Search Results (189)

Background/Objectives: The objective was to establish whether particular SPD risk factors are correlated with particular SPD patterns and whether these factors affect the motor development of children Methods: The study procedures included medical examinations, conducted by a pediatrician/child neurologist, and evaluations, performed by a physiotherapist/sensory integration specialist, which were performed on the study group. Results: The study included 156 Caucasian children with SPD aged 3 to 12 years. The results of this study demonstrate that serological conflict shows correlations with taste, smell, and visual hyposensitivity. Fetal heart rate fluctuations, indicated in CTG, are correlated with tactile hypersensitivity and vestibular hypersensitivity, and cesarean delivery is correlated with auditory hyposensitivity. Incubator care is correlated with tactile hypersensitivity and auditory hyposensitivity. Intrauterine infections are correlated with vestibular hypersensitivity. Delayed motor development is correlated with bed rest in the third trimester of pregnancy, intrauterine infections, and incubator care. Conclusions: We conclude that children’s development must be monitored scrupulously in particular areas of sensory processing with regard to any of the abovementioned risk factors occurring in affected children. It is important to pay special attention to intrauterine infections, bed regimes in the third trimester of pregnancy, and incubator care, because these factors may have a negative impact on motor development. Full article

Background/Objectives. Preterm birth (PTB), affecting approximately 11.1% of pregnancies globally, often results from inflammation at the maternal–fetal interface triggered by microbial or immune dysregulation. This study investigates the efficacy of cell-free supernatant derived from Bifidobacterium longum subsp. infantis CECT 7210 and Lacticaseibacillus paracasei CECT 30660 in mitigating inflammation-induced PTB in a murine model. Methods. Lipopolysaccharide (LPS) was administered to induce preterm labor and systemic inflammation, mimicking infection-related PTB. Results. The results demonstrated that combined administration of CECT 7210 and CECT 30660 cell-free supernatants reduced preterm deliveries from 85.6% to 42.8% in mice and significantly attenuated systemic and intrauterine proinflammatory cytokines, including TNF-α and IL-6, in maternal plasma and myometrial tissues. Importantly, this anti-inflammatory effect was independent of maternal progesterone or oxytocin levels, suggesting a direct modulation of immune responses in this animal model. The cell-free supernatant combination also inhibited the growth of pathogenic bacteria, including Streptococcus agalactiae, highlighting its antimicrobial potential. Conclusions. This study underscores the potential of CECT 7210 and CECT 30660 cell-free supernatants as a therapeutic strategy to reduce the risk of PTB by targeting inflammation pathways. The findings pave the way for further preclinical and clinical research to validate the efficacy of these cell-free supernatants in preventing PTB and associated complications, offering a promising alternative to traditional probiotic approaches. Full article

Background/Objectives: Since the first successful birth following assisted reproductive technologies (ART) several decades ago, the global population of ART-conceived children has surpassed 13 million, with over 40,000 born in Kazakhstan. Despite this growth, questions remain about their long-term neurological outcomes, with existing studies reporting inconsistent findings. This study aimed to assess psychomotor development and the prevalence of nervous system pathologies among ART-conceived children in Kazakhstan and to develop a prognostic model for identifying pathological neurodevelopmental conditions. Methods: We studied 252 children (120 conceived via ART and 132 controls) using clinical examination and medical history data. Brain immaturity predictors were identified by univariate and multivariate logistic regression. Results: ART-conceived children exhibited a higher incidence of neurosonographic signs of brain structure immaturity. However, multivariate analysis indicated that ART itself was not an independent risk factor. Instead, perinatal complications—including prematurity, multiple pregnancy, low birth weight, asphyxia, and intrauterine infections—explained the observed differences. The prognostic model highlighted prematurity and preconceptional progesterone therapy as significant predictors. Overall neurological development did not differ significantly between the groups. Conclusions: These findings underscore the importance of early identification of perinatal risk factors and targeted preventive interventions to mitigate adverse neurodevelopmental outcomes in ART-conceived children. Full article

Background/Objectives: Fungal colonization and biofilm formation on intrauterine device (IUD) strings are known to contribute to recurrent infections and decreased contraceptive efficacy. This study aims to develop a novel approach to prevent Candida reservoir and biofilm formation on IUD strings, thereby lowering the risk of IUD-associated vulvovaginal candidiasis (VVC). Methods: Cervicovaginal samples were collected from human cervix using a sterile cytobrush, avoiding microbial contamination. Cytological examination using the Papanicolaou method was performed to detect the presence of Candida. The antifungal effect of the essential oils (EOs) was determined by broth dilution and disk diffusion methods. Antifungal and biofilm inhibitory effects of Thymus zygis (Tz) EO-coated IUD strings were determined by agar diffusion and crystal violet binding assays, while fungal growth on the coated strings was assessed using Scanning Electron Microscopy (SEM) and Energy-Dispersive X-ray (EDX) analysis. Results: Tz EO exhibited significantly lower minimum inhibitory concentration (MIC ≤ 0.06 µL/mL) and minimum fungicidal concentration (MFC = 0.24 µL/mL) values compared to Melaleuca alternifolia (Ma) EO (MIC > 0.24 µL/mL, MFC = 1.95 µL/mL), along with larger zones of inhibition (ZOI) against both Candida albicans (110.0 ± 6.0 mm vs. 91.3 ± 7.0 mm) and Candida glabrata (84.0 ± 13.1 mm vs. 50.0 ± 9.2 mm), indicating a stronger antifungal potential. On IUD strings coated with 4% (40 μL/g) Tz EO in hypromellose ointment, the biofilm formation of both C. albicans and C. glabrata strains was inhibited by 58.9% and 66.7%, respectively, as confirmed by SEM and EDX. Conclusions: Tz EO-coated IUD strings effectively inhibit Candida growth, suggesting a promising natural strategy to reduce recurrent IUD-associated fungal infections. However, before these results can be translated to clinical practice, additional research is needed. Future investigations may encompass an extended number of Candida isolates, stability and release studies of the EO in relation to the formulation, toxicity to vaginal mucosa, epithelial cells and sperm motility, and the effect on vaginal microbiotia. Full article

Porcine circovirus 2 (PCV2) is still infecting pigs after almost 20 years of massive vaccination all over the world. Vaccines are highly effective at counteracting the clinical signs of systemic disease caused by PCV2 and can significantly reduce the number of subclinically infected pigs. However, current vaccination programs based on one single dose in piglets are insufficient to prevent infection in a proportion of animals. Moreover, systematic vaccination of the herd changes viral epidemiology and, consequently, can cause modifications in infection timing. Such a scenario may prompt intrauterine and piglet early infections, thus facilitating viral circulation even before vaccination takes place. Considering the demonstrated high vaccine efficacy, it would be legitimate to explore the possibility of eliminating PCV2 from swine herds, but only one attempt to eliminate the virus from a herd has been published so far. The present speculative review evaluates the existing scientific literature regarding the feasibility of getting rid of this virus under commercial farm conditions. The use of PCV2 vaccination in all swine populations within a herd and the implementation of regional or national control programs are foreseen as compulsory for the eventual successful elimination of this endemic viral infection. Full article

Introduction: Little is known about the effects of intrauterine exposure to SARS-CoV-2, especially on growth and neurodevelopment in children. Objective: We wished to verify the effect of intrauterine exposure to SARS-CoV-2 on neurological development in children. Methods: Infants born to mothers presenting with SARS-CoV-2 infection during pregnancy were enrolled in a prospective descriptive–analytical study involving outpatient appointments performed 6 and 12 months after birth. Their neurological development was assessed using the Bayley-III Scale, using a score of >85 as the cutoff threshold for identifying developmental delay. Differences between groups were assessed through an ANOVA, using Bonferroni correction for multiple comparisons. Regression models were employed to examine the associations between the Bayley-III scores and maternal features. Results: Two hundred and sixty-nine infants were evaluated, most of whom were born full-term and with birth weights appropriate for gestational age at delivery. Developmental delays were observed in 26% of the infants in at least one of the Bayley-III domains. The language domain was particularly affected, with impairments observed in children exposed to SARS-CoV-2 closer to the time of delivery. These findings were statistically significant (p < 0.05). Conclusions: Infants born to mothers presenting with SARS-CoV-2 infection during pregnancy presented developmental delays at 6 and 12 months, particularly in the language domain. These findings reinforce the relevance of long-term clinical follow-ups of newborns exposed to SARS-CoV-2 infection during pregnancy. Full article

Introduction: Fetal Inflammatory Response Syndrome (FIRS) is widely acknowledged for its contribution to neonatal morbidity in premature infants. Being a systemic inflammatory process triggered by intrauterine infections or other stimuli, FIRS has gained significant attention due to its complex implications for neonatal adverse outcomes: preterm birth, early onset neonatal sepsis, death or long-term neurodevelopmental impairments. Fetal plasma Interleukin-6 (IL-6) levels above 11 pg/mL define FIRS and serve as an essential biomarker, providing insights into the complex mechanisms underlying this response. This study aims to evaluate the clinical, laboratory, and therapeutic differences between preterm neonates with and without FIRS. Methods: A prospective cohort study was conducted, involving 125 preterm neonates with gestational ages between 23 and 37 weeks, who were admitted to the Neonatal Intensive Care Unit (NICU) at the Emergency University Hospital Bucharest between April 2023 and April 2025. Infants were stratified into FIRS and non-FIRS groups based on the measurement of cord blood IL-6 levels greater than 11 pg/mL. Demographic, biochemical, and therapeutic parameters were compared across the two groups. Results: Preterm neonates with FIRS had significantly lower birth weight, length, and head circumference, and lower Apgar scores at 1 and 5 min (p = 0.001). FIRS was associated with a higher incidence of vaginal delivery, meconium-stained amniotic fluid, and neonatal metabolic imbalances, requiring more respiratory support, longer antibiotic treatment periods, and more blood transfusions (p < 0.05). Neonatal complications such as early-onset sepsis (EOS) and late-onset sepsis (LOS), respiratory distress, necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), and retinopathy of prematurity (ROP) were significantly more frequent in the FIRS group (p ≤ 0.01). Among maternal cervical screening, Chlamydia trachomatis was the only pathogen significantly associated with FIRS. Conclusions: FIRS in preterm neonates is linked to important perinatal inflammation, adverse short and long-term outcomes, and extensive medical intervention. These findings highlight the value of early identification of intrauterine inflammation and targeted neonatal monitoring strategies. Further studies are needed to explore long-term outcomes and improve diagnostic and therapeutic protocols. Full article

Primary or recurrent infection of cytomegalovirus (CMV) in pregnant women may cause transplacental transmission to fetuses. We aimed to investigate the rate of transplacental CMV transmission in women with positive anti-CMV IgG and negative anti-CMV IgM and its impact on newborns. Pregnant women with positive anti-CMV IgG and negative anti-CMV IgM during the first or second trimester who delivered by Cesarean section were included. Amniotic fluid collected during the Cesarean section was tested for CMV DNA with quantitative real-time polymerase chain reaction. CMV IgG and IgM were measured with enzyme-linked immunosorbent assay. A total of 695 pregnant women were enrolled between April 2019 and February 2023. Of them, 567 (81.6%) were single pregnancies and 128 (18.4%) were twin pregnancies, and 594 (85.5%) were full-term pregnancies and 101 (14.5%) were premature pregnancies. Of the 823 newborns, 7 (0.9%) were CMV DNA positive in amniotic fluid, demonstrating the transplacental CMV transmission. One of these seven neonates was diagnosed with intrauterine growth restriction at gestation week 25⁺¹ and at birth at a gestational age of 30⁺² weeks. However, all seven children had normal hearing, vision, and neurodevelopment at the age of 18–56 months. Transplacental CMV transmission may occur in offspring of pregnant women with positive anti-CMV IgG and negative anti-CMV IgM, but the long-term sequelae appear to be minimal. Full article

Aim: In sub-Saharan Africa, approximately 40 million pregnant women are exposed to parasitic diseases such as malaria caused by Plasmodium falciparum, Schistosome parasites, and soil-transmitted helminths (STHs). When parasitic diseases share the same habitat and overlap in distribution, then high co-infection rates occur. The co-infection can lead to consequences for the child, such as intrauterine growth retardation, low birth weight, pre-term delivery, and neonatal mortality. Methods: The objective of the study was to determine the nature and extent of coinfection from 100 samples collected from the Battor (50) and Adidome (50) towns of Ghana in collaboration with the Noguchi Memorial Institute for Medical Research, University of Ghana. Results: Out of 50 for the Adidome towns determined for P. falciparum by Rapid Diagnostic Test (RDT), Malaria Pan-specific Antigen (PAN), and Malaria Pf kit, 39 were true positive (TP), 8 were true negative (TN), and 30 were false negative (FN). For Battor, 19 were TP, 12 TN, and 20 FN. For S. mansoni in Adidome via polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP), 21 tested positive, and 29 were negative, with 52.5% sensitivity and 100% specificity. For S. haematobium, 28 were positive and 22 negative using PCR with 70% sensitivity and 100% specificity. In LAMP, 28 were positive, and 22 negatives, with 70% sensitivity and 100% specificity. In Battor PCR for S. mansoni, 28 positives and 22 negatives with 68.3% sensitivity and 100% specificity. In LAMP, 32 were positive, and 18 were negative, with 80% sensitivity and 100% specificity. For S. haematobium, PCR showed 30 positive and 20 negative, with 73.2% sensitivity and 100% specificity. With LAMP, 21 were positive, and 29 negatives, with 51% sensitivity and 100% specificity. In both towns, 20–30 years had the highest infection prevalence for P. falciparum, S. mansoni, S. haematobium, and Strongyloides stercoralis. Conclusion: The results will be utilized as a part of the continuous surveillance for future research aiming at gathering nationally representative data in Ghana on the prevalence of coinfection and proposing interventions based on that for the vulnerable pregnant women population. Full article

Retained products of conception (RPOC) represent a significant cause of morbidity in the post-abortive and postpartum periods, potentially leading to abnormal uterine bleeding, pelvic pain, infections, and intrauterine adhesions. Accurate diagnosis is crucial to avoid unnecessary surgical interventions and to preserve future fertility. Transvaginal ultrasound constitutes the primary imaging modality for identifying RPOC, but the lack of standardized diagnostic criteria complicates clinical decision-making. This narrative review explores the current literature on sonographic findings associated with RPOC, focusing on the diagnostic value of endometrial thickness (ET), the presence of intrauterine echogenic masses, and the use of Color Doppler imaging. Although an ET ≥15 mm is frequently used to suspect RPOC, the variability in cut-off thresholds and limited specificity reduce its diagnostic reliability. The detection of an echogenic intrauterine mass appears to be the most sensitive and specific sonographic feature. Color Doppler assessment, particularly the presence of enhanced myometrial vascularity (EMV) and classification systems like the Gutenberg score, offers further insight by stratifying hemorrhagic risk and guiding therapeutic choices. However, vascular parameters such as peak systolic velocity (PSV) and resistive index (RI) demonstrate a substantial overlap between benign and pathological conditions, limiting their stand-alone utility. The review also addresses the differential diagnosis of RPOC, including blood clots, arteriovenous malformations, placental polyps, gestational trophoblastic disease, and endometrial osseous metaplasia. The role of three-dimensional ultrasound remains limited in clinical practice, offering no significant advantage over two-dimensional imaging. Finally, the timing of follow-up ultrasound after medical treatment with misoprostol is critical: delayed assessment reduces overtreatment by allowing time for spontaneous resolution. In conclusion, despite advances in ultrasound technology, the diagnosis of RPOC remains challenging due to heterogeneity in imaging findings and inter-observer variability. A multimodal approach integrating grayscale and Doppler ultrasound with clinical evaluation is essential for optimal management. Full article

Introduction: Pathophysiological pathways—or endotypes—leading to prematurity can be clustered into two groups: infection/inflammation and dysfunctional placentation. We aimed to perform a systematic review and meta-analysis of studies exploring the association between these endotypes and cystic periventricular leukomalacia (cPVL). Methods: PubMed and Embase were searched for observational studies examining preterm infants and reporting data on the association between endotype of prematurity and cPVL. Chorioamnionitis represented the infectious–inflammatory endotype, while dysfunctional placentation proxies were hypertensive disorders of pregnancy (HDPs) and small for gestational age (SGA)/intrauterine growth restriction (IUGR). Bayesian model-averaged (BMA) meta-analysis was used to calculate Bayes factors (BFs). The BF₁₀ is the ratio of the probability of the data under the alternative hypothesis (H_1; presence of association) over the probability of the data under the null hypothesis (H_0; absence of association). Results: Of 1141 potentially relevant studies; 67 (108,571 infants) were included. The BMA analysis showed strong evidence in favor of a positive association between chorioamnionitis and cPVL (OR 1.58; 95% CrI 1.12 to 2.20; BF₁₀ = 20.5) and extreme evidence in favor of a negative association between HDPs and cPVL (OR 0.63; 95% CrI 0.54 to 0.75; BF₁₀ = 2937). The evidence for the SGA/IUGR group was inconclusive (OR 0.87; 95% CrI 0.75 to 1.01; BF₁₀ = 1.41). Conclusions: This Bayesian meta-analysis provides evidence indicative of an association between antenatal infection–inflammation and an increased risk of developing cPVL in preterm infants. Conversely, infants exposed to HDPs are less likely to develop cPVL. Full article

Bovine viral diarrhea virus (BVDV) is a globally significant pathogen affecting both domestic livestock and wildlife, including white-tailed deer (WTD; Odocoileus virginianus). While experimental infections have demonstrated WTD susceptibility to BVDV, natural infections and associated reproductive outcomes remain scarcely documented. Here, we report the first confirmed case of naturally occurring BVDV-1 infection associated with fetal mummification in farmed WTD in Florida. A two-year-old doe experienced a stillbirth involving two mummified fetuses, which were submitted for necropsy and laboratory diagnostics. Gross findings included diarrhea and underdeveloped eyes in the fetuses, along with small white nodules indicative of amnion nodosum. While not harmful, this condition suggests underlying fetal compromise or intrauterine stress. Virus isolation using Vero E6 and bovine turbinate cell lines, along with a reverse transcription PCR (RT-PCR) assay specifically developed in this study, confirmed the presence of BVDV-1 (Pestivirus bovis) RNA in both maternal and fetal samples, suggesting vertical transmission. Sanger sequencing of RT-PCR amplicons further verified the virus species as BVDV-1. Differential diagnostics for other pathogens, including bluetongue virus, epizootic hemorrhagic disease virus, Mycobacterium spp., and Toxoplasma gondii, were negative. These findings underscore the importance of using biosecurity measures and including BVDV in the differential diagnosis of abortions to reduce the risk of BVDV transmission and potential outbreaks on deer farms, particularly those close to cattle operations. The molecular tools developed in this study provide a robust framework for improved detection and monitoring of BVDV in both wildlife and livestock populations. Full article

Pelvic inflammatory disease (PID) encompasses a broad range of infection-induced inflammatory disorders of the female upper genital tract, commonly caused by ascending sexually transmitted infections. Diagnosis is often challenging because of nonspecific or absent symptoms and the overlap with other pelvic pathologies. While clinical and laboratory assessments are essential, cross-sectional imaging plays a pivotal role, especially in complicated, atypical, or equivocal cases. This review focuses on the typical and atypical imaging features of PID and highlights the crucial roles of computed tomography (CT) and magnetic resonance imaging (MRI) in its diagnostic evaluation. CT is frequently employed in emergency settings because of its widespread availability and ability to detect acute complications such as tubo-ovarian abscesses (TOA), peritonitis, or Fitz-Hugh–Curtis syndrome. However, it is limited by ionizing radiation and suboptimal soft-tissue contrast. MRI provides superior tissue characterization and multiplanar imaging without radiation exposure. When combined with diffusion-weighted imaging (DWI), MRI achieves high diagnostic accuracy, particularly in differentiating PID from other entities such as endometriosis, adnexal tumors, and gastrointestinal or urinary tract diseases. This review also addresses PID in specific clinical contexts, including post-partum infection, post-assisted reproductive technologies (ART), intrauterine device (IUD) use, and chronic or recurrent forms. A comprehensive, multimodal imaging approach integrated with clinical findings is essential for timely diagnosis, effective treatment, and prevention of severe reproductive sequelae. Full article

Biofilms are a spontaneously formed slimy matrix of extracellular polymeric substances (EPS) enveloping miniature bacterial colonies, which aid in pathogen colonization, shielding the bacteria from antibiotics, as well as imparting them resistance towards the same. Biofilms employ a robust communication mechanism called quorum sensing that serves to keep their population density constant. What is most significant about biofilms is that they contribute to the development of bacterial virulence by providing protection to pathogenic species, allowing them to colonize the host, and also inhibiting the activities of antimicrobials on them. They grow on animate surfaces (such as on teeth and intestinal mucosa, etc.) and inanimate objects (like catheters, contact lenses, pacemakers, endotracheal devices, intrauterine devices, and stents, etc.) alike. It has been reported that as much as 80% of human infections involve biofilms. Serious implications of biofilms include the necessity of greater concentrations of antibiotics to treat common human infections, even contributing to antimicrobial resistance (AMR), since bacteria embedded within biofilms are protected from the action of potential antibiotics. This review explores various contemporary strategies for controlling biofilms, focusing on their modes of action, mechanisms of drug resistance, and innovative approaches to find a solution in this regard. This review interestingly targets the extracellular polymeric matrix as a highly effective strategy to counteract the potential harm of biofilms since it plays a critical role in biofilm formation and significantly contributes to antimicrobial resistance. Full article

Background: Since the COVID-19 pandemic, managing acute infections in symptomatic individuals, regardless of vaccination status, has been widely debated and extensively studied. Even more concerning, however, is the impact of COVID-19 on pregnant women—especially its effects on fetuses and newborns. Several studies have documented complications in both expectant mothers and their infants following infection. Methods: In our previous works, we provided scientific evidence of the bacteriophage behavior of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). This demonstrated that a well-defined combination of two antibiotics, amoxicillin and rifaximin, is associated with the same statistics for subjects affected by severe cases of SARS-CoV-2, regardless of vaccination status. We considered the few cases in the literature regarding the management of pregnancies infected with SARS-CoV-2, as well as previous data published in our works. In this brief case series, we present two pregnancies from the same unvaccinated mother—one prior to the COVID-19 pandemic and the other during the spread of the Omicron variant—as well as one pregnancy from a mother vaccinated against COVID-19. We describe the management of acute maternal infection using a previously published protocol that addresses the bacteriophage and toxicological mechanisms associated with SARS-CoV-2. Results: The three pregnancies are compared based on fetal growth and ultrasound findings. This report highlights that, even in unvaccinated mothers, timely and well-guided management of symptomatic COVID-19 can result in positive outcomes. In all cases, intrauterine growth remained within excellent percentiles, and the births resulted in optimal APGAR scores. Conclusions: This demonstrates that a careful and strategic approach, guided by ultrasound controls, can support healthy pregnancies during SARS-CoV-2 infection, regardless of vaccination status. Full article