Malwina Draim

Migraine is one of the most common and burdensome neurological disorders, affecting approximately 15% of the global population. This paper provides a review of the current knowledge on the epidemiology, pathophysiology, and treatment of chronic migraine, with particular emphasis on the role of botulinum toxin type A. It presents the key biological mechanisms underlying migraine, including activation of the trigeminovascular system, the significance of neuropeptides such as CGRP, and the involvement of cortical spreading depression (CSD) in migraine with aura. Modern pathophysiological concepts related to autonomic and metabolic system dysfunction are also discussed. Based on an analysis of clinical trials and meta-analyses, the efficacy and safety of onabotulinumtoxinA therapy according to the PREEMPT protocol are evaluated, as well as its place in current therapeutic guidelines. The paper concludes with a discussion of future research perspectives, including the potential for synergy with biological therapies (anti-CGRP), optimization of treatment regimens, and the use of biomarkers.

Introduction and Purpose: Myopia is currently the most prevalent refractive error worldwide, with a rapidly increasing incidence, particularly among children and adolescents in urbanized regions. This review outlines the most effective evidence-based strategies for preventing and slowing the progression of myopia, with a focus on both pharmacological and non-pharmacological approaches. The State of Knowledge: Recent studies have highlighted that increased time spent outdoors significantly reduces the onset of myopia in non-myopic children, though its effect on progression in already myopic individuals appears limited. Light exposure, especially to moderate-intensity natural light, has shown potential in mitigating axial elongation and promoting choroidal thickening. Sleep quality and duration may also influence myopia development, though further research is needed to confirm this relationship. Pharmacological intervention with low-dose atropine (particularly 0.01–0.05%) is currently the most effective and widely accepted treatment, offering substantial benefits with minimal side effects. Optical interventions such as orthokeratology, multifocal spectacle lenses, and dual-focus contact lenses have demonstrated efficacy in controlling axial elongation by modifying peripheral retinal defocus. Summary: Combining lifestyle modifications (outdoor activity and light exposure) with pharmacological (low-dose atropine) and optical (e.g., orthokeratology and bifocal lenses) interventions provides a comprehensive, multimodal strategy to manage and slow myopia progression. Early implementation of such interventions is essential in addressing the growing public health burden of myopia.

Background: Cryolipolysis has emerged as a popular non-invasive body contouring procedure for localized fat reduction. While generally considered safe, paradoxical adipose hyperplasia (PAH) represents a rare but significant adverse effect characterized by paradoxical growth of adipose tissue in treated areas. Purpose: This review aims to systematically evaluate the current literature regarding the clinical identification, incidence, pathophysiology, risk factors, and therapeutic management approaches for PAH following cryolipolysis procedures. Materials and Methods: A comprehensive search of electronic databases including PubMed, Scopus, MEDLINE, and Embase was conducted for articles published between January 2010 and December 2023. Keywords included “cryolipolysis,” “paradoxical adipose hyperplasia,” “CoolSculpting complications,” and “post-cryolipolysis adverse effects.” Results: Nineteen studies met inclusion criteria, comprising documented cases of PAH. The estimated incidence ranges from 0.0051% to 0.72%, with higher rates observed in studies employing active surveillance methods. Clinical identification features include delayed-onset, sharply demarcated, firm enlargement of the treated area. Male sex and treatment of abdominal areas were identified as potential risk factors. Management approaches include observation, massage therapy, energy-based treatments, and surgical intervention, with liposuction demonstrating the highest efficacy rates. Conclusions: PAH remains an uncommon but distressing complication of cryolipolysis with potentially significant psychosocial impact on affected patients. This review establishes clinical identification criteria and provides evidence-based management recommendations for practitioners.

Introduction and Objective: Bipolar disorder affects approximately 2-4% of the global population, with acute mania representing a significant clinical challenge. While pharmacological interventions remain first-line treatments, 20-30% of patients experience inadequate response or intolerable side effects. This review evaluates the efficacy, safety, and clinical implementation of electroconvulsive therapy (ECT) as a second-line intervention for treatment-resistant bipolar mania. Material and Methods: A comprehensive analysis of contemporary literature was conducted, examining controlled trials, meta-analyses, systematic reviews, and clinical guidelines published between 1988 and 2024. The review focused on clinical response rates, comparative efficacy studies, adverse effect profiles, technical parameters, and integration with pharmacotherapy. Results: Evidence consistently demonstrates high efficacy rates (80-90%) for ECT in treatment-resistant mania, with rapid symptom resolution often occurring within the first week of treatment. Modern ECT techniques have substantially mitigated historical concerns regarding cognitive side effects. Bilateral electrode placement traditionally yields faster response in acute mania, though high-dose right unilateral placement may offer comparable efficacy with reduced cognitive impact. Integration with appropriate pharmacotherapy enhances long-term outcomes. Special populations, including pregnant women, elderly patients, and those with medical comorbidities, may particularly benefit from ECT when properly administered with population-specific modifications. Conclusions: ECT represents an effective, relatively safe, and rapid-acting intervention for treatment-resistant bipolar mania that should be considered earlier in treatment algorithms rather than as a last resort. Individualized approaches to electrode placement, stimulus dosing, and maintenance strategies optimize outcomes while minimizing adverse effects. Future research directions include parameter optimization, identification of predictive biomarkers, and development of cognitive remediation strategies.

Objective: Vasculitis is an increasingly prevalent condition, often characterised by an insidious and multifaceted clinical course, which delays accurate diagnosis and treatment. Case Report: A 63-year-old male diagnosed with granulomatosis with polyangiitis (GPA), who demonstrated pulmonary disease progression after six months of remission-induction therapy with cyclophosphamide. Imaging studies revealed new cavitating infiltrates in the upper lobe of the left lung, along with numerous satellite nodules in both lungs. A thorough differential diagnosis ruled out infectious aetiologies. Conclusions: Despite extensive diagnostic efforts, including invasive procedures and positron emission tomography–computed tomography scanning, exclusion of malignancy remained challenging. Establishing an accurate diagnosis and excluding infectious or neoplastic diseases enables timely and appropriate treatment, which can be life-saving in patients with GPA. Delayed treatment increases the risk of GPA-related organ complications.

Introduction: Yerba Mate (Ilex paraguariensis) is a traditional South American infusion known for its stimulant and antioxidant properties. Historically consumed for its energizing effects, it was also regarded as a medicinal remedy by indigenous cultures, used to treat fatigue, stress and digestive issues [1, 2]. In recent decades, Yerba Mate has gained global recognition and has garnered scientific interest due to its potential health benefits such as improving cardiovascular health, metabolic function and supporting physical performance [1–5]. Its rich content of polyphenols, xanthines and saponins may contribute to a range of protective and restorative effects on the human body [1, 8]. Purpose of the work: The aim of this study is to evaluate existing research on the effects of Yerba Mate consumption on human health and athletic performance, with a focus on its antioxidant activity, metabolic support and cardiovascular benefits. Materials and methods: A comprehensive literature review was conducted using PubMed, Scopus, Google Scholar and Science Direct databases, encompassing clinical studies, randomized trials and relevant animal model research on the bioactive effects of Yerba Mate. Results: This review indicates that Yerba Mate may support lipid metabolism, reduce oxidative stress and improve cardiovascular markers [3–5, 7, 8]. Furthermore, its caffeine content and phytochemical profile may serve as a natural alternative to synthetic stimulants used by athletes [1, 5, 13]. Nonetheless, more rigorous clinical trials are needed to fully establish its efficacy and safety profile in athletic and general populations.

Introduction and purpose Physical activity protects both physical and mental health. However, widespread physical inactivity is the leading risk factor for global mortality. Despite the promotion of healthy lifestyle, there has been no improvement in global levels of physical activity since 2001. This review aims to present the prevalence of physical activity and inactivity across Poland, the European Union (EU) and the world. This cross-national compilation can be used to create campaigns to raise social awareness around physical activity as well as to help health-care providers encourage patients to limit sedentary time. It provides a reliable comparison and indicates vulnerable points regarding the physical activity levels in our societies that should be monitored in further researches. Additionally, there is a summary of the most important health benefits associated with being more active and health risks arising from prolonged sitting time. Brief description of the state of knowledge World Health Organization (WHO) recommends adults to do at least 150 minutes of moderate-intensity, or 75 minutes of vigorous-intensity physical activity per week (or an equivalent combination of the two). Globally, more than 1 in 4 adults are insufficiently physically active. Summary If current trends in insufficient physical activity continue, the global target of a 15% relative reduction between 2018 and 2030 will not be met for adults. Investing in policies to promote active recreation and transport, creating affordable and safe spaces and conducting national and community-based campaigns play a key role in limitting sedentary behaviour and increasing physical activity.