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HIRSCHSPRUNG'S DISEASE- DIAGNOSIS, TREATMENT AND NEW THERAPEUTIC STRATEGIES
No full textHirschsprung's disease (HD, HSCR) is a congenital disorder of intestinal motility characterized by aganglionosis. It is the absence of ganglion cells in the nerve plexuses of the large intestine. It leads to peristalsis disorders and functional obstruction. The disease most often manifests itself in the neonatal period as delayed meconium passage, abdominal distension, vomiting, and symptoms of obstruction. Confirmation of the diagnosis requires a rectal biopsy with histopathological evaluation. Treatment consists of surgical removal of the aganglionic segment of the intestine and restoration of the continuity of the gastrointestinal tract. The choice of surgical method depends mainly on the surgeon's preference and the experience of the center. A common complication is Hirschsprung-associated enterocolitis (HAEC), which may occur before or after surgery. Research is currently underway on the use of cell therapy in the treatment of HD. The review presents the epidemiology, pathogenesis, diagnosis, and current therapeutic strategies for Hirschsprung's disease, with particular emphasis on recent reports from the scientific literature. We highlight also new directions in research and therapeutic perspectives.
Aim of this study: The objective of this study is to summarise the latest information on Hirschsprung's disease, including research on cell therapies and treatments aimed at tissue regeneration.
Materials and methods: A literature review was conducted using the professional PubMed database. Articles published between 2018 and 2025 were included. The searches included combinations of the keywords: “Hirschsprung's disease,” “pediatric surgery,” “aganglionosis,” and “stem cell therapy”
PLEIOTROPIC EFFECTS OF GLP-1 RECEPTOR AGONISTS: A LITERATURE REVIEW
No full textGlucagon-like peptide-1 receptor agonists (GLP-1RAs) have been transformative in the management of type 2 diabetes (T2DM) and obesity. Advances in drug design have improved their bioavailability, allowing effective glucose control and weight loss with minimal side effects. Studies have demonstrated that GLP-1RAs, beyond their metabolic benefits, exert protective effects in multiple pathologies, including cardiovascular disease, liver disorders, kidney disease and neurodegeneration . Cardiovascular benefits include enhanced myocardial function, reduced atherosclerosis, improved endothelial health and a lower risk of major adverse cardiovascular events, alongside improved insulin sensitivity and lipid metabolism. In the liver, GLP-1RAs ameliorate metabolic dysfunction-associated steatotic liver disease by decreasing hepatic fat, inflammation and oxidative stress. In diabetic kidney disease, they exert renoprotective effects through anti-inflammatory, antioxidative and antihypertensive mechanisms. Emerging evidence also suggests neuropsychiatric benefits, including reductions in depressive and anxiety symptoms, decreased substance use and lower risk of Alzheimer’s, Parkinson’s and other dementias, likely mediated by modulation of neurotransmitter systems and neuroinflammation. This review summarizes preclinical and clinical evidence demonstrating the multifaceted effects of GLP-1RAs across multiple organ systems
VITAMIN D — THE IMPACT ON DEVELOPMENT AND TREATMENT OF ATRIAL FIBRILLATION
No full textIntroduction: Atrial fibrillation is the most common cardiac arrhythmia affecting approximately 700 thousand Polish people. In Poland, insufficient vitamin D levels are highly prevalent and concern around 90% of the population. Except the established, modifiable risk factors of AF, new risk factors such as vitamin D deficiency are being described. Some potential mechanisms involving vitamin D in atrial fibrillation pathogenesis include: cardiac remodelling via the vitamin D receptor, modulation of renin-angiotensin-aldosterone system, influence on parathyroid hormone concentration, changes in action potential duration and left atrium contractility, and activation of proinflammatory pathway by low vitamin D levels.
Aim of the study: This review aims to analyze the potential relationship between vitamin D concentration and the risk of developing atrial fibrillation based on the current state of knowledge (as of 2025). Moreover, we tried to examine how vitamin D concentration could influence the efficacy of atrial fibrillation treatment methods such as cardioversion or ablation.
Material and Methods: This review is based on literature from 2011 to 2024, searched in PubMed, Google Scholar, mp.pl and ClinicalTrials.gov that was describing the results of vitamin D deficiency on atrial fibrillation development and the treatment outcomes.
Conclusions: Serum vitamin D concentration may have an impact on both atrial fibrillation onset and its treatment. It is possible that there are several groups of patients among whom the sufficient vitamin D level would be particularly beneficial. Further studies, especially those focusing on vitamin D supplementation, are needed to clarify the role of vitamin D in atrial fibrillation pathogenesis and treatment
THE ROLE OF SHORT-CHAIN FATTY ACIDS IN IMMUNE REGULATION AND INTESTINAL HOMEOSTASIS IN INFLAMMATORY BOWEL DISEASE
No full textBackground: Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, is characterized by chronic relapsing intestinal inflammation driven by dysregulated immune responses and impaired epithelial barrier function. Increasing evidence highlights short-chain fatty acids (SCFAs)—particularly acetate, propionate, and butyrate—produced by gut microbiota as key mediators linking microbial composition to immune regulation and maintenance of intestinal homeostasis.
Methodology: This review was conducted through an extensive analysis of clinical, experimental, and translational studies indexed in PubMed, Google Scholar, and the Cochrane Library, focusing on gut microbiota composition, SCFA metabolism, epithelial barrier integrity, immune mechanisms, and SCFA-targeted therapeutic strategies in IBD.
Results: Patients with IBD consistently show reduced abundance of SCFA-producing bacteria, especially butyrate-generating taxa such as Faecalibacterium and Roseburia, accompanied by decreased fecal SCFA levels and impaired epithelial SCFA utilization. SCFAs exert potent anti-inflammatory effects via histone deacetylase inhibition and activation of SCFA-responsive G protein-coupled receptors, promoting regulatory immune phenotypes and suppressing pro-inflammatory signaling. Concurrently, they enhance intestinal barrier function by stimulating mucus production, reinforcing tight junctions, and supporting epithelial metabolic activity. Dietary fiber enrichment, prebiotics, probiotics, and microbiota-directed therapies demonstrate potential to restore SCFA availability and improve inflammatory and clinical outcomes, although responses remain heterogeneous.
Conclusions: SCFAs represent a crucial interface between gut microbiota, immune regulation, and epithelial barrier integrity, positioning SCFA-related mechanisms as promising therapeutic targets in IBD. Despite encouraging evidence, further well-designed, mechanistic, and personalized studies are needed to clarify causality, optimize SCFA-based interventions, and translate findings into effective clinical strategies
IMPACT OF PHYSICAL ACTIVITY ON SYMPTOM SEVERITY AND QUALITY OF LIFE IN CHRONIC VENOUS DISEASE: A SYSTEMATIC REVIEW
No full textObjectives: Chronic venous disease is a common and progressive condition that affects the veins of the lower limbs and significantly reduces quality of life. It often leads to symptoms such as leg pain, edema, fatigue, and in advanced stages, skin changes and venous ulcers. This narrative review explores current research on the impact of physical activity on symptom severity and quality of life in patients with chronic venous disease.
Methods: A literature search was conducted using PubMed and Google Scholar, focusing on studies published up to the year 2025, with particular emphasis on studies from 2015 to 2025. The following keywords were used: Chronic venous disease, chronic venous insufficiency, physical activity, symptom severity, quality of life.
Conclusions: Results consistently show that physical activity is associated with reduced pain, edema, and fatigue, as well as improved physical functionality. Furthermore, physical activity was also shown to improve quality of life. Despite the positive impact of physical activity, many patients do not meet physical activity guidelines. Physical activity is an effective and low-cost approach to improving both symptom severity and quality of life in patients with chronic venous disease; however, clinical guidelines should aim to improve long-term adherence
CONTEMPORARY CLINICAL APPLICATIONS OF COLCHICINE IN CARDIOVASCULAR AND INFLAMMATORY DISEASES
No full textColchicine, an alkaloid derived from Colchicum autumnale, has gained renewed attention in contemporary medicine following advances in the understanding of inflammation as a central mechanism in cardiovascular and systemic inflammatory diseases. The objective of this narrative review was to synthesize clinical evidence published between 2015 and 2025 regarding the modern therapeutic applications of colchicine. A structured review of peer-reviewed randomized controlled trials, meta-analyses, and international guideline documents was performed, and findings were qualitatively integrated.
Current rheumatology guidelines confirm colchicine as a first-line therapy for acute gout flares and for prophylaxis during urate-lowering treatment. In cardiology, guideline recommendations support its use in acute and recurrent pericarditis. Large randomized trials in patients with recent myocardial infarction and chronic coronary disease demonstrated a reduction in major adverse cardiovascular events when colchicine was added to contemporary standard therapy, and subsequent meta-analyses further evaluated its role in secondary cardiovascular prevention. Recent European guidelines for chronic coronary syndromes state that low-dose colchicine should be considered in selected patients as part of an event-prevention strategy. Additional studies suggest benefit in inflammation-related atrial fibrillation, particularly in postoperative settings, although gastrointestinal adverse events remain the most frequently reported side effects. Colchicine was also investigated in non-hospitalized patients during the COVID-19 pandemic.
Overall, contemporary evidence supports colchicine as an established anti-inflammatory therapy with validated rheumatologic and expanding cardiovascular applications, while emphasizing the importance of careful patient selection and safety monitoring
IMPLICATION OF ACTIVE VIDEO GAMES IN THE TREATMENT AND PREVENTION OF OVERWEIGHT AND OBESITY IN THE PAEDIATRIC POPULATION
No full textBackground: Active video games (AVG) are increasingly recommended as an attractive way to motivate overweight and obese children to include physical activity in their daily routines. However, the consistency and impact on weight, BMI, body composition, fitness, and health improvement remain uncertain and require further trials to examine their effects on children's bodies.
Objectives: To systematically review and collect evidence from systematic reviews, meta-analyses, and randomised controlled trials (RCTs) on how AVGs affect overweight and obese children.
Methods: A comprehensive search was performed on PubMed, Scopus, and Web of Science for English-language articles published between 2020 and 2025. Selected studies included systematic reviews, meta-analyses, and RCTs evaluating AVG interventions in overweight or obese children aged 2–18, focusing on at least one weight or fitness-related outcome. Seven studies met the inclusion criteria.
Results: Across included studies, AVGs were found to influence BMI-related and body composition outcomes. Evidence of improvements in cardiovascular and respiratory function was noticeable, especially when exergaming was combined with multicomponent exercise training. One of the RTCs reported an increase in muscle mass and motor skills.
Conclusions: AVGs appear to be a safe and engaging method for improving BMI and body composition and providing additional benefits in cardiorespiratory fitness, muscular strength, and motor competence. The most consistent and clinically significant effects occur when exergaming is incorporated into structured, multicomponent exercise programs that last long enough. Further high-quality, adequately powered RCTs are needed to better understand the long-term effects on weight and optimise intervention strategies
THE IMPACT OF VITAL SIGN MONITORING DEVICES ON THE QUALITY AND SAFETY OF CARE FOR OLDER ADULTS
No full textPopulation ageing and the growing number of older adults are among the most significant public health challenges of the 21st century. With age, the prevalence of chronic diseases, multimorbidity, functional and cognitive impairment, and the risk of sudden health events such as falls, exacerbations of heart failure, arrhythmias or acute respiratory episodes increase substantially. The traditional model of care, based on periodic medical visits and ad-hoc observation, proves insufficient to ensure continuous safety for older adults. In response to these challenges, technologies for real-time monitoring of vital signs have been developing rapidly. These include certified medical devices, wearable technologies, networks of environmental sensors (Internet of Things), and advanced predictive systems based on artificial intelligence.
The aim of this article is to provide a comprehensive analysis of the impact of vital sign monitoring devices on the quality and safety of care for older adults – taking into account clinical, social, organisational, economic, and ethical dimensions. The article is based on a review of 47 international studies from 2017–2024 and an analysis of implementation reports from long-term care facilities and community-based care. The findings indicate that continuous vital sign monitoring can reduce hospitalisations by an average of 28–36%, decrease falls by 18–31%, shorten staff response time by 30–50%, and significantly improve the subjective sense of safety among older adults and their families. At the same time, these technologies generate new challenges related to data protection, privacy, users’ and staff’s digital competencies and the risk of “alarm fatigue”. The article also proposes a model of integrated care based on multi-level monitoring and identifies key directions for further research
KETAMINE IN PREHOSPITAL MANAGEMENT OF TRAUMATIC BRAIN INJURIES: FROM CONTROVERSY TO ROUTINE USE. A SYSTEMATIC REVIEW OF CURRENT LITERATURE
No full textResearch Objectives: To present the broadest available evidence regarding the safety and efficacy of ketamine in traumatic brain injury (TBI) and explain the evolution of clinical guidelines. This review aims to verify historical contraindications against current knowledge and demonstrate how ketamine's role has evolved from a contraindicated drug to a potentially beneficial therapeutic option in prehospital settings.
Methods: Systematic analysis of clinical studies and systematic reviews examining ketamine's effects on cerebral hemodynamics, intracranial pressure (ICP), and cerebral perfusion pressure (CPP). Evaluation of ketamine's utility as an analgesic-sedative drug in prehospital TBI care, including assessment of safety profiles and clinical outcomes across civilian and military settings.
Conclusions: Ketamine's effect on cerebral hemodynamics is at least neutral and often beneficial, contrary to historical concerns about increased ICP. The drug demonstrates high utility as a prehospital analgesic-sedative agent, providing effective pain control and sedation without compromising patient safety. Historical contraindications must be regularly re-verified in light of current evidence. Clinical guidelines have evolved significantly, reflecting growing recognition that proper ventilation control and hemodynamic monitoring eliminate previous safety concerns. Current evidence supports ketamine as a safe and potentially advantageous therapeutic option in prehospital TBI management, particularly for achieving rapid sequence intubation, maintaining hemodynamic stability, and preventing secondary brain injury in emergency settings
INTERVENTIONS TARGETING IMPAIRED FASTING GLUCOSE: A COMPREHENSIVE REVIEW OF STRATEGIES TO PREVENT TYPE 2 DIABETES
No full textObjective: 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