Background: Dental anxiety in children represents a persistent clinical problem that can compromise cooperation and quality of treatment. Nonpharmacological behavior management techniques are gaining attention as safe, developmentally appropriate alternatives to sedation or general anesthesia. Understanding their comparative effectiveness is essential for optimizing pediatric dental care. Aims: The aim of this review is to assess the effectiveness of four main nonpharmacological behavior management methods (Tell Show Do, behavioral modeling, distraction, and virtual reality) in reducing dental anxiety among children. The objectives are to analyze studies published between 2020 and 2024, to identify psychological and developmental factors influencing the success of these techniques, and to evaluate the potential of artificial intelligence enhanced virtual reality (AI VR) as an innovative tool for individualized behavioral management. Methods: A structured literature review was conducted using PubMed and Google Scholar. The search covered the years 2020–2025 and included studies involving healthy pediatric patients aged 2–12 years. Publications focused on systemic or psychiatric disorders were excluded. Twenty five studies meeting inclusion criteria were analyzed narratively. The review compared the clinical effectiveness, applicability, and limitations of four interventions: Tell Show Do, behavioral modeling, distraction, and virtual reality. Results: All analyzed methods showed significant anxiety reduction and improvement of cooperation in children. Tell Show Do and behavioral modeling demonstrated the strongest effect on familiarization and trust building, while distraction and virtual reality were most effective in reducing fear and pain perception during treatment. Active distraction provided superior results compared with passive approaches. Virtual reality, particularly in AI assisted adaptive form, produced the most consistent anxiety reduction, although evidence remains limited by small sample sizes and methodological diversity. Conclusions: Nonpharmacological behavior management techniques are essential for effective pediatric dental care. Integrating traditional behavioral strategies with modern AI supported VR applications can enhance patient comfort, improve clinical outcomes, and promote positive dental experiences. Future research should standardize anxiety assessment methods, explore long term effects, and validate the safety and efficiency of AI VR for children with developmental and sensory sensitivities.

Background: Pulmonary hypertension (PH) is a chronic cardiovascular disorder marked by elevated pulmonary artery pressure and right ventricular dysfunction. It affects about 1% of adults and up to 10% of those over 65 years. Pulmonary arterial hypertension (PAH), its main subtype, occurs in 2–5 new cases per million annually, with a prevalence of 15–50 per million. Despite therapeutic advances, PH still carries high morbidity and mortality, with annual death rates up to 15% and a median untreated survival of 2–3 years. The condition severely limits exercise tolerance and quality of life. While patients were once discouraged from physical activity, recent trials show that structured, supervised exercise can safely enhance functional capacity and well-being in stable patients. Aim: To critically evaluate contemporary evidence on structured physical activity as adjunct therapy in pulmonary hypertension and to address four questions: mechanisms of benefit, effectiveness of exercise modalities and intensities for functional capacity and quality of life, safety and tolerability profile, integration into personalized and telemonitored programs. Methods: A literature search was performed in PubMed, Scopus and Web of Science for studies published between 2018 and 2024. Eligible randomized trials, cohort studies, systematic reviews and meta analyses in adult pulmonary hypertension populations were included. Thirty two publications were synthesized qualitatively. Main outcomes were six minute walk distance, peak oxygen uptake, pulmonary vascular resistance, right ventricular function and health related quality of life. Results: Supervised physical activity improves six minute walk distance and peak oxygen uptake, reduces dyspnea and fatigue, and enhances quality of life in clinically stable patients. Aerobic training provides the core benefit, resistance training supports functional independence, and inspiratory muscle training improves respiratory strength. Multimodal and home based telemonitored programs increase accessibility and adherence under clinical oversight. Safety was acceptable in stable patients with appropriate screening and monitoring. Hemodynamic improvements were inconsistent across studies and long term effects remain uncertain. Conclusions: Evidence supports endothelial, metabolic, and anti-inflammatory adaptations with exercise in pulmonary hypertension. Individualized supervised programs combining aerobic, resistance, and inspiratory muscle training improve function and quality of life in stable patients. Safety is acceptable under medical supervision. Home-based and telemonitored approaches enhance accessibility. Larger standardized trials are needed to confirm effects on hospitalization and survival.

Background: Low back pain (LBP) is a leading cause of disability worldwide and a major burden on individuals, healthcare systems, and economies. Its prognosis is determined by a multifactorial interplay of psychosocial, demographic, occupational, lifestyle, clinical, and genetic factors, extending beyond biomedical explanations. Previous reviews are now partially outdated, as they did not fully integrate recent findings on systemic comorbidities, genetic predispositions, sleep disturbances, and stress-related disorders. This review addresses this gap by synthesizing evidence up to early 2025, with a particular focus on implications for physical activity and sport participation, an aspect rarely emphasized in earlier literature. Methods: This narrative review was conducted in accordance with SANRA guidelines. A comprehensive search of PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar identified publications between 1987 and early 2025. Eligible studies included systematic reviews, meta-analyses, randomized controlled trials, large prospective cohorts, and landmark conceptual papers. A total of 121 publications were included and synthesized thematically across psychosocial, demographic, occupational, lifestyle, clinical, genetic, and systemic domains. Results: The analysis confirmed psychosocial determinants as the strongest predictors of chronicity and disability. Occupational exposures, lifestyle behaviors, and comorbid conditions such as hypertension, diabetes, and multisite pain also contributed substantially to prognosis. Emerging evidence highlighted novel domains, including genetic predispositions, biological markers, sleep disturbances, and stress-related disorders such as PTSD. Importantly, this review identified the underexplored relationship between prognostic factors and sport participation: moderate leisure-time activity appears protective, whereas excessive or high-load training may increase risk, underscoring the need for sport-specific prognostic insights. Conclusion: LBP prognosis is complex and requires a holistic biopsychosocial approach. The novelty of this review lies in its integration of evidence up to 2025 and its unique emphasis on systemic health indicators, genetic predispositions, and the implications of physical activity and sport participation. These findings expand the scope of prognostic research and highlight domains not adequately addressed in previous reviews. Early risk identification, tailored interventions, and multidisciplinary models of care are essential to improve outcomes and prevent chronicity. Future research should refine prognostic models, incorporate systemic and genetic markers, and develop sport- and activity-specific recommendations to advance prevention, optimize treatment, and support sustained engagement in healthy, active lifestyles.

Background: Dental surgical procedures are common interventions but their outcomes may be significantly affected by systemic comorbidities and concomitant pharmacotherapies, leading to complications such as bleeding, infection, and impaired wound healing. While previous reviews have primarily focused on individual conditions, an integrated synthesis addressing multiple comorbidities and their interactions is lacking. This narrative review evaluates the influence of diverse systemic conditions and drug regimens on perioperative safety, provides clinical recommendations for interdisciplinary management, and identifies gaps for future research. Objectives: The aim of this review is to analyze the impact of systemic comorbidities and pharmacotherapy on the outcomes of dental surgical procedures, to propose tailored clinical strategies for perioperative management, and to identify areas where evidence remains insufficient. Methods: A narrative literature review was conducted using PubMed, Scopus, Web of Science, and selected specialty journals for the period January 2015 to July 2025. Search terms included “dental surgery,” “oral surgery,” “comorbidities,” “cardiovascular disease,” “anticoagulants,” “type 2 diabetes,” “osteoporosis,” “bisphosphonates,” “oncology,” “polypharmacy,” “immunosuppression,” “chronic kidney disease,” “biologic drugs,” and “perioperative complications.” Peer-reviewed articles in English focusing on adult patients were considered. Eligible publications comprised original studies, randomized controlled trials, systematic reviews, and narrative reviews. Case reports, animal studies, and papers with insufficient methodological clarity were excluded. Titles and abstracts were screened, with 50 full texts reviewed and 25 studies included in the final synthesis. Key findings were summarized thematically by condition and pharmacotherapy. Results: Twenty five studies were analyzed (6 observational, 10 systematic or narrative reviews, 4 randomized controlled trials, 5 guidelines). Based on heterogeneous evidence, perioperative risks include bleeding in anticoagulated patients, estimated two- to threefold higher infection rates in uncontrolled diabetes, and clinically significant incidences (e.g., 3-10%) of medication-related osteonecrosis of the jaw (MRONJ) in patients treated with bisphosphonates or denosumab, as well as osteoradionecrosis (ORN) in oncology patients. Effective strategies identified include comprehensive preoperative assessment, pharmacological adjustments, antibiotic prophylaxis, and minimally invasive surgical techniques. Conclusions: Comorbidities and pharmacotherapy exert a substantial influence on the safety of dental surgical procedures. Interdisciplinary collaboration and personalized perioperative strategies are essential to optimize outcomes in medically compromised patients. Future research should prioritize the development of standardized management protocols and predictive models to enhance patient safety and evidence-based practice.

Aims: The main goal of the authors of the work was to dispel the myth that Attention Deficit Hyperactivity Disorder is a childhood disease. It was emphasized that failure to recognize ADHD in adults, especially in young women, leads to serious consequences. Methods: This narrative review was conducted following established standards for non-systematic literature synthesis in biomedical research. Studies published between 2018 and 2025 were identified through PubMed/MEDLINE, Scopus and Web of Science searches using combinations of keywords and MeSH terms related to adult ADHD. Article selection was conducted based on predefined criteria and decisions were made collectively by the research team. Results: Studies indicate that more than half of pediatric ADHD patients continue to struggle with the disorder into adulthood. This new awareness is leading to greater interest in ADHD in the adult population, especially given the underdiagnosis of people over the age of 18, including young women. The etiology of ADHD is multifaceted, with particular emphasis on the role of heredity and dopamine dysregulation. Conclusions: Failure to accurately diagnose ADHD in adults leads to problems in many areas of life (social, professional, emotional) and a lack of understanding for people with this disorder. In young women, undiagnosed ADHD increases the risk of low self-esteem, hopelessness and sexual abuse. In addition, people with ADHD are particularly vulnerable to disorders related to the abuse of psychoactive substances. It is necessary to increase the knowledge of the medical and non-medical community about ADHD in adults. The serious effects of ADHD can be prevented by incorporating appropriate treatment, mainly pharmacological, in the form of stimulants, which are highly effective. However, it is important to remember the possible side effects of these drugs, such as an increase in cardiovascular risk and the rare occurrence of psychosis, which requires constant monitoring of patients.

Aims: This review aimed to evaluate the clinical efficacy and safety of systemic glucocorticoids in children with Mycoplasma pneumoniae pneumonia (MPP), with particular focus on severe (SMPP) and refractory (RMPP) cases, based on prospective studies published between 2015 and 2025. Methods: A structured literature search was conducted using PubMed and Google Scholar. Only English-language prospective studies involving pediatric patients were included. Eight studies met the eligibility criteria. Data were extracted and summarized thematically. No formal bias assessment was performed, but study limitations were analyzed narratively. Geographic distribution, study design, and outcome heterogeneity were taken into account. Results: Combination therapy with glucocorticoids and antibiotics was associated with improved clinical outcomes in MPP, including reduced fever duration, improved pulmonary function, and lower inflammatory marker levels (CRP, IL-6, TNF-α). Intravenous methylprednisolone was the most commonly used steroid (1–2 mg/kg/day, up to 10 mg/kg/day in severe cases). Early administration (within 24–36 hours of hospital admission) was linked to better outcomes. No significant increase in adverse events was reported. One study suggested potential cost-effectiveness in RMPP. However, most data originated from East and Southeast Asia, limiting generalizability to European populations. Conclusions: Glucocorticoid therapy may be beneficial in pediatric MPP, especially in severe and refractory forms. However, current evidence is limited by small sample sizes, heterogeneity in interventions, and regional concentration of studies. No standardized protocol for dosing, duration, or patient selection exists. High-quality, geographically diverse randomized controlled trials are urgently needed to support clinical decision-making in non-Asian populations.

Introduction: Chronic pain is a major global public health issue, affecting an estimated 20% of adults worldwide. Prevalence is particularly high among the elderly and those in long-term care. In Poland, up to 30% of adults are affected, with even higher rates observed among institutionalized populations. Osteoarthritis is the most frequent cause, accounting for over one-third of cases. Despite ongoing medical advances, effective management of chronic pain remains a major clinical challenge due to its multifactorial etiology and high interindividual variability. Aim: This narrative review aims to provide a comprehensive and integrative summary of current knowledge on chronic pain, including its pathophysiological mechanisms, classification, and modern management strategies. Particular attention is given to pharmacological and non-pharmacological approaches, with an emphasis on the role of individualized, interdisciplinary care in improving patient outcomes. Methods: A narrative literature review was conducted using PubMed and Google Scholar. The search prioritized large cohort studies, systematic reviews, meta-analyses, and recent mechanistic investigations. Studies addressing both pharmacological and non-pharmacological methods of chronic pain management were selected based on scientific relevance and evidence quality. Results: Pharmacological treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, antidepressants, and anticonvulsants, although their use is often limited by adverse effects and reduced long-term efficacy. Non-pharmacological interventions such as physiotherapy, psychotherapy, relaxation techniques, neuromodulation, and lifestyle modification play a crucial role in improving patient quality of life and functional status. An individualized treatment plan based on a biopsychosocial model is considered the most effective approach. Conclusions: Chronic pain management requires personalized, interdisciplinary strategies aimed not solely at symptom relief but at enhancing daily functioning and well-being. Improved access to comprehensive pain services and increased awareness among healthcare professionals and patients are essential for optimizing outcomes.

Background: Vitamin D is known for its regulatory effects on both the innate and adaptive immune systems. Its potential role in modulating allergic responses, including the pathogenesis of food allergies, has gained increasing scientific attention. Objective: To review and synthesize the current evidence on the immunomodulatory effects of vitamin D in the context of food allergy, with a focus on proposed mechanisms and clinical observations. Methods: This narrative review was based on a structured literature search conducted in PubMed, Scopus, and Web of Science, covering 32 publications from January 2010 to April 2024. The search strategy used keywords and combinations such as “vitamin D”, “food allergy”, “immunomodulation”, “gut immunity”, “epithelial barrier”, and “regulatory T cells”. The selection emphasized research exploring immunological pathways, epithelial integrity, and microbiota-related mechanisms. Results: The reviewed literature suggests that vitamin D may contribute to immune tolerance through upregulation of regulatory T-cell responses, suppression of Th2- mediated cytokines, reinforcement of epithelial barrier function, and modulation of gut microbiota composition. Several observational and preclinical studies report associations between vitamin D deficiency and increased susceptibility to food sensitization, particularly in early childhood. However, findings remain inconsistent across populations and study designs, and many results derive from animal models or small-scale human cohorts. There is a lack of large, well-controlled clinical trials. Conclusions:Vitamin D appears to modulate immune pathways relevant to food allergy, including cytokine regulation, mucosal barrier integrity, and microbiota balance. However, current evidence is heterogeneous and largely preclinical, limiting firm conclusions. Future studies should focus on human clinical trials and mechanistic research to clarify causality. Individuals at high risk of vitamin D deficiency may benefit from targeted screening and correction, though clinical guidelines require further validation.

Introduction and Aim: This narrative review aims to assess the potential risks of video games in triggering photosensitive epilepsy (VGA) in children and adolescents, with particular focus on the most significant visual risk factors and evidence-based preventive strategies. Content of the Review: A comprehensive review of literature indexed in the PubMed (Medline) database between 1990 and 2024 was conducted. The review discusses the clinical history and neurophysiological mechanisms of video game-related seizures, the impact of visual stimuli (e.g., flashing lights between 3-50 Hz, high-contrast colors, full-screen effects), and risk variability in pediatric populations. Conclusions: Video games may provoke epileptic seizures in children and adolescents with photosensitive or photogenic epilepsy. Awareness of the primary visual triggers and adherence to prevention guidelines can significantly reduce seizure risk during gameplay.