Background: Composite immunonutritional biomarkers reflecting systemic inflammation, nutritional status, and immune competence have emerged as promising tools for perioperative risk stratification in colorectal cancer (CRC). However, their prognostic value during the perioperative period following minimally invasive CRC surgery remains unresolved. This study aimed to evaluate the association between perioperative inflammatory biomarkers, including the neutrophil-to-lymphocyte ratio (NLR), hemoglobin–albumin–lymphocyte–platelet (HALP) score, and Host Index (H-index), and short-term postoperative outcomes after minimally invasive colorectal cancer surgery. Methods: This retrospective single-center study included 105 patients who underwent minimally invasive curative-intent surgery for CRC between 2023 and 2025. Biomarkers were assessed preoperatively and during the first four postoperative days. Severe postoperative morbidity was defined as a Comprehensive Complication Index (CCI) ≥ 20.9. Results: Among all parameters, NLR measured on postoperative day 3 demonstrated the highest apparent discriminatory ability for severe complications (AUC = 0.87, 95% CI: 0.74–0.95; sensitivity 91.7%; specificity 73.7%). Preoperative HALP was the most informative preoperative marker (AUC = 0.78, 95% CI: 0.66–0.87; sensitivity 76.5%; specificity 87.7%). Conclusions: Perioperative inflammatory and immunonutritional biomarkers are associated with postoperative morbidity following CRC surgery. Preoperative HALP and postoperative day 3 NLR demonstrated the strongest apparent discrimination for CCI ≥ 20.9; however, these findings require confirmation in larger, independent prospective cohorts.

Background. Conventional cigarette smoking remains a major modifiable risk factor for cardiovascular and respiratory disease. Exercise testing provides a practical framework for assessing how smoking may influence submaximal heart rate, peak heart rate, and post-exercise heart rate recovery. Aim. The aim of this narrative review was to summarize current evidence on the effect of conventional cigarette smoking on submaximal, maximal and recovery heart rate responses during physical exercise. Material and methods. A narrative literature review was conducted using the PubMed and Scopus databases. Publications from January 2016 to April 2026 were considered, including full-text original studies, systematic reviews, and meta-analyses addressing cigarette smoking, exercise response, heart rate, autonomic regulation, physical fitness, or cardiopulmonary function. Results. The reviewed evidence suggests that smoking is associated with altered cardiac autonomic regulation, reduced cardiorespiratory fitness, impaired pulmonary function, and delayed post-exercise recovery. Differences during moderate submaximal exercise may be subtle, whereas limitations become more apparent at ventilatory or lactate thresholds, during peak exercise, and during recovery. Conclusions. Conventional cigarette smoking may impair the integrated cardiovascular, respiratory, and metabolic response to physical exercise, even in young and physically active individuals. Smoking status and post-exercise heart rate recovery should be considered in sport, clinical, and rehabilitation settings.

Background. Mountain exercise, trekking, skiing and altitude training expose physically active individuals to hypobaric hypoxia and acute altitude illness. AMS usually occurs after rapid ascent above approximately 2500 m and may impair safety and performance. Aim. This narrative review summarizes evidence on AMS in physically active individuals, focusing on fitness, ascent profile, acclimatization, load management, hydration, nutrition, symptom monitoring and anti-doping issues. Material and methods. A PubMed-based narrative search was performed in May 2026 using terms related to AMS, altitude illness, athletes, exercise, mountaineering, acclimatization, prevention, Lake Louise Score, oxygen saturation, hydration and nutrition. English-language studies, reviews, consensus statements and guidelines were prioritized. WADA documents were consulted for doping issues. Results. Rapid ascent, inadequate acclimatization, previous altitude illness, high early exercise intensity, individual oxygenation responses and poor symptom awareness are clinically important determinants of AMS risk. Fluid and energy imbalance may worsen exercise tolerance and complicate symptom interpretation, but they are not substitutes for acclimatization. The 2018 Lake Louise AMS Score is a practical field tool, whereas SpO2 and heart rate are supportive parameters only. Conclusions. High physical fitness does not eliminate AMS risk. Preparation should combine gradual ascent, low training load during the first 24-48 h, individualized risk assessment, adequate nutrition and hydration, and daily symptom monitoring. New headache with gastrointestinal symptoms, dizziness, unusual fatigue, ataxia, confusion or dyspnea at rest should prompt rest, cessation of ascent and, when indicated, descent or treatment.

Background. Dietary supplements are widely used by resistance-trained individuals to support hypertrophy, strength, recovery, and performance. Nephrolithiasis is a recurrent condition influenced by urine volume, urinary pH, calcium, oxalate, uric acid, citrate, sodium intake, and dietary patterns.Aim. The aim of this narrative review was to analyse the potential relationship between common gym supplements and risk factors for kidney stone formation.Material and methods. A narrative literature review was conducted using PubMed, Scopus, Web of Science, ScienceDirect, Google Scholar, urological guidelines, and sports nutrition position statements. The synthesis focused on protein supplements, creatine, vitamin C, calcium, vitamin D, caffeine-containing pre-workout products, hydration, and dietary context.Results. The main concerns relate to high-dose vitamin C, excessive non-dairy animal protein intake, high sodium intake, low urine volume, and poorly supervised calcium or vitamin D supplementation in predisposed individuals. Recommended-dose creatine is not convincingly linked with nephrolithiasis in healthy users.Conclusions. Supplement use should be interpreted within total diet, hydration, training conditions, and individual stone risk. Prevention includes adequate fluid intake, moderate protein intake, sodium restriction, sufficient dietary calcium, avoidance of excessive vitamin C, and medical evaluation in recurrent stone formers.Keywords: resistance training, dietary supplements, nephrolithiasis, kidney stones, protein supplements, creatine, vitamin C, hydration

Background. Sleep is essential for recovery, cognitive performance, and mental health in competitive sport. Athletes may use sleep aids when insomnia, travel fatigue, jet lag, or pre-competition arousal interfere with rest. Aim. This narrative review summarizes current evidence on melatonin, sedative-hypnotics, and related sleep aids in competitive and elite athletes, including their effects on sleep, performance, safety, and anti-doping risk. Material and methods. PubMed, PubMed Central, Google Scholar, and publisher websites were searched in May 2026. Open-access reviews, clinical trials, consensus statements, and official anti-doping documents were prioritized. Results. Current evidence supports structured sleep assessment and non-pharmacological strategies as first-line management. Melatonin appears most relevant for circadian misalignment and travel-related sleep disruption, although direct performance benefits remain uncertain. Evidence regarding classical hypnotics in athletes is limited, while residual sedation, psychomotor impairment, misuse, and dependence remain important concerns. Supplement contamination and variable product quality may also create anti-doping risks. Conclusions. Sleep aids should be used selectively, for clearly defined indications, and under medical supervision. Sleep management in athletes should prioritize behavioral, circadian, and organizational interventions before pharmacological treatment.

Background. Long-term athletic training induces structural, functional, and electrical cardiac adaptations known as athlete’s heart. In some athletes, these physiological changes overlap with hypertrophic cardiomyopathy, creating a diagnostic grey zone. Aim. The objective of this narrative review was to discuss current approaches to differentiating hypertrophic cardiomyopathy from athlete’s heart in sports cardiology. Materials and methods. Publications available in PubMed and Scopus from 2017–2026 were reviewed. The final set comprised 30 freely accessible full-text sources, including narrative reviews, systematic reviews, imaging studies, consensus statements, and clinical guidelines. Results. Differentiation requires integration of clinical history, family history, ECG, echocardiography, cardiac magnetic resonance, rhythm monitoring, genetic testing, exercise assessment, and longitudinal observation. Athlete’s heart is usually supported by proportional chamber enlargement, preserved function, high exercise capacity, and absence of myocardial fibrosis. Hypertrophic cardiomyopathy is suggested by disproportionate or focal hypertrophy, small left ventricular cavity, abnormal ECG findings, arrhythmias, fibrosis, symptoms, or positive family history. Conclusions. A multimodal and individualized diagnostic strategy is essential to reduce sudden cardiac death risk while avoiding unnecessary restriction of healthy athletes from sport.