Aleksandra Sowa

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.

Introduction. The article explores the psychological consequences of climate change on individuals and communities, emphasizing the development and exacerbation of mental health conditions such as depression, anxiety disorders, post-traumatic stress disorder (PTSD), and climate-related anxiety (eco-anxiety). It highlights the need for innovative approaches to understanding and addressing these challenges. Methods. A review of the available scientific literature was conducted in PubMed and Google Scholar databases. The keywords applied included: “climate change”, “climate crisis”, “ecopsychiatry”, “mental health”, “solastalgia”, and “eco-anxiety”. Results. The analysis demonstrates the significant impact of environmental instability, natural disasters, and habitat loss on emotional and psychological well-being. It also identifies ecopsychiatry as a promising, holistic framework that links mental health care with environmental factors. Practical examples of ecopsychiatric interventions are outlined, showing their potential in enhancing resilience and mitigating climate-related distress. Conclusions. Climate change poses a growing risk to public mental health, demanding interdisciplinary collaboration and the integration of ecological perspectives into psychiatric practice. Ecopsychiatry offers an innovative diagnostic and therapeutic direction that can strengthen mental resilience in the era of climatic crises.

Background: Circadian rhythm is a central regulator of human physiology, governing metabolic, endocrine, and neurobehavioral processes. Disruption of circadian alignment has been associated with obesity, insulin resistance, dyslipidemia, depression, and anxiety. Maintaining circadian health is therefore essential for both metabolic and mental well-being. In parallel, the rapid expansion of wearable technologies and digital health applications has enabled continuous, non-invasive monitoring of sleep–wake cycles and physiological parameters. When combined with artificial intelligence (AI), these tools offer new opportunities to assess and optimize circadian health in real-world settings. Objective: This review aims to summarize recent evidence on the use of wearable devices and AI-driven applications in monitoring circadian rhythm, with particular focus on their implications for metabolic and mental health. Methods: A literature review was conducted, focusing on publications between 2020 and 2025. Databases including PubMed, Scopus, and Web of Science were searched using keywords such as “circadian rhythm,” “wearables,” “digital health,” “artificial intelligence,” “metabolic disorders,” and “mental health.” Studies evaluating digital biomarkers, predictive algorithms, and clinical or public health applications of wearable-based monitoring were included. Results: Current evidence indicates that wearables reliably measure sleep duration, activity levels, heart rate variability, and proxies of circadian alignment. AI-driven analytics enhance the precision of these measurements, enabling early detection of circadian misalignment and prediction of health outcomes such as metabolic syndrome or depressive episodes. Applications include continuous monitoring in high-risk populations, integration with telemedicine platforms, and development of personalized lifestyle interventions. However, challenges persist, including limited validation against gold-standard clinical tools, data privacy concerns, lack of standardized protocols, and unequal access to digital health technologies. Conclusion: Wearable devices combined with AI-based analytics represent a promising approach to promoting circadian health and preventing related disorders. Future research should prioritize rigorous clinical validation, ethical frameworks for data management, and integration into healthcare systems to maximize their potential impact on both individual and population health.

Introduction: Ankylosing spondylitis (AS) is a chronic and progressive systemic disease of unknown cause, characterized by inflammation and ossification. This disease affects the sacroiliac joints and the joints of the spine, including the costovertebral and costotransverse joints, as well as the peripheral joints and tendon attachment sites. Due to the long-term and difficult course of AS, improving quality of life is one of the key goals of therapeutic measures. Regular physical activity is considered an important element of comprehensive treatment, supporting both pharmacological and rehabilitative treatment. Objectives: The aim of this study is to analyze the impact of physical activity on the quality of life of patients with AS. Specific objectives include: examining differences in quality of life in the context of physical activity levels (assessed, among others, using the SF-36 and ASQoL questionnaires), to identify the most effective forms of exercise (e.g., stretching, swimming, yoga, Nordic walking), to analyze the relationship between physical activity and pain intensity and mobility, and to assess compliance with activity recommendations in this group of patients. Methodes: This work is based on review materials, the most recent research, and compilations and comparisons of materials. Results: An analysis of existing studies emphasizes that regular physical activity helps reduce pain, improves mobility, has a positive effect on mental well-being, and may slow the progression of the disease. Conclusion: In summary, physical activity is a key element in improving the quality of life of people with AS. Its importance as part of therapy should be emphasized in daily clinical practice, and the greatest benefits are achieved by tailoring the exercise plan to the specific needs of the patient.

Introduction: Visceral obesity contributes to dysfunction of the integrated cardio-renal-pulmonary (CORP) axis, promoting insulin resistance, chronic low-grade inflammation, hypertension, and glomerular hyperfiltration. Physical activity (PA) is recognized as an effective therapeutic and preventive strategy; however, its specific impact on all components of the CORP axis requires a comprehensive analysis. Objective: To evaluate the effects of various forms of physical activity on: cardiovascular fitness and aerobic capacity (VO₂ max, cardiorespiratory fitness - CRF), renal function (glomerular filtration rate - GFR, albuminuria), pulmonary structure and function (lung volumes, tissue compliance), in adults with visceral obesity. Methods: A systematic review of the literature and selected meta-analyses of randomized controlled trials and cohort studies was conducted using PubMed, PMC, and Embase databases up to June 2025. Interventions included aerobic training, high-intensity interval training (HIIT), resistance training, and combined exercise programs. Changes in CRF, visceral adipose tissue (VAT), GFR, blood pressure, and lung function indicators were analyzed. Conclusions: Physical activity- particularly aerobic, interval, and combined training- has a beneficial effect on the function of the cardio-renal-pulmonary axis in individuals with visceral obesity. Key mechanisms include enhanced aerobic fitness, VAT reduction, improved metabolic profile, attenuation of inflammation, and nephroprotection. Regular exercise should be an essential component of therapeutic and preventive strategies in this population. Further research is warranted to clarify the dose-response relationship between exercise type/intensity and improvements in each CORP axis system.

Introduction: Metabolic syndrome (MetS) is an increasingly significant health issue among young adults, marked by the coexistence of visceral obesity, insulin resistance, dyslipidemia, and hypertension. A key component of its pathogenesis is chronic low-grade inflammation, reflected by elevated levels of biomarkers such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Recently, attention has turned to the potential of physical activity as a modifiable factor that can influence inflammatory status and reduce MetS risk. Objective: This study aimed to review current scientific evidence on the impact of regular physical activity on selected inflammatory markers and the risk of MetS in young adults. Methods: A systematic literature review was conducted covering publications from 2015 to 2024. Scientific databases including PubMed, Scopus, and ScienceDirect were searched using keywords such as "physical activity," "inflammatory markers," "cytokines," "CRP," "TNF-alpha," "IL-6," and "metabolic syndrome." Included studies were randomized controlled trials, systematic reviews, and prospective cohort studies involving individuals aged 18–35. Results and conclusion: Findings revealed that regular physical activity- especially programs combining aerobic and resistance training- significantly lowered CRP, TNF-α, and IL-8 levels, while increasing anti-inflammatory cytokines. Participants with higher physical activity levels were consistently less likely to meet MetS diagnostic criteria, even after adjusting for BMI. Additional benefits included improved insulin sensitivity, reduced oxidative stress, and favorable changes in lipid profiles. The anti-inflammatory effects were dose-dependent, with the most significant outcomes observed in those performing at least 150 minutes of moderate-to-vigorous activity weekly. Physical activity should be regarded as a key preventive measure against MetS and long-term cardiovascular risk in young adults.

Attention Deficit Hyperactivity Disorder (ADHD) is currently being thoroughly investigated by the global medical community, resulting in a deeper comprehension of the disorder. The relationship between the intestine microbiome and the human body could be a noteworthy center of advanced inquire about, especially with respect to the gut-brain association. The intestine microbiome influences metabolic, immune, and neurological forms, sending signals to the brain through different immune and neurochemical pathways. Within the past, neuropsychiatric conditions were regularly credited exclusively to modifications within the brain, ignoring the affect of the resistant and metabolic frameworks. Later studies indicate that the microbiome can influence brain functioning by creating neuroactive compounds, which can in this way impact behavior and cognitive capacities. In this setting, there's an expanding interest approximately the part the intestine microbiome plays in neurodevelopmental conditions like ADHD. Aim of the study: The purpose of this paper is to elucidate the current state of knowledge regarding the correlation between gut microbiota and Attention Deficit Hyperactivity Disorder. It examines the pathways via which bacteria may influence the functioning of the gut-brain axis and the development and severity of symptoms of the disorder. It also delineates the most recent findings concerning the potential therapeutic modulation of gut microbiota composition as a complement to conventional ADHD treatment. Materials and methods: A review of the literature available in the PubMed and Google Scholar database was performed, using the key words: “gut microbiome”, “gut-brain axis”, “Attention Deficit Hyperactivity Disorder”, “ADHD”, “prebiotics”, “probiotics”, “synbiotics”, “short-chain fatty acids”.

VEXAS syndrome and Alzheimer’s disease (AD), though distinct in clinical manifestations, share overlapping pathophysiological mechanisms, including systemic inflammation, protein misfolding, and vascular dysfunction. VEXAS syndrome, a rare autoinflammatory disorder characterized by somatic UBA1 mutations, systemic inflammation, and hematologic abnormalities, presents primarily in older males. Meanwhile, AD, the leading cause of dementia, involves progressive neurodegeneration driven by amyloid-beta plaques, tau tangles, and chronic neuroinflammation. This article explores potential connections between the two conditions, focusing on inflammation, neurovascular changes and cellular stress. Systemic inflammation observed in VEXAS syndrome may potentiate neuroinflammatory processes in Alzheimer’s disease (AD), as circulating proinflammatory cytokines have the capacity to cross the blood–brain barrier (BBB), thereby inducing glial activation and promoting neuroinflammation. Additionally, coexisting vascular dysfunctions characteristic of both conditions may synergistically contribute to accelerated cognitive decline. Both conditions involve disruption of the ubiquitin–proteasome system, with UBA1 mutations being specific to VEXAS. Given the established role of UBA1 in maintaining neuronal homeostasis, investigating the overlapping and distinct molecular mechanisms may provide valuable insights into their pathophysiology. The review underscores the need for further research to elucidate these links and improve therapeutic strategies, especially for individuals affected by both disorders.