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Human papillomavirus as an important factor in the development of oropharyngeal cancer - modern diagnostics and new therapeutic methods
Get PDFBackground.
The article focuses on epidemiological trends observed globally over the pastfew decades, which demonstrate a dynamic increase in the incidence of HPV-positive OPC. A significant part of the paper is a discussion of the latest therapeutic and diagnostic methods, enabling the dynamic development of clinical management.
Aim.
The aim of this article was to present the current state of knowledge regarding the impact of HPV infection on the development of OPC.
Material and methods.
The review methodology included an analysis of 28 publications retrieved from the PubMed database, selected based on their currency and relevance to the research topic. The article primarily includes work published between 2018 and 2024, with the largest possible number of participants included.
Results.
HPV-associated OPC is currently one of the fastest-growing types of head and neck cancer worldwide. HPV types 16 and 18 are responsible for the majority of cases. The disease typically has a better prognosis than its HPV-negative counterparts, which is due to the different tumor biology. The introduction and widespread use of HPV vaccinations is a key element of global prevention, potentially significantly reducing the number of new cases in the future.
Conclusions.
Despite the dynamically developing knowledge about the HPV virus, we still need new diagnostic and therapeutic techniques to more effectively treat patients with OPC
Enhancing Instructional Quality in Macro-Unit Physical Education Pathways Informed by Nonlinear Pedagogy
Get PDF The Physical Education and Health Curriculum Standards for Compulsory Education (2022 Edition) emphasize that diversified teaching approaches play an essential role in guiding students to think independently and engage in self-directed practice, thereby fostering their comprehensive practical competence and innovative awareness. Accordingly, traditional single-mode instruction, in which teachers demonstrate and students imitate, must be transformed. Against this backdrop, the present study employs the methods of literature review, experimental research, and logical analysis to investigate the application paradigm of ecological dynamics theory in physical education. The primary manifestation of ecological dynamics in this field is nonlinear pedagogy. The findings indicate that nonlinear pedagogy, through a constraint-led mechanism (the triadic constraints of individual–environment–task), effectively addresses the common dilemmas in teaching—namely, weak student interest, disconnection between learning contexts and skill application, and overly lengthy instructional tasks—by focusing on three dimensions: constructing high-quality learning situations, reinforcing task degeneracy, and stimulating students’ self-organization. Based on these findings, the application of this teaching approach contributes to enhancing students’ exploratory engagement and capacity for self-organization, promotes positive transfer of motor skills, and provides both theoretical support and practical reference for the optimization of large-unit teaching models in physical education
Body Dysmorphic Disorder Among Aesthetic Medicine Patients – A Literature Review
Get PDFIntroduction: Body Dysmorphic Disorder (BDD) is a psychiatric disorder characterised by an excessive focus on perceived flaws in one's appearance. It leads to a strong psychological distress, social withdrawal, and unnecessary aesthetic procedures. The rise of aesthetic medicine in the 21st century has made BDD an important clinical and ethical issue for practitioners.
Aim of the study: This study aims to present the prevalence of BDD, its characteristics, diagnostic difficulties, and treatment. We also discuss ethical challenges associated with aesthetic medicine procedures and clinical management recommendations for aesthetic medicine practitioners.
Materials and methods: A search of the literature review was performed using PubMed, Google Scholar, Scopus, and other databases. We focused primarily on studies published between 2017 and 2025. The following keywords and their combinations were used: “Body Dysmorphic Disorder”, “Aesthetic Medicine”, “Cosmetic Procedures”, “Psychiatry”, “Screening”, “Ethics”.
Brief description of state of knowledge: BDD is more common in aesthetic medicine patients than in the general population and is influenced by social media and culture. Patients with BDD present alterations in the function and structure of the central nervous system. There are a few screening tools easy to use in the everyday practice of an aesthetician. Treatment includes pharmacotherapy and psychotherapy.
Summary: BDD poses many clinical and ethical challenges. Cosmetic interventions alone rarely address underlying psychological distress long-term. Both cognitive-behavioural therapy and pharmacotherapy are useful tools in the treatment of BDD. Integrating screening and patient-centred approaches has the potential to improve safety, satisfaction, and long-term well-being in patients with this disorder
Clinical and biomechanical perspectives on runner’s knee: a literature-based review of patellofemoral pain syndrome
Get PDFPatellofemoral Pain Syndrome (PFPS), widely known as runner’s knee, is one of the most common yet frequently misunderstood causes of anterior knee pain in active individuals. This review highlights the multifactorial nature of PFPS, emphasizing the complex interplay between biomechanical dysfunction, muscular imbalances, anatomical variations, overuse, and psychological influences. The article synthesizes current evidence on pathophysiology, clinical presentation, risk factors, and diagnostic challenges, demonstrating why accurate identification of PFPS remains difficult and often requires a comprehensive, cluster-based clinical approach. Special attention is given to the role of hip and quadriceps weakness, abnormal lower-limb alignment, and altered movement patterns in generating patellofemoral overload. The review also evaluates contemporary treatment strategies, with strong support for conservative, exercise-based rehabilitation focused on strengthening, movement retraining, flexibility, and patient education. Adjunctive tools such as taping, bracing, and orthoses are discussed as supportive options rather than primary interventions. Early, individualized therapy is essential for preventing chronic symptoms and enabling a safe, lasting return to physical activity
Hippotherapy as a Complementary Intervention for Multiple Sclerosis: A Review
Get PDFIntroduction: Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS). The pathogenesis of multiple sclerosis is complex and incompletely understood. The major factors that lead to the disease seem to be inflammation and neurodegeneration. Multiple sclerosis is diagnosed by meeting diagnostic criteria. They are based on demonstrating the involvement of 2 or more areas of the CNS at different time points. There remains no cure for multiple sclerosis. Treatment has three aspects: symptom management, relapse management, and disease-modifying therapy. Despite the benefits of pharmacological and non-pharmacological treatments, studies indicate that several complementary therapies may also be promising. One such therapy is hippotherapy, an equine-assisted form of physical therapy that uses the characteristic movements of a horse.
Aim of the study: The aim of this study was to review the published literature on the impact of hippotherapy on multiple sclerosis.
Materials and methods: A review of available studies examining the relationship between hippotherapy and multiple sclerosis was conducted. To identify relevant literature, the PubMed and Google Scholar databases were used.
Results: Several studies investigating the effect of hippotherapy as a complementary intervention on the course of multiple sclerosis indicate that this intervention can be beneficial for affected patients. Patients in the hippotherapy intervention group showed improvements in balance, fatigue, spasticity, walking performance, spatiotemporal gait parameters, processing of sensory cues for postural control, trunk and upper-limb control, dynamic control, facilitated movement, and quality of life.
Conclusions: Hippotherapy may be a useful complementary treatment for improving walking and other functional outcomes in people with multiple sclerosis, but the available evidence remains limited and further studies are needed
Multimodal Pain Management and Challenges in Patients Undergoing Simultaneous Pancreas and Kidney Transplantation
Get PDFBackground. Diabetic foot syndrome is a severe complication of diabetes mellitus, often complicated by infection, impaired wound healing, and chronic pain. Management is particularly challenging in patients with a history of simultaneous pancreas–kidney transplantation (SPK) and reduced renal function.
Aim. To present a complex case of diabetic foot syndrome in a patient after SPK transplantation, highlighting the challenges of pain management and wound care in the context of opioid history and impaired kidney function.
Case Presentation. A 65-year-old patient was admitted to the diabetic ward due to worsening pain associated with left diabetic foot syndrome. Physical examination revealed swelling, redness, and purulent discharge. The wound was cleaned, limb offloading was applied, and VAC/NPWT (vacuum-assisted closure/negative pressure wound therapy) was initiated, but the patient continued to experience pain, tension, and discomfort around the wound. Laboratory tests demonstrated decreased estimated glomerular filtration rate (eGFR), and increased levels of uric acid, keratin, and leukocytes. The patient had undergone SPK transplantation 1.5 years prior without complications. History of opioid abuse and limited kidney function posed significant restrictions on analgesic therapy.
Conclusions. Diabetic foot syndrome in post-SPK patients presents a multifactorial clinical challenge, requiring careful management of infection, renal impairment, and pain. Individualized, interdisciplinary approaches are essential to optimize wound healing while minimizing opioid use and preventing further complications
The Impact of Cannabidiol (CBD) on Sleep Quality: A Review of Mechanisms and Clinical Evidence
Get PDFCannabidiol (CBD), a non-psychoactive component of Cannabis sativa, has garnered significant interest as a potential therapeutic agent for sleep disturbances. This review synthesizes preclinical and clinical evidence on the effects of CBD on sleep parameters, including sleep architecture, quality, and disorders such as insomnia and REM sleep behavior disorder (RBD). Preclinical studies reveal that CBD modulates sleep architecture in a dose- and region-dependent manner, influencing both slow-wave and REM sleep. These effects are mediated through complex interactions with the endocannabinoid, adenosinergic, serotonergic, dopaminergic, and GABAergic systems. Clinical trials suggest that low to moderate doses of CBD may modestly improve subjective sleep quality, particularly in individuals with co-occurring anxiety or chronic pain, although its efficacy is generally comparable to melatonin. High-dose CBD may enhance restorative sleep stages, yet the benefits are limited and inconsistently sustained. CBD demonstrates a favorable safety profile, though methodological limitations—such as small sample sizes, short follow-up durations, and product variability—impede definitive conclusions. Further research with standardized formulations, objective sleep measurements, and larger populations with diagnosed sleep disorders is needed to fully assess the therapeutic potential and clinical application of CBD for sleep-related conditions
Rheumatoid Arthritis and Mental Health: An In-Depth Review
Get PDFBackground/Objective: Rheumatoid arthritis (RA) co-occurs with depression and anxiety, driven by shared inflammatory pathways, that impair quality of life and treatment response. This review synthesizes evidence on biological mechanisms, biomarkers, and therapeutic strategies targeting RA-related depression.
Methods: Narrative synthesis of epidemiological, biomarker, pharmacological and lifestyle studies linking RA inflammation to mental health.
Results: Pro-inflammatory cytokines (IL-6, TNF-α) mediate the RA-depression nexus, while elevated IL-6, TNF-α, and CRP levels can be used for predicting depression risk. IL-6 inhibitors, TNF inhibitors and JAK inhibitors demonstrate significant improvement in mental state of the patients. SSRIs/SNRIs provide help in maintaining high-minded mood and pain relief, while Mediterranean diet adherence can halve depression odds. Emerging preclinical data support neuroimmune modulators like aucubin targeting CXCL10/BTN3A2.
Conclusion: Integrated care combining cytokine-targeted therapies, antidepressants, psychological interventions, and anti-inflammatory lifestyle measures optimizes outcomes for RA patients with depression, emphasizing early screening and holistic management
Zuranolone in Postpartum Depression: A Review of the First Oral Neurosteroid Treatment
Get PDFBackground: Postpartum depression (PPD) is a severe mood disorder affecting 1 in 7 postpartum women. It significantly impacts maternal functioning and infant development. SSRIs are currently the first-line treatment, but require 4-8 weeks to take effect and show variable efficacy. The neurosteroid hypothesis connects PPD symptoms to an abrupt drop in allopregnanolone after childbirth. Zuranolone, a synthetic modulator of the GABA-A receptor, is the first oral neurosteroid specifically indicated for postpartum depression.
Aim: This review analyzes zuranolone’s pharmacology, Phase III clinical efficacy, and its practical use for postpartum depression.
Material and methods: We conducted a comprehensive literature review using PubMed. Search terms included „zuranolone", „neurosteroid", and "postpartum depression”. We reviewed publications from 2015 to 2025, focusing on Phase III clinical studies, pharmacological analyses, and FDA/EMA regulatory documents.
Results: Zuranolone is administered as 50 mg once daily for 14 days. Two Phase III randomized, placebo-controlled trials (n=150, n=196) evaluated zuranolone for moderate to severe postpartum depression. In the pivotal trial, the least-squares mean difference on the HAM-D was -4.0 versus placebo (95% CI: -6.3 to -1.7; p=0.001). Response rates were 57.0% versus 38.9% (p=0.021), and remission rates were 26.9% versus 16.7%. Effects were seen by day 3 and lasted through day 45.
Conclusions: Zuranolone represents a significant therapeutic advance in the treatment of postpartum depression. It offers immediate symptom relief during the critical early postpartum period. Further research is needed to assess effectiveness and safety in a more heterogeneous population, as well as the long-term effects in mood disorders.
Physical Capacity in Children with Down Syndrome: A Narrative Review
Get PDFBackground: Down syndrome causes developmental challenges including motor delays and reduced physical capacity, often complicated by congenital heart defects in ~50% of cases. Research on children aged ≤14 years is limited.
Aim: This narrative review synthesizes current evidence on physical capacity in children with Down syndrome aged 14 years and younger, focusing on cardiorespiratory fitness, muscle strength, motor coordination, and executive function. The objective is to identify effective therapeutic interventions and provide recommendations for optimizing functional independence and quality of life in this population.
Material and Methods: Literature search of PubMed and Google Scholar (2021-2025) for studies in children aged ≤14 years. Eight studies met inclusion criteria.
Results: Respiratory training (PNF, IMT) combined with aerobic exercise significantly improves respiratory strength and walking capacity. Children with Down syndrome show markedly reduced walking capacity versus typically developing peers (105.6 m difference in 6-minute walk test), limiting physical and social participation. Motor deficits include impaired sensorimotor integration and dual-task control (motor costs: -57.3% to -167%). Motor and cognitive impairments develop independently. Higher BMI correlates with reduced motor skills (r=-0.729). Sport training improves strength, balance, and core stability.
Conclusions: Physical limitations stem from respiratory weakness, impaired motor-cognitive integration, and weight factors. Effective interventions require respiratory training with aerobic exercise, domain-specific motor-cognitive approaches, and weight management. Sport-based programs enhance functional capacity and quality of life