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BETWEEN EFFICACY AND RISK: A CRITICAL APPRAISAL OF METAMIZOLE’S PHARMACOLOGY, CLINICAL USE AND REGULATORY STATUS
No full textThis review critically assesses metamizole's pharmacology, clinical efficacy, and safety profile, with particular focus on its widespread over-the-counter (OTC) availability in Poland versus more restrictive approaches elsewhere. The primary research objective was to evaluate whether the clinical benefits of metamizole outweigh its well-documented risks, especially severe adverse effects such as agranulocytosis and immune-mediated liver injury. During the research PubMed, Google Scholar, and institutional sources were used, applying keywords: “pyralgin,” “metamizole,” “analgesic,” “side effects,” “synergy,” and “combination”. Publications from 2000 to 2025 were screened for relevance, with a primary focus on articles in English and Polish. Abstracts were initially analyzed, followed by full-text review; 20 pertinent sources were ultimately selected for appraisal, comparing indications, mechanisms, and interactions with other analgesics, notably paracetamol, NSAIDs, opioids, and gabapentin. Findings demonstrate that metamizole shows unique spasmolytic, analgesic, and antipyretic properties, and offers therapeutic synergism with various analgesic combinations, aiding multimodal pain management when minimizing opioid or NSAID use is preferred. However, serious adverse events, while infrequent, are potentially fatal and unpredictable, with no effective preventive measures or reliable individual risk prediction identified. The review concludes that the unrestricted OTC availability and mass media promotion of metamizole pose disproportionate public health risks. It recommends limiting access to prescription-only status and ending promotional advertising for common ailments, given the availability of safer first-line analgesics
METFORMIN VERSUS PHARMACOLOGIC AND NON-PHARMACOLOGIC INTERVENTIONS IN PCOS: A REVIEW OF METABOLIC AND ANTHROPOMETRIC OUTCOMES
No full textPolycystic ovary syndrome (PCOS) is a prevalent endocrine and metabolic disorder in reproductive age women, marked by insulin resistance, hyperandrogenism, menstrual irregularities, and increased cardiometabolic risk. This review synthesizes current evidence on the clinical effectiveness of metformin versus alternative strategies across anthropometric, glycemic, and lipid outcomes in women with PCOS.
This narrative review synthesizes secondary data from systematic reviews and meta-analyses retrieved from PubMed and Google Scholar, comparing metformin with other interventions in reproductive-age women with PCOS across anthropometric, glucose, or lipid outcomes.
Metformin showed modest benefits in reducing body mass index, body weight, and waist circumference, with greater effects in overweight and obese individuals. Combined therapies, especially with glucagon-like peptide-1 receptor agonists, were more effective than metformin alone. In glucose metabolism, metformin outperformed placebo and oral contraceptives in reducing fasting glucose, fasting insulin, and homeostatic model assessment of insulin resistance, especially in women with higher insulin resistance. Effects on lipid profiles were moderate; metformin lowered total cholesterol, low-density lipoprotein cholesterol, and triglycerides, particularly when combined with statins. Its effect on high-density lipoprotein cholesterol was limited and sometimes less favorable than that of oral contraceptives.
Metformin remains a core treatment in PCOS, with consistent, modest benefits across metabolic and anthropometric domains. Its effectiveness improves when matched to patient profiles and combined with other agents or lifestyle changes
MAXILLOFACIAL INJURIES IN COMBAT SPORTS: PREVALANCE AND PREVENTION – A LITERATURE REVIEW
No full textIntroduction and Purpose: An increasing number of individuals are engaging in combat sports. Although these activities offer numerous health benefits, they also carry a significant risk of maxillofacial injuries.
Such injuries may include facial bone fractures, dental trauma, soft tissue damage, as well as injuries to the nose and eyes. There are effective methods to reduce this risk, such as the use of mouthguards, helmets, and face masks. However, awareness regarding the use of this protective equipment remains low, and there are no formal requirements mandating their use. The aim of this study is to compare the prevalence of different types of maxillofacial injuries in combat sports and to explore strategies for their prevention.
Materials and Methods: The review is based on throughout analysis of the materials selected from PubMed, Scopus and Google Scholar using following keywords: maxillofacial trauma, maxillofacial injury, combat sports, martial arts, orofacial injury, dental trauma, dental injury, mouthguards, helmets, facemasks
Conclusions: Research shows that the level of awareness regarding the prevention of maxillofacial injuries is low among both athletes and coaches. This highlights the importance of increasing education and awareness in this area. Furthermore, there is a clear need for additional long- term randomized controlled trials to investigate the incidence and characteristics of these injuries, which would contribute to the development of evidence-based prevention strategies
EFFECTIVENESS OF SEMAGLUTIDE IN OBESITY TREATMENT AND THE ROLE OF LIFESTYLE INTERVENTIONS
No full textBackground: Obesity is a global epidemic, affecting ~13% of adults and driving type 2 diabetes, cardiovascular disease, and other comorbidities (World Health Organization, 2021). In Europe and the U.S., prevalence reaches 30–40%, with >20% in Poland (Gajewska & Harton, 2023). Lifestyle interventions alone often fail to ensure durable results, creating demand for adjunctive pharmacotherapy.
Aim: To review obesity epidemiology and evaluate once-weekly semaglutide 2.4 mg regarding mechanism, efficacy, safety, and synergy with lifestyle changes.
Materials and Methods: Narrative review of publications (2018–2025) from PubMed, Google Scholar, and other databases on obesity, GLP-1 analogs, and lifestyle trials. STEP program data, meta-analyses, and guidelines were included.
Results: Risk factors include genetics, aging, sedentary lifestyle, and poor diet. Semaglutide, a GLP-1 receptor agonist, enhances insulin secretion, delays gastric emptying, and reduces appetite (Papakonstantinou et al., 2024). In STEP Phase 3 trials, semaglutide 2.4 mg weekly produced ~15% mean weight loss over 68 weeks, versus ~2–5% with placebo (Wilding et al., 2021) (Davies et al., 2021). About 69–79% achieved ≥10% loss, over half ≥15% (Davies et al., 2021). Safety was consistent with GLP-1 class, dominated by mild-to-moderate gastrointestinal events (Davies et al., 2021). Lifestyle modification alone yields 5–10% reduction, but in STEP 3, semaglutide plus intensive behavioral therapy achieved 16.0% versus 5.7% with lifestyle alone (Wadden et al., 2021). Continued lifestyle support is crucial to maintain outcomes and limit post-withdrawal regain.
Conclusions: Semaglutide represents a breakthrough in obesity pharmacotherapy, approaching bariatric surgery efficacy in some patients. Optimal outcomes occur with integration of diet, activity, and education. Future dual/triple agonists may enhance efficacy, but issues of cost, access, and adherence persist. Broad, equitable availability is essential for public health
NARRATIVE REVIEW: THE IMPACT OF BLUE LIGHT EXPOSURE ON MENTAL HEALTH AND CIRCADIAN RHYTHM
No full textIncreasing exposure to blue light is a major problem in the modern lifestyle of individuals. The increasing use of digital devices and LED lighting is recognised as a major environmental factor affecting human health. While it has a positive effect on alertness during the day, excessive or late-night exposure disrupts the circadian rhythm by affecting the intrinsically photosensitive retinal ganglion cells (ipRGCs), which regulate melatonin secretion and the sleep-wake cycle. The main negative consequences of evening blue light exposure include: disrupted sleep architecture, particularly by reducing slow-wave and REM sleep, which are essential for recovery processes, impaired cognitive performance, increased daytime sleepiness and a higher risk of mood disorders, including depression and anxiety. Interventions and prevention strategies aimed at reducing evening blue light (through filters, night mode settings or glasses) and morning exposure to bright light have been shown to be beneficial for sleep quality, circadian phase regulation and mood stabilisation. Despite progress in this area, there are still significant research gaps, particularly in relation to individual differences in light sensitivity, long-term effects and the optimal timing and intensity of interventions. This review summarises the latest results of 33 studies and provides a structured overview of the current evidence on the short- and long-term effects of blue light on circadian rhythms, sleep and mental health. It highlights practical measures to minimise harmful exposure suggesting the directions for future research to promote circadian health and general well-being in the context of modern lifestyles
EXPLORING THE GENETIC AND CLINICAL OVERLAP BETWEEN EHLERS-DANLOS SYNDROME, AUTISM SPECTRUM DISORDER, AND ADHD: A COMPREHENSIVE REVIEW
No full textBackground: Neurodevelopmental disorders, including Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD), manifest early in life and are characterized by impaired functioning in different life domains. A group of genetic tissue disorders known under the name Ehlers-Danlos Syndrome (EDS) also manifest themselves in early childhood. Recent research points to a possible genetic and symptomatic link between EDS and neurodevelopmental disorders. This review focuses on similar manifestations and co-occurrence of the disorders mentioned above.
Objective: This review investigates the prevalence and significance of comorbid ASD and ADHD in individuals with EDS. Additionally, the genetic and symptomatic connections shared by those conditions are worth exploring, knowing that they could pave the way for joint diagnostic and treatment approaches.
Methods: A systematic literature review was conducted using databases such as PubMed, Cochrane Library, Web of Science, and Google Scholar. Selected studies were chosen based on their focus on the prevalence of ASD and ADHD in EDS patients, genetic or neurobiological links, and statistical analyses of comorbid rates
Results: The prevalence of ADHD in individuals with EDS is significantly higher than in the general population; according to available data, nearly half of EDS patients meet the diagnostic criteria for ADHD. A similar occurrence has been found in individuals diagnosed with EDS - they have a significantly higher chance of being diagnosed with ASD. Shared gene variations between EDS and ASD/ADHD related to synaptic function and neural development have been identified by several genetic studies. The results indicate the possibility of common neurodevelopmental pathways between those conditions. Furthermore, both EDS and ASD/ADHD present with shared symptoms such as joint hypermobility, proprioceptive issues, and autonomic dysfunction.
Conclusion: Numerous reports highlight the higher than-in-population comorbidity rates of ASD and ADHD in EDS patients. This emphasizes the need to implement routine screening and improve the management of individuals suffering from these conditions. Further research into the genetic and neurobiological connections can help introduce new interventions focused on the complexity of the problem and improve results in patient care and quality of life
BEYOND THE GUT: EXPLORING NEUROLOGICAL IMPLICATIONS OF CELIAC DISEASE
No full textIntroduction and purpose: The aim of this article is to provide a comprehensive review of the neurological manifestations associated with celiac disease (CD), a systemic autoimmune disorder triggered by gluten in genetically predisposed individuals. Although CD is traditionally associated with gastrointestinal symptoms, its neurological effects are increasingly recognized and require further analysis.
Material and methods: This narrative review was conducted using literature sourced from scientific databases including PubMed, Scopus, Web of Science, and Google Scholar.
State of knowledge: Neurological symptoms in CD, such as cerebellar ataxia, peripheral neuropathy, cognitive impairment, seizures, and”brain fog, ” may precede or occur without gastrointestinal symptoms. Diagnostic strategies include genetic and serological testing, neuroimaging, and neurological assessments. Although a gluten-free diet remains the cornerstone of therapy, additional treatments such as vitamin E supplementation and intravenous immunoglobulin have shown promise in specific cases.
Results: Neurological symptoms affect a significant proportion of patients with celiac disease, and early diagnosis combined with strict adherence to a gluten-free diet improves treatment outcomes. Quality of life and mental well-being also improve, which is particularly noticeable in the first year of treatment. Celiac disease is characterized by a diverse spectrum of neurological symptoms that may remain undiagnosed without a multidisciplinary approach
ASSOCIATION BETWEEN PSORIASIS AND DEMENTIA: A SYSTEMATIC REVIEW
No full textBackground: Psoriasis is a chronic immune-mediated skin disease characterized by systemic inflammation, while dementia, including Alzheimer’s disease (AD) and vascular dementia, is increasingly recognized as an inflammatory neurodegenerative condition. Both disorders share common risk factors such as age, cardiovascular comorbidity, and metabolic disease. Whether psoriasis independently increases dementia risk remains unclear.
Objectives: To systematically evaluate the epidemiologic association between psoriasis and dementia, explore potential causality using genetic approaches, and assess the impact of systemic therapies, particularly biologics, on cognitive outcomes.
Methods: Following PRISMA guidelines, PubMed was searched for studies published between 2013 and 2025. Eligible studies included observational cohorts, case-control analyses, and Mendelian randomization studies examining dementia outcomes in patients with psoriasis. Data extraction was performed independently by two reviewers.
Results: Epidemiologic evidence from Taiwan, Korea, Denmark, and the UK suggests a modestly increased risk of dementia in psoriasis (odds ratios 1.10–1.25), with higher estimates in younger patients and for vascular subtypes. However, findings were inconsistent, with some cohorts reporting null or protective associations. Notably, systemic and biologic therapies were consistently associated with reduced dementia incidence. Mendelian randomization studies found no genetic evidence supporting psoriasis as a causal risk factor for AD, suggesting shared inflammatory and vascular pathways rather than direct causality.
Conclusions: Psoriasis may modestly increase dementia risk through systemic inflammation and comorbid vascular disease, rather than genetic liability. Systemic therapies, particularly biologics targeting TNF-α and IL-12/23, may confer neuroprotective benefits. Further prospective studies are warranted to clarify causality and therapeutic implications
CHALLENGES OF MODERN PALLIATIVE CARE. A NARRATIVE REVIEW
No full textPalliative Care (PC) is a person-centered, integrated health service designed to support patients with serious illnesses in living actively and with minimal pain until death. It addresses the diverse needs of patients with both cancer and non-cancer diagnoses, aiming to improve quality of life (QoL), relieve symptoms, and provide comprehensive support to patients and their families. Despite its well-documented benefits and recommendations for early improvement, contemporary palliative care faces numerous challenges that limit its effectiveness and accessibility. This article explores the multifaceted obstacles confronting modern palliative care, analyzing why current practices often fall short of meeting patient needs and proposing areas for improvement to ensure timely, equitable, and effective palliative care delivery worldwide.
Methods: The research methodology included an in-depth review if scientific articles available through databases such as Pubmed and Google Scholar. The team analyzed content from 2000 to 2025, placing special emphasis on the latest development. Through careful organization and validation, 83 of the most reliable publications were selected as the primary foundation for the study. The cited references of these publications were included in the analysis.
Results: The scientific studies in this work have demonstrated that palliative care faces major challenges including limited global availability, insufficient specialized workforce, restrictive and inconsistent eligibility criteria, and stigma associated with its terminology. The growing demand from aging populations and increasing cancer cases further strains resources, while financial burdens and a fragmented, under-regulated mobile app market limit effective symptom management and care delivery. Additionally, delayed access to palliative care, insufficient integration within health systems, ethical and legal complexities, and inadequate psychological support for patients and families contribute to these challenges. Emerging technologies like AI offer promise but require careful implementation to maintain person-centered care and address ethical concerns.
Conclusions: A well-functioning palliative care system is vital as it enables patients with serious illnesses to live actively and with improved quality of life, reduces symptom burden, and supports both patients and caregivers throughout the illness trajectory. Effective palliative care also has the potential to decrease healthcare costs by reducing unnecessary hospital admissions and facilitating care in preferred settings. Priorities for advancing palliative care include expanding service availability, revising eligibility criteria to focus on patient needs rather than prognosis, and improving education to reduce misconceptions and stigma. Sustainable funding, policy standardization, and multi-sector collaboration among healthcare providers, policymakers, patients, and communities are essential to building robust palliative care frameworks. Moreover, regulating and enhancing the accessibility of palliative care mobile applications can further support patients and caregivers by improving communication, symptom management, and advance care planning. Coordinated efforts across all stakeholders are crucial to overcoming existing challenges and ensuring equitable, high-quality palliative care that improves quality of life on a global scale
THE BEZOARS: CLASSIFICATION, DIAGNOSIS, TREATMENT AND CLINICAL CASES - REVIEW
No full textIntroduction: Bezoars are foreign bodies found mainly in the gastrointestinal tract (but not exclusively) giving non-specific and sparse symptoms, which can contribute to serious complications such as chronic mucositis, intestinal obstruction, peritonitis, sepsis and in some cases can even lead to death. A distinction can be made between trichobezoars, phytobezoars, lactobezoars, pharmacobezoars and urinary tract bezoars. Endoscopic examination plays a major role in diagnosis.[1]
Objective: The aim of this review is to provide information on the origin, classification, diagnosis and treatment of bezoars and to present several clinical cases involving different types of bezoars.
Methods and materials: For the literature review, a Pubmed database and Polish websites of renowned medical journals were used, using keywords such as: bezoar, trichobezoar, phytobezoar, lactobezoar, pharmacobezoar