Narrative Review of the Role of Nondepolarizing Neuromuscular Blocking Agents in Anesthesia: Perspective 2026 - Article abstract #951845

Background: Caffeine is the most widely consumed psychoactive substance worldwide, that can be found in coffee, tea, energy drinks, and dietary supplements. Numerous studies have confirmed caffeine’s potential to decrease fatigue and increase performance. However, optimal dosing strategies and safety profiles across diverse athletic populations remain under active investigation. Aim: This study present the current knowledge on the prevalence of caffeine consumption, its physiological mechanisms, its impact on physical performance, and the potential risks associated with its use. Material and methods. A literature review of studies published in the PubMed and Google Scholar databases was conducted, analyzing the prevalence of caffeine intake, its physiological mechanisms, effects on physical performance, and associated harms. Results. Caffeine supplementation, ingested approximately 60 minutes before exercise enhance endurance performance. In strength assessments, caffeine has been found to enhance 1RM (bench press, squat, deadlift). However caffeine also has adverse effects, including tremors, tachycardia, gastrointestinal discomfort and in some cases, cardiac arrhythmias, that can occur at doses exceeding 7 mg/kg. Caffeine metabolism can affected by genetic polymorphism, hormonal modulators and age-related factors, influence caffeine’s half-life and risk of accumulation. Conclusions. Caffeine supplementation at 3–6 mg/kg is an effective and generally safe ergogenic enhancer for increasing endurance and muscular strength. However, the narrow margin between optimal and toxic doses can be different at various population. Future research should focus on long-term safety of caffeine supplementation, the factors of inter-individual variability to caffeine safety and potential interactions with other performance-enhancing compounds.

Cannabinoids derived from Cannabis sativa L., particularly cannabidiol (CBD) and minor cannabinoids such as cannabigerol (CBG), cannabichromene (CBC), tetrahydrocannabivarin (THCV), and cannabidivarin (CBDV), have attracted increasing interest due to their potential therapeutic properties in dermatology. These compounds exert anti-inflammatory, antimicrobial, immunomodulatory, sebostatic, and antiproliferative effects, which may benefit a range of skin conditions. Preclinical and early clinical data suggest that cannabinoids may effectively alleviate inflammation, pain, pruritus, and microbial infections in various dermatologic disorders. Topical and transdermal routes show promise due to improved safety and targeted delivery. CBD has demonstrated efficacy in reducing sebum production in acne, modulating immune responses in psoriasis, and accelerating wound healing in EB. However, findings for alopecia areata remain inconsistent. Emerging delivery systems, including CBG-based emulgels and CBD transdermal patches, may improve local bioavailability and clinical outcomes. Cannabinoids, especially CBD, exhibit significant potential as adjuvant or alternative treatments for inflammatory, infectious, and autoimmune skin diseases. Despite promising preliminary results, large-scale, randomized, placebo-controlled trials are needed to establish optimal dosing, formulations, safety, and long-term efficacy in clinical dermatology.

Introduction: Anxiety disorders represent the most common mental health disorders globally which makes their treatment a major clinical problem. Recent research has increasingly focused on the gut-brain axis, because scientists have discovered that gut microbiota functions as a key controller of mental health. Scientists investigate fermented foods as dietary interventions because they contain probiotics and bioactive molecules to potentially adjust the gut-brain axis for anxiety symptom reduction. Methods: This review combines results from PubMed and Google Scholar databases through searches of "probiotics," "gut microbiota," "anxiety disorders," "fermented food" and "gut-brain axis" to evaluate existing evidence. Findings: Research shows that the gut microbiota influences anxiety through multiple pathways, including direct modulation of microbial composition, production of neuroactive compounds like gamma-aminobutyric acid (GABA), and regulation of systemic inflammation. Research conducted in both laboratory and human subjects demonstrates that consuming fermented foods together with particular probiotic strains can positively impact these mechanisms. However, clinical evidence shows inconsistent results because some studies demonstrate substantial anxiety symptom reduction in clinical populations yet other investigations reveal minimal or no effects while bacterial strain and dosage and host factors play a significant role. Conclusion: The gut microbiota is a promising therapeutic target for anxiety disorders. Specific probiotics and fermented foods added to the diet could become important supplementary treatments. Nevertheless, large-scale, well-controlled clinical trials are necessary to establish optimal strains, dosages, and treatment protocols to translate these findings into reliable clinical strategies.

Background: ADHD (Attention Deficit Hyperactivity Disorder) is one of the most commonly diagnosed neurobiological disorders in children and adolescents. It is characterized by difficulties in maintaining attention, impulsivity, and excessive physical activity, which affect daily functioning at school, at home, and in social interactions. Traditional approaches to ADHD treatment are primarily based on pharmacotherapy and behavioral therapy. However, there is a growing interest in the role of physical activity as a natural and complementary method for managing the disorder. Aim: This article aims to analyze the impact of different forms of physical activity on alleviating ADHD symptoms amongst young patients and to explore the mechanisms through which sports can serve as an effective therapeutic tool. Materials and methods: A review was conducted incorporating data from PubMed and Google Scholar using keywords such as “ADHD”, “sports”, “physical activity”,“mental health”, “adolescents” and “children”. Results: Scientific studies indicate that regular physical activity, particularly aerobic exercises and team sports, can improve executive functions, emotional regulation, and concentration levels in children with ADHD. Moreover, physical activity influences neurotransmitters such as dopamine and norepinephrine, which play a key role in ADHD symptoms. Conclusion: A literature review suggests that incorporating physical activity into the daily lives of children with ADHD can help alleviate symptoms such as inattention, impulsivity, impaired executive function, emotional dysregulation, and poor concentration. However, study outcomes remain inconsistent and call for further investigation. Gaining a clearer understanding of the mechanisms through which physical activity exerts its effects, as well as determining the most effective approaches, could support the development of new therapeutic strategies for managing ADHD in young individuals.

Background. Nitric oxide has emerged as a key physiological signalling molecule that has a significant impact on vessels, skeletal muscle function and exercise performance. With this in mind, increasing its production is of great interest to clinicians and athletes, making citrulline malate a potential medication and one of the most popular ergogenic supplements. Aim. This article aims to review current knowledge on citrulline malate supplementation, with emphasis on its pharmacokinetics, proposed medical application and ergogenic benefits. Material and Methods. Literature search in PubMed and Google Scholar for clinical trials, meta-analyses, and reviews on citrulline malate using keywords: citrulline malate, nitric oxide, muscle endurance, medical applications, supplementation”. Results. Citrulline malate exhibit its positive impact on many medical conditions. In pulmonary hypertension by improving exercise tolerance and modestly reducing arterial pressure. In metabolic conditions, leading to better glycaemic control, improved lipid profiles, and reduced inflammation in diabetes. Men with mild erectile dysfunction report subjective improvements when using citrulline malate alone or alongside other therapies. In atherosclerosis, it increases the elasticity of the arteries, which becomes weaker in advanced disease. Beyond medical applications, citrulline malate supplementation is primarily known for supporting short-term, high-intensity exercise by delaying fatigue, improving endurance, lowering perceived exertion during resistance training and reducing post-workout muscle soreness. Conclusion: Citrulline malate could be used as medical application and can enhance exercise performance by delaying fatigue and reducing muscle soreness. Larger, rigorously controlled trials are required to establish optimal dosing, target activities and long-term safety.