Background: The increasing popularity of ultra-endurance sports emphasizes the need for a deeper understanding of their health implications, particularly the impact on kidney function. Given the kidneys’ crucial role in waste filtration, fluid and electrolyte balance, and their close connection to the physiological demands of intense physical activity, it requires detailed investigation from this perspective. Purpose: The objective of this study is to present the current state of knowledge on the topic of kidney function in the context of ultra-endurance sports. It examines the risk factors, underlying mechanisms, and potential strategies for preventing renal injuries associated with these specific types of physical activities. Findings: Ultra-endurance sports present significant risks to kidney health, including acute kidney injury (AKI) estimated to affect approximately 40% of participants, rhabdomyolysis and dehydration, which are often compounded by additional factors such as gastrointestinal distress and the use of non-steroidal anti-inflammatory drugs (NSAIDs). There is a need for improved diagnostic criteria to detect acute renal injury in this population, with novel biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and cystatin C showing promise. A multifaceted preventive approach including strategies such as mandatory pre-event screening, the use of personal monitoring devices, proper hydration and nutrition, adequate race preparation, and the avoidance of NSAIDs is crucial to mitigate these risks and maintain renal health in ultra-endurance athletes.

LADA (latent autoimmune diabetes in adults) is a dual form of diabetes, combining the autoimmune features typical of type 1 diabetes and the clinical and metabolic aspects of type 2 diabetes. Due to the slow development of symptoms and often late age of onset, LADA is frequently misdiagnosed as type 2 diabetes, which can lead to a delay in appropriate treatment. It is estimated that LADA affects between 4% and 12% of adults initially diagnosed with type 2 diabetes, making it a more common disease entity than previously thought. This paper examines current data on the epidemiology, pathogenesis, genetic factors and diagnostic criteria of LADA. Particular attention was given to the immunological and genetic aspects of the disease, which allow a more accurate differentiation of LADA from type 2 diabetes. The review also discusses the significance of early insulin therapy aimed at beta-cell preservation and the role of alternative treatments, such as DPP-4 inhibitors, which may influence disease progression. Diagnostic and therapeutic challenges stemming from the phenotypic similarities between LADA and type 2 diabetes are highlighted, along with potential benefits of early detection.

Introduction: Myocarditis is an inflammatory disease of the heart muscle, presenting with symptoms ranging from mild discomfort to severe cardiac dysfunction. It poses diagnostic challenges due to overlap with conditions such as coronary artery disease and its nonspecific presentation. This review summarizes current diagnostic and therapeutic approaches, emphasizing advancements in imaging and personalized treatment strategies. Aim of the study: The aim of this study was to summarize the existing knowledge of currently relevant diagnostic and therapeutic approaches to myocarditis, highlighting both established methods and emerging advances. Materials and Methods: The literature available in the PubMed database was reviewed using the following keywords: "myocarditis," "myocarditis diagnosis," "myocarditis treatment," "diagnosis of myocarditis," "COVID-19 myocarditis," "viral myocarditis," and "autoimmune myocarditis." Conclusions: Myocarditis is a complex and multifactorial condition that requires improved diagnostic tools and individualized treatment strategies. As with other diseases, personalized approaches considering patient-specific factors are essential for better clinical outcomes. To achieve this, further research into innovative diagnostic methods and targeted therapies is necessary. Additionally, raising awareness of myocarditis is crucial for early diagnosis, timely treatment, and patient support.

Background: Sex hormones have a key impact on the development of the human body during puberty, including a significant influence on bone development - their shape, structure, length, and mineral density. Due to the growing number of transgender and gender diverse (TGD) adolescents and the increasing demand for gender-affirming hormone therapy (GAHT), there is rising curiosity about the impact of this therapy on the developing body of a young person. Purpose: This review aims to summarize the latest scientific reports on the impact of gonadotropin-releasing hormone analogues (GnRHas) and GAHT on the bone mineral density (BMD) of transgender adolescents undergoing gender-changing therapies. Findings: Low pretreatment BMD is more common among TGD adolescents than in the general population, and this is more prevalent in transgirls than in transboys. BMD Z-scores decline during treatment with GnRHas and respond differentially to GAHT. Regular follow-up and health advice are essential. Further long-term studies of the effects of these therapies on peak bone mass and future fracture risk are needed.

Astaxanthin (AST) is a carotenoid renowned for its strong antioxidant properties and its role as a pigment in various aquatic organisms. Initially isolated from lobster and subsequently characterized in detail, AST has garnered significant interest in recent years within the research, pharmaceutical, cosmetic, and supplement industries. This review aims to synthesize current literature on the impact of astaxanthin supplementation on lipid profiles, specifically focusing on low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides. Evidence suggests that AST effectively prolongs the oxidation lag time of LDL, thereby mitigating the risk of atherosclerosis and cardiovascular diseases through its antioxidative mechanisms. The effects of AST on HDL-C levels are less consistent, with some studies reporting modest increases while others show no significant changes. Similarly, the influence of AST on triglyceride levels remains inconclusive, with studies presenting mixed outcomes ranging from significant reductions to negligible effects. AST is characterized by a high safety profile and favorable bioavailability, which is influenced by its source and isomeric composition. Despite these promising findings, many existing studies are limited by small sample sizes, heterogeneous participant groups, and varied dosing regimens, which impede the ability to draw definitive conclusions. Consequently, there is a need for larger, well-standardized clinical trials to accurately assess the efficacy and safety of astaxanthin as a therapeutic agent for lipid modulation and the prevention of metabolic disorders. Future research should focus on robust methodological designs and standardized supplementation protocols to clarify AST’s role in managing dyslipidemia and enhancing cardiovascular health.

BACKGROUND Pruritus is common in chronic dialysis patients, usually due to metabolic imbalance, xerosis, or other cutaneous complications of chronic kidney disease (CKD), leading to a diagnosis of CKD-associated pruritus (CKD-aP). When symptoms persist despite optimized dialysis, stable laboratory indices, and no dermatologic cause, alternative etiologies must be considered. CASE REPORT A 66-year-old man with end-stage renal disease (ESRD) of unknown origin, treated with peritoneal dialysis, developed progressive, treatment-resistant pruritus. Initially localized to the extremities without primary lesions, it was unresponsive to standard therapies. As the itch became generalized, systemic symptoms emerged, including fatigue, lower-extremity edema, and pancytopenia. Differential diagnoses were excluded. Pre-transplant abdominal CT revealed generalized lymphadenopathy and splenomegaly. A bone marrow biopsy confirmed chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) by immunophenotyping. Due to ESRD and active malignancy, the patient was ineligible for chemotherapy or kidney transplantation; pruritus management remained conservative. CONCLUSIONS Persistent pruritus in dialysis patients warrants reevaluation beyond CKD-aP, especially in those with unknown CKD etiology and hematologic abnormalities. Recognizing paraneoplastic itch as a potential early sign of malignancy can enable earlier diagnosis in high-risk populations.