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SLEEP DISTURBANCES IN MAJOR PSYCHIATRIC DISORDERS – PREVALENCE, MECHANISMS AND TREATMENT – A NARRATIVE REVIEW
No full textSleep disturbances are among the most prevalent and disabling symptoms across major psychiatric disorders, yet they remain underrecognized and undertreated. This review synthesizes findings from 43 peer-reviewed studies published between 2008 and 2025, examining the prevalence, neurobiological mechanisms, and treatment of sleep abnormalities in major depressive disorder (MDD), bipolar disorder (BD), schizophrenia (SCZ), and post-traumatic stress disorder (PTSD). Across disorders, insomnia is the most frequent disturbance, affecting up to 80% of patients with MDD and nearly 90% of those with PTSD. Other recurrent abnormalities include hypersomnia during depressive phases of BD, circadian rhythm misalignment, and fragmented sleep in SCZ. Neurobiological evidence implicates dysregulation of the circadian system, hyperactivity of the hypothalamic–pituitary–adrenal axis, orexin signaling imbalance, and neuroinflammatory processes as shared mechanisms underlying psychiatric sleep pathology.
Effective management requires a multimodal approach. Cognitive behavioral therapy for insomnia (CBT-I) demonstrates robust efficacy across disorders, improving both sleep and psychiatric outcomes. Pharmacological interventions—such as dual orexin receptor antagonists, melatonin agonists, and sedating psychotropics—show moderate benefits but require careful monitoring. Chronotherapeutic and neuromodulatory strategies (e.g., light therapy and noninvasive brain stimulation (NIBS) represent promising adjuncts for circadian stabilization.
Overall, sleep disturbances emerge as transdiagnostic phenomena that both reflect and exacerbate psychiatric pathology. Early identification and targeted treatment of sleep problems may enhance therapeutic response, reduce relapse risk, and improve overall functioning. Integrating systematic sleep assessment into routine psychiatric care is essential for achieving comprehensive, recovery-oriented treatment
MENSTRUAL CYCLE AND FEMALE ATHLETIC PERFORMANCE: A SYSTEMATIC REVIEW
No full textThis systematic review and meta-analysis aimed to investigate the effects of menstrual cycle phases on women’s physical performance. Data from 78 studies were analyzed, encompassing assessments of both aerobic capacity and muscular strength. The findings indicate that menstrual cycle phases exert only a minimal influence on physical performance, with small and clinically insignificant differences between phases. The most pronounced variation was observed between the early and late follicular phases, yet these differences did not reach clinical relevance. Network meta-analysis supported these outcomes, demonstrating minor fluctuations in performance across the menstrual cycle. The overall quality of evidence was rated as low, underscoring the need for further high-quality research. In conclusion, the influence of menstrual cycle phases on physical performance appears to be minimal, and training recommendations should be individualized, considering each woman’s specific physiological responses and needs.
Methods: The review was based on an analysis of articles published in the PubMed, Scopus, and Web of Science databases between 2005 and 2025, using the following keywords: menstrual cycle, cycle phases, eumenorrhea, physical performance, endurance, muscle strength, VO₂max, lactate threshold, hormonal contraception, estrogens, progesterone, recovery, fatigue, RPE, training, women’s sport. Only peer-reviewed, full-text articles published in English were included. The selection encompassed original research studies, systematic reviews, meta-analyses, and expert consensus statements, with a particular focus on studies evaluating the effects of menstrual cycle phases on physical performance, strength and power parameters, as well as recovery and fatigue perception indicators. The analysis integrated physiological, hormonal, and metabolic mechanisms with findings from clinical and sports performance studies to provide a comprehensive understanding of the relationship between menstrual cycle phases and female exercise capacity.
Results: Analyses of systematic reviews and meta-analyses indicate that the influence of menstrual cycle phases on physical performance is small but detectable in certain measures. Meta-analyses have shown slight advantages in selected strength metrics (e.g., isometric and isokinetic strength) during the late follicular and ovulatory phases, although the observed effects are small and heterogeneous. Most studies do not confirm significant differences in VO₂max or time to exhaustion between menstrual phases. Experimental data suggest a protective effect of estradiol on muscle damage and a faster recovery following eccentric exercise. Biomechanical analyses and review studies also point to increased joint laxity around ovulation, which may partly explain the higher risk of anterior cruciate ligament (ACL) injuries observed during this period, although the overall quality of evidence remains limited.
Conclusions: A review of the current literature indicates that the phases of the menstrual cycle may modulate women’s maximal strength. Isometric and isokinetic performance measures tend to exhibit a slight improvement during the late follicular phase and ovulation; however, these effects are generally small and often lack clinical significance. In terms of aerobic capacity (VO₂max and time to exhaustion), the evidence does not demonstrate consistent or substantial variations across menstrual cycle phases. Muscle recovery and susceptibility to damage appear to be more favorable during periods of elevated estrogen concentrations. Conversely, biomechanical parameters, including ligament laxity and neuromuscular control, may fluctuate throughout the cycle, potentially increasing injury risk near ovulation, although empirical support for this association remains limited
NON-SURGICAL APPROACH IN LATERAL EPICONDYLITIS, INJECTIONS VERSUS PHYSICAL THERAPY LITERATURE OVERVIEW
No full textIntroduction: Lateral Epicondylitis, also known as tennis elbow, is a common tendinopathy characterized by pain and tenderness over the lateral epicondyle of the humerus. It leads to functional limitations and decreased quality of life. There are numerous available treatment options, including physical therapy, oral pharmacotherapy, injections and surgical interventions.
Aim of the study: The aim of this article was to analyze recent research on non-surgical methods of lateral epicondylitis treatment.
Methods and Materials: Extensive research was conducted using Scopus, PubMed and ProQuest databases, focusing on publications from the past five years, primarily on randomised control trials and meta-analyses. The databases were searched using the following keywords: “lateral epicondylitis”, “Platelet-rich plasma”, “Physical therapy” and “tennis elbow”.
Conclusion: Current evidence remains insufficient to establish clear therapeutic recommendations. However, extracorporeal shockwave shows promising results in pain reduction, while PRP may offer longer-lasting benefits compared to corticosteroids. Available data shows that corticosteroid injections provide only temporary benefits and are commonly associated with symptom recurrence. Further studies are required to assess the efficacy of the injection-based therapies
THE INFLUENCE OF SKIN MICROBIOME IMBALANCE ON SPECIFIC PATHOLOGICAL SKIN CONDITIONS
No full textThe human skin microbiome, comprising bacteria, fungi, viruses, and other microorganisms, plays a crucial role in maintaining skin homeostasis, modulating immune responses, and protecting against pathogens. Emerging research highlights that disruptions in microbial balance - dysbiosis - contribute to the pathogenesis of various dermatological conditions, including atopic dermatitis, psoriasis, acne vulgaris, rosacea, skin cancer, and impaired wound healing. Dysbiosis arises from genetic, environmental, and therapeutic factors, leading to altered barrier function, chronic inflammation, and disease exacerbation.
In inflammatory disorders like atopic dermatitis and psoriasis, pathogenic overgrowth (e.g., Staphylococcus aureus) and reduced microbial diversity drive immune dysregulation. Similarly, acne and rosacea are influenced by shifts in Cutibacterium acnes phylotypes and Demodex-associated bacteria, which promote inflammation and biofilm formation. The skin microbiome also impacts skin cancer progression by modulating DNA damage responses and immunotherapy efficacy, while chronic wounds exhibit delayed healing due to pathogenic dominance and biofilm persistence.
Understanding the intricate host-microbiome interplay offers transformative potential for dermatology, paving the way for precision medicine interventions that harness microbial ecology to enhance skin health and treat disease
LECTURE ABSENTEEISM IN ALGERIAN HIGHER EDUCATION: A CONCEPTUAL FRAMEWORK FOR MULTI-LEVEL ANALYSIS IN THE POST-PANDEMIC ERA (2020–2024)
No full textChronic lecture absenteeism has emerged as a persistent challenge in Algerian higher education, particularly after the COVID-19 pandemic. This theoretical article synthesizes the scholarship to construct an integrated, multilevel framework for understanding the drivers of non-attendance. Moving beyond an individual deficit view, it posits that attendance decisions result from interactions across five nested systems: the micro-system of the student's immediate environment, the meso-system of connections between micro-level components, the exo-system of broader institutional structures, the macro-system of societal forces, and the chrono-system of temporal influences. Key factors include the uneven digitalization of learning systems, linguistic friction in instruction, assessment misalignments, and labor market signals. The analysis shows that the shift to distance learning has devalued physical presence for many students, while exposing disparities in digital access and academic literacy. Consequently, a pattern of disengagement has emerged, characterized by minimizing strategic efforts and a weakened scholarly identity. To counter these trends, this study presents multilevel intervention propositions, emphasizing the need to restore attendance value through participatory pedagogy, formative assessment, and quality assurance mechanisms. It argues for a systemic approach addressing micro-level behavioral norms, meso-level instructional designs, exo-level institutional processes, and macro-level policy frameworks. The article concludes with a call for empirical testing of these propositions to guide evidence-based reforms
PHARMACOLOGICAL TREATMENT OF PTSD WITH PSYCHEDELICS: A FUTURE OUTLOOK
No full textGlobally, approximately 3.9% of the population is estimated to experience Post Traumatic Stress Disorder during their lifetime. PTSD is characterized as a complex mental health condition that develops following exposure to traumatic events, manifesting through intrusive thoughts, hyperarousal, and avoidance behaviors. Despite psychotherapy and conventional pharmacotherapy being the standard primary treatments, a significant number of individuals with PTSD continue to suffer from chronic symptoms and substantial psychiatric and medical comorbidities, underscoring a critical need for innovative therapeutic interventions.
A broad consensus in the literature indicates that existing PTSD treatments offer only marginal effectiveness for a considerable proportion of affected individuals. To address this, the present narrative review endeavors to synthesize the available knowledge regarding novel treatments for PTSD, specifically focusing on psychedelic drugs, acknowledging the current limitations in high-quality empirical literature on the subject.
The primary objective of this study is to conduct a narrative review on the efficacy of psychedelic therapy in managing PTSD. This involves examining current research and evaluating the benefits and drawbacks associated with various psychedelic interventions. The central clinical question explored is: For patients diagnosed with PTSD, what are the current and emerging psychedelic-based pharmacological treatments, and what is their prospective role in future clinical integration?
It is anticipated that this study will provide valuable insights to both practitioners and patients regarding the potential utility of psychedelic compounds within the therapeutic landscape of PTSD
FOCAL THERAPY FOR PROSTATE CANCER: A NARRATIVE REVIEW OF ONCOLOGICAL EFFICACY AND FUNCTIONAL OUTCOMES OF HIFU, IRE, AND CRYOABLATION METHODS
No full textThis narrative review synthesizes current scientific evidence regarding oncological efficacy, functional outcomes, and safety profile of three leading focal therapy (FT) methods in the treatment of localized prostate cancer: high-intensity focused ultrasound (HIFU), irreversible electroporation (IRE), and cryoablation. The analysis is based on 28 clinical studies published between 2022–2025, including prospective cohort studies, multicenter international trials, and meta-analyses. The results indicate that all analyzed ablative techniques offer acceptable oncological control while maintaining high patient quality of life. HIFU therapy provides the most established evidence, with a median biochemical recurrence-free survival (BCR-free survival) of 63 months and a low rate of clinically significant prostate cancer (csPCa) detection in control biopsy (6.5%). Oncological outcomes for IRE are more varied, with a csPCa detection rate of 24.1% in a multicenter study, suggesting strong dependence of efficacy on the extent of ablation (hemi-ablation vs. focal ablation). Cryoablation presents promising early oncological data, with 78.6% of patients free from csPCa at 12 months, but is associated with higher risk of erectile function impairment. Functionally, FT demonstrates clear superiority over radical treatment, with urinary incontinence rates at ~2% and significantly better preservation of potency. Key success factors for focal therapy include rigorous patient qualification based on advanced imaging techniques and precise procedure planning. Focal therapy represents a real and valuable therapeutic option for carefully selected groups of men with prostate cancer, offering a compromise between oncological radicality and preservation of vital functions
EFFECTIVENESS OF LIFESTYLE INTERVENTIONS IN MANAGING CHRONIC MUSCULOSKELETAL PAIN
No full textIntroduction: Chronic musculoskeletal pain, particularly low back pain (LBP), is a major global health issue, leading to reduced quality of life, disability, and a significant economic burden on healthcare systems. Increasing evidence suggests that lifestyle-related factors—including physical inactivity, poor sleep, obesity, and psychosocial stress—play a key role in the persistence and severity of chronic pain. Lifestyle medicine, emphasizing behavioral and non-pharmacological interventions, may offer promising therapeutic alternatives.
Aim of the study: The aim of this review was to analyze the effectiveness of lifestyle-based interventions in the management of chronic musculoskeletal pain, focusing on non-pharmacological strategies and their clinical relevance in long-term pain modulation.
Materials and methods: A systematic literature review was conducted using PubMed, Web of Science, and Google Scholar databases. The search included original studies published in English or Polish after 2013, focusing on adult populations and lifestyle-related interventions for chronic musculoskeletal pain. Studies were selected based on methodological quality and clinical relevance, following PRISMA guidelines.
Results and conclusions: The analysis revealed that interventions such as cognitive functional therapy (CFT), occupational therapy, core stabilization exercises, aquatic therapy, abdominal drawing-in maneuver (ADIM), and telerehabilitation show positive effects on pain reduction, functional improvement, and patient engagement. Moreover, integrated healthy lifestyle behaviors—including physical activity, sleep hygiene, balanced diet, and weight management—were associated with reduced healthcare utilization and improved self-efficacy in pain management. Although current evidence supports the use of lifestyle interventions, further high-quality, long-term studies are needed to establish standardized clinical recommendations
COMPREHENSIVE REVIEW OF CHRONIC LIMB-THREATENING ISCHEMIA: FROM PATHOPHYSIOLOGY TO INNOVATIVE TREATMENT APPROACHES
No full textIntroduction: Chronic Limb-Threatening Ischemia (CLTI) represents the most advanced stage of peripheral artery disease (PAD) and is associated with a high risk of major amputation and mortality. Characterized by rest pain, non-healing ulcers, or gangrene, CLTI reflects severe systemic atherosclerosis with widespread cardiovascular involvement. The disease burden is increasing globally, particularly in aging populations with diabetes or hypertension.
Methods: A literature review of PubMed, Scopus, and Google Scholar summarized current evidence on the definition, pathophysiology, classification, diagnostic strategies, and management of CLTI. It also highlights emerging research directions, including novel endovascular and surgical revascularization techniques, biologic and cell-based therapies, and evolving approaches to patient-centered care.
Results: Advances in imaging modalities and revascularization strategies particularly endovascular, surgical, and hybrid techniques have significantly improved limb salvage and survival rates. Recent studies emphasize the importance of individualized therapy and multidisciplinary management. Concurrently, innovative therapies focusing on angiogenesis, gene therapy, and regenerative medicine show promise for “no-option” patients, although further randomized trials are needed to validate long-term efficacy and safety.
Conclusions: CLTI remains a complex and life-threatening condition requiring early diagnosis, comprehensive risk factor control, and personalized treatment planning. The integration of precision medicine, advanced imaging, and regenerative approaches holds the potential to redefine therapeutic strategies and improve patient outcomes. Future research should focus on optimizing patient selection, expanding access to limb-salvage interventions, and reducing global disease burden through preventive care
FERTILITY DISORDERS IN PRIMARY CILIARY DYSKINESIA: MECHANISMS, DIAGNOSTICS AND MANAGEMENT OPTIONS
No full textIntroduction and purpose: Primary ciliary dyskinesia (PCD) is a rare genetic disorder of motile cilia affecting both respiratory and reproductive systems. Because ciliary motility is essential for sperm propulsion and gamete transport in the female reproductive tract, individuals with PCD frequently present with subfertility or infertility. The purpose of this review is to synthesize current knowledge on mechanisms, clinical presentation, diagnostic pathways, and management of fertility disorders in PCD.
Description of the state of knowledge: Evidence from narrative reviews and recent cohort studies indicates that fertility impairment is more common in men than in women, with subfertility reported in up to 83% of men and 61% of women. A large cross-sectional study found infertility in 78% of men and 61% of women attempting conception and documented an increased rate of ectopic pregnancy (7.6% of pregnancies). In men, infertility is mainly due to immotile or severely dysmotile sperm resulting from axonemal defects, although many sperm remain viable; some genotypes also present with oligozoospermia, MMAF or sperm DNA damage. In women, impaired ciliary motility in the fallopian tubes and endometrium contributes to delayed embryo transport and increased ectopic pregnancy risk. Diagnosis relies on specialized PCD testing (nNO, HSVM, TEM, genetic analysis), combined with standard infertility evaluation. Assisted reproductive technologies—especially ICSI with vitality-based sperm selection—are highly effective for male PCD-related infertility, while IVF/ICSI provides favorable outcomes in women, although early pregnancy ultrasound is recommended.
Summary: Fertility disorders are a significant but manageable aspect of primary ciliary dyskinesia. A substantial proportion of affected individuals can achieve pregnancy, often with the support of ART. Early recognition of PCD in infertile patients, multidisciplinary management, and attention to genotype–phenotype correlations improve counselling and treatment planning. Further prospective studies are needed to refine prognostic predictions and optimize reproductive care in PCD