Background. Overtraining syndrome (OTS) is a maladaptive state arising from chronic imbalance between training/non-training stress and recovery, historically attributed to dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis. Despite decades of research, no validated biomarker or diagnostic threshold exists, and the directionality of HPA involvement remains contested.Aim. To critically synthesise evidence on HPA-axis mechanisms in OTS, contrast them with competing pathophysiological hypotheses, and evaluate the diagnostic uncertainty limiting clinical recognition and management.Materials and Methods. Narrative review of peer-reviewed English-language systematic reviews, cross-sectional and longitudinal cohort studies, case series, consensus statements, and mechanistic physiological studies addressing OTS, HPA-axis function, hormonal biomarkers, and related conditions in athletes.Results. Basal cortisol and ACTH are generally unhelpful diagnostically, whereas stimulation-test responses (insulin tolerance test, two-bout exercise protocol) more consistently reveal blunted late hormonal reactivity in overtrained athletes, though findings remain inconsistent across cohorts. The testosterone-to-cortisol ratio, cytokine, glycogen, central-fatigue, autonomic, and gut-brain-axis hypotheses each explain fragments of the clinical picture without unifying explanatory power. Composite instruments (EROS-COMPLETE, EROS-SIMPLIFIED) show promising discrimination in small single-sex cohorts but lack external validation.Conclusions. HPA-axis dysfunction in OTS is real but neither sufficient nor specific as a diagnostic criterion. Progress requires standardised stimulation-testing protocols, sex-inclusive cohorts, and multi-domain composite instruments rather than continued pursuit of a single biomarker.
Background: Physical activity supports systemic vascular and metabolic health and may be associated with lower risk of selected ocular diseases. Sport nevertheless creates preventable retinal hazards through blunt impact, repetitive head and globe loading, rapid pressure change, and delayed recognition of retinal breaks. Aim: To synthesize the benefits of physical activity for retinal and ocular health while defining mechanisms, sport-specific patterns, diagnosis, management, prevention, and return-to-sport considerations for sports-related retinal trauma. Material and methods: A narrative review was conducted using a user-specified 25-reference core bibliography. PubMed/MEDLINE and publisher records were checked through 14 August 2026. Targeted supplementary searching addressed physical activity and ocular health. Evidence was organized by mechanism, sport, clinical pathway, and prevention; no meta-analysis was performed. Results: The evidence supporting retinal benefit from physical activity is predominantly associative. Squash-ball and soccer-ball impacts, boxing and mixed martial arts, and competitive or compressed-gas diving produce distinct exposure patterns. Reported lesions include retinal dialysis, tears, detachment, macular holes, commotio retinae, hemorrhage, choroidal rupture, and delayed neovascular complications. Conclusions: The appropriate balance is safer participation rather than inactivity. Exercise should be encouraged for established systemic benefits without claiming that it prevents retinal detachment. Certified protective equipment, education, rapid assessment, and individualized ophthalmic clearance can reduce avoidable visual harm.
Introduction: Congenital nephrotic syndrome is a rare condition with symptom onset occurring within the first three months of life. It affects approximately 1 to 3 per 100,000 live births. It has a varied etiology on a genetic, non-genetic, and infectious basis. While management primarily relies on symptomatic care, advances in modern medicine have significantly improved long-term outcomes, slowly ensuring affected children normal functioning in the future. Aim: The primary aim of this literature review is to synthesize current knowledge regarding the etiology and clinical presentation of CNS, and to compare the efficacy of evolving therapeutic methods, contrasting conservative medical management with radical surgical and renal replacement strategies. Keywords: Congenital Nephrotic Syndrome; NPHS1 Gene; Nephrin; Glomerular Filtration Barrier; Bilateral Nephrectomy; Kidney Transplantation; Pediatric Nephrology. Materials and methods: This study is a narrative literature review based on the analysis of scientific articles concerning congenital nephrotic syndrome (CNS). The reviewed studies included neonates and infants with CNS, focusing on genetic causes, medical and surgical management (nephrectomy), and kidney transplantation outcomes. Clinical guidelines, literature reviews, meta-analyse, cohort studies, and case reports published between 2001 and 2026 were analyzed. Conclusions: Congenital nephrotic syndrome (CNS) lacks a universal treatment protocol, demanding a strictly personalized, multidisciplinary approach tailored to the unique clinical, metabolic, and genetic profile of each infant. Early prenatal detection is critical for planned delivery in tertiary centers and immediate postnatal stabilization. While contemporary management remains purely symptomatic and supportive, optimizing long-term outcomes requires expanded multicenter registries and a decisive shift in research toward causal, gene- and molecular-targeted therapies.
Background: The rising popularity of over-the-counter eyelash serums containing prostaglandin analogues (PGAs) has raised safety concerns due to their pharmacological origin as glaucoma treatments and their current cosmetic misuse without medical supervision. Aim: To evaluate scientific evidence regarding the safety of PGA-containing eyelash serums, focusing on mechanisms, adverse effects, impact on intraocular pressure (IOP), and regulatory challenges. Material and Methods: A comprehensive literature search was conducted across PubMed/MEDLINE, Scopus, and Web of Science for publications up to September 2026. Retrieved studies were qualitatively assessed and synthesized. Results: Chronic exposure to cosmetic PGAs is associated with periocular hyperpigmentation, conjunctival hyperaemia, tear film instability, meibomian gland dysfunction, and prostaglandin-associated periorbitopathy (PAP). While direct links to de novo glaucoma are lacking, active compounds can alter IOP and affect diagnostic accuracy. Regulatory bodies like the SCCS highlight insufficient safety data for safe cosmetic use near the eye. Conclusions: PGA-containing serums are pharmacologically active and not inert cosmetics, requiring stricter regulatory oversight, transparent labelling, enhanced cosmetovigilance, and clinical awareness.
Background: Plant-based diets are rising in elite sports, but their combined impact on inflammation, the gut microbiome, and muscle growth is poorly integrated. Objectives: Synthesize evidence on inflammatory/oxidative biomarkers, microbial diversity, short-chain fatty acids (SCFAs), muscle protein synthesis (MPS), hypertrophy, recovery, and performance in trained athletes. Methods: Review of randomized controlled trials (RCTs), acute crossover isotope tracer studies, meta-analyses, observational studies, 16S/metagenomic gut profiling, and metabolomic analyses. Results: Inflammation & Oxidative Stress: Plant diets lowered C-reactive protein (CRP) and urinary F2-isoprostanes; evidence for IL-6 and TNF-α was inconsistent. Gut Microbiome: Fiber- and lentil-rich diets increased SCFA producers and fecal acetate/butyrate, but overall results were too heterogeneous to confirm a performance-enhancing microbial signature. Muscle Anabolism & Performance: Single-source plant proteins showed lower acute MPS than whey, but higher doses, complementary blends, or leucine fortification equalized the response. Long-term training produced equivalent lean mass and strength gains when total protein intake was sufficient. Gaps: Limited data on top-tier professional athletes, women, and strictly vegan cohorts. Conclusion: Well-planned plant-based diets support high-level athletic performance and recovery provided energy, protein, amino acid distribution, and micronutrients are managed. While anti-inflammatory and gut health benefits are plausible, claims of superior athletic performance remain unproven.
