Median Arcuate Ligament Syndrome, also known as Dunbar’s syndrome, is a rare condition caused by stenosis of the celiac artery (CAS) through the fibrous arch connecting the diaphragmatic branches. It manifests as postprandial abdominal pain, nausea, vomiting, weight loss and increased epigastric tenderness. The condition most commonly affects young females without coexisting vascular comorbidities. Diagnosis is difficult due to the non-specific symptoms, often overlapping with other gastrointestinal diseases. Standard investigations include duplex ultrasound, computed tomography angiography (CTA) and contrast-enhanced magnetic resonance imaging (CE-MRA). Treatment mainly consists of surgical release of the arch ligament, which can be performed by open, laparoscopic or robotic methods. Surgery is often supported by celiac truncal stenting for residual stenosis, which significantly improves vascular flow. Alternative approaches include visceral plexus blocks and novel hybrid techniques, such as a combination of ligament release and endovascular treatment of the celiac trunk. In severe cases, vascular by-passes are recommended. The aim of this paper is to discuss the clinical manifestations, diagnostic possibilities, therapeutic options and directions for further research on MALS from the perspective of a vascular surgeon. It emphasizes the need for a multidisciplinary approach, including collaboration between the surgeon, radiologist, gastroenterologist and psychologist, which enables comprehensive disease management and improved quality of life for patients. In addition, the need for further development of diagnostic and therapeutic methods for early diagnosis and effective treatment was pointed out.

Background. Athletic pubalgia is a frequent yet poorly defined cause of chronic groin pain in athletes. It is not associated with a true inguinal hernia but results from overload-related injury to the musculotendinous and fascial structures responsible for pelvic and core stability. Heterogeneous terminology and diagnostic uncertainty lead to delayed diagnosis and inconsistent treatment strategies. Aim. To synthesize current evidence regarding the pathophysiology, diagnostic approach, and management strategies for athletic pubalgia. Materials and methods. A narrative review of the literature was conducted using PubMed, Google Scholar, and Scopus databases. English-language studies published after 2000 and involving adult populations were included, with a focus on etiology, clinical presentation, imaging, conservative treatment, surgical techniques, and rehabilitation protocols. Results. Available evidence indicates that athletic pubalgia is primarily caused by an imbalance between the abdominal wall and hip adductor musculature, leading to chronic overload of the pubic symphysis complex. Clinical diagnosis remains challenging due to overlapping symptoms with other causes of groin pain. Magnetic resonance imaging plays a key role in confirming characteristic musculotendinous injuries and excluding alternative diagnoses. Conservative treatment is recommended as first-line therapy. Surgical intervention provides higher success rates and a more reliable return to sport in patients with persistent symptoms. Conclusions. Athletic pubalgia is a complex, multifactorial condition requiring a comprehensive diagnostic and therapeutic approach. While rehabilitation is fundamental in initial management, surgery offers superior outcomes in refractory cases, highlighting the need for high-quality prospective studies to standardize diagnostic criteria and treatment algorithms.

Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder increasingly associated with changes in the composition and function of the gut microbiota. A growing body of evidence suggests that microbial metabolites, immune modulation, and intestinal barrier integrity play a key role in regulating insulin sensitivity and chronic low-grade inflammation. This literature review synthesizes current mechanistic, clinical, and translational evidence on the gut microbiota–metabolic axis in T2DM, with a particular focus on short-chain fatty acids, bile acid signaling, branched-chain amino acids, tryptophan metabolites, and novel microbiota-derived compounds. Key pathways include metabolic endotoxemia, incretin regulation, immune modulation, and the influence of the microbiota on pharmacotherapy and lifestyle factors such as diet and physical activity. Clinical studies indicate that changes in the microbiota correlate with glycemic control, markers of inflammation, and disease progression, while microbiota-targeted strategies—including dietary interventions, prebiotics, probiotics, and selected antidiabetic drugs—may contribute to improved metabolic outcomes. However, study design heterogeneity, population differences, and methodological limitations currently hinder causal interpretation. Future studies combining multiomic approaches and personalized interventions may help elucidate the therapeutic potential of microbiota modulation in T2DM. Overall, the gut microbiota appears to be a dynamic regulator of immunometabolic homeostasis and a promising target for future precision-based strategies in the treatment of metabolic diseases.

Background: Over the past decade, electric scooters have become a common element of urban micromobility, offering a convenient and environmentally friendly alternative to short-distance car travel. However, the rapid growth in the number of users has not been supported by parallel infrastructure development or consistent legal regulations, leading to a growing number of injuries related to their use. These incidents place a growing burden on healthcare systems, particularly emergency departments and trauma surgery. Aim: The aim of the study was to review the current literature on epidemiology, accident mechanisms, types and locations of injuries, and strategies for preventing injuries related to the use of electric scooters, with particular emphasis on the pediatric population. Materials and methods: A narrative literature review was conducted using the PubMed and Scopus databases. Studies on e-scooter-related injuries were analyzed, including epidemiological data, injury mechanisms, risk factors, anatomical injuries, and preventive measures. Results: Available research indicates a rapid increase in the number of injuries associated with e-scooter use in various regions of the world. Young adults are the most injured group, but children and adolescents are at increased risk of serious injury. The predominant mechanism of injury is falls without the involvement of other road users. The most common injuries are head and facial injuries, as well as upper limb fractures. Failure to wear a helmet, driving under the influence of alcohol, driving at night, and excessive speed are the main risk factors. Conclusions: Injuries related to e-scooter use constitute a significant and growing public health challenge. Effective prevention requires comprehensive measures encompassing legal regulations, user education, infrastructure improvements, and the implementation of technological solutions.

Background: Radical mastectomy often results in upper extremity complications, including shoulder impairment, pain, reduced range of motion, lymphedema, and diminished muscle strength, which significantly impact quality of life. Key risk factors include extent of lymph node dissection, older age, and axillary radiation, exacerbating morbidity. Aim: This review synthesizes current literature on upper extremity complications post-radical mastectomy and evaluates the effectiveness of rehabilitation strategies. Material and methods: A comprehensive search of PubMed, PEDro, and Scopus identified English-language studies from the last decade on shoulder impairment in adult women post partial or total mastectomy for breast cancer. Results: Complications are highly prevalent, with rehabilitation interventions demonstrating efficacy in improving shoulder function, reducing pain and lymphedema. Challenges persist due to heterogeneous protocols and limited high-quality trials. Conclusions: Targeted rehabilitation interventions post-radical mastectomy significantly improve shoulder function, range of motion, muscle strength, and reduce pain and lymphedema incidence, thereby enhancing quality of life and functional independence (Marco et al., 2023; Xu et al., 2024; Zhang et al., 2022). Despite these demonstrated benefits from early exercises and structured programs (Lazaraviciute & Chaturvedi, 2017; Naqvi, 2021), heterogeneous protocols, paucity of high-quality randomized trials, and variability due to risk factors like axillary dissection and radiation underscore the urgent need for standardized guidelines and further large-scale RCTs (Bruce et al., 2021).

Background: Isolated systolic hypertension in young adults is a problem of rising importance. Although it has been considered a benign condition caused by a hemodynamic phenomenon in a specific patient group, current population-based studies challenge this view. These data suggest increased cardiovascular risk and possible progression to sustained hypertension. Aim: The aim of this narrative review is to summarize current evidence on isolated systolic hypertension in young adults and to compare recent findings with previous studies and the concept of spurious systolic hypertension.Materials and methods: A systematic literature search using PubMed and Google Scholar online databases was conducted. Authors included and analyzed 30 studies published between 2000 and 2025 focusing on epidemiology, pathophysiology, hypertension progression, cardiovascular risk and therapeutic management of isolated systolic hypertension. Results: The prevalence of isolated systolic hypertension appears to be increasing, affecting a considerable proportion of the young adults population, especially men. Hemodynamic findings suggest heterogeneity of pathophysiological mechanisms underlying this condition, including high arterial pulse pressure amplification, elevated stroke volume and aortic stiffness. Evidence indicates possible progression to sustained hypertension and increased cardiovascular disease and mortality risk. Data regarding therapeutic management is limited with current guidelines recommending a non-pharmacological approach.Conclusions: Isolated systolic hypertension in young adults is a heterogeneous condition requiring further research to optimize its clinical management.