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.

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.

Introduction: Idiopathic intracranial hypertension (IIH) is a rare neurological condition characterized by elevated intracranial pressure in the absence of a detectable cause. It predominantly affects obese women of childbearing age. The underlying pathophysiological mechanisms remain unclear, but increasing evidence suggests a significant role of obesity-related metabolic and hormonal disturbances. Materials and methods: A review of selected literature in the PubMed database was conducted, using the following keywords: “idiopathic intracranial hypertension”, “pseudotumor cerebri”, “obesity” Summary: The development of IIH appears to be multifactorial, involving impaired cerebrospinal fluid dynamics, venous outflow obstruction, and endocrine dysfunction. Obesity contributes through increased intra-abdominal and intracranial pressure, altered secretion of adipokines (such as leptin), and chronic low-grade inflammation. The review highlights the role of obesity as a modifiable risk factor and the impact of weight loss on symptom relief and disease progression. Conclusions: Understanding the link between obesity and IIH is crucial for effective prevention and treatment. Multidisciplinary care, including neurologists, ophthalmologists, and nutritionists, should focus on weight management and early detection of visual complications. Further research is needed to clarify the molecular mechanisms involved and to develop more targeted therapeutic strategies.

Background: Creatine was first isolated from muscle in 1832 and now is a globally popular ergogenic supplement, valued at USD 1.11 billion in 2024 and projected to reach USD 4.21 billion by 2030. It functions as a rapidly mobilizable energy reserve via the phosphocreatine system and modulates Ca²⁺ handling in muscle cells. Aim: This study present the current knowledge on creatine supplementation, its prevalence, mechanisms of action, effects on performance and muscle growth and safety profile. Material and methods: A literature review of studies published in the PubMed and Google Scholar databases was conducted, analysing clinical trials, meta-analyses, and systematic reviews concerning creatine metabolism, dosing strategies, performance outcomes (anaerobic, strength, aerobic), hypertrophy and adverse effects. Results: Creatine supplementation improves short-burst efforts and strength, however moderately enhances and even can decrease endurance. Creatine also has anabolic properties and can improve gains in muscle mass. Dosing regimens reliably elevate intramuscular stores within days (loading) or weeks (daily use). Side effects are generally conducted to transient water retention and gastrointestinal symptoms, with no evidence of renal or hepatic harm. Conclusions: Creatine is a safe, well-researched supplement that can enhance anaerobic capacity, muscular strength, and hypertrophy when used in appropriate dosing protocols. Its benefits for prolonged aerobic exercise are modest, but users should expect temporary weight gain, that can decrease endurance.

Introduction:Pulmonary hypertension is a chronic cardiovascular disease defined by a mean pulmonary artery pressure (mPAP) of > 20 mmHg, as measured by right heart catheterization (RHC). Rhythm disturbances are relatively common in this condition and significantly worsen patient prognosis. Elucidating the mechanisms that drive arrhythmia development may help identify therapeutic intervention strategies to enhance patient outcomes. Materials and methods:We performed a literature review of epidemiology, pathogenesis, and clinical impact of cardiac arrhythmias in Pulmonary Arterial Hypertension (PAH) and Chronic Thromboembolic Pulmonary Hypertension (CTEPH), analysing registry data, histopathological and electrophysiological studies, and clinical outcomes. Results:Supraventricular arrhythmias (SVA) occur in 10–33 % of patients, rising to ~30 % over 10 years. Key mechanisms include atrial stretch and fibrosis, autonomic imbalance, and right ventricular ischemia. Arrhythmias correlate with reduced cardiac output, impaired exercise capacity, and increased mortality. Conclusions:Early detection and maintenance of sinus rhythm enhance survival and functional capacity, highlighting the necessity of research and interventions directed at atrial remodelling, neurohormonal modulation and myocardial ischaemia.

Introduction: Tendinopathy refers to pathological changes in tendons that cause pain, functional impairment, and limited physical activity. These changes often result from repetitive overloading without adequate recovery, leading to microtrauma, collagen disorganization, vascular alterations, and chronic inflammation. While corticosteroids offer short-term relief, they may weaken tendon structure, and regenerative therapies like PRP and stem cells remain inconclusive. Recently, vitamin D has gained attention for its potential role in tendon healing. Low vitamin D levels are linked to higher tendinopathy risk and delayed recovery. This review aims to summarize current evidence on the role of vitamin D in tendon regeneration and its potential therapeutic application. Materials and methods: A review of selected literature in the PubMed, Scopus, Web of Science and Google Schoolar databases was conducted, using the following keywords: “Tendinopathy”, “Vitamin D”, “Tendon”. Conclusions: The potential role of vitamin D in tendon regeneration is a subject that offers novel perspectives on the treatment of tendinopathies. The therapeutic options currently available are limited in scope, frequently offering only symptomatic relief without addressing the underlying pathophysiology. The evidence from in vitro and in vivo experiments suggests that vitamin D can modulate inflammation, support collagen synthesis, and protect tenocytes from oxidative stress. Multidisciplinary management of tendinopathy should consider the assessment and correction of vitamin D deficiency, especially in older or physically active individuals. Further high-quality clinical studies are required to confirm these findings, determine optimal supplementation strategies, and evaluate long-term functional outcomes.