Background: Methylphenidate is a psychostimulant that enhances dopamine and norepinephrine neurotransmission through the mechanism of reuptake inhibition at the synaptic cleft. Studies indicate that sexual dysfunction is prevalent among psychiatric patients. The objective of our study was to assess the impact of methylphenidate on patients’ sexual health, identify specific types of sexual dysfunction, and analyse the correlations between psychiatric disorders, treatment dosages and durations, and the presence of sexual dysfunction. Additionally, we aimed to evaluate the prevalence of improved sexual function resulting from methylphenidate use. Methods: A systematic literature review was performed using the PubMed database in accordance with PRISMA guidelines. The initial search yielded 186 articles, of which 14 met the inclusion criteria and were analyzed. Clinical studies involving changes in libido, erectile function, ejaculation, semen quality, and sexual behavior due to methylphenidate were reviewed. Results: The findings indicate that methylphenidate can have both negative and positive effects on sexual function. In some patients, particularly those with psychiatric comorbidities, methylphenidate was associated with decreased libido and ejaculation disorders. In other cases, especially in individuals with preexisting dysfunctions or on low doses, it appeared to enhance sexual arousal and performance. Conclusions: Methylphenidate may influence sexual function in complex ways depending on individual patient profiles and treatment variables. Clinicians should be aware of these potential outcomes and consider sexual health as part of the therapeutic discussion when prescribing methylphenidate.

Background: The kidney is covered with a renal fascia consisting of a fibrous capsule and a fatty capsule and is located extraperitoneally. The properties of this organ allow for mechanical protection, protecting against injury. Materials and methods: We describe an anatomical variation observed during the dissection of the body of an 85-year-old man. Results: The right kidney was located intraperitoneally, freely among the loops of the small intestine, and had normal vascularization. In addition, it measured 12.5 cm in length and 5.7 cm in width. The left kidney was significantly smaller, with no abnormalities. Conclusions: According to the databases, this is the third case of intraperitoneal kidney described in the world. Such a localization variant should be considered because of the complications it brings to diagnostic imaging and surgical management. Keywords: kidney intraperitoneal parietal peritoneum variation

Introduction: Tularemia, a zoonosis caused by the Gram-negative bacterium Francisella tularensis, is a serious threat to public health. The disorder can take the ulceroglandular, pneumonic, oropharyngeal, oculoglandular, gastrointestinal, or typhoidal forms. Infection occurs through contact with infected animals, tick/insect bites, or inhalation of contaminated aerosols. The clinical presentation of tularemia may vary; the condition is often confused with streptococcal pharyngitis, infectious mononucleosis, or other diseases. Aim: The aim of this paper is to systematize the knowledge on tularemia in the context of ENT practice, to discuss the recommended treatment, and to present typical clinical presentations. Material and methods: A review of the literature published in the years 2000–2025 as available through the PubMed database was carried out in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Demographic data and information on the clinical course, source and routes of infection, as well as complications and treatment, were extracted for analysis. Results: The database query returned a total of 178 papers; of these, 12 articles describing 25 children were finally qualified for the review. The results, as reported for children aged 8 months–17 years, were divided into 3 groups depending on the variant of tularemia, namely oropharyngeal tularemia, ulceroglandular tularemia, or tularemia of the middle ear. Oropharyngeal tularemia and ulceroglandular tularemia were the most predominant variants. The main vectors were rodents and ticks. The most common symptoms included fever, sore throat, enlarged lymph nodes, and skin lesions. Conclusions: Despite being well described in the literature, tularemia remains rarely diagnosed in most Central European countries. Early diagnosis and prompt management are key to preventing severe complications. The best therapeutic results are obtained using antibiotics from the group of fluoroquinolones, tetracyclines, or aminoglycosides. The recommended duration of antibiotic therapy is 14–21 days.