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.

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.

Background. Regional anesthesia is increasingly used due to its advantages over general anesthesia; however, its potential complications require careful evaluation. Aim. This review aimed to synthesize current evidence on the incidence, risk factors, and prevention of neurological injury, hematoma, and infection associated with regional anesthesia. Material and methods. Relevant peer-reviewed literature—including systematic reviews, retrospective cohorts, and randomized trials—was analyzed to provide a comprehensive overview. Results. Neurological complications, though uncommon, may persist in a subset of patients and are linked to factors such as high-pressure intrafascicular injection and inadequate needle guidance. Hematomas remain rare but are more likely in patients on anticoagulants and can result in permanent deficits if diagnosis and decompression are delayed. Infections, particularly with prolonged catheter use, present a serious risk, with higher rates in peripheral nerve blocks and pediatric populations. Conclusions. Preventive strategies include ultrasound guidance, triple safety protocols, careful antithrombotic management, and strict aseptic techniques. Recent evidence supports the efficacy of real-time pressure monitoring and prophylactic antibiotic use in reducing adverse outcomes. This review underscores the importance of patient-specific risk assessment and adherence to evolving safety protocols in minimizing complications from regional anesthesia.

Background. Subconcussive head impacts (SHIs) in contact sports induce subclinical axonal injury, microglial activation, and neuroinflammation without acute concussive symptoms, potentially disrupting frontolimbic networks. Aim. To synthesize evidence on pathophysiological cascades linking cumulative SHIs to fluid neuro-biomarkers (NfL, GFAP, cytokines) and downstream executive and affective dysfunction. Material and methods. A targeted review of literature (2015–2026) across PubMed, Scopus, and Web of Science evaluating SHI biomechanics, biomarkers, and neuropsychiatric outcomes in athletes was conducted. Results. Repetitive SHIs trigger subclinical axonal shearing and microglial M1 polarization, elevating serum NfL, GFAP, and proinflammatory cytokines (IL-6, TNF-α). Neuroinflammation in frontostriatal and frontolimbic circuits (DLPFC, amygdala) directly correlates with executive dysfunction, behavioral impulsivity, and affective dysregulation. Conclusions. Cumulative SHIs cause progressive neuroinflammatory damage. Longitudinal tracking combining fluid biomarkers with digital neurocognitive screening is essential for early risk stratification in contact sports.

Background. Prostate cancer is a leading malignancy in men, with incidence expected to increase by 2040. Curative treatments prolong survival, but they are associated with substantial adverse effects, particularly during androgen deprivation therapy (ADT), comprising physical functions and quality of life. Aim. To review the current evidence on the efficacy and safety of exercise as an adjunctive intervention across the prostate cancer care continuum with its potential translation into practical clinical recommendations. Material and methods. A narrative review of randomized controlled trials, systematic reviews and meta-analyses, mechanistic studies, and clinical practice guidelines from 2010–2026 was performed. The evidence was organized according to treatment phase and qualitatively evaluated with respect to efficacy, safety, and clinically relevant outcomes. Results. Across all phases of prostate cancer management, structured exercise is safe and improves physical function, strength, body composition, and quality of life, attenuating the metabolic and cardiovascular effects of ADT. Exercise modality may be more important than dose in determining clinical benefits, with programs combining resistance and aerobic exercise showing the strongest evidence. Whether exercise improves oncological outcomes remains to be established. Conclusions. Structured exercise is a safe and effective supportive care across the prostate cancer continuum. Individualized exercise prescriptions should reflect the treatment phase, patient needs, and clinical objectives. Adequately powered randomized trials with oncological endpoints and implementation research are needed to optimize translation into routine clinical care.