Mateusz Zimowski

Introduction. Creatine monohydrate is among the most extensively researched dietary supplements, yet it remains widely perceived as a tool of athletic performance enhancement. Its fundamental role in cellular energy homeostasis across metabolically demanding tissues — including skeletal muscle, brain, and myocardium — suggests a broader clinical relevance that has not been systematically addressed in recent literature. Materials and Methods. A narrative review was conducted using PubMed and Google Scholar, focusing on peer-reviewed original research, systematic reviews, meta-analyses, and position statements published up to April 2025. Search terms included combinations of "creatine," "creatine monohydrate," "phosphocreatine," and condition-specific terms covering skeletal muscle diseases, neurodegenerative disease, depression, sarcopenia, type 2 diabetes, cancer cachexia, traumatic brain injury, pregnancy, and renal safety. A total of 98 sources were included. Conclusions. Creatine supplementation demonstrates well-established ergogenic efficacy in sport and clinically meaningful benefits in skeletal muscle diseases, sarcopenia, and cognitive ageing. Promising evidence supports its adjunctive role in depression and type 2 diabetes, while data in traumatic brain injury remain largely paediatric. Evidence in cancer cachexia is predominantly negative. The safety profile of creatine monohydrate is reassuring across age groups; the observed rise in serum creatinine represents a pharmacokinetic artefact. Pregnant women and patients with advanced chronic kidney disease require individualised assessment. Across clinical areas, mechanistic evidence is often compelling but large trials with standardised dosing and clinically meaningful endpoints remain scarce. Creatine is not only for athletes — its accessibility, tolerability, and growing clinical evidence base make it a strong candidate for broader integration into clinical practice.

Introduction:Hypertension is considered one of the most common chronic diseases affecting over 30 % of the population of adults in the world. Also is the most important modifiable risk factor for cardiovascular disease(CVD). Heatwaves, defined as periods of extremely high temperatures lasting at least 2–3 days, pose a growing threat to public health amid climate change. The climate is changing, and simultaneously leading to a higher frequency of extreme weather events, including heatwaves. The impacts of heatwaves on human health and their underlying mechanisms, particularly regarding the cardiovascular system, are well-known. Heatwaves can impact blood pressure and control of hypertension through many different mechanisms. This paper aims to review the relationship between heatwaves and hypertension, including incidence, blood pressure variability, and cardiovascular outcomes.Materials and methods: A review of selected literature in the PubMed, Scopus, and ScienceDirect for studies published between 1990 and 2026.Conclusions:The rise of heatwaves as an increasingly concerning environmental issue, that can affect cardiovascular health will contribute to blood pressure regulation. Heat causes vasodilation initially, but there are compensatory mechanisms like dehydration, activation of the sympathetic nervous system, hormonal response which will result in transiently elevated blood pressure, and increased risk for cardiovascular events. Despite mounting research evidence, the link between heatwaves and the development of hypertension is poorly understood, current literature contains limited heterogeneous data on this topic. Additional research is needed to evaluate whether heatwaves act as a causal or triggering agent to cause dysregulation of blood pressure in order to develop effective public health interventions.

Background. Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders worldwide and remains an important public health concern. The disorder is characterized by persistent inattention, hyperactivity, and impulsivity that impair functioning across multiple domains. Purpose: This narrative review aimed to synthesize current evidence on the effects of physical activity and structured exercise interventions on cognitive performance, behavioral symptoms, and neurobiological mechanisms in individuals with ADHD. Materials and methods: Peer-reviewed studies published between 2010 and 2025 were identified through PubMed, Scopus, Web of Science, and ScienceDirect. Studies evaluating exercise interventions in people with ADHD and reporting cognitive, behavioral, or neuropsychological outcomes were included. Results: Available evidence suggests that physical exercise may reduce ADHD symptom severity and improve executive functions, especially working memory, inhibitory control, and cognitive flexibility. These effects are likely mediated by neurobiological adaptations involving catecholamines, neurotrophic factors, and enhanced neural efficiency. Conclusions. Physical exercise appears to be a promising adjunctive intervention in ADHD management. Although it should not replace pharmacotherapy when indicated, regular physical activity may strengthen therapeutic outcomes and support cognitive, behavioral, and emotional functioning.

Introduction: Active and passive smoking are leading global causes of cardiovascular (CVD) mortality, accounting for 2.25 million deaths annually (2021 data). Alternative nicotine delivery systems (e-cigarettes, heated tobacco products [HTP], snus, nicotine pouches) have surged in popularity, driven by aggressive marketing, 15,000 known flavor additives, and misconceptions of negligible harm, especially among youth. This study assesses how eliminating combustion in these products modifies CVD risk. Nicotine's independent role in atherosclerosis pathogenesis remains under investigation. It strongly stimulates the sympathetic nervous system, increasing plasma adrenaline up to 2.5-fold. This heightens hemodynamic load, potentially triggering acute CVD events, particularly in patients with existing cardiac conditions. Materials and methods: A PubMed literature review was conducted using keywords: "Nicotine pharmacokinetics", "Cardiovascular risk", "E-cigarettes", "Heated tobacco products", "Snus", "Nicotine pouches", "Endothelial dysfunction". Conclusions: Eliminating combustion (pyrolysis) significantly reduces released toxins compared to tobacco smoke. HTP aerosols contain >90% fewer harmful substances, and e-cigarettes release <2 µg of HPHC versus 3000 µg in tobacco. However, these products remain unsafe for the CV system. Nicotine's sympathomimetic effects increase blood pressure and heart rate, and exacerbate insulin resistance; animal studies indicate up to a 57% decrease in insulin-dependent glucose uptake. Furthermore, HTP and ENDS aerosols induce inflammation (increased IL-6, TNF-α, hsCRP), oxidative stress, and secondary vascular endothelial dysfunction. Popular flavor additives (cinnamaldehyde, eugenol, diacetyl) also demonstrate proven cytotoxic effects. Alternative nicotine products have high addictive potential and an undeniably negative CV impact, highlighting an urgent need for long-term health outcome studies.

Background. The microbiota–gut–brain axis (MGBA) is a key pathway in the pathophysiology of depression, integrating neural, immune, and metabolic mechanisms and influencing processes relevant to mood regulation. Aim. This narrative review summarizes current evidence on the role of the MGBA in depression, including microbial composition, functional pathways, biomarkers, and therapeutic interventions. Material and methods. A literature search was conducted in PubMed and PMC (2018–March 2026, including key earlier studies). The review focused on microbial alterations, metagenomic functions, intestinal barrier and immune biomarkers, microbial metabolites, and clinical trials. Results. Cohort studies show associations between depressive symptoms and gut microbial taxa involved in neuroactive pathways; however, findings are heterogeneous and of limited diagnostic value. Experimental studies support causality, as microbiota from patients with major depressive disorder induce depression-like behaviors in rodents. Vagal nerve integrity appears necessary for some microbiota-mediated effects, and stress-related dysbiosis may contribute to microglial activation and impaired neurogenesis. Biomarker studies indicate increased intestinal permeability and elevated markers of microbial translocation (e.g., zonulin, LPS-binding protein, sCD14), though their clinical utility remains unclear. Clinical trials suggest probiotics may reduce depressive symptoms as adjunctive therapy, while evidence for prebiotics is inconsistent and fecal microbiota transplantation remains experimental. Conclusions. The MGBA plays an important role in depression, but further standardized and longitudinal studies are needed to clarify mechanisms and support clinical applications, particularly for personalized therapies.

Collagen is the main structural protein of connective tissues and plays an important role in maintaining skin structure, elasticity, and hydration. In recent years, oral collagen peptide supplementation has attracted considerable scientific interest as a nutritional strategy aimed at supporting skin health and connective tissue metabolism. The aim of this review was to summarize current evidence from human clinical studies investigating the effects of oral collagen peptide supplementation on skin-related outcomes and to discuss its potential implications for connective tissue in the context of physical activity. A literature search was conducted in the PubMed database focusing on human studies evaluating oral collagen supplementation and its effects on skin physiology. Studies assessing skin hydration, elasticity, wrinkle depth, and dermal matrix structure were included in the analysis. The reviewed clinical trials generally report improvements in skin hydration and elasticity following several weeks of collagen peptide supplementation. Some studies also indicate reductions in wrinkle depth and improvements in dermal structure. In addition, evidence suggests that collagen supplementation combined with physical activity may support connective tissue adaptation. Overall, oral collagen peptide supplementation may represent a promising nutritional strategy supporting skin health and potentially connective tissue function.