1 Military Clinical Hospital with Outpatient Clinic

Wstp: Neuroborelioza jest jedn z najczstszych pozamzgowych manifestacji zakaenia Borrelia burgdorferi i moe prowadzi do uszkodzenia nerwu twarzowego.Poraenie nerwu VII skutkuje asymetri twarzy, ograniczeniem funkcji mini mimicznych, trudnociami w artykulacji, poykaniu i mimice emocjonalnej.Rehabilitacja w przebiegu neuroboreliozy obejmuje zarwno kinezyterapi, jak i metody fizykalne, w tym elektrostymulacj mini twarzy, ktrej celem jest pobudzenie osabionych wkien miniowych,

Wstp: Neuroborelioza jest jedn z najczstszych pozamzgowych manifestacji zakaenia Borrelia burgdorferi i moe prowadzi do uszkodzenia nerwu twarzowego.Poraenie nerwu VII skutkuje asymetri twarzy, ograniczeniem funkcji mini mimicznych, trudnociami w artykulacji, poykaniu i mimice emocjonalnej.Rehabilitacja w przebiegu neuroboreliozy obejmuje zarwno kinezyterapi, jak i metody fizykalne, w tym elektrostymulacj mini twarzy, ktrej celem jest pobudzenie osabionych wkien miniowych,

Wheat allergy (WA) poses a diagnostic challenge due to its diverse clinical phenotypes-ranging from classic food allergy and wheat-dependent exercise-induced anaphylaxis (WDEIA) to baker's asthma. An additional diagnostic aspect is serological cross-reactivity with grass pollen. Undoubtedly, the transition from extract-based diagnostics to precise component-based diagnostics (CRDs) facilitates the management of wheat allergy. It has significantly improved the diagnostic accuracy for WDEIA ω-5-gliadin (Tri a 19), although considering new knowledge about wheat proteins, it seems necessary to include them in the diagnostic scheme, especially where Tri a 19 remains negative despite clinical symptoms. Therefore, in this review, we evaluate the clinical utility of new wheat molecules with a high risk of anaphylaxis. We pay particular attention to Tri a 37 (α-purothionin), a thermally stable allergen associated with a 4-fold increase in the risk of severe anaphylaxis, and Tri a 36 (LMW glutenin), which shows higher sensitivity than Tri a 19 in specific pediatric cohorts. In addition, we emphasize the role of Tri a 14 (nsLTP) in distinguishing true wheat sensitization from pollen-related cross-reactivity caused by profilins (Tri a 12) or carbohydrate determinants (CCDs). Beyond diagnostics, the review discusses dynamic changes in sensitization profiles in relation to the allergic march and the phenomenon of spontaneous remission in children. New management strategies are also discussed, including the potential of omalizumab (based on the data from the OUtMATCH study) in facilitating the reintroduction of allergens into the diet.

Background: Caffeine is one of the most popular and widely consumed stimulants. Its impact on various sports disciplines and types of exercise has been widely examined. However, its influence varies depending on the dosage and athletic discipline. This systematic review examines studies published recently (2020-2025), which assess the impact of caffeine on team sports and endurance-based sports. Aim: This study aims to present current knowledge regarding the role of caffeine on athletic performance in various sports disciplines. Materials and Methods: This review followed the PRISMA guidelines. The PubMed database was the main source of examined studies, where a structured search was conducted with strict criteria being: published year 2020-2025, well-trained athletes, and caffeine administered orally. The primary number of research results was 114; 73 were removed in the initial evaluation. Ultimately, after full-text analysis, 19 articles were included in this review. Results: Across 19 studies, caffeine doses ranged from 2 to 9 mg per kilogram or 160–250 mg in fixed-dose beverages. Mostly caffeine was administered 60 minutes before the examination. Endurance-based sports seem to benefit the most, which results in increased time to exhaustion, faster time on measured distances, and increased VO2 max. Team sports benefit from caffeine in better attack accuracy and improved jump height. The results presented in resistance and strength-based sports were inconsistent and were overall task and dosage-dependent. Conclusions: Caffeine can be an effective and beneficial aid, especially in endurance-based sports, where results were the most promising. Although its positive effect was also documented in basketball in volleyball’s jumping exercises. Evidence presented in the resistance and strength-based studies is not consistent enough to recommend caffeine as a reliable performance aid and more research is needed in this area.

Polycystic ovary syndrome (PCOS) represents the most common endocrine disorder in women of reproductive age, affecting 6–20% of this population depending on diagnostic criteria applied. Beyond its metabolic and reproductive consequences, PCOS significantly impacts mental health, particularly depression, anxiety, and body image disturbance. This clinical literature review synthesizes evidence from clinical studies and observational research examining the psychological burden of PCOS. Evidence indicates that women with PCOS experience markedly elevated rates of depression (approximately 49%) and anxiety compared to healthy controls, with depression predominantly presenting as mild to moderate severity. Lifestyle factors, including lack of exercise (OR=7.5), psychological stress (OR=6.5), sleep disturbance, and high-fat diet, constitute significant modifiable risk factors for depression. Body image disturbance emerges as a critical mediating factor between PCOS symptoms and psychological distress, affecting quality of life and overall well-being. Body appreciation, in contrast to mere absence of dissatisfaction, constitutes a particularly important protective factor for mental health. Cognitive-behavioral therapy (CBT) and psychosocial interventions demonstrate substantial efficacy in reducing depression and anxiety symptoms. Routine mental health screening and implementation of evidence-based psychological interventions are essential components of comprehensive PCOS care. This review emphasizes the necessity of integrated, multidisciplinary approaches addressing both physical and psychological aspects of PCOS, with particular attention to lifestyle modification as a therapeutic strategy.

This manuscript comprehensively reviews psilocybin-assisted therapy for major depressive disorder and treatment-resistant depression. It aims to synthesize current understanding regarding its mechanisms, efficacy, safety, costs, and accessibility, comparing it with conventional antidepressant and ketamine treatments. The methodology involved a narrative synthesis of academic literature, drawing from systematic reviews, meta-analyses, and clinical trials identified through targeted database searches. Key findings indicate that psilocybin therapy demonstrates rapid, robust, and sustained antidepressant effects, with high response and remission rates, often after one or two sessions. Its safety profile is generally favorable, with transient and mild adverse events. Mechanistically, psilocybin primarily acts on serotonin 5-HT2A receptors, modulating brain networks and enhancing neuroplasticity. However, significant challenges exist in terms of high costs, limited accessibility due to the intensive therapeutic model, and regulatory hurdles. In conclusion, psilocybin-assisted therapy offers a promising alternative for depression, particularly where standard treatments fail, by providing rapid and durable symptom reduction through unique neurobiological pathways. Future research should focus on optimizing treatment protocols, exploring long-term outcomes, identifying predictors of response, and addressing systemic barriers to accessibility and cost-effectiveness to facilitate its integration into broader mental healthcare.

In recent years, there has been growing interest in cannabinoids as potential analgesics and alternatives to opioids. Cannabinoids, through modulation of the endocannabinoid system, affect nerve transmission, neuroplasticity, and inflammatory processes, and their action on CB1 and CB2 receptors is similar to the mechanisms of the opioid system, in particular μ, δ, and κ receptors. The aim of this study was to compare the mechanisms of action of cannabinoids and opioids, review studies on their combined use, and assess the impact of chronic cannabinoid use and dependence on the effectiveness of opioid-based pain treatment. Analysis of the available data showed that moderate use of cannabinoids, especially preparations with a balanced THC and CBD content, can lead to an "opioid-sparing" effect, allowing opioid doses to be reduced without losing the analgesic effect. However, chronic use of cannabinoids, especially those with high THC content, is associated with the development of tolerance, mood disorders, desensitization of CB1 receptors, and disturbances in the co-regulation of μ receptors, which may lead to compensatory escalation of opioid treatment and the development of cross-addiction. In addition, partial clinical benefits have been observed in patients with neuropathic pain from the combination of cannabinoid and opioid therapy, while no clear analgesic effects have been observed in acute pain. The proposed predictive model integrates molecular, clinical, and psychological aspects, indicating that the effectiveness of analgesic therapy depends on the duration of exposure to cannabinoids, the type of pain, and the individual predisposition of the patient. The authors point to the need for further research involving patients who are chronic users of cannabinoids or addicted to them and who are scheduled to be treated with opioids. The results of such analyses could form the basis for the development of clinical guidelines for integrated pain therapy that minimizes the risk of addiction and treatment failure.

Background: Acute coronary syndromes in the course of ischemic heart disease remain the dominant cause of death in both female and male populations. In recent years, there has been increasing interest in gender-based differences in disease symptoms and outcomes. Taking the data into consideration and implementing it in a day to day practice might prove beneficial to patients and reduce the sex-specific disparities. Aim: The aim of this study is to gather recent information on the topic of sex-based differences in myocardial infarction and ischemic heart disease. We wanted to bring awareness to the issue and help clinicians understand what approach is best for patients prognosis. Material and methods: A review of studies including meta-analyses, clinical trials, cohort studies and systematic reviews was done with the use of various databases. The review focused on studies from last 10 years with individual older papers all mentioning the variations in women and men concerning ischemic heart disease and myocardial infarction. Results: Larger studies with better female representation seem to highlight the problem of women frequently carrying the burden of different risk profile, pathophysiology behind the disease, delayed presentation and less promising outcomes. However some studies in opposition show less significant differences in men and women regarding symptoms and mortality in myocardial infarction. Conclusions: The problem of sex differences in acute coronary syndromes should not be disregarded nor treated lightly since it has impact on both female morbidity and mortality. Part of research might still be inconclusive but that should only encourage researchers to delve deeper into it. Women seem to benefit from more personalized approach in both diagnostic procedures as well as treatment options.

Background. Candida auris is an emerging, multidrug-resistant fungal pathogen ofsignificant public health concern. Noted for its environmental persistence and hightransmissibility, it poses a substantial threat in healthcare settings, particularly inintensive care units, driving the need for specific infection control protocols. Aim. The aim of this study was a comparative analysis of environmental disinfectionmethods used in the prevention and control of Candida auris in various countries andhealthcare facilities.Material and methods. This review analyzed literature from 2016-2025, sourcedfrom databases such as PubMed, alongside public health guidelines andepidemiological reports. A comparative analysis of the selected data wasconducted. Results. Disinfection strategies against C. auris primarily recommend chlorine- andhydrogen peroxide-based agents, with UV-C and vaporized hydrogen peroxide (VHP)noted as supplementary measures. A comparative analysis revealed significantinternational divergence, particularly regarding quaternary ammonium compounds(QACs), which are largely restricted except in specific contexts like India. Overallefficacy is highly variable and dependent on disinfectant selection, workflow, stafftraining, and the consistency of protocol implementation. Conclusions. Chlorine- and peroxide-based disinfectants are most effective against C.auris, while QACs are discouraged despite their localized use. To counter variabilityin international guidelines, a unified regulatory framework is recommended. Keyrecommendations include standardizing procedures, enhancing staff training, andmaintaining strict surveillance. Further research, including hospital case studies, isneeded due to insufficient current data.

Background. Proton pump inhibitors (PPIs) are widely prescribed for gastrointestinal disorders. Their potent and persistent inhibition of gastric acid ensures efficacy but has raised concerns about adverse effects during long-term therapy. Aim. To summarize current evidence on the indications and clinical benefits of proton pump inhibitors in adults, and to review major long-term adverse effects and drug–drug interactions to guide safer treatment strategies. Material and methods. A narrative literature review was conducted using PubMed/MEDLINE for articles published between January 2016 and November 2025. Peer-reviewed human studies and major reviews on adults receiving oral PPIs were included if they addressed utilization, indications, duration of therapy, long-term adverse effects, drug-drug interactions, or deprescribing strategies. Pediatric studies, purely animal research, and non-peer-reviewed articles were excluded. Results. PPIs remain first-line treatment in gastroesophageal reflux disease, peptic ulcer disease, Helicobacter pylori eradication, and selected hypersecretory conditions. However, many patients receive these medications chronically without a clear ongoing indication or regular reassessment. Long-term PPI therapy can be linked to nutrient and electrolyte disturbances, increased fracture risk, renal complications, infections, and clinically relevant interactions with drugs such as clopidogrel and methotrexate. Cardiovascular and neurological risk signals remain inconclusive. Conclusions. PPIs should not be withheld from patients with justified indications, but must be prescribed thoughtfully. Clinicians need to use the lowest effective dose for the shortest necessary duration, regularly review indications, and educate patients to limit unnecessary chronic exposure while preserving the substantial benefits of PPI therapy.