Sirtuins are a family of proteins with enzymatic activity. There are seven mammalian sirtuins (SIRT1-SIRT7) that are found in different cellular compartments. They are a part of crucial cellular pathways and are regulated by many factors, such as chemicals, environmental stress, and phytochemicals. Several in vitro and in vivo studies have presented their involvement in anti-inflammatory, antioxidant, and antiapoptotic processes. Recent findings imply that phytochemicals such as resveratrol, curcumin, quercetin, fisetin, berberine, and kaempferol may regulate the activity of sirtuins. Resveratrol mainly activates SIRT1 and indirectly activates AMPK. Curcumin influences mainly SIRT1 and SIRT3, but its activity is broad, and many pathways in different cells are affected. Quercetin mainly modulates SIRT1, which triggers antioxidant and antiapoptotic responses. Fisetin, through SIRT1 regulation, modifies lipid metabolism and anti-inflammatory processes. Berberine has a wide spectrum of effects and a significant impact on SIRT1 signaling pathways. Finally, kaempferol triggers anti-inflammatory and antioxidant effects through SIRT1 induction. This review aims to summarize recent findings on the properties of phytochemicals in the modulation of sirtuin activity, with a particular focus on biochemical aspects.

Ursolic acid (UA) is a natural pentacyclic triterpenoid found in a number of plants such as apples, thyme, oregano, hawthorn and others. Several in vitro and in vivo studies have presented its anti-inflammatory and anti-apoptotic properties. The inhibition of NF-κB-mediated inflammatory pathways and the increased scavenging of reactive oxygen species (ROS) in numerous ways seem to be the most beneficial effects of UA. In mice and rats, administration of UA appears to slow down the development of cardiovascular diseases (CVDs), especially atherosclerosis and cardiac fibrosis. Upregulation of endothelial-type nitric oxide synthase (eNOS) and cystathionine-λ-lyase (CSE) by UA may suggest its vasorelaxant property. Inhibition of metalloproteinases activity by UA may contribute to better outcomes in aneurysms management. UA influence on lipid and glucose metabolism remains inconsistent, and additional studies are essential to verify its efficacy. Furthermore, UA derivatives appear to have a beneficial impact on the cardiovascular system. This review aims to summarize recent findings on beneficial effects of UA that may make it a promising candidate for clinical trials for the management of CVDs.

The rise in energy drink (ED) intake in the general population and athletes has been achieved with smart and effective marketing strategies. There is a robust base of evidence showing that adolescents are the main consumers of EDs. The prevalence of ED usage in this group ranges from 52% to 68%, whilst in adults is estimated at 32%. The compositions of EDs vary widely. Caffeine content can range from 75 to 240 mg, whereas the average taurine quantity is 342.28 mg/100 mL. Unfortunately, exact amounts of the other ED elements are often not disclosed by manufacturers. Caffeine and taurine in doses 3–6 mg/kg and 1–6 g, respectively, appear to be the main ergogenic elements. However, additive or synergic properties between them seem to be implausible. Because of non-unified protocol design, presented studies show inconsistency between ED ingestion and improved physical performance. Potential side effects caused by abusive consumption or missed contraindications are the aspects that are the most often overlooked by consumers and not fully elucidated by ED producers. In this review, the authors aimed to present the latest scientific information on ED components and their possible impact on improving physical performance as well as to bring emphasis to the danger of inordinate consumption.

Background: The anterior cruciate ligament (ACL) is a major sagittal plane stabilizer of the knee joint. Even if anterior laxity can be brought under control by utilizing modern surgical techniques, internal rotational instability may not always be controlled adequately. Various surgical techniques are used to prevent this coronal or rotational instability, such as lateral extra-articular tenodesis (LET). Despite an abundance of articles in recent decades discussing LET in ACL reconstruction, no definitive indicators for extra-articular tenodesis have been described in the literature. Purpose: Given the scarcity of literature assessing the indications in LET, the purpose of this study was to conduct a systematic review of the described indications for this operation in the context of concurrent ACL reconstruction. Study Design: Systematic review; Level of evidence, 4. Methods: We searched PubMed, Cochrane Central, ScienceDirect, Web of Science, and Embase using the following key terms with no limits regarding the year of publication: (extraarticular OR extraarticular) AND (tenodesis OR plasty OR augmentation OR procedure or reconstruction OR reconstructive OR surgical OR surgery OR technique) AND (ACL OR anterior cruciate ligament). We included clinical human studies based on levels of evidence 1 to 4 that were written in English. We excluded studies not written in English, case studies, reviews, letters to editors, conference abstracts, or studies containing incomplete or irrelevant data. Results: The analysis evaluated 29 articles published between 1999 and 2023. We evaluated mostly level 3 (n = 13) and level 4 (n = 12) evidence; however, there were 4 articles with level 1 evidence. The majority of the studies were retrospective (n = 21), although there were prospective studies (n = 8). The mean age of the participants was 24.4 years. The most prevalent indications for LET were high-risk sports (16 articles), medial meniscal repair/excision (11 articles), and pivot-shift test grades 2 and 3 (11 articles). Conclusion: The reviewed articles showed reduced pivoting and laxity, improved clinical outcomes, and decreased revision rates after primary ACL reconstruction. The main frequent and repeated indications for using LET in ACL reconstruction are meniscal surgery, sports activity, and grade 2 and 3 pivoting.

Lateral extra-articular tenodesis (LET) is a surgical technique that can be used in conjunction with anterior cruciate ligament reconstruction (ACLR), improving rotational stability and reducing the risk of anterior cruciate ligament (ACL) re-rupture. However, as with any surgical procedure, LET carries a risk of complications. Despite numerous articles published in recent decades discussing LET in the context of ACLR, relatively few complications associated with the LET procedure have been documented in the literature. This study aimed to systematically review adverse events associted with the LET procedure when combined with ACLR. The following key terms were used: (extra-articular OR extraarticular) AND (tenodesis OR plasty OR augmentation OR procedure or reconstruction OR reconstructive OR surgical OR surgery OR technique) AND (ACL OR anterior cruciate ligament), with no limits regarding the year of publication in PubMed, ScienceDirect, Cochrane Central, Web of Science, and Embase databases. English-language clinical human studies with evidence levels I-IV were included. This analysis evaluated seven articles published between 1999 and 2023. Level IV evidence was identified in the majority of studies (n = 5), level III evidence was found in one (n = 1), and level I evidence was noted in another (n = 1). Nine distinct types of complications were identified with rates rangingfrom 0.6% to 17% across the analysed studies. The modified Lemaire technique had the highest complication rate, reaching 7.5%. Overall, the complication rate across all reviewed LET techniques in this study was 4.2%. This is the first study to systematically document the occurrence of complications in LET. The most common problems included LET hardware irritation – predominantly after staple fixation, and subsequent removal, haematoma over the LET site, and pain over the LET site. The analysed studies show that combining LET with ACLR appears to be a safe procedure associated with infrequent and mild side effects.

Vitamin D helps to balance the levels of calcium and phosphorus to maintain proper bone structure. It is also involved in essential biological roles and displays a wide spectrum of potential benefits in the human body. Since there are many types of fractures that occur at specific ages and due to different circumstances, the influence of vitamin D on the frequency of a particular fracture may differ. Thus, the authors investigated the possible preventive effect of vitamin D on the risks of vertebral fractures, hip fractures, stress fractures and pediatric fractures. Additional aspects of vitamin D, especially on recuperation after injures and its impact on the severity of particular fractures, were also discussed. It was suggested that vitamin D supplementation may contribute to a reduction in hip fracture risk due to reduced bone turnover, decreased frequency of falls and improved muscle function. Furthermore, vitamin D appears to lower the risk of stress fractures in athletes and military recruits. Due to a nonunified protocol design, presented investigations show inconsistencies between vitamin D supplementation and a decreased risk of vertebral fractures. However, a vitamin D preventive effect on pediatric fractures seems to be implausible.