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Introduction The article provides an overview of the available methods of contraception, effectiveness, safety, advantages and disadvantages of using a given contraceptive. The use of contraception is becoming more and more popular in society. There are many methods of contraception. The choice depends mainly on the patient's preferences, but diseases and a well-collected history are also important. The aim of the study Review the latest literature on methods of contraception Material and methods The research was conducted using Articles by PubMed and Google Scholar on methods of contraception Description of the state of knowledge: There are many methods of contraception, Hormonal methods include oral contraceptive pills, contraceptive patches, implants, hormone injections. Barrier products such as copper / levonogestrel IUDs prevent pregnancy by creating a mechanical barrier to prevent conception. [1,2] The most common method - the use of condoms prevents sperm from entering the uterus. All products and methods have benefits and potential complications, therefore the method should be selected individually for each patient. [6,7] Summary: There are many types of contraception . Some of them are almost 100% effective in preventing pregnancy. [1,3,4,5,] It should be remembered that each method of contraception should be selected individually, depending on the patient's needs. [8,9]

Introduction: UV radiation is related to skin cancers, skin photoaging and sunburn. It can be harmful for human skin, so it is crucial to have a protection against sun rays. Substances protecting people from sun are sunscreens, that block and absorb UV radiation. The first sunscreen was discovered in 1928 and, since then, there have been many concerns about its safety, efectiveness and impant on the environment. Types of accessible sunscreens are physical sunscreens, chemical sunscreens and a combination. This study review is performed to assess possible risks of using sunscreens and evaluate if there are more positive or negative effects of their action. The aim of the study: To evaluate positive and negative effects of sunscreens action. Materials and methods: We searched Pubmed and ResearchGate in order to find relevant studies about sunscreens and their impact on human skin, human health and environment. Results: There seem to be some adverse effects of sunblockers for the environment, such as destroying coral reefs, bioaccumulating in fish tissue and water sources. In some studies there was mentioned a negative impact of sunscreens on hormonal systems and pregnancy, as well as on human skin. On the other hand, many studies display that sunblockers inhibit the carcinogenic effect of sun rays, preventing people from developing skin cancers. Conclusions: Althought sunscreens can have some negative effects, studies showed that there are more positive effects of their action. They can be harmful for the environment, but at the same time they can be a protection. Sunscreens protect skin from developing skin cancer and also delay skin aging. However, the protection against sun is complex.

Introduction Tourette syndrome is a disorder characterized by tics. It usually begins in childhood and often remains in adulthood. Tiki is best described as body movements performed automatically excluding the patient's will. It affects boys more often than girls and is associated with attention deficit hyperactivity disorder and obsessive-compulsive disorder. The etiology of Tourette syndrome has not yet been fully clarified. The aim of the study Review the latest literature on Tourette syndrome. Material and methods The research was conducted using Articles by PubMed and Google Scholar on Tourette syndrome. Description of the state of knowledge Tourette syndrome is a movement disorder most commonly found in schoolchildren. The occurrence peaks in the pre-puberty period, and half of the cases disappear in early adulthood and, while the severity of occurrence is higher than commonly assumed. It is often associated with mentally concomitant diseases, mainly attention deficit hyperactivity disorder and obsessive-compulsive disorder. Given the diverse presentation, Tourette's syndrome can mimic many hyperkinetic disorders, making it difficult or delaying correct diagnosis. Treatment can be behavioral, pharmacological or surgical and is dependent on the symptoms causing the greatest dysfunction. Summary Tourette syndrome can cause severe stress and worsen health-related quality of life. Often it is an embarrassing condition for patients. Treatment is multimodal, however, an important issue of treatment among patients is to undertake psychotherapy, so as not to perpetuate the tic reflex, as well as to cope with functioning in society.

Primary dysmenorrhea is defined as pain in the pelvic area that occurs for no specific reason during menstrual cycle. Dysmenorrhea occurs in 50% to 90% of adolescent girls and women of reproductive age which makes it one of the most common causes of pelvic pain in women. The mechanism of this condition is overproduction of prostaglandins by the endometrium, causing uterine hypercontractility, thereby leading to uterine muscle ischemia, hypoxia and pain. Dysmenorrhea significantly reduces the quality of women life, often making it impossible to perform daily activities and, in addition, it may cause a mental stress that makes both professional and school life difficult. Despite this, females often consider these symptoms as a normal part of their menstrual cycle, which makes this disease underrated and untreated. Dysmenorrhea can be treated in a various ways such as non-pharmacological, pharmacological and surgical. However, women with a typical history of primary dysmenorrhea can commence empirical therapy without any additional tests. Hormonal contraception and nonsteroidal antiinflammatory drugs have proved to be effective in this treatment. However, if conventional treatment is contraindicated, alternative treatments such as topical heat, lifestyle modification, transcutaneous electrical nerve stimulation, dietary supplements, acupuncture, and acupressure may be used. Surgical treatment is possible, but it is used rarely and only in severe cases of treatment-resistant dysmenorrhea. However, it should be emphasized how important it is to exclude secondary causes of dysmenorrhea.

Introduction: Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disease. It is characterized by persistent pruritus, usually occurring after 30 weeks of pregnancy, and by elevated levels of bile acids and transaminases, which decrease over the course of 2-3 weeks postpartum. [1,2]The occurrence of ICP in the mother may be associated with significant complications in the fetus, such as: preterm labor, intrauterine asphyxia, or sudden fetal death. Currently, the treatment of choice is ursodeoxycholic acid (UDCA).[2,6] Recently, it was observed that the administration of metformin in cases not responding to standard therapy improved lipid disorders in pregnant women. The aim of the study: The aim of the study is to present the possibility of using metformin in the treatment of ICP in pregnant women not responding to standard treatment and to present a clinical case.. Material and methods: The work is a review of the literature on the management of ICP and the use of metformin in the treatment of lipid metabolism disorders, as well as a brief case report of a patient with intrahepatic cholestasis of pregnancy. Description of the state of knowledge: Metformin is an oral antidiabetic drug belonging to the group of biguanides. However, the latest observations show that metformin also has a beneficial effect on the liver function and on the lipid metabolism in pregnant women. In these patients, the levels of bile acids and liver enzymes decreased after the use of metformin. Summary: The mechanism of action of metformin explaining its beneficial effect on the lipid metabolism in pregnant women with intrahepatic cholestasis is not fully understood.

Introduction: Dioxins and dioxin-like polychlorinated biphenyls are considered to be among the most toxic to humans due to their persistence, resistance to degradation and chemical properties. Endometriosis is characterized by the presence of endometrial cells outside the uterine cavity showing secretory activity. It is one of the most common causes of pelvic pain and decreased fertility; is formed as a result of the action of hormonal and immune mechanisms. The exact etiology is unknown and multifactorial; risk factors for endometriosis include both family conditions and various environmental factors, including exposure to chemicals. The aim of the study: Evaluation of the impact of dioxins on endometriosis development. Materials and methods: A research was performed using Pubmed, Google Scholar and ResearchGate; we made review and meta-analysis of the most relevant studies. Results: Dioxins can contribute to cancer development, which is well documented, as well as several conditions, such as sexual dysfunctions, oxidative stress and inflammation. Doxins have similar structure to steroid hormones, so their main target are male and female gonads, thyroid gland and other organs in which steroid hormones are produced. Conclusions: Endometriosis is a multifactorial disease, whereas dioxins are strong poisons that have an adverse effect on live organisms. Many epidemiological studies suggest that dioxins may significantly contribute to the development of endometriosis.

Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, acute conditions, potentially life-threatening, immune-mediated and often unpredictable. Characteristic for SJS and TEN is acute necrosis of the epidermis and mucous membranes, caused by the extensive death of keratinocytes. These syndromes are considered hypersensitivity reactions. They are most often caused by drugs. There have also been reports of SJS / TEN being caused by infection, SJS/TEN disease is very rare and due to its rarity there is no specific pharmaceutical algorythm. Supportive care and treatment of symptoms are very important. The most crucial part of non-pharmacologic treatment of SJS/TEN is the detection and cessation of the pharmaceutical that caused the disease. The aim of this literature review was to summarize current knowledge about the pathogenesis, clinical features, diagnosis and treatment of Stevens- Johnson Syndrom and Toxic Epidermal Necrolysis. Standard criteria were used to review the literature data. The search of articles in the PubMed and Google Scholar database was carried out using the following keywords: Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, cutaneous adverse drug reactions

Introduction Nowadays, it has become fashionable to use dietary supplements containing large doses of vitamin D available without a prescription. In the case of children, dietary supplementation with a properly selected dose of vitamin D is extremely important and brings many benefits, of which it is important to prevent rickets in the pediatric population, attention is also drawn to its toxicity and consequences in the event of an overdose of vitamin D preparations, to which infants and young children are most exposed, examples of risks are hypercalcemia, hypercalciuria and nephrocalcinosis. The aim of the study Showing the benefits and dangers of vitamin D supplementation. Material and methods The research was conducted using PubMed articles and on: vitamin D supplementation in children, vitamin D overdose, vitamin D deficiency. Description of the state of knowledge Vitamin D is the generic name for ergocalciferol and cholecalciferol that we can find in foods, however, food and supplementation are not its only sources, it should be borne in mind that it is possible to synthesize vitamin D in the skin after exposure to ultraviolet reproduction (UV-B). The concentration of 25(OH)D in childhood serum is influenced by the amount and frequency of vitamin D consumed, sun exposure, body weight and body fat levels. The main risk of vitamin D deficiency in children is rickets and defromation of the osteoarticular system and metabolic disorders, and long-term use of its high doses can lead to hypercalcemia and nephrocalcinosis. Summary It is very important to educate parents about the importance of vitamin D supplementation in a dose properly selected for the newborn along with an explanation of the possible consequences of deficiency, as well as overdose.

Introduction Iodine is necessary for the proper production of triiodothyronine and thyroxine, which affect the development and proper functioning of the body. Thyroid hormones are involved in the transformation of proteins, fats, carbohydrates and vitamins, and also regulate the processes of cell growth and maturation. Iodine deficiency during pregnancy has many consequences for the fetus and newborn, some of them an increased risk of miscarriage, stillbirth, birth defects or abnormal mental development. Iodine deficiency through lack of supplementation or deficiency in the daily diet, as well as the consumption of an excess amount of this microelement, may be associated with serious and irreversible consequences affecting the development and further functioning of the fetus. Aim of the study Presentation of the impact of iodine supplementation in reproductive age and pregnancy on fetal development and students' knowledge of the need for this supplementation. Materials and method A survey of 404 students. The results were compared with the current scientific literature. Statistical analysis was performed using Microsoft Excel. Results In the study group, almost every third student believed that current recommendations recommend that women planning pregnancy should take iodine preparations. Every tenth student gave the correct dose of recommended supplementation of the microelement in question. Conclusions Research shows that more than half of students are not aware of the need to supplement iodine at the reproductive age. The data indicate that young people should be made aware of the need for iodine supplementation.

Introduction: The prevalence of diabetes in the world continues to increase. Most cases of type 2 diabetes are caused by modifiable risk factors, including unhealthy diets based on meat and processed products, low physical activity, overweight and obesity. Research suggests that plant-based diets have shown significant weight reduction benefits compared to non-plant-based diets and improve glycemic control to a greater extent than conventional diabetic diets. The aim of the study: assessment of the frequency of developing diabetes t.2 in people eating various types of vegetarian diets compared to people whose diet contains animal products. Material and methods: Standard criteria were used to review the literature data. The search of articles in the PubMed and Google Scholar database was carried out using the following keywords: plant based diet, vegetarian diet, type 2 diabetes. Description of the state of knowledge: Food products such as red meat, especially processed meat, are one of the most important risk factors for metabolic disorders, including diabetes. A healthy and properly balanced plant-based diet can positively affect the carbohydrate metabolism. Due to the high fiber content, this diet has a low energy density. It also contains flavonoids and a high amount of antioxidants beneficial to human health. Summary: Properly balanced vegetarian diets lower the risk of developing metabolic syndrome and diabetes. Plant-based diets range from vegan, lacto-ovo-vegetarian, peso-vegetarian, and semi-vegetarian diets. Different types of diets show differences in therapeutic effects. The most important factor connecting these different diets is the focusing on whole grains, vegetables and fruits, nuts, legumes, and limiting consumption of saturated and trans fats.

Fibromyalgia (FM) is a syndrome manifested by chronic, generalized muscle and joint pain and symptoms such as sleep problems, mental disorders, mainly depression, which significantly reduces the patients' quality of life. The etiology, pathogenesis, and pathomechanism of symptoms in FM are still not fully understood, which makes the therapeutic options unsatisfactory. Treatment is mainly based on relieving the symptoms of the disease and is based on both pharmacological and non-pharmacological treatments. It seems that the best results are achieved by a combination of cooperation between a rheumatologist, psychiatrist, psychologist and phosiotherapist. The aim of the study is to present the current state of knowledge about the possibilities of non-pharmacological treatment in people with fibromyalgia Standard criteria were used to review the literature data. The search of articles in the PubMed and Google Scholar database was carried out using the following keywords: fibromyalgia, chronic pain, non-pharmacological therapy in fibromyalgia

Introduction: Ovarian cancer accounts only for 4.7% of female malignancies in Poland but has the worst prognosis among gynaecological neoplasms. Due to non-specific and scant symptoms the disease is diagnosed in nearly 70% of cases in stages III and IV (FIGO). The primary goal of surgical treatment is complete cytoreduction with no residual disease left after surgery involving hysterectomy, bilateral adnexectomy, omentectomy and removal of all metastatic foci from the peritoneum and abdominal organs. If it is not possible to achieve the complete cytoreduction, patients may be qualified for neoadjuvant chemotherapy (NACT) and surgery after achieving complete or partial remission.Purpose: Description of NACT protocol used for the treatment of stage IIIC ovarian cancer. Comparison of treatment results of advanced ovarian cancer using NACT and primary debulking surgery (PDS).Case report: A 58-year-old female patient was hospitalized with the diagnosis of the pelvic mass. Her predominant signs were abdominal pain on the right flank and flatulence. Laboratory tests and imaging studies indicated a high risk of metastatic ovarian cancer. Initial diagnosis was confirmed on the laparoscopy. Ovarian cancer matched stage IIIC with Fagotti score of 8 points. The inspection of the abdominal organs revealed tumors in both adnexa, miliary spread on the parietal peritoneum, the surface of the small intestine and the diaphragm and the thick infiltration of greater omentum. Multiple specimens for the pathology were collected and left adnexectomy was done. Due to the inability to achieve complete cytoreduction, the patient was qualified to NACT. Following 6 cycles of standard protocol paclitaxel and carboplatin chemotherapy, laparotomy with hysterectomy, bilateral adnexectomy and omentecomy was done. Residual disease was found only within greater omentum but complete cytoreduction was achieved. The patient was discharged in good condition.Summary: Clinical data indicates that patients with advanced ovarian cancer treated with NACT and surgery have similar prognosis to those treated by primary cytoreductive surgery. The advantages of NACT are reduced perioperative morbidity and mortality, lower complication rate and shorter hospital stay. In the described patient, the implementation of the NACT protocol has resulted in complete surgical cytoreduction which is the main factor permitting prolongation of life expectancy in woman with advanced ovarian cancer.

Introduction: Cervical cancer (CC) is currently the eight most common cancer among women and the seventh leading cause of cancer-related death in women in Poland. Early, non-invasive cervical cancer may develop over the years without clinical symptoms. Also, given the fact that early forms are treatable effectively, it's important to get preventive examinations. It is especially important in the group of women at high risk of developing CC. Purpose: The aim of the study is to assess women's knowledge of the risk factors for cervical cancer.Material and method: Women's knowledge of cervical cancer risk factors was verified with an anonymous online questionnaire. The obtained results were analysed and checked on the basis of scientific literature.Results: The vast majority of respondents consider family history of cancer as a risk factor for CC. 75.9% of women consider infection with HPV a risk factor. Chronic vaginal infections were chosen by over half of the women. The onset of intercourse at an early age was considered a risk factor by only 24.6%, while a large number of sexual partners by 45.4%.Conclusions: The results of the conducted research indicate that the knowledge of women from the studied group about the risk factors for cervical cancer and methods of prevention is average. In order to improve the epidemiological situation of cervical cancer in Poland, efforts should be intensified to increase the education of women in this field.

Introduction:One of the main characteristics of cancer is uncontrolled cell proliferation as well as loss of cells adhesion in the case of metastases. Cadherins and catenins are the molecules responsible for cell-to-cell interaction. Together, they form a complex called ECCU (E-cadherin/catenin complex) which maintains the proper tissue structure. However, an impairment in its functioning can result in many adverse health effects, such as cancer promotion. Purpose: To evaluate the potential role of ECCU complex in carcinogenesis. Materials and methods: We performed the database research using PubMed, Springer Link and ResearchGate and we made review and meta-analysis of relevant studies. We searched for studies analyzing the relationship between ECCU complex and carcinomas development. Results: ECCU takes part in many cell processes and pathways, such as Wnt/Wingless‐signaling pathway or EMT/MET processes. It interacts with various molecules, for instance p27 protein or transcription factors. Aberrations in the expression of ECCU components is related to carcinoma promotion, shorter survival rate of patients and poor differentiation of the tumor. Conclusions: A role of the ECCU complex is complicated, however there is a clear correlation between loss of cell adhesion and carcinoma promotion and progression. The complex can be a possible target of anti-cancer therapy in the future; it is also under investigations as a marker of the disease, however it is questionable.

Introduction: Iodine is essential for the synthesis of the thyroid hormones. Proper thyroid function in a pregnant woman depends on the accumulated reserves of iodine in the pre-pregnancy period. If they are sufficient, the production of thyroid hormones is adequate even in the case of increased demand. Adequate iodine status during pregnancy is crucial for maternal health and foetal growth. Severe iodine deficiency causes maternal and foetal hypothyroxinaemia, leading to irreversible brain damage, manifested by mental retardation and neurological disorders. The daily requirement for iodine for pregnant women has been determined by The World Health Organization (WHO) at 250 µg. Most likely, the demand for it cannot be covered only by dietary iodine intake, so iodine should be supplemented in the form of tablets at a dose of 150-200 µg daily.Purpose: The aim of the study is to assess students' knowledge on iodine supplementation by women planning pregnancy and pregnant women.Material and method: Students' knowledge regarding the importance of iodine supplementation was verified using anonymous Internet questionnaire. The obtained results were analysed and checked on the basis of scientific literature.Results: The percentage of students who think iodine supplementation should be recommended is 22.7%, and 9.7% believe it is not necessary. Only 8.8% of the respondents chose the correct recommended dose of iodine. Surprisingly, most of the respondents do not know the recommended iodine dose, as much as 71.7% of them.Conclusions: The proper supply of iodine has a decisive impact on the proper functioning of the body, and its deficiency has serious consequences, especially in the womb. The problem of iodine deficiency is serious. This is also confirmed by the results of our surveys. It is important to educate students on the recommendations for iodine supplementation in women of childbearing age.

Introduction:Urinary incontinence is an involuntary, decision-dependent urination that leads to partial or complete emptying of the bladder. The causes include overactive bladder syndrome, which is diagnosed on the basis of clinical symptoms, such as urgency to urinate, increased frequency of voiding, nocturia caused by increased reactivity of the detrusor muscle. Treatment of this condition includes, but is not limited to, pharmacotherapy, behavioral therapy, and pelvic floor exercises. It is also possible to use an innovative method of local injection of botulinum toxin into the bladder. It inhibits the release of acetylcholine, which results in the inhibition of the contractile activity of the detrusor muscle.The aim of the study: The purpose of the systemic review was to collect and analyze material of application of botulinum toxin in the treatment of urinary incontinence caused by overactive bladder.Material and methods: The work is a review of the literature on the use of botulinum toxin in the treatment of overactive bladder, published in 2002-2020.Description of the state of knowledge:The use of the described method gives long-lasting results compared to pharmacotherapy. In addition, it eliminates the side effects caused by drugs because the administration of drugs is reduced or discontinued. The use of botulinum toxin has many more benefits than simply improving the lives of people affected by urinary incontinence. When selecting the therapy, one should also pay attention to possible side effects resulting from the use of the described drug. Summary:Intravesical administration by means of botulinum toxin cystoscopy is a modern, safe, effective and minimally invasive method of treating urinary incontinence, possible on an outpatient basis, allowing to improve the urodynamic parameters. Side effects are very rare. The botulinum toxin serotype A used in this method is the most studied serotype used for therapeutic purposes. The conducted research shows that over 90% of women reported a clinically significant improvement in sexual function after using the method.

Introduction:The term “preeclampsia” (PE) refers to a multisystem disorder occurring after 20 weeks of pregnancy; it includes a new onset of hypertension and proteinuria and affects from 2 to 8% of all pregnancies. Cardiovascular disease (CVD) is a group of pathologies, which present significant mortality rate all over the world. The literature implicates that both disorders are linked in a sense of further cardiovascular complications in women who had preeclamptic pregnancy.Purpose:Evaluation of the relationship between pre-eclampsia and the risk of future potential maternal cardiovascular complications and proposal of the possible causes of this association.Materials and methods:We performed the database research using Pubmed, Springer Link and ResearchGate and we made review and meta-analysis of relevant studies. We searched for studies analyzing the relationship between preeclampsia and future maternal cardiovascular risk.Results:Systematic reviews and cohort studies qualified for the purpose of this review showed the relationship between preeclampsia and future cardiovascular diseases in mothers. The possible explanations include endothelium dysfunction enduring after delivery and the co-existence of common risk factors for both diseases.Conclusions:Preeclampsia is a risk factor predisposing to cardiovascular diseases and may lead to cardiac complications later in life. The course of pregnancies is very important for the future maternal health.Key words: preeclampsia; pregnancy; hypertension; cardiovascular disease

Introduction:The incidence of sinonasal cancers (SNCs) is quite rare; they contribute to 0,16% of all malignant tumors and to 3% among head and neck cancers. The survival rate remains poor - it is 59.5% for 5 years. The two most common subtypes are squamous-cell carcinoma (SCC) and adenocarcinoma (ADC). Both subtypes of SNC are associated to occupational exposures. Main risk factors for SNC include chemical components, wood and textile dusts, nickel and chromium, welding fumes. Thus, people doing particular jobs are at higher risk of SNC. Purpose: Evaluation of the influence of wood dust on SNCs development. Materials and methods: We performed a database research using Pubmed, Google Scholar, Springer Link and ResearchGate and we made review and meta-analysis of relevant studies. We searched for studies analyzing the relationship between wood dust and sinonasal cancer incidence. Results: Studies have shown that the risks of SNCs were great for workers in wood-related jobs, especially cabinetmaking, carpentry or joinery. There was a strong correlation between ADC incidence and wood dust, however the morbidity for SCC was also high. Conclusions: SNCs development is related to the occupational exposures. People engaged in jobs associated with wood processing are at great risk. Proper ventilation and protection is necessary while doing wood-related jobs. Key words: wood dust; nasal sinus carcinoma; occupational exposure; ADC

Introduction: The intestinal microflora (IM) is a heterogeneous complex of all microorganisms inhabiting the human body, both commensal, symbiotic and pathogenic. It consists mainly of bacteria, but also of viruses, archaea, fungi and protozoa. IM has an important metabolic and immunological role and participates in the course of pathological processes. The composition of a newborn and baby’s IM changes dynamically in the first year of life. Just in the first days of birth, the newborn is exposed to many different strains of bacteria, including Staphylococcus sp. and Enterococcus sp.Aim: To purpose of systematic review was to collect and analyze material of effect of the mother's gut microbiota on the pregnancy and of the health of baby.Material and methods: Review of the literature published in 2008-2020.Conclusion: The uterus environment was originally considered sterile and the newborn's intestines were to be colonized only during and after delivery. However, recent studies indicate that placenta and amniotic fluid are involved in microbiota colonization of fetal intestines during prenatal life. This means that the fetus has an initial stock of microorganisms before birth. In addition, a significant effect of maternal diet and probiotic supplementation during pregnancy on the composition of microorganisms found in the amniotic fluid has been demonstrated. There is also a relationship between microbiotic programming in the aspect of civilization diseases. Summary: The education of women of reproductive age on the subject of proper nutrition and supplementation during pregnancy and the puerperium is extremely important. Undertaking pro-health activities will affect the child's future health and development.

Introduction Cervical cancer (CC) is one of the most prevalent malignancies of female reproductive tract. In Poland in 2017 CC accounted for 3.0% of all newly registered tumour cases among women, and was the eighth most common female malignancy. Persistent infection with carcinogenic human papillomavirus (HPV) is the leading risk facor. Currently, it is believed that infection with the human papillomavirus (HPV), especially its oncogenic types 16 and 18, is of fundamental importance in the development of cervical cancer. Vaccination prevents from infection with certain types of viruses, and consequently the development of cancer induced by a given type of virus. Therefore, their effi­cacy can be measured only in the long term, in a large cohort of vaccinated adolescents reaching the age charac­terized by the peak incidence of these cancers.Purpose The objective of the study was to evaluate knowledge about CC, as well as awareness of HPV and HPV vaccination among female respondents.Material and method The research was conducted on the group of 1,260 survey respondents, who filled out the Internet questionnaire. The obtained results were analysed and checked on the basis of scientific literature.Results The percentage of respondents who select human papillomavirus infection as a risk factor for the cervical cancer is 75.9%. The onset of intercourse at an early age was considered a risk factor by only 24.6%, while a large number of sexual partners by 45.4%. Women were also asked about knowledge of HPV vaccination. Only 73.8% of them heard about it and 26.2% declare unawarness of this type of vaccination.Conclusions Health promotion campaigns and educational programs are necessary in order to reduce cervical cancer burden and should be directed particularly towards those who have demonstrated low cervical cancer knowledge and low awareness regarding HPV and its vaccine.

Introduction:Mięśniaki macicy są najczęstszymi łagodnymi guzami macicy. Większość mięśniaków przebiega bezobjawowo i nie wymaga interwencji lekarskiej, jednak jeśli tak się dzieje, podstawą terapii pozostaje dostęp chirurgiczny. Miomektomia to jedna z chirurgicznych metod usuwania mięśniaków dla osób chcących zachować płodność. W dzisiejszych czasach udoskonalono techniki operacyjne i opracowano metody mniej inwazyjne, takie jak laparoskopowa miomektomia (LM). Jednak bezpieczeństwo i skuteczność LM jest dobrze udokumentowana w przypadku mięśniaków średniej wielkości. Dostęp laparoskopowy w przypadku większych guzów macicy (średnica> 10 cm) może budzić kontrowersje i może stanowić wyzwanie ze względu na możliwe trudności. Cel, powód: Ocena skuteczności, wyzwań technicznych i powikłań LM w leczeniu dużych mięśniaków. Materiały i metody: Przeszukaliśmy bazy danych Pubmed, Springer Link i ResearchGate. Wyniki: Systematyczne analizy zakwalifikowane do tego przeglądu sugerowały, że pomimo wielu możliwych komplikacji i trudności, metoda może być z powodzeniem stosowana przez doświadczonego specjalistę. Jednak leczenie LM w dużych mięśniakach jest nadal rzadkie, a dane na ten temat są nadal ograniczone. Wnioski: Miomektomia laparoskopowa może być alternatywną metodą leczenia dużych mięśniaków. Chirurgia laparoskopowa dużych mięśniaków LM może stanowić wyzwanie, a skuteczność takiego leczenia zależy od umiejętności chirurga. Metoda jest również przydatna u kobiet rozważających ciążę.

Psoriasis (skin psoriasis, PsO) is a chronic auto‐immune skin inflammatory condition. In about one-third of cases, the joints are affected (psoriatic arthritis, PsA). Both conditions, especially PsA, profoundly impact patients' health-related quality of life. This disease affects between 2% and 3% of the population. The onset occurs before the age of 40 as a sharply demarcated scaly, red skin lesions, most often on the elbows, knees, scalp, hands, feet and joints considering osteoarticular involvement. Patients are suffering from itching, irritations, stinging and pain. Etiology of this disease is multifactorial, with genetic and environmental involvement, psychological stress and depression being the key factors considering the onset, flare or therapeutic resistance of psoriatic disease. The purpose of this article is to review and analyze how depression and stress affect the life of patients with psoriasis and in which way prevention could play a role regarding the evolution of this disease.Proinflammatory cytokines such as interleukin (IL)‐1 and IL‐6 are elevated in both psoriasis and depression, indicating that the inflammatory process may be involved in the progression of both diseases. Psoriasis has long been recognized to be associated with potentially adverse effects on mental health. However, there have been relatively few studies evaluating psychological outcomes in patients with psoriasis.Depression and stress decrease the quality of life, psoriasis being the last drop in the glass, with bimodal intensification of these pathologies. Quality of life in patients with psoriasis is directly associated with the severity of the disease, family status, work status and stigmatization.

Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders in women in reproductive age, defined as a combination of signs and symptoms resulting from androgen excess and ovarian dysfunction in the absence of other specific diagnoses. PCOS is often associated with an increased risk of obesity, insulin resistance, metabolic disorders and cardiovascular events. The aim of the study: The purpose of this systemic review was to collect and analyze materials about risk factors, diagnostics, and the current treatment of polycystic ovary syndrome.Material and method: Review of the literature published in 2004-2018.Description of the state of knowledge: PCOS is characterized by an excessive secretion of androgens from the ovaries and / or adrenal glands. Intrinsic ovarian factors, such as altered steroidogenesis, and factors external to the ovary, such as hyperinsulinemia, contribute to the ovarian overproduction of androgens. PCOS requires careful selection of an appropriate diagnostic method and therapeutic approach to combat hyperandrogenism, a consequence of ovarian dysfunction and related metabolic disorders. Treatment of both women at risk of PCOS and those with a confirmed diagnosis of PCOS includes education, healthy lifestyle interventions and symptomatic therapeutic interventions.Summary: PCOS is a complex disorder involving many organs and affecting many body functions. It is important to diagnose this disease as soon as possible in order to implement appropriately selected therapeutic treatment aimed at eliminating disease symptoms and reducing the systemic consequences of hyperandrogenism in patients.

Obstructive sleep apnoea-hypopnoea (OSAH) syndrome is a sleep disorder characterised by pauses in breathing (apnoea) or periods of reduced breathing (hypopnoea) during sleep. It results in cerebral hypoxia and a disturbed sleep pattern. The gold standard treatment for OSA is continuous positive airway pressure (CPAP). However, significant number of patients are not able to tolerate this device and approximately 50% of patients report inability to achieve long term usage to CPAP.Robotic surgery is an emerging technique for sleep surgery. TORS is an alternative treatment for OSA for patients who have failed CPAP treatment or conventional non-robotic sleep surgery. This technology is assisted by remote-controlled miniaturized surgical instruments and magnified visualization with a high-definition three-dimensional camera. Tongue base reduction (TBR) refers to the primary focus of this targeted surgery for obstructive sleep apnea (OSA).TORS approach for OSA may include 2 different surgical steps frequently combined in the same procedures according to the patient’s features: tongue base reduction and supraglottoplasty (SGP).In the light of the present results and of the literature, TORS tongue-base reduction appears to be effective. With the improved visualization and precise tissue removal provided by robotic surgery, TORS may become more widespread in the treatment of OSA in the coming years. There was an improvement in objective and subjective sleep measures. The comparison among pre-operative and post-operative parameters showed a significant decreasing in post-operative AHI, ESS and an increasing of the lowest SpO2 value.

Introduction Cervical cancer (CC) is currently the eight most common cancer among women and the seventh leading cause of cancer-related death in women in Poland. Early, non-invasive cervical cancer may develop over the years without clinical symptoms. Also, given the fact that early forms are treatable effectively, it's important to get preventive examinations. It is especially important in the group of women at high risk of developing CC.Purpose The aim of the study was to analyse the opinions of 1,260 women on the cytology as a prophylactic method in cervical cancer.Material and methods Women's knowledge was verified with an anonymous online questionnaire. The obtained results were analysed and checked on the basis of scientific literature.Results The vast majority of respondents (89,6%) consider Pap smear test as a screening test for CC. According to 40.4% of women, the first test should take place after sexual initiation. 17.7% believed that the examination should be done after the first menstruation. 55% of the respondents answered that Pap smear test should be performed every year. 38.4% believed that the test should be performed every 3 year. 20.3% of respondents do not know when to take the first Pap smear test and 30.1% of the respondents had never performed a pap smear.Conclusions Most women know the importance of regular cytology, but unfortunately not all women relate this knowledge to themselves. Early, regular and continuous education of women on the prevention of cervical cancer is extremely important

Gynaecological examination is one of the most intimate medical procedures. It is also a very important examination and should be performed every year. Women visit a gynaecologist for a variety of reasons, often in case of sudden pain. The aim of the study was to find out the reasons why women they report for visits to the gynaecologist and their frequency. The research was conducted on the group of 1,260 survey respondents. More than half of them visit a doctor each year. The most common reason for visiting a gynaecologist is a preventive visit. Our research confirms that the problem of too rare visits to the gynaecologist is still current. It is important to encourage visits by women who rarely come to the gynaecologist or never visit the gynaecologist.

Sudden cardiac arrest (SCA) is defined as a significant impairment of the mechanical function of the heart muscle, characterized by the patient's lack of response to stimuli, no perceptible pulse and apnea or agonal breathing, most often caused by acute coronary syndrome (ACS). ACS during pregnancy is a rare phenomenon and its incidence increases with the age of giving birth.The most common cause of ACS in pregnancy are typical changes in the etiology of atherosclerosis or coronary artery thrombosis. Other factors increasing the risk of a heart attack are arterial hypertension, diabetes, obesity and lipid disorders. To describe a rare clinical case and demonstrate the importance of maintaining cardiac vigilance in pregnant patients. A 32-year-old patient, at 16 weeks of gestation, hospitalized due to an anterior and lateral ST Elevation Myocardial Infarction (STEMI), complicated by SCA due to the mechanism of ventricular fibrillation. The patient was qualified for invasive reperfusion treatment which included left anterior descending (LAD) coronary artery surgery with drug eluting stent (DES) implantation and ballooning of the diagonal first coronary artery. Echocardiography done after treatment revealed apical hypokinesia and left ventricular ejection fraction of 70%. Subsequently the patient was kept under obstetrical and cardiological care. At 37 weeks of gestation, the pregnancy was finished by a successful caesarean section. Pregnancy is a state of hypercoagulability and decreased activity of the fibrinolytic system.The clinical management in this case does not differ from the clinical procedure adopted for non-pregnant women. It is important to make a diagnosis quickly and implement a life-saving procedure as soon as possible.

Laryngeal squamous cell carcinoma is one of the most common head and neck cancer, and it occurs more commonly in men than in women. The thought of losing phonatory and swallowing function has become the driving force of advancements in laryngeal cancer treatment.Transoral robotic surgery (TORS) is one of the fastest growing areas of head and neck surgery. This technology is assisted by remote-controlled miniaturized surgical instruments and magnified visualization with a high-definition three-dimensional camera. TORS is increasingly being used and was described in the context of laryngeal cancer surgery. It has been explored as minimally invasive surgery for supraglottic and glottic lesions, as well as for total laryngectomy. Transoral organ-preserving approaches have shown favorable oncologic and functional outcomes with good quality of life. Rapidly advancing TORS technique affords surgeons exceptional views of the larynx and hypopharynx with facile maneuverability in difficult to access areas. Thus, achieving negative margins and preserving normal laryngeal structures has become increasingly possible. The use of the robot for laryngeal cancer falls into three main categories: supraglottic laryngectomy, total laryngectomy and glottic cordectomy. Transoral robotic surgery for laryngeal cancer has been shown to be feasible for minimally invasive partial laryngectomy for either supraglottic or glottic cancer, as well as for total laryngectomy, in selected patients. TORS supraglottic laryngectomy and TORS total laryngectomy have demonstrated good functional and oncologic outcomes.

Abstract Introduction: Infertility caused by tubal occlusion is a relatively frequent affliction among women of child-bearing age. A common cause of tubal occlusion are mucous plugs accumulated inside the fallopian tubes, which results in blocking them. Selective hysterosalpingography (SHSG) is a method of removing the obstruction located in a proximal section of the fallopian tube. The most serious complication developed from this procedure is a fallopian tube perforation, however, it affects less than 1% of patients who undergo the treatment. The clinical success of recanalization of the fallopian tubes is estimated at about 85-88% and the frequency of successful pregnancies after the treatment is about 27%. Aim: To show the usage and effectiveness of SHSG in diagnosis and treatment in the obstruction of proximal section of fallopian tube. Case report: The patient, 33 years old, diagnosed with primary infertility, qualified to the SHSG at Independent Public Clinical Hospital No. 4 in Lublin. The first stage of SHSG was the insertion of a catheter into the uterine cavity and introduction of a contrast agent to the uterine cavity. The fallopian tubes did not release the contrast into the peritoneal cavity. After increasing the contrast, delivery pressure agent obtained the free flow of the contrast agent into the peritoneal cavity through the right fallopian tube. The uterine outlet of the left fallopian tube was selectively catheterized and a micro tool was inserted into the left fallopian tube. As the result, both fallopian tubes were unblocked. Summary: SHSG is a non-invasive and safe method of removing the obstruction located in the proximal section of the fallopian tube. Women subjected to SHSG can return to their normal activities in a few hours after treatment.

Introduction: Pregnancy is a period in which the supply of vitamins, micro- and macroelements is essential for the proper growth of the fetus. One of the most important substances, which is believed to have a considerable influence on the proper fetus growth is folic acid. Folic acid (i.e. vitamin B9) plays a significant role in rapidly dividing cells and lack of this vitamin causes serious fetal defects - for example neural tube anomalies. Supplementation is important not only during pregnancy but also during the period of pregnancy planning. Methods: Students' knowledge regarding the importance of folic acid supplementation was verified using anonymous Internet questionnaire. The obtained results were analyzed using statistical methods and checked on the basis of scientific literature. Results: The percentage of students who supply folic acid is 18,1% and only 9,5% do this regularly. The most common cause of supply is due to the fact that that folate can be found in vitamin kits students usually take. Part of respondents claim that they plan the pregnancy and want the fetus to develop correctly. Other causes of vitamin B9 intake is prevention of arteriosclerosis, vascular system diseases, anemia, lung, esophagus and uterus cancer. Conclusion: Outcomes showed that students are not fully aware of the importance of vitamin B9 during pregnancy and there is a great need to share knowledge about folic acid supplementation among people in procreative age.

Sepsis is a life-threatening dysfunction of the body that causes a host to respond incorrectly to an infection. Sepsis and septic shock are a major health issue affecting millions of people each year worldwide. Every fourth person with sepsis dies. Multi-organ trauma, acute myocardial infarction or stroke, early diagnosis and management in the first hours after the onset of sepsis improve survival rate. The Sequential Organ Failure Assessment (SOFA) scale is mainly used to assess sepsis. SOFA helps medical staff to assess the risk of morbidity and mortality due to sepsis. The basic parameters of SOFA are: assessment of the respiratory system based on partial oxygen pressure in the blood (PaO2), assessment of the nervous system based on the Glasgow Coma scale (GCS), assessment of the cardiovascular system based on the average blood pressure or after vasopressor administration (any dose), assessment of liver function based on the level of bilirubin in the blood, assessment of kidney function based on the level of creatinine in the urine, assessment of blood clotting based on the amount of thrombocytes contained in the plasma. This scale is used in hospital settings. qSOFA (Quick Sequential Organ Failure Assessment score) is a simplified version of the SOFA score as the first way to identify high-risk patients due to poor results associated with infection. qSOFA simplifies the SOFA score drastically, taking into account only three clinical criteria and introducing "any change" instead of requiring GCS ≤13. It uses three criteria, assigning one point for low blood pressure (SBP ≤100 mmHg), high respiratory rate (≥ 22 breaths per minute) or changed mentation (GCS

Introduction: Infections are a common complication in the treatment of acute stroke. Among them, most often pneumonia, which contributes to increased mortality from stroke, prolong hospitalization, difficulties in care, reduce functional performance improvement and increased cost of treatment. The aim of the work is less analysis of the causes and consequences of the development of pneumonia in the early period after stroke and identify predictors of pneumonia and the need to take preventive measures to prevent the development of disease. Summary: Pneumonia developing in the early period after stroke affects the final outcome and contributes to longer hospitalization, deterioration of clinical status of patients and the results of functional improvement. Current methods to prevent the development of lung zaplenia require the involvement of the entire therapeutic team, which involves a large investment of time and cost of therapy. Therefore, constantly sought are more effective methods of prevention and treatment of pneumonia among stroke patients.

Inadvertent perioperative hypothermia is a serious clinical problem, which could lead to the development of serious complications that prolong hospital care and increase medical costs. Anesthesia, surgery and microclimate in the operating room contributes to impaired physiological mechanisms of thermoregulation and thus the development of hypothermia in the patient. Therefore, it is essential that personnel responsible for the safety of perioperative patient had knowledge of the principles of maintaining normothermia and applied in clinical practice.

Introduction: Medical Simulation allows to improve knowledge, skills and social competences in undergraduate and post-graduate training in medical professions in a shorter time than traditional education. The aim of the paper was to assess the level of knowledge of paramedics on the use of medical simulation during undergraduate education in the field of emergency medicine. Material and Method The study was conducted from January to June 2014 among 60 paramedics from the Podkarpackie Province aged over 21. The research tool was the questionnaire developed by the authors. Results Men dominated in the study (18% women and 82% men). The most numerous group were the youngest subjects, i.e. between 21 and 30 (76%), and the smallest group was the oldest, i.e. over 40 (7%). The study demonstrated the relationship between respondents' responses regarding the use of patient simulators during university or postsecondary training and their self-assessment in terms of improved practical skills and their positive effect on the communication of paramedics with patients. Self-assessments of paramedics in terms of the increase of their practical skills through medical simulators correlated with the suitability of these skills in daily work and the impact on communication of medical rescue teams. Conclusions The medical simulation is used in the education of the students of medicine, but it is also of great importance in terms of modern teaching in emergency medicine, nursing, obstetrics in under and postgraduate education.

ECMO (Extracorporeal Membrane Oxygenation) is an extracorporeal gas exchange method that, despite many, carries the risk of many complications. ECMO is a modern intensive care method which in many cases is the last resort for the patient. Care and supervision are provided by a multidisciplinary team of specialists: physicians, perfusionists, nurses. The aim of the article was to present ECMO nursing care and the principles of care and care during and after ECMO therapy

Foreword. The paper presents new solutions in approach to telemedicine related to the development and implementation of advanced technologies. In the coming years, it is expected that technologies such as 3D imaging, telemedicine, etc., will contribute to enhancing the quality of medical care and allow faster and cheaper management of patients. Aim. Evaluating the operation of the teletransmission system used by emergency medical services (ZRM) and its impact on the enhancement of medical care quality. Material and methods. The survey was carried out on 50 persons employed in the emergency medical services system (PRM system) within the Podkarpackie Province. The method of diagnostic survey was employed. A questionnaire was designed in order to collect information necessary to meet the research purpose of this work. The questionnaire consists of questions regarding various views, health-related behaviours, and respondents’ knowledge and awareness of ICT (information and communication technology) solutions in medicine. Results. Among 50 surveyed persons, there were 30 paramedics (60%), 11 PRM nurses (PRM: emergency medical services) (22%), 8 PRM doctors (16%), and a doctor of medicine (2%). 10 of the surveyed persons were women (20%) while 40 were men (a majority of 80%). As far as age groups are concerned, 5 persons (10%) were below 25, 17 persons (34%) were between 26 and 35, 25 persons (50%) were between 36 and 45, and 3 persons (6%) were over 46 years of age. All participants work for hospital emergency wards in the Podkarpackie Province. The survey has proven that the idea of the innovative patient care based on telemedicine is strongly supported by the respondents. Conclusions. In the opinion of the PRM personnel, the system operates efficiently. Teletransmission is used by the emergency medical services as a diagnostic tool and allows one to improve procedures and provides help in taking decisions related to managing patients with ACS. It contributes to enhancing quality of medical care and patient comfort. This is also a high potential area.

Expertise in providing first aid, ensuring an appropriate support until qualified services arrive reduces consequences of injury or getting ill and increases chance for surviving of the injured people at the same time. The aim of the research was to recognise and evaluate level of knowledge among students of University of Rzeszów and State Higher School of Vocational Education in Sanok on providing premedical first aid. A group of 109 students was subject to research. A method of a diagnostic survey was used in the research where a survey questionnaire of authors’ own development was used as a research tool. Results Most of respondents tested, that is 53.2 %, showed lack of a respective preparation to provide first aid. Proper actions to raise the level of knowledge should be undertaken as soon as possible, not only among students but in the whole society, by implementing subject matter of life-saving to curricula starting at the early school education. Conclusions: Knowledge obtained during previous training sessions was too superficial and did not reflect the students’ life-saving skills, knowledge on providing premedical first aid thus did not have influence on actions being undertaken. Obtained results prove necessity to provide training sessions on life-saving activities on a regular basis. The majority of students is interested in deepening their

Introduction. As a result of rising patient expectations and the implementation of medical priority for medical facilities is an increase in satisfaction with the quality of services offered. Identify areas requiring modification is possible by analyzing patient satisfaction. Verification of the data makes it possible to request that the recipient have to say about the services offered at the institution, as well as help determine dysfunctions of the activities of these institutions. The aim of the study is to evaluate the satisfaction of patients hospitalized in the Department of Clinical Neurological Rehabilitation and systemic University Hospital in Olsztyn. Material and methods. The survey questionnaire survey was conducted based on the original questionnaire using Likert scale. Respondents were hospitalized at the University Clinical Hospital in Olsztyn. Statistical analyzes were performed using Statistica 10PL Results. Overall satisfaction with the received health benefits patients assessed at 4.1 on a scale of 1-5. In contrast, satisfaction with health services performed by nurses rated at 4.7, and the activities performed by a doctor and physiotherapists rated at 4.3.The lowest level of satisfaction applies to the first contact of the patient with the hospital staff (3.1).Conclusions. The level of patient satisfaction with medical procedures depends on patients educational level. Top rated benefits are realized by nurses. Patient’s expectations are varied in relation to the members of the therapeutic team. The first contact with the patient has no effect on the final assessment of the medical services. Overall satisfaction with the quality of medical services is satisfactory.

Abstract Stroke is a serious problem of modern medicine. It leads to death, permanent disability or lack of independence. Prevention and early detection and treatment of complications are the most important element of treatment. A key role in this time plays a nurse caring for the patient. She is responsible for the diagnosis distressing symptoms in a patient in the early stages of the disease. The aim of the study was to test the level of knowledge about stroke and its consequences among nursing staff working in the Specialist District Hospital and analysis of educational expectations of patients hospitalised in neurological department of this hospital. Material and methods. The survey method and questionnaire technique were applied. The sources of data were the answers given by groups of nurses and patients from the same department of Specialist District Hospital. The statistical program SPSS v.14 was used for data analysis. We used statistical inference test of independence chi-square-based statistics χ2 and α=0,05. Results. The majority of nurses (64.52%) indicated the immobilisation of the patient and complications associated with it as the most important nursing problem in caring of patients after stroke. Other important problems were the swallowing difficulties (54,84%) and urinary incontinence. The level of nursing education, years of work experience and age did not significantly influence the nurses opinions. Conclusions. Nurses have knowledge of prevention of complications after a stroke and performed benefit does not depend on additional qualifications acquired by nurses. Patients most often await information on their disease from a nurse. Patients consider it reasonable to take educational activities for the prevention of complications after a stroke.