In this comprehensive review supported by clinical examples, the authors explore the topic of cervical cancer in pregnancy, with emphasis on potential pre-cancer progression, the possibility of coexisting preinvasive and invasive disease, and neoadjuvant chemotherapy. This manuscript addresses the challenges of managing cervical cancer in pregnant women with a pregnancy-preserving approach, including the importance of screening, the timing of surgery, and the impact of pregnancy on the course of the disease. The first case study illustrates the potential for a benign cervical lesion to transform into a malignant one during pregnancy and the possible coexistence of preinvasive lesions together with early-stage cervical cancer. It also questions the rationale behind the non-treatment of pregnant patients initially diagnosed with CIN 2/3 during pregnancy. The second presented clinical example shows the histologically confirmed response to neoadjuvant chemotherapy, resulting in a radiologically diagnosed FIGO stage IIA1 being downgraded to adenocarcinoma in situ in the histology report after surgery performed six weeks postpartum. The treatment of cervical cancer, which is becoming increasingly prevalent among pregnant women, and the necessity for an individualized diagnostic and therapeutic approach represent significant challenges for contemporary medicine. Discrepancies in therapeutic options proposed among centers within the same region lead to the conclusion that there is a need for centralization and unification of evidence-based management in referral centers with both high-level oncological and perinatal care.

Background. Despite growing evidence supporting the safety and benefits of exercise in pregnancy, pregnant women and their healthcare providers frequently lack clear guidance on which specific sports are safe, which require modification, and which should be avoided. Aim. This narrative review synthesizes current evidence on physical activity during pregnancy, with focus on classifying specific sports as recommended, conditionally permitted, or contraindicated, and on providing trimester-specific recommendations. Material and Methods. A structured search of PubMed/MEDLINE, Scopus, and Web of Science was conducted, covering publications from January 2010 to January 2025. Results. Regular moderate-intensity physical activity reduces the risk of gestational diabetes, excessive weight gain, hypertensive disorders, and prenatal depression. Walking, swimming, stationary cycling, prenatal yoga, Pilates, and moderate resistance training are safe across all trimesters. Contact sports, scuba diving, high-altitude exercise, hot yoga, and maximal-intensity exertion constitute absolute or relative contraindications. Recreational running and tennis may be continued with progressive modification by previously active women. Conclusions. Physical activity in pregnancy is safe and beneficial when appropriately selected and adapted to each trimester. Current guidelines converge on general principles but lack sport-specific detail. This review provides a clinically applicable, evidence-based classification of individual sports within a trimester-sensitive framework.

IntroductionInsulin resistance (IR) is a key mechanism underlying metabolic syndrome, type 2 diabetes, non-alcoholic fatty liver disease, and cardiovascular disease. Its prevalence is rising worldwide, including in Poland, with many cases undiagnosed. Lifestyle strategies, especially physical activity, are essential. High-Intensity Interval Training (HIIT) has recently drawn attention as a time-efficient method with strong potential to improve metabolic health. AimThis study aims to evaluate the effects of HIIT on metabolic health in individuals with insulin resistance. The focus is on insulin sensitivity, glycemic control, lipid profile, blood pressure, and hepatic function, and compares HIIT with moderate-intensity continuous training (MICT). State of KnowledgeHIIT involves repeated bouts of vigorous activity with recovery periods, usually at 80–100% of maximal heart rate. Evidence shows that it enhances glucose uptake, reduces HOMA-IR, lowers HbA1c, and improves lipid balance by decreasing LDL and raising HDL cholesterol. HIIT also reduces systolic blood pressure and improves liver parameters in non-alcoholic fatty liver disease. Benefits are often greater than or comparable to MICT, despite shorter training duration. The strongest effects occur when combined with weight reduction and dietary changes. Summary (Conclusions)HIIT is an effective non-pharmacological strategy for managing insulin resistance and related disorders. It improves glycemic control, lipid and blood pressure regulation, and markedly enhances insulin sensitivity. Thanks to its time efficiency and ease of integration into daily life, HIIT is a valuable therapeutic option that may significantly support prevention and treatment of insulin resistance in both clinical

This narrative review aimed to evaluate the effectiveness of Pilates in reducing pain and functional disability in adults with chronic non-specific low back pain, with additional consideration of quality of life, psychological outcomes, comparisons with other exercise modalities, and factors influencing treatment effectiveness. A literature search was conducted between May and June 2026 using PubMed, Scopus, and Embase, and reference lists of relevant systematic reviews and meta-analyses were also screened. Randomized controlled trials, prospective clinical studies, systematic reviews, meta-analyses, network meta-analyses, clinical practice guidelines, and state-of-the-art reviews were considered, with 24 publications included in the final narrative synthesis. Current evidence indicates that Pilates reduces pain intensity and functional disability and may improve health-related quality of life and selected psychological outcomes, including fear of movement and sleep-related measures. Pilates generally provides greater benefits than no intervention, minimal intervention, or non-specific exercise; however, its superiority over other structured exercise programmes is not consistently demonstrated. Treatment outcomes appear to be influenced by exercise dose, supervision, individualization, programme quality, and adherence, while heterogeneity in intervention protocols, participant characteristics, outcome measures, and follow-up duration limits direct comparisons across studies. Overall, Pilates represents an effective evidence-based exercise option for chronic non-specific low back pain and may be incorporated into individualized rehabilitation according to patients’ functional limitations, preferences, and therapeutic goals. Further high-quality randomized controlled trials with standardized protocols and longer follow-up periods are needed.

Background. Overtraining Syndrome (OTS) represents a complex, maladaptative state characterized by a persistent decline in athletic performance and systemic physiological dysfunction. Despite its prevalence in elite and amateur sports, it remains one of the most challenging conditions to diagnose and treat. Aim. The study aims to provide a comprehensive review of the current physiological frameworks, diagnostic challenges, and modern management strategies for OTS, while integrating classical theories with emerging research on the gut-brain axis and metabolomics. Material and methods. A narrative review of academic literature from 1980 to 2024 was conducted using databases such as PubMed and Google Scholar. The selection focused on joint consensus statements, clinical trials, and systematic reviews. Analysis was assisted by AI tools for structural organization and linguistic refinement, ensuring adherence to modern scientific writing standards. Results. The findings indicate that the pathophysiology of OTS is multifaceted, involving systemic inflammation (the cytokine hypothesis), metabolic depletion (the glycogen hypothesis), and structural changes in intestinal permeability (the gut-brain axis). The review distinguishes between sympathetic and parasympathetic OTS phenotypes, each requiring different monitoring approaches. Modern research highlights a significant clinical overlap between OTS and Relative Energy Deficiency in Sport (RED-S), suggesting that low energy availability is a primary driver of the syndrome. Diagnostic methodologies continue to rely on the exclusion of organic diseases, supplemented by longitudinal monitoring of heart rate variability (HRV) and psychological profiling (POMS).