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IMPACT OF LIFESTYLE FACTORS, NUTRITIONAL CHOICES AND SUPPLEMENTS ON ALOPECIA AREATA: A LITERATURE REVIEW
No full textAlopecia areata (AA) is a chronic, immune-mediated condition characterized by non-scarring hair loss which can significantly impact patients' quality of life. While its precise etiology remains elusive, emerging evidence suggests that various lifestyle factors may contribute to disease onset, progression, and severity. This review aims to synthesize current findings on the potential impact of modifiable lifestyle elements including smoking, alcohol consumption, psychological stress, sleep disturbances, physical activity, obesity, and diet on the pathogenesis and clinical course of AA. The role of specific micronutrients such as iron, vitamin D, zinc, B vitamins, and biotin is also examined. Although several studies suggest associations between these factors and AA, the evidence remains inconsistent and largely observational. At present, no definitive lifestyle modification guidelines can be proposed for AA patients. However, this review underscores the need for increased clinical awareness and further high-quality research to elucidate the mechanisms by which lifestyle and dietary habits may influence autoimmune processes involved in AA, with the ultimate goal of integrating holistic approaches into patient care
CHRONIC PELVIC PAIN SYNDROME IN WOMEN WITH VAGINAL DYSBIOSIS: A SYSTEMATIC REVIEW OF PRESENTATION, DIAGNOSIS, AND MANAGEMENT
No full textBackground: Chronic pelvic pain syndrome (CPPS) with vaginal dysbiosis is challenging to diagnose and can significantly affect women's health and daily life.
Objective: To review recent research on the symptoms, diagnosis, and treatment of CPPS with vaginal dysbiosis, and to summarize new findings and clinical practices.
Methods: Articles from PubMed, Scopus, and Google Scholar published between 2000 and 2025 were included. The review focused on original studies and systematic reviews involving adult women with CPPS and vaginal microbiota assessment. Case reports, non-English articles, and studies lacking vaginal microbiota analysis were excluded from the analysis. Data extraction and quality assessment were conducted using the Newcastle-Ottawa Scale and AMSTAR 2.
Results: Women with CPPS and vaginal dysbiosis often experience persistent pelvic pain, sexual and urinary symptoms, and emotional distress. Diagnosis typically includes clinical examination, laboratory testing, and vaginal microbiota analysis using bacterial or genetic methods. Treatment may involve antibiotics, microbiota restoration, physical therapy, and mental health support. Advances in vaginal microbiome research and precision medicine are expected to shape future treatments
EVALUATING THE IMPACT OF INNOVATIVE HYDRATION TECHNOLOGIES ON ATHLETE PERFORMANCE: A SYSTEMATIC REVIEW OF ALKALINE WATER EFFICACY
No full textBackground. Alkaline water often above pH 7 with a defined mineral profile is introduced to athletes as a means of hydration and recovery. The claims include increases in acid–base balance, the markers of hydration and performance. However, empirical evidence is mixed.
Aim. To integrate the human evidence around the effects of alkaline water intake on hydration status, acid–base balance and athletic performance, and to contextualize the claims against sports nutrition protocols.
Material and methods. A review of the literature was conducted to search for studies related to impacts of alkaline water on hydration, acid–base balance, and exercise performance. The search of the databases PubMed, Scopus, and Google Scholar was conducted for papers published between 2010 and 2025 with the following words: “alkaline water”, “electrolyzed water”, “hydration”, “acid–base balance”, “exercise”, “athletes”, and “performance”. Only human interventional or controlled studies were included.
Results. Consistently, alkaline water elevated urine pH and reduced urine specific gravity, sometimes decreasing blood viscosity upon rehydration [1]. However, results for systemic hydration markers (e.g., plasma osmolality, body mass restoration) were varied [1–4,7,8,10]. Only minor, inconsistent improvements were noted in acid–base markers (e.g., bicarbonate) and certain anaerobic performance metrics; these gains were limited to small, short-term trials [1,2,7]. Many studies found no performance advantage over neutral water or standard sports drinks [4,8,10].
Conclusions. Alkaline water is safe and consistently induces urinary alkalinization and modulates acid–base markers. However, its superiority over traditional hydration practices remains unproven. Future research requires well-powered, blinded RCTs with standardized water composition and athletic outcomes. Practical guidance should view alkaline water as an optional preference, not a replacement, for established hydration protocols [6]
BIOLOGIC THERAPY IN CROHN’S DISEASE: MECHANISMS, TREATMENT OPTIONS AND ADVERSE EFFECTS
No full textBackground and aim: Crohn’s disease (CD) is a chronic inflammatory bowel disease that can involve any segment of the gastrointestinal tract. It is characterized by a relapsing-remitting clinical course, significantly impairing patients' daily functioning and quality of life. This article reviews the current evidence on biologic therapies for CD and discusses their practical application in primary care settings.
Material and methods: This study was based on an analysis of the guidelines issued by the Polish Society of Gastroenterology and the National Consultant in Gastroenterology, along with the updated B.32 drug program (effective February 2024). Additionally, a systematic review of available scientific literature from the PubMed database was conducted. The article selection process utilized the following search terms: "Crohn's disease," "biological treatment," and "Crohn's disease treatment."
Results: The treatment of Crohn’s disease is chronic and initially relies on conventional therapies, including glucocorticosteroids and immunosuppressants. In moderate-to-severe cases, biological medicines are introduced. Currently, five biologic drugs are approved for use in Poland: infliximab, adalimumab, vedolizumab, ustekinumab, and upadacitinib—the first oral biologic approved for CD treatment. Further research is needed to treat Crohn's disease patients more effectively.
Conclusions: The rapid advancement of biologic therapies has significantly improved disease control, reduced reliance on steroids, and enhanced patient outcomes. For primary care physicians, recognizing the typical adverse effects of biologics and differentiating them from CD exacerbations is essential for effective management
THE IMPACT OF NEUROENDOCRINE, GENETIC, AND ENVIRONMENTAL FACTORS ON THE PATHOPHYSIOLOGY OF POLYCYSTIC OVARY SYNDROME AND FEMALE FERTILITY: A COMPREHENSIVE REVIEW OF HORMONAL REGULATION AND CLINICAL IMPLICATIONS
No full textPolycystic ovary syndrome (PCOS) represents one of the most prevalent endocrine disorders among women of reproductive age, exerting significant effects on fertility, metabolic homeostasis, and overall health. The syndrome arises from complex interactions among hormonal, genetic, and environmental factors that disrupt the hypothalamic-pituitary-ovarian (HPO) axis. Neuroendocrine dysregulation, characterized by increased pulsatility of gonadotropin-releasing hormone (GnRH) and an elevated luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio, promotes excessive ovarian androgen production and follicular arrest. Hyperandrogenism, insulin resistance, and chronic anovulation form the core pathophysiological triad of PCOS. Genetic studies (GWAS) have identified loci associated with gonadotropin regulation, steroidogenesis, and insulin signaling, while environmental exposures, including endocrine-disrupting chemicals (EDCs), may act as epigenetic triggers in genetically susceptible individuals. Epidemiological analyses demonstrate a steady global increase in PCOS incidence, with the highest prevalence in high-income regions. Clinical heterogeneity is reflected by four Rotterdam phenotypes, differing in metabolic and reproductive consequences. PCOS not only impairs natural fertility but also affects assisted reproductive outcomes by altering oocyte quality and ovarian responsiveness. Comprehensive understanding of hormonal and metabolic disturbances is essential for individualized diagnosis and therapy. Future research should focus on elucidating epigenetic mechanisms and optimizing targeted treatments to improve fertility and reduce long-term metabolic risks in affected women
THE IMPACT OF WHOLE BLOOD DONATION ON ATHLETIC PERFORMANCE
No full textIntroduction and Purpose: Whole blood donation induces acute hematological alterations that may temporarily impair aerobic performance, particularly in athletes whose training and competition outcomes depend on maximal oxygen transport capacity. This review aims to synthesize current evidence regarding the physiological and performance-related consequences of a standard whole blood donation (450-500 mL), with particular emphasis on changes in hemoglobin concentration, hemoglobin mass, maximal oxygen uptake (VO₂max), and recovery timelines.
Results: Across controlled studies published between 1990 and 2025, whole blood donation consistently reduces hemoglobin concentration by approximately 7-10% within 24-48 hours, accompanied by a 5-10% decline in VO₂max. These hematological and physiological changes result in measurable reductions in maximal exercise capacity, including decreased peak power output and shorter time to exhaustion. Submaximal exercise responses are largely preserved, suggesting that functional impairment is most pronounced at intensities near or at VO₂max. Full restoration of hemoglobin mass and maximal aerobic performance typically requires 3-6 weeks and is strongly influenced by individual iron status, donation frequency, and training load. Plasma donation, by contrast, does not appreciably affect VO₂max but may transiently alter anaerobic performance due to reduced buffering capacity.
Conclusion: Whole blood donation transiently diminishes oxygen-carrying capacity and maximal aerobic performance by reducing hemoglobin concentration and total hemoglobin mass. While these effects are reversible, recovery can be prolonged in individuals with low iron stores or high endurance demands. Understanding the magnitude and time course of these changes is essential for athletes, coaches, and clinicians in planning training and competition schedules. Recognition of the physiological mechanisms involved may also guide the development of individualized donation strategies and iron management protocols for athletic populations
DIAGNOSTIC AND TREATMENT IN TETANY: EXPLORING NON-HYPOCALCEMIC CAUSES AND CLINICAL CHALLENGES
No full textNormocalcemic tetany is a clinical condition characterized by neuromuscular hyperexcitability in the absence of overt hypocalcemia, resulting from disturbances in ionized calcium, magnesium, potassium, or acid–base balance. Although tetany is most commonly associated with hypocalcemia, cases with normal total calcium levels pose diagnostic challenges and are frequently underrecognized. This review consolidates current knowledge regarding the etiology, clinical manifestations, diagnostic evaluation, and management of normocalcemic tetany. The etiology includes hereditary renal tubulopathies such as Gitelman and Bartter syndromes, hyperventilation-related alkalosis, magnesium deficiency, and rare autoimmune disorders involving antibodies against the voltage-gated potassium channel complex (CASPR2). Clinical presentations range from overt tetanic seizures with characteristic carpopedal spasms to latent tetany detectable via Chvostek and Trousseau signs or ischemia-induced EMG abnormalities. Case reports highlight unusual scenarios, including tetany triggered by vomiting, postoperative parathyroidectomy, and hereditary neuromuscular hypersensitivity, emphasizing that serum total calcium may remain normal while ionized calcium or other electrolytes fluctuate. Management strategies focus on prompt recognition, correction of underlying electrolyte disturbances—particularly calcium, magnesium, and potassium—and supportive care. Early administration of intravenous calcium, alongside addressing precipitating factors, is critical for rapid symptom relief. Latent or recurrent tetany in the context of normal electrolytes warrants consideration of genetic, neurologic, or autoimmune etiologies, and may require specialized testing including EMG, antibody panels, or genetic analysis. Increased awareness among clinicians, timely evaluation of ionized calcium and other electrolytes, and early intervention are essential to prevent severe complications, including life-threatening muscle spasms, rhabdomyolysis, and cardiovascular instability. This review underscores the need for further population-based studies to define the prevalence, at-risk groups, and optimal management of normocalcemic tetany
ASSESSING ACADEMIC WRITING IN HIGHER EDUCATION : COGNITIVE, MOTIVATIONAL, AND PEDAGOGICAL PERSPECTIVES
No full textDespite long-standing formal instruction, the evaluation of students’ written production at university continues to reveal persistent shortcomings. This article identifies four interrelated challenges that hinder the development of academic writing: (1) students’ ambivalent relationship to French—vis-à-vis the growing prominence of English—which affects motivation; (2) pedagogical practices that privilege linguistic sub-systems and the final product over a process-oriented approach; (3) negative perceptions of drafting, often dismissed as time-consuming; and (4) the sacralization of writing as a rigid, intimidating act. Drawing on didactic and cognitive models of writing, the paper proposes concrete avenues to desacralize writing and cultivate competence: authentic communicative tasks, explicit teaching of the writing process (planning–composing–revising), and collaborative revision with formative assessment. These strategies aim to help learners progressively build both competence and confidence in academic writing
SURFER’S EAR – A HIDDEN CHALLENGE IN WATER SPORT: PATHOGENESIS, DIAGNOSIS AND TREATMENT STRATEGIES
No full textBackground: External Auditory Canal Exostosis (EAE), or surfer’s ear, is a benign yet progressive condition involving new bone formation within the external auditory canal, typically triggered by repeated exposure to cold water and wind. This review summarises current knowledge on the anatomy, pathogenesis, clinical presentation, and management of EAE, including preventive and surgical strategies.
Aim: The aim of this review is to evaluate the current understanding of the pathogenesis, clinical features, diagnostic methods, and therapeutic approaches to surfer’s ear, and to provide a comprehensive synthesis to support clinical practice and guide future research.
Methodology: This literature review was conducted using PubMed, OVID and Google Scholar. Keywords included: “Surfer’s ear”, “Exostosis”, “Exostosis in aquatic athletes” and “Canaloplasty”. Studies were selected based on relevance and methodological quality.
Results: EAE prevalence is high among water sports participants, particularly those exposed to cold water. Reported rates range from 38% to 75.1%, with the latter observed in German wind- and kitesurfers, a population relevant to Polish athletes due to comparable climatic conditions. Severity of exostoses strongly correlates with cumulative exposure to cold water and wind. Symptoms typically include water trapping, pain and hearing loss. Various instruments are used for surgical removal. Microdrills, though common, are associated with suboptimal postoperative outcomes and potential complications. Osteotomes present a safer alternative: a large retrospective study showed that osteotome-only excision resulted in the lowest rates of postoperative symptoms and complications, including tinnitus.
Conclusion: EAE is a largely preventable condition driven by cumulative cold-water and wind exposure. Diagnosis is primarily clinical, with CT used for surgical planning. Consistent earplug use remains the most effective preventive measure. Increased awareness and preventive education in aquatic communities are needed. Future studies should refine risk assessment and evaluate newer surgical approaches
MITOCHONDRIAL DYSFUNCTION IN DISEASE: PATHOGENIC MECHANISMS AND NOVEL THERAPIES
No full textMitochondria serve as vital cellular components with functions extending far beyond ATP generation, encompassing calcium homeostasis, oxidative balance, and programmed cell death regulation. Their malfunction contributes to a wide spectrum of disorders spanning neurological (Alzheimer's, Parkinson's), metabolic (diabetes), cardiac, liver, and cancerous conditions. Shared disease mechanisms include disrupted energy production, oxidative stress, impaired organelle dynamics, and persistent mtDNA damage. In neurological degeneration, mitochondrial impairment initiates and worsens protein aggregation pathologies, whereas in metabolic diseases it promotes insulin insensitivity and fat deposition. Malignant cells hijack mitochondrial adaptability to support growth and treatment evasion. Current therapies primarily address symptoms, though innovative approaches show potential: mitochondria-specific antioxidants (MitoQ), dynamics regulators (DRP1 blockers), mitophagy stimulators, and genetic interventions. Emerging techniques include mitochondrial transfer and nanoparticle-based delivery systems. Non-pharmacological approaches like physical activity positively influence mitochondrial performance. Critical obstacles involve enhancing drug targeting precision, reducing unintended effects, and improving clinical applicability. Future priorities should emphasize establishing robust biomarkers, creating standardized disease databases, and advancing tailored treatment protocols. Deciphering mitochondrial disease mechanisms holds revolutionary promise for managing chronic illnesses, connecting basic science with therapeutic implementation