Aluminium (Al) is the most ubiquitous metal in the Earth’s crust. Even though its toxicity is well-documented, the role of Al in the pathogenesis of several neurological diseases remains debatable. To establish the basic framework for future studies, we review literature reports on Al toxicokinetics and its role in Alzheimer’s disease (AD), autism spectrum disorder (ASD), alcohol use disorder (AUD), multiple sclerosis (MS), Parkinson’s disease (PD), and dialysis encephalopathy (DE) from 1976 to 2022. Despite poor absorption via mucosa, the biggest amount of Al comes with food, drinking water, and inhalation. Vaccines introduce negligible amounts of Al, while the data on skin absorption (which might be linked with carcinogenesis) is limited and requires further investigation. In the above-mentioned diseases, the literature shows excessive Al accumulation in the central nervous system (AD, AUD, MS, PD, DE) and epidemiological links between greater Al exposition and their increased prevalence (AD, PD, DE). Moreover, the literature suggests that Al has the potential as a marker of disease (AD, PD) and beneficial results of Al chelator use (such as cognitive improvement in AD, AUD, MS, and DE cases).

Hepatocellular carcinoma (HCC) is the most common primary liver cancer with an increasing worldwide mortality rate. Cholangiocarcinoma (CCA) is the second most common primary liver cancer. In both types of cancers, early detection is very important. Biomarkers are a relevant part of diagnosis, enabling non-invasive detection and control of cancer recurrence, as well as in the application of screening tests in high-risk groups. Furthermore, some of these biomarkers are useful in controlling therapy and treatment selection. Detection of some markers presents higher sensitivity and specificity in combination with other markers when compared with a single detection. Some gene aberrations are also prognostic markers in the two types of cancers. In the following review, we discuss the most common biomarkers and genetic markers currently being used in the diagnosis of hepatocellular carcinoma and cholangiocarcinoma.

Epilepsy is an important medical problem with approximately 50 million patients globally. No more than 70% of epileptic patients will achieve seizure control after antiepileptic drugs, and several epileptic syndromes, including Lennox-Gastaut syndrome (LGS), are predisposed to more frequent pharmacoresistance. Ketogenic dietary therapies (KDTs) are a form of non-pharmacological treatments used in attempts to provide seizure control for LGS patients who experience pharmacoresistance. Our review aimed to evaluate the efficacy and practicalities concerning the use of KDTs in LGS. In general, KDTs are diets rich in fat and low in carbohydrates that put the organism into the state of ketosis. A classic ketogenic diet (cKD) is the best-evaluated KDT, while alternative KDTs, such as the medium-chain triglyceride diet (MCT), modified Atkins diet (MAD), and low glycemic index treatment (LGIT) present several advantages due to their better tolerability and easier administration. The literature reports regarding LGS suggest that KDTs can provide ≥50% seizure reduction and seizure-free status in a considerable percentage of the patients. The most commonly reported adverse effects are constipation, diarrhea, and vomiting, while severe adverse effects such as nephrolithiasis or osteopenia are rarely reported. The literature review suggests that KDTs can be applied safely and are effective in LGS treatment.

Introduction and objective. Depression is a common mental disorder that affects over 264 million people worldwide. Medical students are at a particularly high risk of this disease. The aim of the study was to investigate the prevalence of depression among Polish medical students and to determine predictors of this disease that are related to student’s lifestyle. Material and method. A total of 1023 medical students took part in the study. The research tool included a Polish version of the PHQ-9 questionnaire and author’s questions which concerned sociodemographic characteristics of the investigated group and analyzed factors. Answers were collected in the April of 2020. Results. About a half of the students (51.61%, 95% CI: 48.50 – 54.72) were found to have major depression (PHQ score ≥ 10). 30.21% of the students had mild depressive symptoms, 26.00% – moderate depressive symptoms and 15.05% – moderately severe depressive symptoms. 10.56% of the participants had symptoms of severe depression. A statistically significant relationship was found between major depression and: frequent feelings of loneliness, not doing sports regularly, not getting enough sleep, not participating in social meetings often enough, having problems with maintaining stable body weight, using alcohol in order to relieve stress or negative emotions and being non-religious. Conclusions. Depression among medical students in Poland is common. There are many lifestyle-linked predictors which are associated with this disease in the above-mentioned group. It is crucial to take actions aimed at reducing the high prevalence rates of depression among medical students in Poland, such as introducing routine screening for depression and creating resources that would enable students to obtain help.

Introduction: Overtraining syndrome (OTS) is a state of excess sportsmen's overload caused by too high an intensity of training. The main cause of OTS is too big a training load. Also, they are other risk factors like restrictive diets, inordinate stress, and inflated expectations of a family and a coach. Description of the state of knowledge: despite numerous hypotheses like dysregulation of hypothalamus and pituitary, inflammatory hypothesis, and glycogen hypothesis the exact cause of OTS is not fully understood. None of these hypotheses explains completely all of the symptoms. In diagnosis, several laboratory tests are required to exclude other diseases. After it, because of possible systemic character diagnostic process of OTS is still problematic. One of the diagnostic methods relies on the measurement of hormone levels. Another potential diagnostic method is the measurement of saliva immunoglobulins and other anti-viral proteins. Also, the measurement of serum cell-free DNA can be used. After the onset of OTS, the most important treatment method is rest, which should last for 6-12 weeks or longer. Nowadays, treatment options are looking for shortenings this time. These options are anti-inflammatory drugs and repeated hypoxia-hyperoxia exposure combined with low-intensity training. Since the only well-established treatment method is prolonged rest, prevention is the most important aspect of OTS management. Adequate education of young athletes and their parents is also important. Summary: Overtraining syndrome is a serious problem that concerns many athletes. This problem not only affects results and careers but also sportsmen’s life. Because of the wide scope of symptoms, which can be often nonspecific making the correct diagnosis can be difficult.

Introduction and purpose. Adverse Childhood Experiences (ACEs) are potentially traumatic events experienced before the age of 18 that have lasting negative effects on physical and mental health. Numerous studies have shown that exposure to Adverse Childhood Experiences increases the probability of chronic health conditions, such as obesity, diabetes, coronary heart disease, asthma, depression or PTSD. The aim of the study was to investigate the prevalence of Adverse Childhood Experiences among medical and dental students of Polish Medical Universities and to examine an association between ACEs and chosen factors associated with social relationships of the students.Material and method. A total of 1162 medical and dental students from each year of education and 18 different Polish universities took part in the study. The research tool contained the Adverse Childhood Experiences standardized questionnaire and authors’ questions.Results. More than a half of the students (57.4%) had at least 1 exposure to ACEs. 8.43% of them experienced 4 or more childhood adversities. The most commonly reported ACEs were: emotional neglect (23.06%), emotional abuse (22.98%) and mental illness or a suicide attempt in a household member (21.86%). An overall graded relationship was found between ACE score and: parents’ lower level of education, negative relationship with parents, siblings and friends and having a diagnosis of depression.Conclusions. Adverse Childhood Experiences are common among Polish medical and dental students and are associated with worsened social relationships and depression in adult life of the students. It is important to implement strategies that aim to prevent ACEs and help to build social support networks for those that are affected by them.