Introduction and purpose  The role of virtual reality (VR) is increasingly being discussed not only in the context of entertainment, but also in the medical field. Recently, there has been a growing number of literature analyzing its effect on reducing pain and anxiety, which are common problems of pediatric patients. These feelings can negatively affect their psyche, health recovery, but also doctor-patient cooperation and avoidance of treatment in the future.The purpose of this study is to analyze and summarize the potential of using virtual reality to reduce pain and anxiety in pediatric patients. Material and methods  A literature review of 2015-2022 based on PubMed and Google Scholar. Results  The literature reviewed shows the extensive use of virtual reality in the treatment of pain and anxiety in pediatric patients. VR is a good method for reducing perioperative anxiety, pain during wound care and pain as well as anxiety in invasive procedures. This method may not be beneficial in the treatment of acute pain and its role is uncertain during dental treatment. Disadvantages of this technique include the need for financial investment in equipment and trained staff. Patients may experience dizziness and motion sickness during its use. Another disadvantage is also that it does not provide a long-term analgesic effect. Conclusion There appears to be merit in using this technology as an adjunctive method to reduce pain and anxiety in pediatric patients. There is also a need for further research in this area and the development of appropriate therapeutic intervention for a specific age group and procedure in a well-defined process by a trained team.

Introduction: Adolescent pregnancy remains a contentious issue despite improvements in quality of life and increased access to sexual education. The average age of first pregnancy has shifted due to financial instability among young people, leading to delayed pregnancies until financial stability is achieved. Teenage mothers face social stigma, and early sexual initiation not only increases the risk of pregnancy but also sexually transmitted infections (STIs). Often, adolescent pregnancies are unwanted, resulting in delayed medical consultation due to fear or ignorance. Aim of the Study: This study aims to investigate the medical and social implications of adolescent pregnancy, emphasizing the importance of early sexual education and comprehensive healthcare support. Description of the State of Knowledge: Adolescent pregnancy, defined as pregnancy between ages 10 and 19, is a global concern with millions of cases annually. It poses significant health risks, including premature birth, low birth weight, and intrauterine growth restriction. Socially, it affects educational attainment and financial stability, with adolescents from lower socioeconomic backgrounds facing greater challenges. Early sexual initiation and risky sexual behaviors further compound the issue, increasing the risk of STIs. Lack of comprehensive sexual education exacerbates these risks, highlighting the need for multidisciplinary support from healthcare professionals. Conclusions: Adolescent pregnancy requires a holistic approach encompassing medical, social, and legal dimensions. Effective sexual education programs, involving gynecologists, pediatricians, and educators, are essential for prevention. Legal frameworks must protect adolescents and address issues of consent and sexual health. Additionally, access to comprehensive healthcare services, including prenatal care and contraception, is crucial for mitigating the adverse effects of adolescent pregnancy on both individuals and society.

Clinical depression is a psychiatric disorder characterized by symptoms such as loss of interest and pleasure from typically enjoyable activities (anhedonia), pervasive low mood, and diminished energy leading to excessive fatigue and lower activity which have been present in a patient for at least two weeks. Available therapies consist primarily of pharmacological intervention. Indeed, some groups of medications such as SSRIs, SNRIs, TCA’s and tetracyclic antidepressants have been used to treat depression for decades, frequently in combinations. An example of such a combination is “California Rocket Fuel” composed of venlafaxine and mirtazapine Objective: To review the current literature on the efficacy of the combination of venlafaxine and mirtazapine in treating clinical depression both in drug-resistant depression and as a first-line option. To explore the risks and benefits of this choice of therapy and discuss its potential mechanism of action. Methods: Literature review of Pubmed, Google Scholar, Science Direct, and available medical textbooks. Conclusions: Treatment with venlafaxine and mirtazapine is safe, especially for drug-resistant depression. It is worth considering adding venlafaxine to already ongoing pharmacotherapy with mirtazapine when the patient experiences sleepiness and the symptoms of depression have not been sufficiently reduced. Augmenting venlafaxine treatment with mirtazapine also seems necessary when the patient complains of insomnia. One may consider implementing such therapy as a first-line treatment in patients who suffer from depression for a long time and experience insomnia in its course.

Introduction and purpose Frostbite is a serious injury caused by cold, which is an inseparable element of human contact with nature. It can cause tissue damage and loss of function if not properly treated. It treatment consists of several stages that require the involvement of many people. The purpose of the article is to summarize information on epidemiology, pathophysiology, prehospital and hospital procedures and to draw attention to the complexity of patient care. Materials and methods A literature review based on PubMed and Google Scholar using the following keywords: frostbite, cold injury. Description of the state of knowledge: The literature review shows the breadth of the issue. The effectiveness of therapy depends on: knowledge of pathophysiology and risk factors, early diagnosis, discontinuation of exposure to cold, effective analgesic treatment, fluid therapy, transport of the victim to the appropriate center, rapid warming of frozen tissues, imaging diagnostics, initiation of thrombolytic treatment and, if necessary, surgery. It is also important to remember about long-term complications that worsen the quality of life of patients, such as chronic pain, hyperaesthesia or impairment or loss of limb functionality. Conclusions Frostbite is a relatively rare problem, but especially in winter, every medic will have to deal with it sooner or later. Considering the above information, the management of a patient with frostbite is a demanding and long-term process in which the cooperation and involvement of many medics is important, so it is worth having knowledge about them.

Carotid-cavernous fistulas are a rare vascular disorder resulting from an abnormal connection between the cavernous sinus and the carotid arteries. Direct carotid-cavernous fistulas require endovascular treatment. Indirect fistulas may resolve spontaneously or with non-invasive treatment, but worsening symptoms may also require endovascular treatment. Endovascular treatment is performed using detachable balloons, detachable coils, stents, and embolization materials such as n-BAC or Onyx. The symptoms occur as a result of increased pressure within the venous drainage vessels. The most common clinical manifestation are symptoms within the eyeball. Due to their rare occurrence and often non-uniform clinical symptoms, carotid-cavernous fistulas may pose diagnostic difficulties. The Aim of this work: Carotid-cavernous fistula is a disorder that may result in complete loss of vision. Appropriate diagnostics and the involvement of an interdisciplinary team of specialists are important. Such a team should consist of an ophthalmologist, a radiologist and a neurosurgeon. The fistula requires differentiation from other more common diseases with similar symptoms, hence the knowledge of the etiology, diagnosis and treatment of the fistula is crucial. Methods: Selected articles from Pubmed and specialist literature were analyzed in detail. We focused on selected issues related to carotid-cavernous fistulas. Conclusion: When the clinical symptoms are vague, the diagnosis may be incorrect or established with a long delay. Early correct diagnosis can effectively prevent irreversible vision impairment.

The dominant approach in the fight against breast cancer is mastectomy. Surgical operations include diagnostic, therapeutic, palliative and reconstructive procedures. The decision as to the procedure depends on the type, location and advancement of the tumor, as well as on the preferences of the patients, the skills of the operator and the availability of methods at a given centre. It is worth noting that with the increasing number of patients, there have also been significant advances in treatment, the surgical techniques used, and consequently the quality of life index has also increased. Nowadays, clinicians' attention is focused not only on the elimination of the cancer, but also on the best possible cosmetic effect of the treatment. In breast cancer, the approach to the patient should be multidisciplinary, because mastectomy and its complications affect the patient's appearance after surgery, as well as psychological aspects, changing self-perception and pain complaints.