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SYSTEMATIC REVIEW OF ORAL JANUS KINASE INHIBITORS IN ALOPECIA AREATA: INSIGHTS FROM 2020 TO 2025 STUDIES
No full textBackground: Alopecia areata (AA) is an autoimmune, non-scarring hair loss disorder with variable clinical presentations. Its pathogenesis involves immune privilege collapse of the hair follicle, CD8+ T-cell activation, and cytokine signaling—particularly IFN-γ and IL-15—via the JAK/STAT pathway. Recent studies highlight Janus kinase (JAK) inhibitors as promising therapeutic agents for moderate-to-severe AA.
Objectives: This systematic review aimed to evaluate the efficacy and safety of oral JAK inhibitors in the treatment of adolescent and adult patients with AA based on studies published between 2020 and 2025.
Material and Methods: Following PRISMA 2020 guidelines, a comprehensive search of PubMed, Cochrane Library, and ClinicalTrials.gov was conducted for studies assessing oral JAK inhibitors (e.g., baricitinib, ritlecitinib, deuruxolitinib) in AA. Inclusion criteria encompassed RCTs, observational studies, and interventional trials involving patients ≥12 years old with moderate-to-severe AA.
Results: Ten studies met the criteria, including seven RCTs. Efficacy was measured predominantly by the Severity of Alopecia Tool (SALT) score. Baricitinib and deuruxolitinib consistently demonstrated superior outcomes compared to placebo and traditional therapies, with up to 41.5% of patients achieving SALT ≤20 at 24 weeks. Long-term data confirmed sustained benefits. Adverse events were mostly mild (e.g., URTI, headache, acne); serious events and discontinuations were rare.
Conclusions: Oral JAK inhibitors represent an effective and generally well-tolerated option for treating moderate-to-severe AA. Their targeted mechanism offers advantages over traditional immunosuppressants, and accumulating long-term data support their integration into therapeutic guidelines
TRAFFIC NOISE EXPOSURE AND THE RISK OF HYPERTENSION AND CARDIOVASCULAR DISEASES: A REVIEW
No full textIntroduction: Environmental noise originating from road, rail, and air traffic is one of the most significant environmental stressors in urbanized areas. In recent years, growing evidence has indicated that long-term exposure to noise constitutes an independent risk factor for arterial hypertension and cardiovascular diseases. The aim of this review is to provide an in-depth analysis of the biological and social mechanisms underlying these associations, to examine health inequalities related to noise exposure, and to present opportunities for the use of modern noise-monitoring technologies in socio-medical research.
Methods: A systematic review of the scientific literature from 2015 to 2025 was conducted, including randomized controlled trials, observational studies, meta-analyses, and reports from the World Health Organization (WHO) and the European Environment Agency (EEA). The review focused on studies assessing the effects of long-term environmental noise exposure on the development of arterial hypertension and the risk of cardiovascular events.
Results: Long-term exposure to environmental noise levels exceeding 55 dB significantly increases the risk of hypertension, sleep disturbances, ischemic heart disease, and stroke. The primary pathophysiological mechanisms include activation of the hypothalamic–pituitary–adrenal axis, increased cortisol secretion, oxidative stress, and sleep disruption.
Conclusions: Noise is a social determinant of health. Individuals with lower socioeconomic status are more likely to live in areas with high traffic density and poor acoustic insulation, leading to cumulative adverse health effects. In recent years, advanced noise-monitoring technologies such as IoT-based sensors, mobile applications, and geographic information systems (GIS) have been developed to support public health policy. The findings of this review highlight the need for integrated health, environmental, and social strategies aimed at reducing the impact of environmental noise on population health
USE AND QUALITY ASSESSMENT OF YOUTUBE VIDEOS ON THE MOST COMMON DERMATOLOGIC DISORDEERS: A SYSTEMATIC REVIEW
No full textThis systematically conducted narrative review explores the quality and reliability of dermatology-related information available on YouTube. A comprehensive literature search of PubMed and Scopus (up to November 2024) identified 8,521 records, of which 25 studies met the inclusion criteria addressing six major dermatologic topics: hidradenitis suppurativa, acne vulgaris, atopic dermatitis, psoriasis, skin cancer, and Mohs micrographic surgery. Across conditions, YouTube was found to be a popular platform for health information seeking, yet most videos were created by non-medical individuals and exhibited low educational quality based on validated instruments such as DISCERN, JAMA, and the Global Quality Scale. Common issues included incomplete, misleading, or unreferenced information, with misleading content often attracting higher engagement than professional materials. While videos produced by healthcare professionals were generally more accurate, they represented a minority and achieved limited visibility. Despite YouTube’s potential for public health education, current dermatology-related content often fails to meet evidence-based standards. These findings highlight the urgent need for dermatologists and professional organizations to create and promote high-quality, comprehensible, and reliable video content to improve public understanding, counter misinformation, and support informed patient decision-making
TRAINING METHODS IN NEUROSURGERY - WHAT SOLUTIONS XXI CENTURY CAN OFFER?
No full textNeurosurgical training has evolved in recent years, influenced by technological innovations, an increasing complexity of neurosurgical procedures, and growing patients’ expectations. While highly effective, traditional methods of learning in neurosurgery require the support of modern technologies to address the intricacy of the field. By synthesizing recent findings and trends, this article aims to provide valuable perspectives on improving neurosurgical training programs to prepare the next generation of neurosurgeons for the demands of a rapidly advancing field. This review explores innovations in neurosurgical education, highlighting 3D printing, virtual reality, augmented reality, and artificial intelligence. New technologies support traditional neurosurgical education, providing reusability, limitless repetitions, relevant feedback, and increased procedure comprehension, but with partial realism. Hence, high-technology solutions remain a valuable complement to traditional training
DIGITAL TRANSFORMATIONS IN THERAPY: A COMPREHENSIVE REVIEW OF ARTIFICIAL INTELLIGENCE AND VIRTUAL REALITY-BASED INTERVENTIONS IN THE TREATMENT OF ANXIETY AND DEPRESSIVE DISORDERS (2020–2024)
No full textResearch Objectives: This comprehensive systematic review and meta-analysis aim to critically evaluate the clinical evidence regarding the efficacy, feasibility, and cost-effectiveness of Artificial Intelligence (AI)- and Virtual Reality (VR)-based interventions in the treatment and monitoring of Anxiety Disorders (AD) and Major Depressive Disorder (MDD) between 2020 and 2024.
The study focuses on two primary pillars of innovation: AI tools (Generative AI chatbots, natural language processing, crisis prediction) and VR technologies (Exposure Therapy, VR-enhanced Behavioral Activation, mindfulness training, bio/neurofeedback). Additionally, the review analyzes ethical, legal, social, and implementation (ELSI) barriers that must be addressed to achieve large-scale deployment.
Methods: A scoping review of the scientific literature was conducted across databases including PubMed, Scopus, and Google Scholar, applying inclusion criteria that covered Randomized Controlled Trials (RCTs), systematic reviews, and meta-analyses published from January 2020 to July 2024. Seven key meta-analyses and eighteen RCTs were analyzed in detail, focusing on effect sizes (Hedges’ g). Risk of bias and regulatory frameworks were also assessed.
Main Findings: AI demonstrated high scalability (g = 0.52-0.61 for chatbots (Li et al., 2023)), showing short-term efficacy comparable to traditional digital interventions. A key factor was the integration of Generative AI models that enhanced the therapeutic alliance, as well as NLP-based predictive systems. VR, in turn, provided an experiential depth (presence) essential for effectiveness in specific phobias and social anxiety (g = 0.75-0.88 (Wang et al., 2024)), particularly in VRET and VR-BA models. Major barriers included issues of Explainable AI (XAI), algorithmic bias, and technological integration with healthcare systems (EHR).
Conclusions: Digital technology is becoming an integral part of psychiatric care. The future lies in blended care models that combine the scalability of AI with the immersive depth of VR under clinical supervision. Long-term RCTs and clear regulatory frameworks concerning ethics and legal liability must be established prior to widespread implementation
DIVING AS A HIGH-RISK SPORT: INJURY PREVENTION, SAFETY PROTOCOLS AND HUMAN FACTORS – A LITERATURE REVIEW
No full textIntroduction: Diving is a high-risk activity due to physiological and psychological stressors. This review addresses diving-related injuries and accidents, with particular emphasis on human factors and prevention strategies.
Materials and Methods: We conducted a literature review (PubMed, 1995–2025) of studies on diving hazards (e.g., barotrauma, decompression sickness, drowning), psychological factors (anxiety, panic), human errors (miscommunication, overconfidence), and training and safety compliance measures.
Results: Divers face barotrauma (ear, sinus, pulmonary), decompression illness, physical and thermal injuries, and drowning. Psychological stress (anxiety, panic) and human errors (communication failure, inattentiveness, overconfidence) contribute substantially to accidents. Many incidents involve cascading errors. Simulation-based training and adherence to evidence-based safety procedures have been shown to improve preparedness and reduce incidents.
Conclusion: Effective dive safety requires addressing hazards and human error. Emphasizing adherence to dive protocols (ascent rates, decompression stops), clear communication, and error recognition is essential. Comprehensive training and the development of a safety culture are essential to mitigate risk and prevent injuries
MODERN LIFESTYLE AND DRY EYE DISEASE: A NARRATIVE REVIEW OF MODIFIABLE RISKS AND PREVENTIVE STRATEGIES
No full textBackground: Dry eye disease (DED) is a multifactorial ocular-surface disorder characterized by loss of tear-film homeostasis, resulting in ocular discomfort, visual disturbances, and progressive surface damage. While intrinsic factors such as age, sex, autoimmune disease, and systemic medications influence susceptibility, lifestyle and environmental determinants—including prolonged screen time, poor sleep, contact-lens wear, smoking, and suboptimal diet—have emerged as important, modifiable contributors to disease onset and severity. Addressing these factors is critical for effective prevention and management.
Methods: This narrative review synthesizes evidence from PubMed, Scopus, and Web of Science (1990–2025) on associations between lifestyle behaviors and DED. Eligible studies included randomized controlled trials, cohort and cross-sectional studies, and systematic reviews published in English. Emphasis was placed on identifying modifiable behaviors that impact tear-film stability, ocular-surface inflammation, and symptom burden.
Results: Evidence indicates that extended digital-screen use, disrupted sleep, contact-lens wear, and smoking increase DED risk and exacerbate symptoms. Conversely, interventions targeting modifiable behaviors—such as scheduled visual breaks, hydration, improved sleep hygiene, eyelid hygiene, smoking cessation, and nutritional optimization—are associated with improved tear-film stability, reduced inflammation, and symptomatic relief.
Conclusions: Lifestyle behaviors play a critical role in DED pathogenesis and progression. Integrating behavioral counseling into clinical practice and public-health strategies provides a low-cost, patient-empowering approach to reduce disease burden and improve ocular-surface health
CHRONIC VENOUS INSUFFICIENCY: DEFINITION, PATHOPHYSIOLOGY, DIAGNOSIS, MANAGEMENT, AND PREVENTION
No full textIntroduction: Chronic venous insufficiency (CVI) is a prevalent, progressive condition affecting the lower-limb venous system. It results from venous valve dysfunction, sustained venous hypertension, and chronic inflammation. Despite advances in diagnostic technologies and therapeutic strategies, CVI remains a significant cause of morbidity and decreased quality of life worldwide.
Aim: This narrative review aims to provide a comprehensive overview of CVI, highlighting its definition, pathophysiology, clinical presentation, diagnosis, management, and prevention. The review emphasizes evidence-based guidelines and the latest diagnostic and therapeutic technologies, offering an updated perspective on the condition.
Methodology: A total of 28 publications were reviewed, consisting of clinical guidelines, systematic reviews, and recent original studies related to CVI. The sources were obtained through PubMed, Scopus, and Cochrane databases, focusing on articles published between 2010 and 2025.
Results: CVI typically develops due to venous reflux and microcirculatory dysfunction, leading to symptoms such as edema, skin changes, and ulceration. Duplex ultrasonography is currently the diagnostic gold standard for assessing venous reflux. Advanced imaging techniques, including MR venography, CT venography, infrared thermography, and near-infrared imaging, can improve diagnostic accuracy. Management of CVI involves a multimodal approach, combining compression therapy, pharmacologic treatment, and minimally invasive endovenous techniques. Preventive measures, including weight control, regular physical activity, and consistent use of compression, are crucial to slowing disease progression and reducing the risk of recurrence.
Conclusions: CVI remains a significant health and socioeconomic burden globally. Early diagnosis, patient education, and adherence to both conservative and interventional treatments are essential for achieving optimal outcomes. Future directions in CVI management include personalized medicine, digital health integration, and biomarker-driven approaches for earlier detection and targeted therapy
FROM CIGARETTES TO THE FUTURE: ALTERNATIVE WAYS TO ADMINISTER NICOTINE
No full textTobacco use continues to be one of the most critical public health challenges globally. The current number of active tobacco consumers hovers around 1.2 billion, with half of these individuals expected to die from tobacco-related causes. In recent years, there has been a rapid increase in alternative nicotine delivery methods, such as electronic nicotine delivery systems, heated tobacco products, and the resurgence of snus in the form of nicotine pouches. Most of these alternatives have been promoted as safer options compared to traditional smoking, aiming to encourage cessation of conventional tobacco use. Regrettably, narratives propagated by companies benefiting from these products often lead to an oversight of the health implications associated with these so-called "healthier alternatives." Nonetheless, although multiple studies have yielded diverse results, the latest data suggest that these alternatives do indeed impact health. This study aims to review accessible research, elucidate current knowledge on these products, and offer projections for future research
COGNITIVE REAPPRAISAL, AFFIRMATION, AND EMOTIONAL INTEGRATION AS MECHANISMS ENHANCING THE EFFECTIVENESS OF PSYCHOTHERAPY: A NEUROPLASTICITY PERSPECTIVE
No full textThe aim of this paper is to present mechanisms that may strengthen the process of psychotherapy, taking into account the neuroplasticity of the brain. The paper discusses issues of cognitive reappraisal, affirmation, and emotional integration, emphasizing their influence on neuronal remodeling and the durability of therapeutic effects. A literature review was conducted using PubMed and Google Scholar databases, including studies published between 2006 and 2025 in English and Polish. The analysis focused on neurological, imaging and clinical research exploring how psychological interventions induce measurable brain changes. Results indicate that both psychotherapy and pharmacotherapy contribute to neuroplastic modifications, particularly within the prefrontal cortex, hippocampus and limbic structures, which correspond to improved emotion regulation and cognitive processing. Furthermore - optimism and positive self-affirmation appear to reinforce adaptive neural patterns and enhance therapeutic outcomes. These findings suggest that the integration of neuroplastic principles into psychotherapeutic practice may strengthen resilience, promote emotional balance and improve long-term treatment efficacy