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.

Introduction: Chronic skin diseases impose a multidimensional burden that extends far beyond physical symptoms. Epidemiological evidence consistently reveals a disproportionately high prevalence of psychiatric comorbidities in dermatology patients, particularly anxiety and depression. Historically, the psychological distress observed in this population has been attributed primarily to the psychosocial impact of body image dissatisfaction. However, this perspective is increasingly viewed as incomplete. Emerging research suggests that persistent sleep disturbance acts as a physiological pathway linking cutaneous inflammation to mental health decline, yet its specific role as a functional mediator remains underappreciated. Aim of the study: This review aims to evaluate the evidence supporting sleep disturbance as a key mediator linking cutaneous symptoms to mental health disorders. Materials and method: A narrative literature review was conducted in the PubMed database up to the year 2025. Conclusions: Evidence suggests that nocturnal pruritus cause severe sleep fragmentation and alter sleep architecture, particularly reducing rapid eye movement sleep. This sleep deprivation acts as a primary biological stressor, activating the HPA axis and upregulating pro-inflammatory cytokines, which are shared biomarkers for both cutaneous inflammation and major depressive disorder. Furthermore, sleep loss impairs emotional regulation and lowers the threshold for stress coping, creating a cycle where psychological distress exacerbates skin symptoms. Sleep disturbance is not merely a secondary symptom of skin disease but a critical mediator of psychiatric morbidity. Effective management of chronic skin diseases must include the assessment and restoration of sleep quality. Targeting sleep disruption - through itch control or behavioral interventions - may serve as a potent strategy to prevent the development of secondary mental health problems in dermatological patients.

The aim of this paper is to discuss, based on the literature on the subject, the problem of food addiction, binge eating, anorexia nervosa, and to compare these disorders in terms of their biology and neurobiology. The literature review includes the definition of the concepts of food addiction, binge eating, and anorexia nervosa, the epidemiology of these phenomena based on population studies, the diagnostic criteria for these disorders, and the likely neurobiological factors responsible for their development, as well as a list of types of anorexia nervosa and their differentiation in terms of coexistence with food addiction. The paper also includes a brief discussion of the somatic symptoms observed in the course of obesity and anorexia nervosa.