Karolina Szałata

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder marked by memory impairment, cognitive deterioration, and neurobiological changes, notably the accumulation of amyloid-beta (Aβ) and tau pathology. Recent data suggests that consistent physical activity (PA) may delay the onset and progression of Alzheimer's disease (AD) through various neuroprotective mechanisms. This research synthesizes results from 31 contemporary investigations encompassing both human and animal subjects. The focus is on the impact of physical activity on brain-derived neurotrophic factor (BDNF) expression, cerebral blood flow, inflammation reduction, and proteinopathy management. Brain-Derived Neurotrophic Factor (BDNF) is crucial for maintaining synaptic plasticity and promoting neurogenesis in the hippocampus, both of which are significantly compromised in Alzheimer's Disease (AD). PA-induced elevations in BDNF enhance cognitive resilience and neuronal integrity. Furthermore, exercise has been shown to enhance cerebral perfusion, so improving the delivery of oxygen and nutrients while promoting the disposal of waste, including glymphatic flow. The anti-inflammatory effects of PA entail the downregulation of pro-inflammatory cytokines (e.g., IL-6, TNF-α) and the upregulation of anti-inflammatory mediators, which alleviate chronic neuroinflammation commonly seen in Alzheimer's disease. Furthermore, PA appears to reduce oxidative stress by enhancing innate antioxidant systems, including superoxide dismutase and glutathione peroxidase. PA may significantly affect essential pathophysiological features of AD, such as amyloid-beta buildup and tau hyperphosphorylation, by promoting proteostasis and stimulating autophagy. Research from both preclinical and clinical studies repeatedly reveals associations between regular physical activity and improved cognitive function, augmented brain structural integrity, and less neurodegeneration. The data indicate that physical activity serves as a cost-effective, accessible, and non-pharmacological intervention with significant neuroprotective potential to reduce the risk of Alzheimer's disease and delay its development.

Introduction: The human skin microbiome is essential for maintaining skin homeostasis, modulating the immune response, and protecting against external threats. In recent years, researchers have increasingly focused on prebiotics and postbiotics bioactive chemicals that promote the proliferation of beneficial microorganisms or are produced by them as potential regulators of skin health. Although probiotics have attracted considerable interest as therapeutic agents, recent attention has focused on prebiotics, which selectively stimulate beneficial microbial populations, and postbiotics nonviable microbial products or metabolites with biological activity. Materials and Methods: This narrative review was based on an extensive analysis of the scientific literature published between 2010 and 2024. References were selected from sources such as PubMed, Scopus, and Google Scholar. The review focused on studies examining the mechanisms of action, clinical outcomes, and potential of prebiotics and postbiotics in the treatment or management of dermatological conditions. Results: The reviewed studies indicate that prebiotics and postbiotics can influence the skin microbiome by increasing microbial diversity, restoring barrier function, and reducing inflammatory responses. Evidence supports their effectiveness as supplements in the treatment of acne vulgaris, atopic dermatitis, psoriasis, and rosacea. Furthermore, their inclusion in cosmetic formulations appears to improve hydration, reduce transepidermal water loss, and enhance the skin's innate defense mechanisms. Conclusions: Prebiotics and postbiotics represent a potential microbiome-targeted therapeutic approach to dermatological problems, both cosmetic and medical. Their incorporation into dermatological and cosmetological techniques may facilitate personalized, non-invasive, and preventative skin care approaches. However, additional, standardized, large-scale clinical trials are necessary to confirm their long-term safety and efficacy.

Jaskra to postępująca neuropatia nerwu wzrokowego, która nieleczona prowadzi do nieodwracalnej ślepoty. Schorzenie to zajmuje drugie miejsce na świecie wśród przyczyn trwałej utraty wzroku. Choć podstawowym celem leczenia jest obniżenie ciśnienia śródgałkowego, to coraz większą uwagę zwraca się na strategie neuroprotekcyjne, mające na celu ochronę komórek zwojowych siatkówki przed degeneracją. Celem niniejszej pracy jest przegląd dostępnych metod neuroprotekcji w jaskrze. Omówiono w niej zarówno farmakologiczne podejścia, obejmujące inhibitory kinazy Rho, antagonistów glutaminianu (memantynę, cytykolinę), agonistów receptorów adrenergicznych (brymonidynę), statyny, czynniki neurotroficzne, antyoksydanty, kanabinoidy, preparaty roślinne (Ginkgo biloba, hupercyna A), jak i nowoczesne terapie oparte na komórkach macierzystych. Uwzględniono również mechanizmy działania tych substancji oraz aktualny stan badań klinicznych. Choć wiele z opisanych metod uzyskało obiecujące wyniki w modelach eksperymentalnych, to skuteczność kliniczna większości interwencji pozostaje przedmiotem dalszych badań.

Background/Objectives: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an effective treatment for motor symptoms in Parkinson’s disease (PD), but concerns remain regarding its impact on cognitive function. Identifying neuroanatomical predictors of postoperative cognitive decline could improve patient selection and outcomes. This study aims to investigate the relationship between preoperative brain morphology and postoperative neuropsychological outcomes in PD patients undergoing bilateral STN-DBS. Methods: Thirty-eight PD patients underwent standardized neuropsychological testing and preoperative MRI before and 3–24 months after STN-DBS. Manual MRI morphometric measurements were obtained for 42 cortical, subcortical, and ventricular parameters. Changes in cognitive domains—including executive function, memory, language, visuospatial abilities, attention, and global cognition—were analyzed, and correlations between structural metrics and cognitive changes were assessed using Spearman’s coefficients. Results: Significant postoperative declines occurred selectively in language functions: verbal fluency (phonemic and semantic, d = −0.49 to −0.84) and confrontation naming (d = −0.47). Memory, executive functions, attention, and global cognition remained preserved. Enlarged lateral ventricles were consistently associated with poorer outcomes across multiple domains, while increased left precentral gyrus width correlated with executive and memory decline. Additionally, smaller midbrain and cingulate gyrus width were associated with greater executive impairment. Conclusions: STN-DBS in PD is associated with selective postoperative cognitive changes, most prominently in verbal fluency. Simple preoperative MRI morphometric measures, including ventricular size, limbic structure volumes, and specific cortical parameters, may serve as clinically feasible predictors of cognitive risk. Incorporating such measures into preoperative assessments could enhance patient selection, counseling, and individualized surgical planning.

Background/Objectives: To evaluate whether incorporating both diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) in pituitary MRI examinations improves differential diagnosis by providing additional diagnostic value. Methods: A retrospective analysis was performed on 88 patients with histologically confirmed sellar or parasellar tumors who underwent 1.5T MRI with DWI and dynamic susceptibility contrast PWI (DSC-PWI) between October 2007 and April 2023. DWI parameters included minimum apparent diffusion coefficient (ADCmin) and relative ADCmin (rADCmin). PWI parameters included mean and maximum relative cerebral blood volume (rCBV, rCBVmax) and relative peak height (rPH, rPHmax), normalized to white matter. Tumor regions of interest were manually segmented, excluding calcified or hemorrhagic areas. Group comparisons and ROC analyses assessed diagnostic performance of individual and combined parameters. Results: Significant differences in diffusion and perfusion metrics were observed among the five tumor types. The combined analysis of DWI and PWI improved diagnostic accuracy in selected comparisons. The greatest benefit occurred in distinguishing meningiomas from solid non-functional pituitary adenomas (pituitary neuroendocrine tumors-PitNET), where the combination of ADCmin and rPHmax yielded an AUC of 0.818, sensitivity of 88%, and specificity of 76%, exceeding the performance of either parameter alone. In other comparisons, including meningiomas versus invasive PitNETs and adamantinomatous craniopharyngiomas, combined analysis did not substantially improve accuracy when single parameters, particularly rCBVmax (AUC = 0.995), already demonstrated excellent performance. Conclusions: Integration of DWI and PWI into pituitary MRI protocols enhances diagnostic performance in selected tumor groups. The additive value is context-dependent, supporting the tailored application of these sequences in the evaluation of sellar and parasellar tumors.

Polycystic ovary syndrome (PCOS) is a prevalent endocrine and metabolic disorder in reproductive age women, marked by insulin resistance, hyperandrogenism, menstrual irregularities, and increased cardiometabolic risk. This review synthesizes current evidence on the clinical effectiveness of metformin versus alternative strategies across anthropometric, glycemic, and lipid outcomes in women with PCOS. This narrative review synthesizes secondary data from systematic reviews and meta-analyses retrieved from PubMed and Google Scholar, comparing metformin with other interventions in reproductive-age women with PCOS across anthropometric, glucose, or lipid outcomes. Metformin showed modest benefits in reducing body mass index, body weight, and waist circumference, with greater effects in overweight and obese individuals. Combined therapies, especially with glucagon-like peptide-1 receptor agonists, were more effective than metformin alone. In glucose metabolism, metformin outperformed placebo and oral contraceptives in reducing fasting glucose, fasting insulin, and homeostatic model assessment of insulin resistance, especially in women with higher insulin resistance. Effects on lipid profiles were moderate; metformin lowered total cholesterol, low-density lipoprotein cholesterol, and triglycerides, particularly when combined with statins. Its effect on high-density lipoprotein cholesterol was limited and sometimes less favorable than that of oral contraceptives. Metformin remains a core treatment in PCOS, with consistent, modest benefits across metabolic and anthropometric domains. Its effectiveness improves when matched to patient profiles and combined with other agents or lifestyle changes.

Aim. Online surveys have become a vital tool in health research due to their cost- effectiveness, speed, and global reach. However, their methodological limitations – par- ticularly various forms of bias – may affect the validity and generalisability of findings. This review aims to provide an overview of the most common types of bias in online health surveys and to discuss strategies for their mitigation. Methods. A narrative literature review was conducted to identify and categorise the primary sources of bias associated with online survey research in health-related contexts. The review focused on three main areas: survey design and presentation bias, cognitive and psychological response biases, and selection bias. Studies addressing these issues were examined to extract examples and recommended mitigation approaches. Results. The review identified several key sources of bias. Poor survey design, exces- sive length, or misleading visual formatting – was associated with reduced data quality and increased dropout rates. Response biases, such as social desirability, recall errors, or avoidance of sensitive questions, were found to skew data, particularly in self- reported health measures. Selection bias emerged as a major concern, as access to and familiarity with digital technologies significantly influences who participates in online surveys. Indi- viduals with poorer health or limited digital literacy are often underrepresented. Conclusions. Despite their numerous advantages, online health surveys are vulner- able to various forms of bias that can compromise data validity. Researchers must care- fully consider survey design, sample recruitment, and respondent characteristics. Apply- ing strategies such as pre-testing, use of clear language, adaptive sampling techniques, and bias correction methods can enhance the quality of online survey data. When ethical standards are upheld and methodological rigour is applied, online surveys can remain a powerful and reliable tool in public health research.