Background Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment and dementia. The underlying mechanisms and the effectiveness of preventive interventions remain incompletely understood. Aim To review the association between T2DM and dementia risk, with particular emphasis on Alzheimer’s disease. Materials and Methods This narrative review included 53 publications identified through PubMed and Google Scholar searches conducted in May and June 2026, covering publications from January 2015 to June 2026. Reference lists were screened for additional sources. Eligible publications were written in English, with an exception for Polish national clinical guidelines. Publications without accessible full texts were excluded. Evidence was synthesized narratively. Results T2DM was associated with increased dementia risk, with a generally stronger association for vascular dementia than for Alzheimer’s disease. Proposed mechanisms included cerebral insulin resistance, oxidative stress, inflammation, and vascular injury. However, the evidence did not establish that T2DM directly causes Alzheimer’s disease. Longer diabetes duration, hypoglycaemia, and greater HbA1c variability were associated with higher dementia risk, while findings concerning mean HbA1c required cautious interpretation. Cognitive impairment may compromise diabetes self-management. Evidence concerning antidiabetic medications differed across drug classes and study designs. A meta-analysis of randomized trials reported a lower risk of dementia or cognitive impairment with GLP-1 receptor agonists, but limitations in outcome ascertainment and follow-up restrict its implications for prevention. Conclusions T2DM is associated with increased dementia risk. Cognitive difficulties should be considered within comprehensive diabetes care, but the reviewed evidence does not establish a specific glycaemic target or pharmacological intervention for dementia prevention. Further trials with adequate follow-up and systematic assessment of cognitive outcomes are needed.
Background Problematic smartphone use (PSU) has been associated with physical inactivity, mental health symptoms, and excess body weight in young people. However, its specific contribution beyond overall screen time and the mechanisms underlying these associations remain unclear. Aim To examine associations between PSU, physical activity, and obesity risk in children and adolescents, including potential psychological and behavioral pathways and relevant interventions. Materials and Methods A narrative review was conducted using PubMed and Google Scholar in September 2026. Forty-five sources published between 2010 and 2026 were included, comprising observational and intervention studies, systematic reviews, other literature reviews, and meta-analyses. The review focused on children and adolescents, with selected studies of young adults included as supplementary evidence. Results Studies reported associations between PSU, lower physical activity, and overweight or obesity, although findings varied. Reduced smartphone use was associated with increased physical activity in some studies, while exercise interventions reduced PSU scores. A cross-sectional mediation analysis identified indirect statistical associations with BMI z-scores through depressive symptoms and eating behaviour scores, without establishing causality. Sleep disturbances were also associated with PSU. Activity trackers increased daily step counts in a meta-analysis but did not significantly improve moderate-to-vigorous physical activity. Conclusions PSU is associated with physical activity and weight-related outcomes, but heterogeneous and predominantly observational evidence limits causal interpretation. Reducing smartphone use and promoting exercise may improve selected behavioural outcomes; their effectiveness in preventing obesity remains unestablished. Long-term prospective and intervention studies are needed to clarify these relationships and evaluate preventive strategies.
Background Cannabis-derived products are increasingly discussed in sports medicine for potential effects on performance, recovery, and athlete health. Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) have distinct pharmacological profiles, but evidence in athletes remains heterogeneous. Aim To summarize evidence on cannabinoids in exercise performance, recovery, athlete health, and anti-doping. Materials and Methods A narrative review was conducted using PubMed and MEDLINE, supplemented by reference-list screening of relevant publications available through 2025. Human studies in athletes or physically active populations and relevant reviews were synthesized qualitatively. Results The literature includes small controlled exercise studies, cross-sectional comparisons, recovery trials, and surveys. Evidence does not demonstrate consistent improvements in physical performance. One study of 24 physically active women found 17.6% and 20.1% lower power during the first two Wingate stages among regular cannabis users. Conversely, a placebo-controlled crossover study of nine habitual users found no significant effects of 10 mg oral THC on cardiorespiratory responses, functional threshold power, or peak sprint power. THC exposure has been associated with changes in reaction time, memory, and oculomotor measures, although many psychomotor studies were not sport-specific. Athletes report possible CBD benefits for sleep, pain, and recovery, but controlled evidence in athletes remains limited. Cannabis use also raises cardiovascular and respiratory safety concerns. Conclusions Cannabis is not established as an ergogenic aid. THC may impair psychomotor function, while CBD-related recovery benefits remain unconfirmed. Larger, well-controlled studies in athletes are needed.
ackground Chronic cholestatic liver diseases disrupt bile acid homeostasis and may cause severe pruritus that impairs quality of life. Conventional treatments often provide incomplete relief. Ileal bile acid transporter (IBAT) inhibition reduces enterohepatic bile acid recirculation, offering a targeted approach to cholestatic pruritus. Aim To synthesize the current evidence on IBAT inhibition in chronic cholestatic liver diseases, focusing on its mechanisms of action, efficacy in controlling pruritus, effects on liver-related outcomes, safety, and potential for disease modification. Materials and Methods PubMed, Google Scholar, and ClinicalTrials.gov were searched for publications from January 2016 to August 2026; the final search was on 25 August 2026. Clinical, observational, preclinical, and guideline-based evidence on IBAT inhibition in chronic cholestatic liver diseases was narratively synthesized, focusing on efficacy, safety, liver-related outcomes, and potential disease modification. Results IBAT inhibitors reduced pruritus and serum bile acids in several cholestatic disorders, with effects varying across studies. Odevixibat and maralixibat improved pruritus in PFIC and Alagille syndrome, while linerixibat showed efficacy in PBC. Evidence for volixibat remains preliminary. Observational associations with improved native liver and event-free survival do not establish disease modification. Diarrhea was the most common adverse event; fat-soluble vitamin deficiency and liver test abnormalities are additional safety concerns. Conclusions IBAT inhibition represents an established therapeutic approach for cholestatic pruritus in selected cholestatic disorders. However, its effects on long-term liver disease progression, the need for liver transplantation, and mortality remain unestablished. Further adequately powered, long-term studies using clinically meaningful endpoints are needed to determine whether sustained IBAT inhibition can modify the natural history of chronic cholestatic liver disease.
Background The potential effects of chronic tonsillitis (CT) on female reproductive function have been discussed in the context of systemic inflammation and focal infection. However, the clinical significance of its hypothesized association with infertility remains unestablished. Aim To critically evaluate clinical and experimental evidence and formulate a testable hypothesis of tonsillar-ovarian interaction. Materials and Methods A narrative literature review was conducted with consideration of the SANRA criteria. PubMed was searched through 29 September 2026 without a lower publication date limit. Additional searches covered scientific journal websites, research repositories, and reference lists of retrieved publications. A total of 61 publications were included in the analysis. Direct clinical evidence and indirect mechanistic evidence were synthesized separately, taking into account study design, population, reproductive outcomes, and limitations. No meta-analysis was performed. Results None of the included publications established active CT as an independent risk factor for female infertility. Direct clinical studies primarily assessed pregnancy loss, intermediate physiological measures, and outcomes following tonsillectomy. Their interpretation is limited by observational designs, probable overlap between some study populations, and incomplete reporting of methods. The association between tonsillectomy and a higher rate of subsequent pregnancy does not establish a causal effect of surgery. Indirect evidence suggests four groups of potential mechanisms: alterations in ovarian endocrine function, endometrial immune regulation, hematogenous microbial translocation, and oxidative damage. However, findings from models of oral inflammation, systemic inflammation, and other pathological conditions do not establish analogous processes in women with CT. Conclusions Tonsillar-ovarian interaction remains a hypothesis requiring direct clinical and experimental investigation. The evidence reviewed does not justify incorporating tonsillar assessment into routine infertility evaluation or treating CT to increase the probability of pregnancy. Prospective studies assessing the probability of conception and time to pregnancy, with adjustment for potential confounding factors, are needed.
