Adrianna Pielech

Background: Anabolic-androgenic steroid (AAS) use has evolved into a significant public health concern affecting diverse populations beyond elite athletics. Objective: To examine evidence-based changes in AAS usage patterns including demographics, motivations, and health consequences from 2005-2025 using systematic reviews and peer-reviewed research. Methods: Literature review of peer-reviewed studies and systematic reviews from PubMed and National Health Institute Library focusing on AAS epidemiology, demographic changes, and health consequences published between 2005-2025. Results: Global lifetime prevalence of AAS use is estimated at 6-29%. Female participation is estimated to be constantly growing. Evidence indicates expansion beyond traditional athletic populations with significant cardiovascular, psychiatric, and reproductive health consequences. Conclusions: AAS use represents a widespread public health concern requiring enhanced clinical awareness and evidence-based management approaches among medical practitioners.

Introduction: Atrial fibrillation is the most common cardiac arrhythmia affecting approximately 700 thousand Polish people. In Poland, insufficient vitamin D levels are highly prevalent and concern around 90% of the population. Except the established, modifiable risk factors of AF, new risk factors such as vitamin D deficiency are being described. Some potential mechanisms involving vitamin D in atrial fibrillation pathogenesis include: cardiac remodelling via the vitamin D receptor, modulation of renin-angiotensin-aldosterone system, influence on parathyroid hormone concentration, changes in action potential duration and left atrium contractility, and activation of proinflammatory pathway by low vitamin D levels. Aim of the study: This review aims to analyze the potential relationship between vitamin D concentration and the risk of developing atrial fibrillation based on the current state of knowledge (as of 2025). Moreover, we tried to examine how vitamin D concentration could influence the efficacy of atrial fibrillation treatment methods such as cardioversion or ablation. Material and Methods: This review is based on literature from 2011 to 2024, searched in PubMed, Google Scholar, mp.pl and ClinicalTrials.gov that was describing the results of vitamin D deficiency on atrial fibrillation development and the treatment outcomes. Conclusions: Serum vitamin D concentration may have an impact on both atrial fibrillation onset and its treatment. It is possible that there are several groups of patients among whom the sufficient vitamin D level would be particularly beneficial. Further studies, especially those focusing on vitamin D supplementation, are needed to clarify the role of vitamin D in atrial fibrillation pathogenesis and treatment.

Background: This study aimed to analyze the relationship between the levels of tumor markers—specifically, carcinoembryonic antigen (CEA) and Ca19-9 antigen—determined in both serum (sCEA and sCa19-9) and intraoperative peritoneal washings (pCEA and pCa19-9) and the advanced stage of gastric cancer (including the occurrence of cancer cells in cytology from abdominal fluid). Methods: This study included 47 patients with histopathologically confirmed gastric cancer or gastroesophageal junction cancer who underwent surgical treatment. The material for the cytological examination and assessment of CEA and Ca19-9 concentrations in peritoneal fluid was collected intraoperatively. Later, blood was drawn to assess the CEA and Ca19-9 concentrations in blood serum. Results: There was a statistical correlation between a positive cytology result or the presence of peritoneal carcinomatosis and a positive result for the tumor markers obtained from abdominal washings. This correlation was not observed with marker levels obtained from blood serum. The pCEA marker was highly sensitive (93.3%) and specific (93.8%) for detecting cancer cells. The pCa19-9 marker was less effective in detecting cancer but matched pCEA in identifying the absence of cancer. No differences were observed in sCEA and sCA19-9 levels between patients who underwent neoadjuvant chemotherapy and those who did not receive this treatment. However, statistical analysis showed that this relationship did not apply to pCEA and pCa19-9 levels. Conclusions: Intraoperative determinations of tumor marker levels in peritoneal washings may be a predictive factor for a poor prognosis in patients with gastric cancer.