Background: Myocardial fibrosis (MF) is a dynamic remodeling process characterized by excessive extracellular matrix (ECM) deposition, fibroblast activation, and dysregulated matrix turnover. Although initially reparative, persistent fibrotic remodeling promotes myocardial stiffening, electrical instability, and progressive cardiac dysfunction across diverse cardiovascular diseases. Circulating biomarkers reflecting collagen synthesis, degradation, proteolytic regulation, and inflammatory activation have emerged as potential tools for assessing fibrotic activity and risk stratification. Methods: This targeted narrative review was based on manually guided searches of PubMed and Scopus, supplemented by citation chaining and inclusion of landmark mechanistic and translational studies. Publications addressing myocardial extracellular matrix remodeling, circulating fibrosis-related biomarkers and imaging-derived fibrosis phenotypes were selected for qualitative synthesis. Results: Myocardial fibrosis reflects interconnected inflammatory, neurohormonal, oxidative, and extracellular matrix remodeling pathways. Among circulating biomarkers, C-terminal propeptide of procollagen type I (PICP) showed the most consistent association with myocardial collagen burden and adverse outcomes, whereas carboxy-terminal telopeptide of type I collagen (CITP), matrix metalloproteinases (MMPs), tissue inhibitors of metalloproteinases (TIMPs), galectin-3, osteopontin, soluble suppression of tumorigenicity 2 (sST2), and natriuretic peptides provided more context-dependent signals. Standalone interpretation remains limited by restricted cardiac specificity, renal dysfunction, systemic inflammation, assay heterogeneity, and lack of standardized thresholds. Integration with cardiac magnetic resonance (CMR)-derived late gadolinium enhancement (LGE), T1 mapping, and extracellular volume (ECV) may improve biological and structural phenotyping. Conclusions: Circulating biomarkers capture complementary dimensions of myocardial remodeling but cannot replace structural imaging. We propose an updated, hypothesis-generating biomarker–imaging framework integrating inflammatory activation, collagen turnover, matrix quality, hemodynamic stress, and structural imaging to support phenotypic stratification and future validation of antifibrotic strategies.

Background: International travel and global mobility have led to an increasing number of pediatric patients presenting with infections acquired outside Europe. However, epidemiological data on imported infectious diseases in children remain fragmented, with substantial heterogeneity across studies. This systematic review aimed to synthesize current evidence on the spectrum, distribution, and epidemiological characteristics of imported infections in children and adolescents returning to Europe. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251245531). PubMed, Scopus, and the Cochrane Library were searched for studies published between 2010 and December 2025. Studies reporting laboratory-confirmed or clinically diagnosed imported infections in pediatric populations (0–18 years) returning to Europe were included. Data were extracted and synthesized descriptively, with separate analyses for malaria-specific, non-malarial, and syndromic cohorts. Results: A total of 31 studies was included. Malaria was the most consistently reported infection, predominantly caused by Plasmodium falciparum and most frequently reported in association with travel to sub-Saharan Africa, which accounted for the largest proportion of reported exposures in clinical cohorts. Visiting friends and relatives (VFR) was the dominant travel category, representing between 45.8% and 87.4% of cases in disaggregated malaria cohorts and a substantial proportion across non-malarial studies. Non-malarial infections—including gastrointestinal, bacterial, parasitic, and viral diseases—represented a substantial proportion of cases in mixed and post-travel cohorts, with gastrointestinal illness frequently constituting the leading diagnosis. Considerable heterogeneity was observed across studies in terms of design, diagnostic approaches, and reporting practices, precluding formal meta-analysis. Conclusions: Imported infections in pediatric travelers encompass a broad and heterogeneous spectrum extending beyond malaria alone. Diagnostic approaches should integrate travel history, geographic exposure, and clinical presentation. Standardized pediatric-specific surveillance and harmonized reporting are needed to improve comparability and support more accurate epidemiological assessment.

Coronary artery disease (CAD), including acute coronary syndromes, frequently co-occurs with depression and is associated with adverse outcomes. Trace elements may influence shared biological pathways, including oxidative stress, inflammation, and neurovascular signaling. This study evaluated the association between trace element status and depressive symptoms in CAD. A systematic review was conducted in accordance with PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420251231129). PubMed, Scopus, and the Cochrane Library were searched from inception to 2 December 2025. Studies assessing trace element concentrations in adults with CAD and depressive symptoms were eligible. Due to limited direct evidence, partially aligned and indirect studies were also included. Data were synthesized narratively. Of 699 records, four studies were included. No studies fulfilled Tier 1 criteria. The available evidence consisted of partially aligned (Tier 2) and indirect (Tier 3) studies. Lower zinc and magnesium levels and higher copper concentrations were suggested to be associated, based exclusively on Tier 2–3, low-certainty, predominantly indirect evidence. Interventional studies reported modest improvements following zinc or combined magnesium and zinc supplementation, although not in CAD-specific populations. Evidence directly addressing trace elements and depression in CAD is extremely limited and largely indirect. Current data do not support causal inference or clinical recommendations. Findings should be considered exploratory and hypothesis-generating.

Introduction: The COVID-19 pandemic disrupted schooling, physical activity, diet, and daily routines, contributing to excess weight gain among children and adolescents. Whether these changes persisted after restrictions eased remains uncertain. Objectives: To evaluate the persistence of pandemic-associated changes in weight status among children and adolescents after major restrictions were eased. Methods: PubMed, Scopus, and the Cochrane Library were searched through December 2025 for observational studies of general pediatric populations (<18 years) reporting weight-related outcomes before the pandemic, during lockdown, school closure, or other major restrictions, and at least six months after school reopening or restriction easing. Owing to methodological heterogeneity, findings were synthesized narratively without meta-analysis. Results: Ten studies from nine countries were included. Most reported increases in BMI-related measures or the prevalence of overweight or obesity during the pandemic or restriction period. After restrictions eased, adverse trends generally attenuated, but complete normalization was inconsistent. Recovery was more frequently observed among younger children, whereas residual or renewed elevations occurred in some older children and adolescents and in selected groups with obesity or severe obesity. Findings by sex and baseline weight status were inconsistent, while socioeconomic and geographic disparities persisted in several settings. Conclusions: Pandemic-associated changes in pediatric weight status partially or completely resolved in some populations but persisted in others. Continued growth monitoring and longer-term, population-representative studies using standardized outcome definitions are needed to identify children with persistent adverse trajectories.

Background: Manganese (Mn) is an essential trace element with antioxidant properties; however, excessive exposure may contribute to inflammation and vascular dysfunction. Hair analysis provides an indicator of long-term Mn exposure. This study evaluated the relationship between hair Mn levels, acute coronary syndrome (ACS), coronary artery disease (CAD) severity, and cardiovascular risk factors, with particular emphasis on metabolic status in a cardiometabolic population. Methods: Hair Mn concentration was measured using inductively coupled plasma optical emission spectrometry (ICP-OES) in 80 patients (mean age 67 ± 11 years; 28.8% women) undergoing coronary angiography for suspected ACS. Final diagnoses included stable CAD (N = 42) and ACS [ST-elevation myocardial infarction (STEMI) N = 17, non-ST-elevation myocardial infarction (NSTEMI) N = 12, and unstable angina (UA) N = 9]. CAD severity was quantified using the SYNTAX score and the Coronary Artery Surgery Study Score (CASSS). Associations with clinical variables were assessed using non-parametric tests and Spearman correlations. The median SYNTAX score was 13.8 (range 0.0–68.5), and the median hair Mn concentration was 0.22 ppm (range 0.01–1.65). Results: SYNTAX scores were higher in ACS than in stable CAD (p = 0.027), with the highest values observed in NSTEMI. Hair Mn levels did not differ among diagnostic groups and showed no association with CASSS or SYNTAX (R = −0.11; p = 0.348). No differences were detected with respect to sex, smoking, prior myocardial infarction, hypertension, hyperlipidemia, or type 2 diabetes. A modest inverse correlation was observed between hair Mn and body mass index (BMI) in unadjusted analysis (R = −0.25; p = 0.03), but this association was not robust after correction for multiple comparisons, suggesting a potential exploratory link between manganese homeostasis and cardiometabolic status. Conclusions: Although hair Mn concentration was not associated with angiographic indices of CAD severity or ACS subtypes, the observed relationship with BMI may indicate a role of Mn homeostasis in cardiometabolic regulation. Larger prospective studies are required to clarify these associations.

Introduction: Sauna bathing has been investigated for its potential health and recovery effects, but its implications for respiratory and immune function in competitive athletes remain uncertain. Objectives: This narrative review synthesizes current evidence on the respiratory and immunological effects of sauna bathing in competitive athletes, evaluating whether the practice constitutes a benefit or a risk in this population. Materials and methods: A non-systematic literature search was conducted in PubMed, Scopus, and the Cochrane Library during August 2026. Experimental and observational studies, case reports, and review articles available in English or Polish were considered. Findings were synthesized narratively, distinguishing athlete-specific evidence from findings in other populations. No formal risk-of-bias assessment was performed. Results: Sauna exposure can transiently alter circulating leukocytes, serum heat-shock proteins, and selected inflammatory mediators, but these responses do not establish improved immune defense. Related analyses of a Finnish population cohort associate frequent sauna bathing with lower respiratory disease incidence, without demonstrating causality or applicability to competitive athletes. Evidence for improved pulmonary function or prevention of respiratory infection in athletes is insufficient. Heat-acclimation and recovery findings address different outcomes. Potential risks include additional thermal and cardiovascular strain, fluid loss, and airway responses that depend on exposure conditions and individual susceptibility. Conclusions: Sauna bathing may offer respiratory and immune benefits, but supporting evidence is largely indirect and derived from non-athlete populations. These benefits remain unconfirmed in competitive athletes. Controlled athlete-specific studies assessing respiratory symptoms, confirmed infections, immune function, and adverse events are needed to clarify the benefit–risk balance.