Background: Effective labor analgesia is a cornerstone of obstetric care, influencing maternal satisfaction and birth outcomes. This systematic review evaluates both conventional and emerging analgesia techniques for natural vaginal delivery, emphasizing multimodal and patient-centered strategies. Methods: We conducted a systematic search of PubMed, Scopus, and the Cochrane Library from January 2018 to September 2024 using MeSH terms such as “labor anesthesia”, “natural delivery”, “multimodal analgesia”, and “non-pharmacological pain management”. Randomized controlled trials, systematic reviews, meta-analyses, and cohort studies were included. Studies focusing exclusively on cesarean delivery or non-clinical interventions were excluded. The risk of bias was assessed qualitatively using the Cochrane Risk of Bias Tool for randomized trials and ROBINS-I for observational studies. However, no detailed study-by-study reporting was performed. Seventy studies met the inclusion criteria for full analysis. Results: Included studies were categorized into four themes: (1) neuraxial techniques (e.g., epidural, CSEA), (2) intrathecal and systemic opioids, (3) non-pharmacological approaches (e.g., TENS, hydrotherapy), and (4) technological innovations (e.g., programmed boluses, telemedicine). Neuraxial methods showed the highest analgesic efficacy and maternal satisfaction. Non-pharmacological interventions were associated with improved patient autonomy and minimal side effects. However, heterogeneity in study design and outcomes limited direct comparisons. Limitations: The evidence base exhibited variability in study quality, sample sizes, and reporting. The absence of standardized outcome measures, a lack of meta-analyses, and limited data on long-term outcomes limit the robustness and generalizability of the conclusions that can be drawn. Conclusions: This review supports a multimodal, individualized approach to labor analgesia. Future research should prioritize large, well-designed trials using standardized tools such as the VAS, PQoL, and EPDS to validate innovative techniques and ensure equitable maternal care.

Introduction: Currently, progesterone is notably absent from conventional feminizing hormone therapies for transgender women. Anecdotal reports indicate the potential for health advantages following the incorporation of progesterone into treatment regimens. The primarily female hormone, progesterone naturally surges in women during the menstrual luteal phase. When administered exogenously, it may expedite bodily changes that are pivotal for gender transition. Progesterone holds promise as a potential remedy for various health conditions prevalent in the transgender woman population. Methods: This narrative review synthesizes existing literature and presents a comprehensive account of the administration of exogenous progesterone in transgender women. A literature search was conducted using the PubMed, Embase, ScienceDirect, and ResearchGate databases. The following keywords were used in the search: progesterone, transgender, breast neoplasms, lactation, prostate, testicular neoplasms, and thrombosis. These terms were combined using Boolean operators. The results of the initial search were screened by three independent reviewers based on their relevance to the topic under study. Results: A total of 104 studies were initially identified as meeting the criteria for inclusion. Following an assessment based on the contents of the title, abstract, and full text, 39 studies were deemed eligible for inclusion. A critical examination of health outcomes was conducted across key sections, including breast development, mental health, lactation, cancer risk (breast and prostate), thrombosis, and nervous and other systems. Discussion: The use of progesterone in the transgender woman population is a topic that has yet to be sufficiently researched. The limited sample size, short follow-up periods, and lack of randomization restrict the potential for achieving a robust scientific evidence base. In order to gain a fuller understanding of this topic, findings from studies on contraception, hormone replacement therapy, and animal models were considered. Conclusions: Progesterone may have a beneficial effect on the bodies of transgender women without significant adverse health effects. Further investigation through well-designed studies is recommended. Randomized controlled trials that include various dosages, broad and long-term effects, and precise demographics are needed. There is an immediate need for more knowledge to create appropriate patent and clinical practice guidelines.

The prevalence of erectile dysfunction (ED) among the male population worldwide has significant ramifications for their quality of life and psychological well-being. This narrative review explores both conventional treatments, such as pharmacotherapy and surgery, and emerging approaches, including regenerative therapies, dietary interventions, physiotherapy, and vacuum erection devices (VEDs). Unlike prior reviews, this study emphasises unconventional therapies and their role in comprehensive ED management. A systematic literature review was conducted using PubMed, Embase, and Medline, including studies published up to 2024. Keywords such as “ED”, “pharmacotherapy”, “shock wave therapy”, “regenerative medicine”, and “dietary interventions” were used to identify relevant studies. Eligible studies examined treatment efficacy, mechanisms, and patient outcomes. Phosphodiesterase type 5 (PDE5i) inhibitors remain the primary treatment, demonstrating effectiveness across diverse populations. Regenerative therapies, including stem cells and platelet-rich plasma (PRP), show promise, but require further validation. Surgical interventions, particularly penile prostheses, provide high patient and partner satisfaction. Non-invasive methods, including physiotherapy and dietary changes like adoption of the Mediterranean diet, improve vascular health and erectile function. The efficacy of VEDs as standalone or adjunct treatments has been demonstrated, enhancing outcomes in prosthetic surgery. A multimodal, personalised approach is essential for optimising ED treatment. Despite promising advancements, gaps remain in terms of long-term data, standardised protocols, and partner-centred outcomes. Future research should focus on large-scale, multi-centre trials and synergistic treatment approaches to improve therapeutic outcomes and patient satisfaction.

Background: Mood disorders, including major depressive disorder (MDD) and anxiety disorders, significantly impact global mental health, contributing to disability and reduced quality of life. While pharmacotherapy and psychotherapy are standard treatments, many patients experience residual symptoms or treatment resistance. Aerobic exercise has emerged as a promising adjunctive intervention due to its psychological and neurobiological benefits. This review examines its efficacy, mechanisms, optimal implementation strategies, and integration into psychiatric care.Methods: A narrative literature review was conducted using PubMed, Embase, and other relevant databases, focusing on studies published up to 2025. Keywords such as "aerobic exercise," "depression," "anxiety," "psychiatric disorders," and "neurobiological mechanisms" were used to identify studies assessing clinical outcomes, neurobiological effects, and adherence factors.Results: Aerobic exercise significantly reduces depression and anxiety symptoms across diverse populations, with moderate-to-large effect sizes in randomized controlled trials. Mechanistically, it enhances neurotransmitter balance, increases brain-derived neurotrophic factor (BDNF), regulates the hypothalamic-pituitary-adrenal (HPA) axis, and improves cognitive function. Optimal outcomes are observed with moderate-intensity exercise (60–80% HRmax), performed three times per week for at least 8–12 weeks. Supervised and group-based interventions improve adherence, particularly in psychiatric populations.Conclusions: Aerobic exercise represents a viable, low-cost, and effective adjunct to traditional psychiatric treatments. However, methodological limitations, lack of long-term data, and adherence challenges remain. Future research should focus on standardized protocols, personalized exercise prescriptions, and large-scale, multi-center trials to maximize clinical integration and optimize patient outcomes.

BackgroundAutism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition characterized by deficits in social communication and restricted, repetitive behaviors. Its growing prevalence and functional burden have increased interest in non-pharmacological interventions, particularly physical activity and sport-based programs, as potential strategies to improve physical and neurobehavioral outcomes in pediatric populations. AimThis narrative review aimed to summarize current evidence on the effects of physical activity and exercise interventions on motor, cognitive, behavioral, and psychosocial outcomes in children and adolescents with ASD. Material and methodsA narrative literature review was conducted using peer-reviewed studies on exercise-based interventions in pediatric ASD populations. Included were systematic reviews, meta-analyses, randomized controlled trials, and experimental studies assessing outcomes such as motor skills, executive functioning, social interaction, sleep, and behavioral regulation. ResultsEvidence indicates that structured physical activity may positively affect multiple domains in children with ASD. Exercise interventions were associated with improvements in motor skills, executive functions, and social abilities, along with reductions in behavioral problems and anxiety. Some studies also reported improved sleep and overall well-being. However, significant heterogeneity in intervention types, duration, and outcome measures was noted. ConclusionsPhysical activity is a valuable complementary element of multidisciplinary ASD management, supporting both physical health and neurobehavioral functioning. Further well-designed studies with standardized protocols and long-term follow-up are needed to determine optimal intervention strategies and their sustained effects.

Atopic dermatitis (AD) is a chronic, inflammatory skin disease that often begins in early childhood and significantly affects the quality of life of patients and their families. Conventional treatments include emollients, corticosteroids, and calcineurin inhibitors; however, these are often insufficient in moderate-to-severe cases. In recent years, novel targeted therapies, including biologics and Janus kinase (JAK) inhibitors, have shown promising clinical results in pediatric patients. Dupilumab and tralokinumab, monoclonal antibodies, have demonstrated significant improvement in AD symptoms, including reduction of pruritus and inflammation. JAK inhibitors, such as upadacitinib, abrocitinib, and baricitinib, modulate cytokine pathways involved in AD pathogenesis, leading to rapid and sustained improvement of skin lesions. These novel therapies exhibit favorable safety profiles and enable personalized approaches. This article reviews current evidence on the efficacy and safety of dupilumab, tralokinumab, and JAK inhibitors in the pediatric population, highlighting their role in modern AD management.