Objectives: Pain and postoperative nausea and vomiting are among the most unpleasant sensations experienced after surgery. Patients after gynaecological surgery are at higher risk for both complications. Former methods of pain management based mainly on opioid administration were much less safe, especially for elderly patients. In addition, they generated an even greater increase of postoperative nausea and vomiting. Multimodal therapies in anesthesiology are currently being used more and more often. These include both multimodal postoperative pain management and multimodal prophylaxis of postoperative nausea and vomiting. The aim of the study was to assess the benefits of the methods used for gynaecological patients in the immediate postanesthetic period. Material and methods: The research material is an analysis of medical documentation of 150 patients from the gynaecology clinic who underwent surgical procedures of categories III and IV from October 2018 and until January 2019, carried out in one of the clinical hospitals in Szczecin at the Anesthesiology and Intensive Care Clinic. Patients were divided into 3 groups: 1. Patients who received multimodal analgesia using non-opioid and opioid analgesics. 2. Patients who received multimodal analgesia using non-opioid and opioid analgesics and adjuvants. 3. Patients who received multimodal analgesia using non-opioid and opioid analgesics and central blockade. Results: The highest age was in the third group at 57.48 years of age, 50.86 in the second group, and 47.8 in the first group. Healthy patients classified as ASA 1 accounted for 14% of group I, 18% of group II and 10% of group III. Patients with severe systemic disease (ASA 3) constituted 30% of group III 18%, of group II and 8% of group I. Upon leaving the operating room, as many as 80% of the patients from groups II and III did not feel any pain. In group I was 52%. When entering the recovery room, 26% of the patients in group I, 10% in group III, and 8% in group II rated their pain as higher than 5. The most used antiemetic medication in the studied facility was ondansetron. In group II it was given to 36 (72%) patients, in group III to 23 (46%) patients, and 13 (26%) patients in group I. In the postanaesthetic care unit, 9 (18%) patients in group III, 6 (12%) patients in group I, and 3 (6%) patients in group II received ondansetron. Metoclopramide was given only to patients in group III-one intraoperatively, and the other in the recovery room. Conclusions: Multimodal analgesia is effective in pain treatment. The use of PONV prevention is used for gynaecological patients. The analysis of the surgical records facilitated the recognition of patient needs.

Chemoprevention, or prevention of malignant tumours by using natural or synthetic chemical compounds, can be an invaluable tool in the fi ght against cancer -one of the most substantial public health problems. A defence mechanism of vitamin C, E, selenium and carotenoids is based on the inhibition of oxidative damages of tissues or DNA by sweeping free oxygen radicals, regulating proliferation and apoptosis of atopic cells. Vitamin D inhibits excessive proliferation and stimulates cell differentiation, and by increasing the differentiation of tissues and promoting apoptosis, it reduces the risk of metastasis. Furthermore, vitamin D decreases the risk of ovarian cancer, breast cancer, uterine carcinoma, bladder cancer, oesophagal and colon carcinoma development.

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Objective:The problem of urinary incontinence affects half of the adult female population, impacting adversely on their comfort of life and significantly hindering ordinary life activities (laughing, sneezing, coughing, physical activity); it also affects the quality of their sexual life. Physiotherapy is an increasingly common method for the conservative treatment of genital static disorders and stress urinary incontinence. Mechanism: In this article, the authors consider the following aspects: the use of various physiotherapy interventions as adjunctive treatment for urinary incontinence. The authors reviewed the literature databases in PubMed, Medline and Embase to identify links between the applied physiotherapeutic treatment and its effectiveness. Findings in Brief: The applied physiotherapeutic treatments and their effectiveness in urinary incontinence are presented. Conclusions: Physiotherapy treatments are effective and supportive of the treatment process in women of all age ranges with urinary incontinence, thus improving their quality of life.

The problem of childhood disturbed by sexual violence in the light of the philosophy of John Paul II (ethical context) is outlined and important medical aspects related to this pathology, also important in the practice of a family doctor, are discussed. Unfortunately, childhood is not a time of carefree and happiness for everyone. Violence, especially sexual violence, seems to be the greatest cruelty towards a child, negatively influencing the child’s psychosexual development, health, including sexual health, in later life. Both in gynecology and in sexology of developmental age, as well as in family medicine in terms of the problem of sexual crimes against children, care for a child is expressed in a special and specific way. It requires a special, empathetic and professional approach.