inducing a state of ketosis, in which the body switches from using glucose to ketone bodies as its main energy source. Cancer remains one of the world's most serious public health problems, and the effectiveness of current anti-cancer therapies is still sometimes limited. As a result, there is a growing interest in methods that support treatment, including nutritional interventions. The ketogenic diet (KD), based on high-fat intake, low carbohydrate intake, and moderate protein intake, shows potential as an adjuvant therapeutic strategy for cancer treatment. KD can affect the metabolism of cancer cells by increasing oxidative stress and reducing glucose availability, making cancer cells more susceptible to chemotherapy and radiotherapy, while protecting healthy cells. The ketogenic diet has been used with great success for more than 100 years to alleviate the course of many serious neurological diseases. The rapidly increasing number of patients suffering from obesity and type 2 diabetes in recent years has forced the search for new, effective ways to reduce body weight. The use of the ketogenic or low-carbohydrate diet in this context is of increasing interest to both physicians and the general public. This review presents current evidence from preclinical and clinical studies on the anticancer properties of the ketogenic diet, including its effects on tumor growth, angiogenesis, immune response, and the inflammatory environment. In addition, the use of KD in the treatment of other conditions, such as diabetes and Alzheimer's disease, is discussed. Although the diet is widely used clinically and has shown promising results in treating many pathologies, further research is needed on its long-term safety, especially in the context of cardiovascular risk. The article also provides an overview of the mechanisms of action of KD and possible side effects resulting from its use.

ADVANCES IN THE DIAGNOSIS AND TREATMENT OF IDIOPATHIC PULMONARY FIBROSIS - A LITERATURE REVIEW

Paulina Redel — 2025-07-24

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive interstitial lung disease of unknown cause, characterized by irreversible fibrosis of the lung parenchyma, which leads to progressive deterioration of respiratory function, hypoxemia, and eventually respiratory failure and death. The average survival from the time of diagnosis is about 3-5 years, making IPF one of the most fatal chronic respiratory diseases. The disease most often affects men over the age of 60, often smokers or former smokers, and its symptoms - such as chronic dry cough, exertional dyspnea and crackles over the bases of the lungs - are nonspecific, making early diagnosis significantly more difficult. Although advances have been made in the diagnosis and treatment of IPF in recent years, there is still a lack of effective methods to completely stop or reverse the fibrosis process. Currently available therapies - pirfenidone and nintedanib - have been shown to slow the progression of the disease, but do not reverse it. Lung transplantation remains the only causal treatment option, although it is reserved for a limited group of patients. Recent years have seen an intensification of research into new drugs targeting specific molecular mechanisms involved in the pathogenesis of IPF, such as TGF-β, PDGF, VEGF, FGF or inflammatory and epigenetic pathways. In parallel, techniques are being developed to more accurately differentiate disease phenotypes and personalize therapy. The purpose of this paper is to review the current state of knowledge on IPF, with particular emphasis on recent advances in pathogenesis, diagnosis, pharmacological and non-pharmacological treatment, as well as prospects for future research aimed at improving patients' quality of life and prognosis.