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POSTOPERATIVE REHABILITATION FOLLOWING ANTERIOR CRUCIATE LIGAMENT (ACL) RECONSTRUCTION: STAGES, PROTOCOLS AND THEIR ROLE IN PREVENTING REINJURY
Get PDFIntroduction and purpose: An anterior cruciate ligament (ACL) injury is one of the most common knee joint injuries, particularly among athletes. Its reconstruction is one of the most frequently performed orthopedic procedures, enabling a return to full physical function. However, a crucial component of recovery is a well-planned and consistently implemented postoperative rehabilitation program, which helps reduce the risk of reinjury. This review discusses the individual stages of rehabilitation, the methods used, and their role in minimizing the aforementioned risk.
Material and methods: A comprehensive review and analysis of the literature from 2000 to 2025 was conducted using the PubMed, Google Scholar, Scopus, and Web of Science databases (including randomized controlled trials, meta-analyses, and guidelines). The focus was on various rehabilitation methods following ACL reconstruction and their impact on reducing the risk of reinjury.
Brief description of the state of knowledge: Current guidelines and studies identify four phases of rehabilitation: early, intermediate, late, and return to sport. Modern rehabilitation protocols vary in terms of progression rate, techniques used, and tools for assessing therapy outcomes. The psychological aspect is also emphasized, as fear of reinjury can have a significant impact on recovery.
Conclusions: Rehabilitation programs based on functional criteria and individualization allow for precise adaptation of therapeutic interventions to the patient’s needs at different stages of the recovery process, thereby significantly reducing the risk of reinjury. Moreover, modern technologies such as biofeedback, virtual reality, and biomechanical analysis can enhance the effectiveness of therapy by improving exercise precision and enabling better monitoring of the patient’s progress
MYOPIA – EPIDEMIOLOGY AND MANAGEMENT IN THE PEDIATRIC POPULATION
Get PDFIntroduction and Purpose: Myopia is currently the most prevalent refractive error worldwide, with a rapidly increasing incidence, particularly among children and adolescents in urbanized regions. This review outlines the most effective evidence-based strategies for preventing and slowing the progression of myopia, with a focus on both pharmacological and non-pharmacological approaches.
The State of Knowledge: Recent studies have highlighted that increased time spent outdoors significantly reduces the onset of myopia in non-myopic children, though its effect on progression in already myopic individuals appears limited. Light exposure, especially to moderate-intensity natural light, has shown potential in mitigating axial elongation and promoting choroidal thickening. Sleep quality and duration may also influence myopia development, though further research is needed to confirm this relationship. Pharmacological intervention with low-dose atropine (particularly 0.01–0.05%) is currently the most effective and widely accepted treatment, offering substantial benefits with minimal side effects. Optical interventions such as orthokeratology, multifocal spectacle lenses, and dual-focus contact lenses have demonstrated efficacy in controlling axial elongation by modifying peripheral retinal defocus.
Summary: Combining lifestyle modifications (outdoor activity and light exposure) with pharmacological (low-dose atropine) and optical (e.g., orthokeratology and bifocal lenses) interventions provides a comprehensive, multimodal strategy to manage and slow myopia progression. Early implementation of such interventions is essential in addressing the growing public health burden of myopia
CONTROVERSIAL ISSUES REGARDING THE USE OF GADOLINUM-BASED CONTRAST AGENTS – THE LATEST REPORTS
Get PDFIntroduction and objective: Gadolinium-based contrast agents (GBCAs) are paramagnetic substances that have been used over the past 30 years in MRI diagnostics, and have significantly improved imaging and diagnostic capabilities for many diseases. Although they are used in small amounts in individual patients, their use worldwide involves the consumption of many thousands of liters of GBCAs per year and is growing. With such widespread demand for contrast-enhanced MRI, there is a need for these agents to be as safe as possible.
Review methods: A comprehensive literature review was conducted, analyzing 33 studies from the PubMed and Google Scholar database (English-language, published within the last 8 years).
Brief description of the state of knowledge: In recent years, much attention has been paid to the fact of gadolinium deposition in tissues and accumulation in the environment, the risk of nephrogenic systemic fibrosis (NSF), and safety issues in use in pregnant patients and the pediatric population. The risk of the above-mentioned events has been shown to vary depending on the type of GBCA, with macrocyclic GBCAs having a lower risk than linear GBCAs. Despite a great number of studies, many issues regarding the clinical significance of the side effects of GBCAs still remain unclear and controversial. Therefore, even more stable and better-performing GBCAs, new MRI approaches requiring lower doses of GBCAs, and alternative contrast agents need to be developed to ensure patient welfare.
Summary: In this review, we will try to present the current state of knowledge on the above-mentioned issues with a perspective of the future of this branch of medicine
ENERGY DEPENDENCY INDEX OF GEORGIA
No full textEnergy independence is a central objective for national energy security. Energy import dependency measures the share of imported energy in a country’s total energy demand. The European Union (EU) applies the Energy Dependency Index (EDI) to quantify energy independence. This study assesses Georgia’s energy dependency using the EU methodology and compares Georgia’s position with that of EU member states
REVIEW OF UNDERSTANDING TECHNOLOGY IN THE CONTEXT OF NATIONAL DEVELOPMENT: CRITICAL REFLECTIONS (2025)
No full textUnderstanding Technology in the Context of National Development: Critical Reflections by Tiwari, Kostenko, and Yekhanurov (2025) has quickly gained academic and pedagogical significance. The work offers a comprehensive examination of how digital transformation and technological innovation intersect with national development strategies, governance models, and economic growth. It situates technology as both a driver of progress and a subject of critical reflection within development economics and ICT4D (Information and Communication Technologies for Development). Drawing on key policy frameworks including OECD’s digital transformation guidelines, United Nations (UN) development agendas, and the Network Readiness Index the authors analyze themes such as technological advancements, human capital, governance, and innovation ecosystems. The review finds that the book makes a valuable contribution to debates on digital transformation and development by identifying thematic pillars, capturing stakeholder insights, elaborating on twin foundations of tech enabled growth, and proposing concrete solutions to governance and inclusion challenges. This is shown by its adoption as post graduate course material for Industrial & Organizational programs at Universiti Malaysia Sabah (UMS), Malaysia and Esa Unggul University, Indonesia, where the author is associated with and currently using the book for post graduate studies courses listed in the curriculum. The curricular integration underscores the book’s broader pedagogical relevance in Southeast Asia. In doing so, it bridges theoretical discourse with practical policy considerations, providing scholars, policymakers, and practitioners a timely resource aligned with global development frameworks
OBSTRUCTIVE SLEEP APNEA AND ITS IMPACT ON ATHLETES AND SPORTS PERFORMANCE – THE REVIEW
No full textObstructive sleep apnea (OSA) is a prevalent and underdiagnosed condition with significant systemic health implications. It is characterized by recurrent upper airway collapse during sleep, leading to intermittent hypoxia, sleep fragmentation, and an array of comorbidities. Among the risk factors, obesity is the most common, but other factors such as sex, age, tonsillar hypertrophy, and the presence of comorbid conditions also play a role. Untreated obstructive sleep apnea (OSA) can lead to cardiovascular diseases, diabetes, strokes, and even sudden death. Diagnosis is based on medical history, clinical examination, and most importantly, polysomnographic testing. Treatment includes lifestyle modifications, continuous positive airway pressure (CPAP) therapy, and in some cases, surgical interventions. This literature review synthesizes current evidence regarding the pathophysiology, clinical presentation, diagnostic approaches, and therapeutic options for OSA in adults
CUTANEOUS MELANOMA – DIAGNOSIS, TREATMENT, AND THE POTENTIAL IMPACT OF PHYSICAL ACTIVITY
No full textMalignant melanoma is one of the most aggressive forms of skin cancer, with its incidence steadily increasing worldwide. Although it accounts for a minority of skin cancer cases, it is responsible for the majority of skin cancer–related deaths. This review discusses the epidemiology, clinical characteristics, and histopathological features of the main melanoma subtypes, including superficial spreading melanoma (SSM), nodular melanoma (NM), lentigo maligna melanoma (LMM), and acral lentiginous melanoma (ALM). Particular attention is given to current diagnostic strategies, ranging from the gold standard of histopathological examination to emerging non-invasive techniques such as dermoscopy, reflectance confocal microscopy (RCM), optical coherence tomography (OCT), high-frequency ultrasound (HFUS), and the novel tape stripping method. These approaches have improved early detection and the accurate assessment of tumor margins, supporting more personalized therapeutic planning. Treatment remains primarily surgical in early-stage melanoma, while advanced cases increasingly benefit from immunotherapy and targeted therapies, which have significantly improved survival outcomes. Additionally, this article explores the potential association between physical activity and melanoma risk, emphasizing that outdoor activity may increase susceptibility due to greater ultraviolet (UV) exposure. Prevention strategies, including public education and effective photoprotection, remain essential in mitigating disease burden. In conclusion, despite significant advances in diagnosis and therapy, malignant melanoma continues to pose major clinical and public health challenges, underscoring the importance of early detection, prevention, and ongoing research
NEW PHARMACOLOGICAL THERAPIES FOR CELIAC DISEASE – A SYSTEMATIC REVIEW
No full textBackground: Celiac disease is an immune-mediated condition caused by gluten in genetically susceptible individuals. Although a gluten-free diet is the basis of treatment, it is often difficult to maintain and may not fully prevent symptoms or intestinal damage.
Objective: This systematic review examines emerging non-dietary therapies for celiac disease, with emphasis on their mechanisms, clinical effectiveness, and safety.
Methods: A total of 23 peer-reviewed studies were analyzed, covering enzyme therapies, gluten sequestrants, tight junction modulators, immunotherapies, cytokine inhibitors, transglutaminase blockers, and probiotics.
Results: TAK-062 and ZED1227 emerged as the most promising candidates. TAK-062 showed strong gluten-degrading activity, while ZED1227 consistently reduced mucosal injury. Other enzymes, like latiglutenase, offered partial benefit, especially in seropositive patients. BL-7010 sequestered gliadin effectively in preclinical models. Larazotide acetate improved symptoms at low doses. Immunotherapies showed mixed outcomes—Nexvax2 failed in phase 2, while TAK-101 showed early potential. AMG 714 helped in refractory cases but lacked strong histological effects. Probiotics improved gut symptoms and microbiota balance, supporting their role as adjuncts.
Conclusions: While most therapies remain investigational, several show real potential as supplements to the gluten-free diet. Future research should focus on long-term outcomes and personalized approaches to improve disease management
UNDERSTANDING THE RELATIONSHIP BETWEEN CAFFEINE AND SLEEP - A REVIEW
No full textResearch objectives: Sleep is a fundamental physiological process essential for the proper functioning of the body and mind. It supports physical restoration, emotional regulation, cognitive performance, and overall health. Due to its complexity, even slight disruptions in sleep patterns can significantly affect well-being. Caffeine is the most widely consumed psychoactive substance worldwide. Found in coffee, tea, energy drinks, and various medications, it is used daily by the majority of the population to enhance alertness and reduce fatigue. Given its popularity and stimulating properties, it is important to examine how caffeine consumption affects sleep.
Methods: A comprehensive literature review was conducted, analyzing 44 studies from the PubMed database (English-language, up to 2025) that assess the relationship between caffeine and sleep.
Key findings: This work reviews existing research on how caffeine intake, particularly in moderate to high doses, influences sleep timing, duration, architecture, and recovery, with a focus on timing of consumption and habitual use.
Conclusions: Caffeine disrupts sleep by reducing total sleep time and altering key sleep stages, impairing recovery and daytime functioning. Even caffeine consumed hours before bedtime affects sleep quality. Limiting afternoon and evening intake is important to maintain healthy sleep. Further research is needed on individual sensitivity and long-term effects
PHYSIOLOGICAL AND HEALTH EFFECTS OF WINTER SWIMMING: A COMPREHENSIVE MEDICAL REVIEW
No full textWinter swimming, defined as immersion in cold water, is gaining popularity as a form of physical activity and a natural health-enhancing intervention. This article provides a comprehensive medical review of the physiological and health effects associated with cold water exposure. Acute bodily responses to cold immersion are discussed, including activation of thermoregulatory mechanisms, cardiovascular, respiratory, and neuromuscular changes, as well as the risks of hypothermia and cold shock. Chronic adaptations observed in regular winter swimmers are also presented, encompassing hormonal, metabolic, and immunological modifications that enhance cold tolerance and support homeostasis. The health benefits of winter swimming are analyzed, highlighting improvements in cardiovascular performance, immune system modulation, mood enhancement, and metabolic regulation. Concurrently, potential risks are emphasized, particularly for individuals with chronic illnesses, children, and the elderly. The article concludes with a comparative analysis of winter swimming and other cold therapies, noting differences in exposure intensity and therapeutic efficacy. This review underscores the need for further research to standardize protocols and better elucidate the long-term effects of winter swimming