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DIABETES IN POLAND: EPIDEMIOLOGY, MORTALITY AND DIAGNOSTICS
No full textThis paper presents current knowledge on diabetes mellitus (ICD-10 E10-E14) and its clinical impact. Diabetes is a growing global problem, with over 3 million adults affected in Poland alone. The disease develops as type 1, caused by autoimmune destruction of pancreatic β-cells, or as type 2, driven mainly by insulin resistance and obesity. Both forms lead to impaired glucose uptake and abnormal fat and protein metabolism. Common symptoms include thirst, polyuria, fatigue, weight loss, and recurrent infections, though type 2 diabetes often remains silent for years. Persistent hyperglycemia promotes toxic metabolite accumulation, microangiopathy, neuropathy, and multiorgan complications. Cardiovascular manifestations, such as diabetic cardiomyopathy and arrhythmias, significantly increase morbidity and mortality. Early detection, lifestyle modification, and improved diagnostic strategies remain essential to reduce the burden of disease
THE INTERPLAY BETWEEN DIET AND HORMONAL REGULATION: A NARRATIVE REVIEW
No full textDiet is one of the key external factors that can modify hormonal activity across the major endocrine axes and affect metabolic and appetite-regulating hormones including insulin, leptin, ghrelin, and cortisol. A literature search conducted between October and November 2025 using PubMed, Scopus, Web of Science, and Google Scholar identified peer-reviewed studies examining the effects of caloric restriction, macronutrient distribution, glycemic load, micronutrient intake, and structured dietary interventions on endocrine function. The evidence shows that diets high in glycemic load, saturated fats, and low in fiber can disrupt insulin sensitivity, alter leptin and ghrelin signaling, affect cortisol responses, and contribute to thyroid and reproductive hormone imbalances. In contrast, Mediterranean-style and low-glycemic diets, time-restricted feeding, and adequate intake of iodine, selenium, and zinc appear to support metabolic health and more stable hormonal activity. Diet also plays a therapeutic role in endocrine-related conditions including polycystic ovary syndrome, Hashimoto’s disease, acne vulgaris, endometriosis, and thyroiditis, with improvements seen in inflammation, insulin regulation, and hormonal homeostasis. Overall, the review emphasizes that diet can both disturb and restore endocrine balance. Well-structured, nutrient-dense dietary strategies may serve not only as preventive measures but also as valuable tools in supporting long-term hormonal health
CENTRAL SENSITIZATION IN CHRONIC PAIN: NEUROPHYSIOLOGICAL MECHANISMS AND CLINICAL IMPLICATIONS
No full textThe definition of central sensitization encompasses enhanced processing and transmission of neural impulses within the central nervous system, ultimately leading to increased pain sensitivity. It is a key mechanism contributing to the development of chronic pain. This phenomenon is of great clinical relevance and plays a role in such conditions as migraine, chronic low back pain, fibromyalgia, and irritable bowel syndrome. The main aim of this review is to present the mechanisms underlying central sensitization, diagnostic methods, and potential therapeutic interventions in patients with chronic pain. Diagnostic tools that allow for the identification of patients with sensitization-related pain, as well as key neurophysiological mechanisms necessary for maintaining central sensitization, are also discussed. Future research should focus on developing therapeutic protocols targeting CS, identifying sensitization biomarkers, and improving diagnostic precision
HEALTH IMPLICATIONS OF COMPETITIVE ESPORTS: A SYSTEMATIC REVIEW OF PHYSICAL, MENTAL AND SOCIOBEHAVIORAL OUTCOMES
No full textBackground: Competitive electronic sports (esports) represent a rapidly expanding global discipline with distinctive training loads and lifestyle patterns. While esports provide opportunities for performance development and social connectedness, they also raise concerns regarding musculoskeletal strain, sleep disruption, sedentary cardiometabolic risk, mental-health burden, and the use of cognitive enhancers.
Objective: To systematically synthesize evidence from last decade on physical, psychological, and sociobehavioral health outcomes associated with competitive esports participation, and to evaluate implications for clinical practice, athlete welfare, and public-health policy.
Methods: We will search PubMed/PMC, Scopus, Embase and Web of Science. Eligible studies include observational research, randomized trials, systematic reviews, and position statements assessing health outcomes in competitive gamers or comparing esports athletes with controls. Outcomes include musculoskeletal symptoms, sleep and circadian patterns, mental health (depression, anxiety, stress, problematic gaming), cardiometabolic markers and sedentary behavior, visual strain, and stimulant/nootropic use. A meta-analysis or narrative synthesis will be performed where appropriate, with subgroup analyses by age, competitive level, and game genre.
Results: Evidence consistently shows high rates of musculoskeletal complaints, sleep irregularities, and sedentary behavior among professional eAthletes. Studies also report mixed cardiometabolic findings, mental-health vulnerabilities, and emerging concerns regarding performance-enhancing stimulant or nootropic use. Heterogeneity in study methods and definitions limits data pooling but identifies priority areas for prevention.
Conclusions: Overall, competitive esports are associated with a multifaceted health profile encompassing physical, psychological, and lifestyle domains. Standardized methodologies, longitudinal monitoring, and structured pre-participation screening are needed to inform evidence-based guidelines and improve athlete safety across clinical, public-health, and governance settings
THE INFLUENCE OF GUT MICROBIOTA ON PERFORMANCE IN ATHLETES
No full textIntroduction and objective: The gut microbiota, consisting mainly of bacteria, plays a key role in human health, including athletes. Its composition can be modulated by diet, antibiotics, stress, and physical activity. The aim of this paper is to present the influence of the gut microbiota on athletes' performance and to assess the potential benefits of probiotic supplementation.
Review methods: The literature search for this review was performed using the PubMed database and other available literature sources and the following keywords: gut microbiota, physical activity, competitive athletes, gut barrier defense mechanisms.
A brief description of the state of knowledge: The gut microbiota has protective functions, fermenting undigested carbohydrates, synthesizing vitamins, and metabolizing lipids. Studies suggest that the microbiota can improve metabolic and immune function, which reduces mental fatigue and improves performance in athletes. Probiotic supplementation can increase endurance, aerobic capacity, and recovery from exercise, as well as reduce gastrointestinal symptoms. Probiotics may also affect the mental and cognitive health of athletes through mechanisms related to the gut-brain axis.
Conclusions: The gut microbiota plays a significant role in the health and performance of athletes. Probiotic supplementation can provide a variety of benefits, including improved performance, recovery, and mental health. Additionally, it can improve the bioavailability of key nutrients such as branched-chain amino acids (BCAAs), supporting muscle recovery and performance. However, further research is needed to determine the optimal doses and strains of probiotics, as current evidence, although promising, remains limited and not fully validated
PSYCHOSOCIAL IMPACT OF POLYCYSTIC OVARY SYNDROME ON WOMEN’S QUALITY OF LIFE: BODY IMAGE, MENTAL HEALTH, AND FERTILITY-RELATED DISTRESS
No full textBackground: Polycystic ovary syndrome affects 8-13% of women of reproductive age and is one of the most common endocrine disorders. Although PCOS has traditionally been viewed as a reproductive and metabolic pathology, accumulated evidence demonstrates significant psychological and social consequences affecting women's quality of life.
Aim: This literature review systematizes current scientific evidence on the psychological and social impact of PCOS on women's quality of life, with emphasis on body image concerns, mental health comorbidities, and fertility-related distress.
Methods: We searched PubMed/MEDLINE, Embase, Web of Science, PsycINFO, and Cochrane Library databases for relevant literature. The review included systematic reviews, meta-analyses, cohort studies, and qualitative studies. No time restrictions were applied; we included both recent research and foundational publications from earlier years.
Results: Women with PCOS show much higher body dissatisfaction than healthy women. Visible symptoms like excess hair growth and acne, combined with weight control problems, clash with cultural ideals of femininity and cause ongoing emotional distress. The prevalence of depressive and anxiety symptoms is elevated, with this association being multifactorial and involving both biological mechanisms (insulin resistance) and psychosocial factors. Eating disorders represent a particular area of vulnerability, with concerns about weight and body shape occupying a central role. Reproductive difficulties create a severe emotional burden, exacerbated by sociocultural contexts where motherhood is considered an essential part of female identity.
Conclusion: PCOS has significant psychosocial consequences requiring a comprehensive approach to patient management. A medical model focused exclusively on physical symptoms is insufficient. Integration of mental health screening and a multidisciplinary approach are necessary for providing quality care to women with PCOS
REHABILITATION IN PERSISTENT EFFECTS OF COVID-19 INFECTION REVIEW: IMPORTANCE OF TELE-REHABILITATION, INTEGRATED MULTIDISCIPLINARY APPROACH
No full textGiven the global prevalence of Post-COVID-19 Condition, marked by a varied spectrum of persistent symptoms, the imperative for efficacious rehabilitation strategies is evident. This systematic review consolidates existing evidence concerning rehabilitation interventions, specifically examining their effectiveness in enhancing functional outcomes and the quality of life among affected individuals. The findings consistently indicate that rehabilitation substantially contributes to ameliorating physiological impairments, bolstering physical capacity, and fostering improvements in respiratory function, psychological well-being, and overall quality of life. Traditional, in-person rehabilitation modalities provide considerable advantages, especially when delivered under supervision and tailored to individual needs. Notably, telerehabilitation and integrated, multidisciplinary approaches have emerged as particularly effective and forward-looking solutions. Telerehabilitation mitigates geographical and logistical impediments, offering accessible and frequently comparably effective care for enhancing functional capacity and alleviating symptoms. Hybrid models, integrating virtual and in-person components, further optimize comprehensive patient care. Although ongoing research is essential to refine optimal protocols and address existing limitations, the evidence robustly supports the superiority of rehabilitation over its omission. Furthermore, innovative, personalized, and technology-driven approaches demonstrate considerable potential for fostering long-term recovery in Post-COVID-19 Condition
THE USE OF STEM CELLS IN NEUROLOGY
No full textStem cells, due to their ability to differentiate and self-renew, have found applications in various therapeutic processes, including the treatment of neurological diseases. Because the central nervous system has limited regenerative capacity, neurological disorders remain both a clinical and societal challenge. Clinical studies have shown that regenerative therapy using stem cells produces beneficial effects in the treatment of conditions such as Parkinson’s disease, Alzheimer’s disease, stroke, and spinal cord injury. However, safety concerns - including the risk of tumor formation, variable cell survival, heterogeneity of cell preparations, and lack of standardized procedures- continue to be analyzed.
This article presents various sources of stem cells - embryonic stem cells (ESC), induced pluripotent stem cells (iPSC), and adult stem cells such as mesenchymal stem cells (MSC) and neural stem cells (NSC). Therapeutic mechanisms and modern technologies, including biomaterials, tissue engineering, and gene therapy, which enhance the effectiveness of cell-based therapies, are also discussed. Current applications of regenerative therapy in selected neurological disorders are presented, with particular emphasis on mechanisms of action, results from preclinical and clinical studies, and ethical and legal issues. The article highlights the need for further clinical research and for advancements enabling controlled cell differentiation.The use of stem cells may transform the understanding and treatment of neurological diseases; however, fully utilizing their potential requires further multidisciplinary research
THE TRANSFORMATION OF CARDIOVASCULAR SCREENING IN ATHLETES: THE MULTIMODAL ROLE OF ARTIFICIAL INTELLIGENCE IN DIFFERENTIATING CARDIAC PATHOLOGIES FROM PHYSIOLOGICAL ADAPTATION
No full textPurpose: The primary objective of this review is to evaluate the efficacy, clinical applications, and current limitations of Artificial Intelligence (AI) and Machine Learning (ML) in diagnosing cardiovascular diseases (CVD) among competitive athletes. Specifically, this study addresses the critical diagnostic challenge of differentiating benign physiological adaptations known as "athlete's heart" from potentially lethal pathologies, including cardiomyopathies and channelopathies, to prevent sudden cardiac death.
Materials and Methods: A systematic literature search was conducted across PubMed, Scopus, and Web of Science databases covering the period from 2000 to 2025. The review identified and synthesized 48 key studies utilizing AI algorithms—specifically deep learning applied to electrocardiography (AI-ECG) and automated imaging analysis (Echocardiography, CMR)—for the detection of Hypertrophic Cardiomyopathy (HCM), Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC), valvular anomalies, and inherited channelopathies. Diagnostic performance metrics were analyzed to compare AI methodologies against standard clinical criteria.
Results: Deep learning models applied to ECG demonstrate superior sensitivity (>90%) in detecting occult cardiomyopathies compared to traditional methods , while AI-enhanced imaging significantly improves the reproducibility of tissue characterization. AI algorithms, such as those analyzing phonocardiograms, show efficacy comparable to echocardiography in detecting valvular heart disease.
Conclusions: AI represents a paradigm shift in sports cardiology, offering potential for scalable and cost-effective screening. However, widespread clinical implementation is currently hindered by the "black box" nature of algorithms and the scarcity of large, athlete-specific training datasets. Future deployment requires explainable AI models validated on diverse athletic cohorts
BOTULINUM TOXIN IN THE TREATMENT OF STRABISMUS: A REVIEW OF THE LITERATURE (2015–2025)
No full textBackground: Botulinum toxin type A (BoNT-A) has become an important minimally invasive tool in the management of strabismus, either as an alternative or as an adjunct to extraocular muscle surgery. Over the last decade, a growing body of evidence has evaluated its efficacy, safety and optimal indications.
Purpose: To review current evidence (2015–2025) on the use of botulinum toxin type A in the treatment of strabismus, with a focus on mechanism of action, clinical indications, efficacy, safety profile and its role in modern management algorithms.
Methods: Narrative review based on literature published between 2015 and 2025 identified in PubMed, Cochrane Library and major ophthalmology journals. Included were systematic reviews, meta-analyses, randomized controlled trials, observational studies and evidence-based guidelines.
Results: BoNT-A is effective in small- and moderate-angle comitant strabismus, infantile esotropia in selected cases, acquired non-accommodative and acute acquired comitant esotropia, paralytic strabismus and residual postoperative deviations. In some indications its outcomes are comparable to surgery, although repeated injections may be required. Adverse events are usually mild and transient, such as ptosis, transient overcorrection and temporary diplopia.
Conclusions: BoNT-A is an established and safe option in the management of selected forms of strabismus. Further high-quality clinical trials are needed to standardize dosing protocols, timing of intervention and combined approaches with extraocular muscle surgery