Filip Szydzik

Background: Habitual physical activity (PhA) may contribute to overall physiological reserve, yet its relevance for lung transplantation (LTx) remains unclear, as existing studies almost exclusively explore short-term exercise interventions. This study evaluates whether life-course PhA before LTx influences postoperative outcomes: functional capacity measured by 6 min walk test (6MWT), chronic lung allograft dysfunction (CLAD), and length of hospital stay (LOS). Methods: In this retrospective study, ninety-seven LTx recipients completed the Historical Adulthood Physical Activity Questionnaire (HAPAQ), assessing PhA from age 20 to transplantation. All participants were assessed within the same time frame, with varying time intervals since transplantation. Patients were classified into no/recreational/intensive sport groups based on regular participation. Statistical analyses examined sport group differences in 6MWT, CLAD, and LOS and interactions with sex, pulmonary disease type, and secondary pulmonary hypertension (PH). Results: Lifelong PhA did not significantly differentiate quantitative 6MWT, CLAD, or LOS, and no interaction effects were observed. A modest trend was noted in patients without secondary PH, among whom intensive PhA corresponded to more frequent within-norm qualitative 6MWT results. Outcomes were comparable between single- and double-lung (DLTx) recipients, although a moderate effect between sports groups suggested a possible DLTx compensatory advantage. Conclusions: This study provides the very first life-course assessment of PhA in LTx recipients, highlighting the value of HAPAQ for estimating pre-transplant physiological reserve. Despite postoperative outcomes being largely independent of lifelong PhA, and recovery appearing multifactorial, habitual PhA should not be overlooked in developing individualized prehabilitation strategies in transplant medicine.

Objective: This review aims to synthesize current evidence on the injury epidemiology of kitesurfing, focusing on common trauma patterns, underlying risk factors, and the effectiveness of safety strategies. Methods: A systematic literature search was conducted in PubMed and SPORTDiscus for articles published between 2000 and 2024. Studies were included if they reported original quantitative data on kitesurfing-related injuries, including incidence, anatomical distribution, severity, or safety practices. A narrative synthesis was applied due to methodological heterogeneity. Results: Injury incidence rates ranged from 4.3 to 10.5 per 1, 000 hours of kitesurfing exposure. The most frequently injured areas were the lower extremities, particularly the foot, ankle, and knee. Common injury types included abrasions, sprains, and soft-tissue trauma, with serious injuries such as spinal fractures and head trauma occurring less frequently but with notable severity. Experience level was inversely correlated with injury risk, while environmental factors—such as wind instability and shallow water—significantly contributed to accidents. Although quick-release harness systems are now widely adopted (97%), their real-time use during injury events remains low (7.3%). Helmet (4%) and impact vest (19.5%) usage remains limited despite recommendations. Conclusion: Kitesurfing presents a distinct injury profile influenced by biomechanical demands, environmental variables, and user behavior. While most injuries are mild and permit rapid return to sport, severe cases still occur, underscoring the need for improved safety education, structured training, and increased protective gear compliance. Future research should emphasize standardized reporting and long-term outcome tracking to better inform injury prevention strategies.

Introduction: Inherited retinal diseases (IRDs) are a group of disorders that lead to progressive vision loss, for which no effective treatments have previously been available. Advances in molecular biology have enabled the development of gene therapies and innovative strategies such as optogenetics, offering hope for improvement or restoration of visual function. Aim: The aim of this work is to present the current state of knowledge regarding gene therapies used in IRDs, with particular emphasis on their mechanisms of action, possibilities for personalization, integration with other methods, and the potential of optogenetics as an alternative in advanced stages of the disease. Methods: A literature review was performed using PubMed, Google Scholar, Scopus, and Web of Science. Thirty-nine English publications relevant to inherited retinal diseases and gene therapies were selected. Studies covered mechanisms, efficacy, safety, and diagnostic advances. Irrelevant or methodologically weak papers were excluded. Results: Therapies based on AAV vectors, CRISPR/Cas9 techniques, prime editing, and antisense oligonucleotides demonstrate effectiveness depending on the type of mutation and disease stage. Optogenetics enables the restoration of light sensitivity regardless of the mutation, even in the absence of photoreceptors. Combining gene therapy with other methods, such as stem cells or neuroprotection, enhances therapeutic potential. Conclusions: Gene and optogenetic therapies are transforming the treatment approach for IRDs. Selecting strategies based on the molecular background and disease stage enables a personalized approach. Technical and regulatory challenges remain, but development trends indicate a real possibility of effective treatment for many forms of IRDs.

Introduction and Aim: The advancement of immunosuppressive therapy has significantly increased organ transplantations. Among immunosuppressive agents, basiliximab and anti-thymocyte globulin (ATG) are key in induction therapy. However, clear guidelines on when to use basiliximab alone, ATG alone, or their combination are lacking, posing clinical challenges. This study aims to review recent data on basiliximab and ATG use in induction therapy post-transplant. Materials and Methods: A literature review was conducted using PubMed with keywords “basiliximab”, “ATG” and “immunosupression" including articles published up to September 2024, focusing on studies from the last two years. The review targeted information on their application in induction immunosuppression after vascularized organ transplantation, effects relative to organ type, and drug combinations. Results: Basiliximab and ATG differ in efficacy and side effects. ATG is more effective in reducing acute rejection, especially in high-risk patients, but carries higher infection and hematologic risks. Basiliximab has a better safety profile, suitable for elderly or low-risk patients. Treatment should be individualized by age, immunological risk, and infection susceptibility. Steroid continuation after basiliximab induction improves outcomes, a benefit not clearly seen with ATG. Conclusion: Induction therapy is advised for high-risk patients and certain transplants, mainly using ATG, Grafalon, or basiliximab. ATG may be a safe, effective alternative to basiliximab, which is preferred in older or comorbid patients. Limited data support ATG use in other transplants like pediatric heart transplants. Further multicenter trials and personalized therapy are needed.

Introduction and Aim: Systemic sclerosis (SSc) is a chronic, progressive disease that leads to multi-organ failure. In its pathogenesis, inflammation plays a significant role, particularly due to the reduced frequency of regulatory T cells that modulate this process. The aim of this paper was to analyze the available scientific evidence to determine how physical activity influences the reduction of inflammation and its relevance in the therapy of systemic sclerosis. Results: Systemic sclerosis is associated with a chronic inflammatory state, as indicated by elevated inflammatory markers such as C-reactive protein and ferritin, which correlate with disease severity and symptom progression. Physical activity demonstrates potential in modulating inflammation by lowering inflammatory markers and improving overall bodily function. Regular, supervised exercise in patients with SSc yields measurable benefits, enhancing exercise capacity, muscle strength, quality of life and respiratory function. Materials and Methods: During the writing of this paper, data analysis was conducted based on a review of available articles published in the PubMed database. The following combination of keywords was used: „sport in systemic sclerosis", „physical exercise in systemic sclerosis", "sport in systemic sclerosis”, „inflammation in systemic sclerosis” „inflammation and exercise”. The following filters were applied: Free full text, Clinical Trial, Randomized Clinical Trial and within the last 10 years. Conclusion: Chronic inflammation in systemic sclerosis accelerates the development of complications, while regular, moderate physical activity under supervision can improve physical capacity, microcirculation, and reduce inflammatory symptoms. However, further research is necessary to confirm the beneficial effects of exercise as a therapeutic intervention in systemic sclerosis.

Objectives: Syncope in athletes presents a complex diagnostic challenge requiring systematic evaluation to differentiate benign neurally-mediated causes from potentially life-threatening cardiac conditions. Unrecognized cardiovascular disease in athletes can lead to sudden cardiac death, making accurate risk stratification essential for athlete safety and appropriate return-to-play decisions. We aim to provide a comprehensive synthesis of current evidence regarding the indications, protocols, diagnostic yield, and limitations of exercise stress testing in athletes presenting with syncope. Methods: We conducted a narrative literature review of PubMed databases from 2004-2025, focusing on studies involving athletic populations and recent consensus statements from major cardiovascular and sports medicine organizations. Evidence was synthesized from observational studies, clinical guidelines, and expert consensus documents. Key findings: Exercise stress testing is strongly recommended for all athletes with exertional syncope, with sport-specific, maximal-effort protocols yielding arrhythmic or ischemic findings in 15-25% of cases. Negative predictive values approach 95% when proper protocols are employed, significantly reducing the probability of exercise-induced life-threatening events, though residual risk remains. Current evidence supports individualized testing protocols rather than generic clinical protocols designed for ischemia detection. Integration with comprehensive clinical assessment, ECG, echocardiography, and risk factor evaluation optimizes diagnostic accuracy and clinical decision-making. Conclusions: Sport-specific, effortful exercise stress testing serves as a pivotal diagnostic tool and safety gatekeeper in athletic syncope evaluation. When integrated within systematic algorithms it enables accurate risk stratification, specialist referral, and evidence-based return-to-play decisions. Future research should focus on protocol validation, long-term outcome studies, and integration of emerging technologies for further enhancement of diagnostic precision.

Introduction and Aim: COVID-19, especially severe in the elderly, causes symptoms ranging from mild to critical organ failure and death. Treatments have included chloroquine, hydroxychloroquine, and corticosteroids. Tocilizumab, a monoclonal antibody blocking the IL-6 receptor, offers a promising biological therapy by reducing inflammation and possibly lowering thrombosis risk in COVID-19 patients. The aim of this review is to summarize current evidence on tocilizumab’s mechanism and its role in treating SARS-CoV-2 infection. Material and Methods: A PubMed literature search was conducted using terms: “tocilizumab in COVID-19”, “interleukin-6 in COVID-19”, “interleukin-6 blockade with tocilizumab”, and “COVID-19 and inflammation”. Filters included Free Full Text, Clinical Trial, Randomized Clinical Trial, within the last 10 years. Results: Studies show that tocilizumab reduces inflammation, shortens hospitalization, and accelerates recovery in COVID-19 patients, especially those with respiratory failure not yet on mechanical ventilation. Additionally, tocilizumab exhibits anticoagulant effects, potentially reducing thrombosis risk. Conclusion: Originally used for rheumatologic diseases, tocilizumab shows therapeutic potential in COVID-19 by lowering inflammation and reducing mechanical ventilation needs, improving clinical outcomes. However, inconsistent study results highlight the need for further large, well-designed clinical trials to confirm its efficacy and safety.