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.

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.

Background: Epilepsy affects approximately 50 million individuals worldwide and represents a major contributor to global neurological morbidity. Despite increasing evidence supporting the safety and benefits of exercise, physical activity remains underutilized in this population. Individuals with epilepsy are consistently less active than the general population, largely due to persistent safety concerns and limited clinical guidance. Aim: This narrative review aims to examine the relationship between epilepsy and physical activity, including epidemiology, underlying physiological mechanisms, potential benefits, associated risks, and clinical recommendations. Materials and methods: A structured literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar, including studies published between 2008 and 2025. Eligible sources included original research articles, systematic reviews, and clinical guidelines addressing physical activity in individuals with epilepsy. Results: The available evidence indicates that moderate-intensity physical activity does not increase seizure frequency in most patients and may, in some cases, contribute to seizure reduction. Proposed mechanisms include upregulation of brain-derived neurotrophic factor (BDNF), reduction of neuroinflammation, and improved autonomic regulation. Exercise is also associated with improvements in quality of life, mood, and physical fitness, which are often inadequately addressed by pharmacological treatment alone. The International League Against Epilepsy (ILAE) classification of sports according to seizure-related risk provides a practical framework for individualized recommendations. Conclusions: Current evidence supports the incorporation of physical activity into epilepsy management, provided that recommendations are tailored to the individual patient.

Background: Mitral annular disjunction (MAD) is a structural abnormality of the mitral valve apparatus characterized by atrial displacement of the leaflet hinge point away from the left ventricular myocardium. Once considered an incidental finding, MAD is now recognized as a component of the arrhythmic mitral valve prolapse phenotype and a potential substrate for ventricular arrhythmias and sudden cardiac death, particularly in physically active individuals. Objectives: To summarize current evidence regarding the anatomy, epidemiology, arrhythmogenic mechanisms, multimodality imaging, risk stratification, and management of MAD, with emphasis on its relevance in athletes. Methods: A narrative review of the literature was performed using PubMed/MEDLINE and major cardiology and sports medicine journals. Publications from 1999 to 2024 were reviewed using the terms “mitral annular disjunction”, “arrhythmic mitral valve prolapse”, “athlete”, “exercise”, “sudden cardiac death”, “eligibility”, and “return to play”. Priority was given to recent guidelines, expert consensus documents, systematic reviews, large cohort studies, and landmark publications. Results: Physiological cardiac remodeling in athletes may obscure the diagnosis of MAD, while exercise-related hemodynamic and autonomic changes may facilitate ventricular arrhythmias in susceptible individuals. Current recommendations support individualized risk assessment and shared decision-making rather than universal sports restriction. Conclusions: MAD should be considered during cardiovascular evaluation of athletes with bileaflet mitral valve prolapse, unexplained ventricular arrhythmias, or a family history of sudden cardiac death. Further studies are needed to establish athlete-specific risk stratification and long-term management strategies.

Background: Access to psychotherapy among adolescents in public health systems remains a significant challenge despite the growing burden of youth mental health disorders. Individual, family, service, and system-level factors influence whether adolescents initiate and sustain engagement with treatment. Objectives: To synthesize evidence on barriers and facilitators to accessing psychotherapy among adolescents within publicly funded or subsidized health systems and to identify multilevel determinants relevant to equitable service delivery. Methods: A systematically informed narrative review was conducted following PRISMA 2020 conventions. PubMed, Scopus, and the Cochrane Library were searched for studies published between 2015 and December 2025 on psychotherapy access among children and adolescents within public health systems. Qualitative, quantitative, and mixed-methods studies reporting barriers or facilitators to access or engagement were included and synthesized narratively using a four-level individual, family, service, and system framework. Results: Twenty studies met the inclusion criteria. Structural barriers, including long waiting times, limited specialist availability, geographic distance, and fragmented service coordination, were the most consistently reported obstacles. Stigma and cultural or linguistic mismatch further hindered engagement, particularly among migrant and minority populations, while limited mental health literacy and parental non-acceptance were key family-related barriers. Key facilitators included strong therapeutic relationships, active family support, school-based delivery, telehealth, and culturally adapted care models. Conclusions: Access to adolescent psychotherapy is shaped by interacting multilevel determinants. Reducing inequities requires coordinated strategies addressing structural barriers and psychosocial factors. Future research should adopt standardized definitions of access and prioritize underserved populations and low-resource settings.

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.