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Objective: Size at birth is a key indicator of in utero growth. Our objective was to generate sex-specific percentiles for birth weight and head circumference in neonates born between 22 and 29 weeks gestation from pregnancies without hypertension or diabetes and assess differences between vaginal and caesarean births and between singletons and twins., Methods: We used data from 12 countries participating in the International Network for Evaluating Outcomes in Neonates database from 2007 to 2021. We excluded data that were influenced by truncation with 1500g birth weight cut-offs in databases and neonates with major congenital anomalies or born to mothers with hypertension or diabetes., Results: After exclusions, 132 727 neonates contributed to birth weight and 65 406 contributed to head circumference. The percentiles of birth weight were similar between countries at the 50th and 90th percentiles, though variability was noted in the lower percentiles from countries with smaller sample sizes. Head circumference percentiles were comparable between countries. Caesarean births had birth weights similar to vaginal births until 26 weeks after which the weight at 10th percentile diverged by approximately 239 g at 29 weeks. Vaginal births had birth weights very similar to Hadlock's intrauterine estimated fetal weights. There were no differences in head circumference between vaginal and caesarean births and between singletons and twins., Conclusions: We present updated information on weight and head circumference at birth for preterm neonates of 22-29 weeks gestation born to mothers without hypertension or diabetes derived from a large multicountry cohort. Research is needed to explore the predictive value of these birth size data for health and developmental outcomes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Lung involvement in children with congenital cytomegalovirus infection has been scarcely described. We describe three new cases of persistent pulmonary hypertension in children with congenital cytomegalovirus and review the other seven cases reported in the literature since 1988. All children had a symptomatic infection, including severe central nervous system or visceral findings. Morbidity and mortality were high. Persistent pulmonary hypertension may be a rare complication in severely symptomatic congenital cytomegalovirus infants. It is important to screen for congenital cytomegalovirus in cases of idiopathic refractory persistent pulmonary hypertension. Intensive treatment should be undertaken to treat this potentially rare lung involvement in combination with antiviral treatment., (© 2024 Japanese Teratology Society.)

Background: Although extremely premature birth disrupts lung development, adolescent survivors of extreme prematurity show good clinical and physiologic outcomes. Cardiopulmonary limitations may not be clinically evident at rest. Data regarding exercise limitation in adolescents following preterm birth in the postsurfactant era are limited., Research Question: What are the long-term effects of bronchopulmonary dysplasia (BPD) and extreme prematurity (<29 weeks) on ventilatory response during exercise in adolescents in the postsurfactant era?, Study Design and Methods: We followed a longitudinally recruited cohort of children aged 13-19 years who were born at a gestational age of <29 weeks (study group - SG). We compared the cardiopulmonary exercise testing (CPET) results of those with and without BPD, to their own CPET results from elementary school age (mean 9.09 ± 1.05 years)., Results: Thirty-seven children aged 15.73 ± 1.31 years, mean gestational age 26 weeks ( ± 1.19), completed the study. CPET parameters in adolescence were within the normal range for age, including mean V̇O 2 peak of 91% predicted. The BPD and non-BPD subgroups had similar results. In the longitudinal analysis of the SG, improvement was observed in adolescence, compared with elementary school age, in breathing reserve (36.37 ± 18.99 vs. 26.58 ± 17.92, p = 0.044), tidal volume as a fraction of vital capacity achieved at maximal load (0.51 ± 0.13 vs. 0.37 ± 0.08, p < 0.001), and respiratory exchange ratio at maximal load (1.18 ± 0.13 vs. 1.11 ± 0.10, p = 0.021)., Interpretation: In the current cohort, adolescents born extremely premature have essentially normal ventilatory response during exercise, unrelated to BPD diagnosis. CPET results in this population improve over time., (© 2024 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC.)

Purpose: To provide a comprehensive report of the experience gained in the prenatal treatment of congenital diaphragmatic hernia (CDH) using fetoscopic endoluminal tracheal occlusion (FETO) following its implementation at a newly established specialized fetal medicine center., Methods: Mothers of fetuses with severe CDH were offered prenatal treatment by FETO., Results: Between 2018 and 2021, 16 cases of severe CDH underwent FETO. The median gestational age (GA) at balloon insertion was 28.4 weeks (IQR 27.8-28.6). The median GA at delivery was 37 weeks (IQR 34.4-37.8). The survival rate was 8/16 cases (50%). None of the survivors required home oxygen therapy at 6 months of age. Comparison between the survivors and deceased showed that survivors had balloon insertion 1 week earlier (27.8 vs. 28.4 weeks, p = 0.007), a higher amniotic fluid level change between pre- to post-FETO (3.4 vs 1.3, p = 0.024), a higher O/E LHR change between pre- to post-FETO (50.8 vs. 37.5, p = 0.047), and a GA at delivery that was 2 weeks later (37.6 vs. 35.4 weeks, p = 0.032)., Conclusions: The survival rate at 6 months of age in cases of severe CDH treated with FETO in our center was 50%. Our new fetal medicine center matches the performance of other leading international centers., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

To evaluate the effectiveness of a novel protocol, adopted in our institution, as a quality improvement project for congenital diaphragmatic hernia (CDH). A maximal lung protection (MLP) protocol was implemented in 2019. This strategy included immediate use of high-frequency oscillatory ventilation (HFOV) after birth, during the stay at the Neonatal Intensive Care Unit (NICU), and during surgical repair. HFOV strategy included low distending pressures and higher frequencies (15 Hz) with subsequent lower tidal volumes. Surgical repair was performed early, within 24 h of birth, if possible. A retrospective study of all inborn neonates prenatally diagnosed with CDH and without major associated anomalies was performed at the NICU of Schneider Children's Medical Center of Israel between 2009 and 2022. Survival rates and pulmonary outcomes of neonates managed with MLP were compared to the historical standard care cohort. Thirty-three neonates were managed with the MLP protocol vs. 39 neonates that were not. Major adverse outcomes decreased including death rate from 46 to 18% (p = 0.012), extracorporeal membrane oxygenation from 39 to 0% (p < 0.001), and pneumothorax from 18 to 0% (p = 0.013)., Conclusion:  MLP with early surgery significantly improved survival and additional adverse outcomes of neonates with CDH. Prospective randomized studies are necessary to confirm the findings of the current study., What Is Known: • Ventilator-induced lung injury was reported as the main cause of mortality in neonates with congenital diaphragmatic hernia (CDH). • Conventional ventilation is recommended by the European CDH consortium as the first-line ventilation modality; timing of surgery is controversial., What Is New: • A maximal lung protection strategy based on 15-Hz high-frequency oscillatory ventilation with low distending pressures as initial modality and early surgery significantly reduced mortality and other outcomes., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Despite advances in neonatal care, late-onset sepsis remains an important cause of preventable morbidity and mortality. Neonatal late-onset sepsis rates have decreased in some countries, while in others they have not. Our objective was to compare trends in late-onset sepsis rates in 9 population-based networks from 10 countries and to assess the associated mortality within 7 days of late-onset sepsis., Methods: We performed a retrospective population-based cohort study. Infants born at 24-28 weeks' gestation between 2007 and 2019 were eligible for inclusion. Late-onset sepsis was defined as a positive blood or cerebrospinal fluid culture. Late-onset sepsis rates were calculated for 3 epochs (2007-11, 2012-15, and 2016-19). Adjusted risk ratios (aRRs) for late-onset sepsis were calculated for each network., Results: Of a total of 82,850 infants, 16,914 (20.4%) had late-onset sepsis, with Japan having the lowest rate (7.1%) and Spain the highest (44.6%). Late-onset sepsis rates decreased in most networks and remained unchanged in a few. Israel, Sweden, and Finland showed the largest decrease in late-onset sepsis rates. The aRRs for late-onset sepsis showed wide variations between networks. The rate of mortality temporally related to late-onset sepsis was 10.9%. The adjusted mean length of stay for infants with late-onset sepsis was increased by 5-18 days compared to infants with no late-onset sepsis., Conclusions: One in 5 neonates of 24-28 weeks' gestation develops late-onset sepsis. Wide variability in late-onset sepsis rates exists between networks with most networks exhibiting improvement. Late-onset sepsis was associated with increased mortality and length of stay., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Background and Objectives: Late-onset sepsis is associated with significant morbidity and mortality among very low birth weight (VLBW) infants. Our objective was to determine risk factors associated with late-onset sepsis and to present temporal trends in overall and pathogen-specific rates., Methods: Population-based study by the Israel Neonatal Network on VLBW infants (≤1500 g) born between 1995 and 2019. Late-onset sepsis required clinical symptoms and microbiologic confirmation. Bivariate and multivariable analyses were performed to identify risk factors. The study period was divided into 4 epochs. Overall and pathogen-specific late-onset sepsis rates for each epoch were compared., Results: The study population comprised 31 612 VLBW infants, of whom 7423 (23.5%) had late-onset sepsis. An increased adjusted risk of late-onset sepsis was associated with gestational age <27 w (odds ratio [OR] 8.90, 95% confidence interval [CI] 7.85-10.09) and delivery room resuscitation (OR 1.43, 95% CI 1.34-1.52) and a decreased adjusted risk among infants born between 2013 and 2019 (OR 0.32, 95% CI 0.29-0.35). Late-onset sepsis rates declined from 29.5% in 1995 to 2000 to 13.0% in 2013 to 2019. Gram-negative and fungal rates decreased in all epochs, whereas gram-positive rates decreased only in the last epoch. The adjusted hazard ratios (95% CI) decreased in the 2013 to 2019 versus 1995 to 2000 epochs and were: all late-onset sepsis, 0.40 (0.37-0.43); gram-positive, 0.47 (0.37-0.59); gram- negative, 0.54 (0.48-0.61); fungal, 0.17 (0.12-0.22)., Conclusions: The strongest risk factor for late-onset sepsis was gestational age <27 w. Over a 25-year period, the pathogen-specific rates of late-onset sepsis among VLBW infants decreased approximately twofold for gram-positive and gram-negative bacterial infections and sixfold for fungal infections., (Copyright © 2023 by the American Academy of Pediatrics.)

Introduction: Perianal fistulizing Crohn's disease (CD) is a phenotype with a poor prognosis. There are no studies in our country. Our objective is to determine the clinical, sociodemographic and treatment characteristics of perianal fistulizing CD in a Colombian multicenter registry., Materials and Methods: A retrospective, multicenter observational study was carried out, with prospective data collection, in the main reference centers for inflammatory Bowel disease (IBD) in the country. Continuous variables were expressed as medians and interquartile ranges. The categorical outcome variables were compared by the Chi-square test., Results: Sixty-five patients with perianal fistulizing CD were documented, with a median age of appearance of perianal fistula of 31.0 years (range: 24-42), predominantly in men (61.5%; H:M ratio: 1.4:1). Complex perianal fistulas were more frequent than simple ones (75.35 vs. 24.6%). Regarding medical treatment, 66.2% of the patients received antibiotics, 64.6% steroids, 78.5% biological therapy, 47.7% non-cutting setons, and 46.2% required surgical management, other than seton placement. Only 29.2% achieved complete remission of the fistula, and 9.2% of the patients ended up in a definitive colostomy. CD patients with complex fistulas received more biological therapy, compared to CD patients with simple fistulas (84.8 vs. 56.3%; P: 0.038)., Conclusions: Perianal fistulizing CD has a poor prognosis in our setting, only 3 out of 10 patients achieve complete remission despite treatment. A multidisciplinary management is essential for the comprehensive management of this difficult pathology., (Copyright © 2022 Elsevier España, S.L.U. All rights reserved.)

Adrenal gland infection is a clinical entity of great importance, but it is a largely unrecognized pathology. Immunosuppressed individuals are at a higher risk of presentation. Herein, we describe a young female patient, recently diagnosed with HIV, who presented with severe sepsis due to methicillin-resistant Staphylococcus aureus, associated with a left adrenal abscess. She was initially treated with antibiotics; however, due to the persistence of the systemic inflammatory response and bacteremia, endoscopic ultrasound-guided drainage was performed. This procedure was successful in resolving the clinical situation. Endoscopic ultrasound-guided adrenal gland drainage can be a safe, efficacious, and minimally invasive option for managing antibiotic-refractory adrenal abscesses in immunosuppressed patients.

Rationale: Idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) have high morbidity and mortality; thus, novel treatments are needed. Objectives: Assess efficacy and safety of admilparant (BMS-986278), an oral lysophosphatidic acid receptor 1 antagonist, in patients with IPF and PPF. Methods: This phase 2, randomized, double-blind, placebo-controlled trial included parallel cohorts of patients with IPF (n = 278 randomized, n = 276 treated) or PPF (n = 125 randomized, n = 123 treated) who received 30 mg of admilparant, 60 mg of admilparant, or placebo (1:1:1) twice daily for 26 weeks. Background antifibrotics (both cohorts) and immunosuppressants (PPF only) were permitted. Measurements and Main Results: Rates of change in percentage of predicted FVC over 26 weeks for IPF were −2.7% (placebo), −2.8% (30 mg), and −1.2% (60 mg) and for PPF were −4.3% (placebo), −2.9% (30 mg), and −1.1% (60 mg). Treatment differences between 60-mg admilparant and placebo were 1.4% (95% confidence interval, −0.1 to 3.0) for IPF and 3.2% (95% confidence interval, 0.7 to 5.7) for PPF. Treatment effect was observed with or without background antifibrotics in both cohorts. Diarrhea occurred at similar frequencies in admilparant arms versus placebo. Transient Day 1 postdose blood pressure reductions were observed in all arms in both cohorts but were greater with admilparant. Treatment discontinuations because of adverse events were similar across IPF arms and lower with admilparant (2.5% [30 mg]; 0% [60 mg]) versus placebo (17.1%) for PPF. Conclusions: In this first phase 2 study to evaluate antifibrotic treatment in parallel IPF and PPF cohorts, 60-mg admilparant slowed lung function decline and was safe and well tolerated, supporting further evaluation in phase 3 trials. Clinical trial registered with clinicaltrials.gov identifier (NCT04308681). [ABSTRACT FROM AUTHOR]

Background: Panic disorder (PD) is highly prevalent during the peripartum period. The aim of this systematic review was to summarize evidence on risk factors and course patterns of peripartum PD as well as maternal, infant or dyadic outcomes during the first three years after delivery. Methods: A literature search was conducted according to PRISMA guidelines. Inclusion criteria were: (1) a diagnosis of PD or panic attacks during pregnancy, (2) risk factors and course as well as maternal, infant or dyadic outcomes measured in pregnancy and/or up to 3 years postpartum (3) peer-reviewed articles in English or German published between 1980 and April 2024. After screening of n = 2,740 records, n = 75 records based on n = 64 projects were eligible for this systematic review. Results: Overall, n = 47 studies investigated the course of PD during the peripartum period, n = 23 studies examined the associations of PD and obstetric, neonatal or infant outcomes, and n = 5 studies focused on the associations of PD and characteristics of the mother-infant dyad. We found (1) no common trajectory, but heterogeneous courses of maternal PD in the peripartum period, (2) associations of maternal PD with birth complications and subsequent postpartum depression, and (3) evidence for associations of PD with infant and dyadic outcomes. Limitations: Diverse outcome measures in recent original publications did not allow for a meta-analytic approach. Conclusion: Heterogenous courses and outcomes of peripartum PD require comprehensive monitoring of affected mothers and their infants. There is a need for further longitudinal investigations into familial transmission of anxiety disorders. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study aims to assess the effects of combined hormonal contraceptives (CHCs) on bone metabolism markers. It primarily measures osteocalcin and additionally examines other bone health markers, seeking to determine their responses to estrogen–progestogen treatments. Methods: This study involved a comprehensive evaluation of the pertinent literature and a meta-analysis explicitly conducted on data describing women of reproductive age. The analysis encompassed accessible papers ranging to December 2024 (i.e., those listed in PubMed/Medline, Embase, Scopus, the Cochrane Database, International Clinical Trials Registry, and ClinicalTrials.gov). We examined published randomized controlled trials (RCTs) and prospective studies. The quality of the studies was assessed using the Cochrane tool for RCTs and the Newcastle–Ottawa Scale for prospective studies. The selected indicators for primary and secondary outcomes were ascertained by standardized mean change (SMC), displaying the difference between conditions before and after treatment. Trends were evaluated using meta-regressions. Results: Ultimately, 34 articles out of 1924 identified items met the inclusion criteria, covering 33 unique studies. In EE/E4 combinations, osteocalcin dropped significantly (SMC −0.54 (CI.95 −0.64/−0.43) and −0.43 (CI.95 −0.76/−0.10)). Similar effects were observed for other bone-formation and reabsorption markers, with less significant reductions observed in E2-containing CHC (e.g., alkaline phosphatase (bone) EE combinations, SMC −0.39 (CI.95 −0.67/−0.11); P1NP E2 combination, 0.12 (CI.95 −0.10/0.33); and EE combinations, −0.55 (CI.95 −0.83/−0.26)). The reduction patterns also exhibited differences according to the women's age (e.g., osteocalcin in EE combinations ≤21, SMC −0.63 (CI.95 −0.77/−0.49) and >21, SMC −0.42 (CI.95 −0.61/−0.24); alkaline phosphatase (bone) EE combinations ≤21, SMC −0.55 (CI.95 −0.86/−0.24) and >21, SMC −0.06 (CI.95 −0.47/0.35)). This analysis found that CHC maintains or reduces bone turnover in childbearing women, with effects varying by age and hormone combination. Moreover, bone-formation and reabsorption markers correlated positively to pro-androgenic progestins (p < 0.05). Thus, estrogen–progestogen combinations reduce bone turnover less when weak estrogens and a pro-androgenic or neutral progestin are present. Conclusions: This study found that CHCs reduce bone turnover, with natural estrogens and androgenic progestins appearing to be more beneficial than EE and anti-androgenic types. These findings would potentially influence decisions relevant to CHC prescriptions during a woman's reproductive phases, emphasizing the need for additional research to tailor CHC usage to bone health. [ABSTRACT FROM AUTHOR]

To investigate the effects of early-onset sepsis (EOS) on retinopathy of prematurity (ROP) in extremely premature infants (EPIs) by using propensity score matching (PSM). Clinical data of 591 EPIs admitted to NICU, Senior Department of Pediatric, PLA General Hospital from May 1, 2015 to May 1, 2022 were retrospectively analyzed. They were divided into an EOS group and a non-EOS group according to whether they had confirmed EOS or not. The incidence of ROP and severe ROP was compared between the two groups using the 1:1 PSM method. Of the 591 EPIs, 57 (9.6%) fell in the EOS group and the remaining 534 in the non-EOS group. There were statistical differences in artificial conception, cesarean section, bronchopulmonary dysplasia, duration of invasive mechanical ventilation, days of oxygen use, amniotic fluid contamination, and premature rupture of membranes between the two groups (all P < 0.05), and then match these variables as covariates. Before matching, the incidence of ROP and severe ROP in the EOS group was higher than that in the non-EOS group [ROP: (35/57)61.4% vs. (224/534)41.9%, OR 2.202, 95% CI 1.257 to 3.856, P = 0.005; severe ROP: (25/57)43.9% vs. (149/534)27.9%, OR 2.019, 95% CI 1.157 to 3.521, P = 0.012], and after matching all covariables were well matched (all P > 0.05). Of the 57 cases in the EOS group, 51 were successfully matched, in which the incidence of severe ROP was higher than that in the non-EOS group [47.1% (24/51) vs. 27.5% (14/51), OR 2.349,95% CI 1.030 to 5.360, P < 0.05]. There was no significant difference in the incidence of ROP between the two groups [62.7% (32/51) vs. 49.0% (25/51), OR 1.752,95% CI 0.795 to 3.858, P > 0.05]. EOS didn't seem to increase the incidence of ROP in EPIs, but was associated with an increase in the degree of ROP lesions. The progression of fundus lesions in EPIs with EOS during hospitalization should be closely monitored. [ABSTRACT FROM AUTHOR]

Poor dietary habits have been associated with dysbiosis and microbial imbalance in pregnant women. Such imbalances can pose health risks during pregnancy. This study aimed to explore the impact of Polygonati Rhizoma on the gut microbiota of pregnant women through In vitro simulated fermentation. Interestingly, significant differences in microbial community richness and structure were found between the control and the treatment with Polygonati Rhizoma. Analysis of composition and variability indicated that the treatment with Polygonati Rhizoma group showed higher levels of Lactobacillus and Bifidobacterium, but lower levels of Parabacteroides and Lachnoclostridium. The study also investigated specific genera differences between groups using the co-occurrence network analysis and their correlations with microbial metabolites by the redundancy analysis (RDA), Mantel-test network heatmap, and heatmap highlighting the relationships among gut microbiota, short-chain fatty acids (SCFAs), and gases in the absence or presence of Polygonati Rhizoma supplementation. Functional predictions from BugBase phenotype prediction indicated changes in potentially pathogenic and aerobic bacteria in Polygonati Rhizoma supplementation. Overall, the findings provide valuable insights into the influence of Polygonati Rhizoma on the gut microbiota in pregnant women associated with poor dietary habits. [ABSTRACT FROM AUTHOR]

Background: Patients requiring extracorporeal life support (ECLS) support post-Norwood operation constitute an extremely high-risk group. Materials and methods: We retrospectively aimed to evaluate the relationship of hyperoxia with mortality and other clinical outcomes in patients who required ECLS following Norwood operation between January/2010 and December/2020 in a large volume center. Results: During the study period 65 patients required ECLS post-Norwood. Using receiver operating characteristic (ROC) curve analysis, mean PaO2 of 182 mmHg in the first 48-hour on ECLS was determined to have the optimal discriminatory ability for mortality (sensitivity 68%, specificity 70%). Of the 65 patients, 52% had PaO2 > 182 mmHg and were designated as hyperoxia group. Patients in the hyperoxia-group had longer cardiopulmonary bypass time (187 vs. 165 min, p = 0.023), shorter duration from CICU arrival to ECLS-cannulation (13.28 vs. 132.58 h, p = 0.003), higher serum lactate within 2-hours from ECLS-canulation (14.55 vs. 5.80, p = 0.01), higher ECLS flows in the first 4-hours (152.68 vs. 124.14, p = 0.006), and higher mortality (77% vs. 39%, p = 0.005). In the unadjusted-analysis, using a derived cut-point, patients in the hyperoxia-group had 5.15 higher odds of mortality (p = 0.003). However, this association was insignificant when adjusting for confounding variables (p = 0.104). Using a functional status scale, new morbidity (38% vs. 21%), and unfavorable outcomes (13% vs. 5%) were higher in the hyperoxia group. Despite being higher in the hyperoxia group, this did not reach statistical significance. Conclusion: Neonates with hyperoxia (PaO2 > 182 Torr) during the first 48-hour of ECLS post-Norwood operation had 5 times higher odds of mortality in the unadjusted analysis, however, this was insignificant when adjusting for confounding variables. Patients in the hyperoxia group had shorter duration from CICU arrival to ECLS-cannulation, higher serum lactate prior to ECLS-canulation, and higher ECLS flows in the first 4-hours, (p < 0.05). Multicenter evaluation of this modifiable risk factor is imperative to improve the care of this high-risk cohort. [ABSTRACT FROM AUTHOR]

Introduction: Conventionally, the raw wound after gingival excision is protected with non eugenol periodontal pack, in order to alleviate pain and preserve healing tissue which includes some potential disadvantages such as patient intolerance, pack loosening, speech difficulties and plaque accumulation. Aim: To clinically evaluate wound healing following the use of a resorbable periodontal dressing following gingival excisional procedures and to compare the outcomes with the conventional COE-PAKTM periodontal dressing. Materials and Methods: A randomised controlled trial was conducted in the Department of Periodontology, SRM Dental College, Chennai, Tamil Nadu, India from June 2022 to March 2023. Patients requiring gingival excision for gingival pigmentation, gummy smile correction and crown lengthening were included in this study, 36 patients in control group were treated with Laser assisted surgery followed by conventional COE-PAKTM and 36 patients in test group were treated with Laser assisted surgery protected with resorbable pack (RESO-PAC®). Wound healing scores (Landry's scale) and patient comfort assessment {Visual Analogue Score (VAS)} was recorded at 7, 14 days following therapy. Data were analysed with IBM Statistical Packages for Social Sciences (SPSS) software 17.0 version using Independent t-test with level of significance 5%. Results: A total of 72 patients (38 males and 34 females) with a mean age range of 32.6 years were randomised into two study groups. Following the intervention, two participants in the test group and one subject in the control group could not report for the seven day follow-up and hence, the data of 69 participants, control (n=35) and test (n= 34) was used for final analysis. Both test and control groups showed satisfactory healing. Results in the test group were significantly better with respect to both wound healing and VAS assessment. Statistically significant difference was noted in the Wound Healing Index (WHI), VAS and Pain Intensity (PI) scores at the 7th and 14th day follow-ups (p<0.001). VAS and PI scores at 7th and 14th day (p<0.001). No of analgesics consumed during the first week were also significantly higher in the control group as compared to the test group (p<0.001**). Conclusion: RESO-PAC®, resorbable pack aided in wound healing following gingival excision and improved patient comfort during the initial healing phase. To add on the patients in the test group reported better compliance to the resorbable dressing and reported no adverse effects. Resorbable dressings could possibly facilitate secondary wound healing following surgical excision of gingiva. [ABSTRACT FROM AUTHOR]

This study aimed to estimate the potential optoelectronic and biological properties of AgO:ZnO nanocomposite synthesized by an environmentally friendly method. The synthesis of nanocomposite was carried out by reducing silver nitrate with Salvia hispanica extra, and zinc nitrate was mixed to produce the nanocomposite. An extensive examination was carried out on the physical and biological characteristics of the synthesized nanocomposite using several approaches. The EDX analysis confirmed the purity of the synthesized sample via the presence of elements Ag, Zn, and O only in the nanocomposite. The crystal structure of nanocomposite with hexagonal phase and average crystallite size of 56.8 nm was confirmed by X-ray diffraction. The formation of fibrous AgO:ZnO nanoparticles with an average diameter of 1.021 ± 0.6 μm was indicated by field-emission scanning electron microscopy examination. The optical property investigation revealed that the nanocomposite had a wide absorption band with an absorption peak at 425 nm. The observed phenomenon was attributable to the occurrence of electronic transitions within the material. The direct bandgap energy of 2.90 eV and the Urbach energy of 0.456 eV for the nanocomposite demonstrated the presence of defect states in the bandgap region. The measured values of the conduction band edge (ECB) and valence band edge (EVB) additionally revealed the material's electronic structure. The biological potential of AgO:ZnO nanocomposite was evaluated by the agar well diffusion technique against Gram-positive and Gram-negative bacteria and a fungus. The extensive investigation of the AgO:ZnO nanocomposite's characteristics has shown its potential for use in a wide range of photonic, optoelectronic, and biological applications. [ABSTRACT FROM AUTHOR]

Objective: Evaluation of neonatal morbidity after maternal central neurotropic drug exposure. Methods: Retrospective single-center level-III neonatology cohort analysis of neonates after CND from 2018 to 2021. Control group of neonates born to mothers without CND cared for at the maternity ward. Results: Significantly more frequent therapy need of neonates with CND [OR 23 (95% CI: 7.8–62); RR 14 (95% CI: 5.4–37); p < 0.01]. Neonates after CND had lower Apgar-scores LM 1 [CND 8.1; CG 8.6; p < 0.05]; LM 5 [CND 9; CG 9.7; p < 0.01]; LM 10 [CND 9.6; CG 9.9; p < 0.05]. The first symptom occurred in 95.35% within 24 h (mean: 3.3 h). CND group showed significantly more often preterm delivery [OR 3.5; RR 3.2; p < 0.05], and especially cumulative multiple symptoms [OR 9.4; RR 6.6; p < 0.01] but no correlation to multiple maternal medication use (p = 0.3). Conclusions: Neonates exposed to CND are at increased risk for postnatal therapy, often due to multiple symptoms. Neonates should be continuously monitored for at least 24 h. [ABSTRACT FROM AUTHOR]

Urinary tract infections (UTIs) are one of the most common bacterial infections, affecting more than 150 million people each year in the world. UTIs have grown exponentially in the last few years. They represent a major load for both individuals and society. The highest incidence (about 55–60%) concerns women. Many pathogens are involved in UTIs, most of which are derived from the gut. Recent studies, together with recent diagnostic techniques (such as quantitative culture of urine or next-generation sequencing), have improved the knowledge of microbial communities in the urinary tract. It turned out that gut dysbiosis is strictly involved in the pathogenesis of UTIs. In particular, the human gut is the natural habitat for Escherichia coli (E. coli), the main bacterium responsible for UTIs. The overgrowth of E. coli pathogenic strains represents a risk factor for them. Furthermore, the human gut microbiota acts as a "global reservoir" for genes conferring resistance to clinically relevant antibiotics, thus influencing the treatment of UTIs. In addition, differently from the past, the idea of a sterile urinary environment has been replaced by the characterization of a urinary microbiome. The aim of our review is to explore recent studies on the association between gut microbiota and urinary microbiome and to summarize the current knowledge about the effects of interactions between gut and urinary microbial communities in the pathogenesis of UTIs, considering UTIs more as a "gut disease" and not only a urinary disease and providing new insight into the therapeutic options such as the use of probiotics. [ABSTRACT FROM AUTHOR]

Background: Bacterial meningitis (BM) in infants is a serious condition that can lead to significant complications. Lumbar puncture (LP) is essential to provide diagnoses, however false negatives may result if LP is performed after the starting of antibiotic therapy. Methods: We conducted a retrospective analysis of infants of any gestational age with BM within their first 90 days of life and admitted to the Neonatal Intensive Care Unit of Modena Policlinico between 1 January 2011, and 31 December 2023. Results: A total of 44 episodes of meningitis were confirmed in 40 infants, diagnosed by positive cerebrospinal fluid cultures (n = 37), polymerase chain reaction testing (n = 4), or both methods (n = 3). Three out of forty infants (8%) experienced a relapse of meningitis. Most episodes (31/44, 70%) occurred in preterm infants. The incidence of early-onset meningitis was lower than that of late-onset (0.18 vs. 0.94 cases per 1000 births, respectively), with Gram-positive accounting for most cases (27/44, 61%). LP was performed prior to antibiotic administration in most episodes (30/44, 68%). Two preterm infants (5%) died from meningitis-related complications. Forty-two episodes occurred among thirty-eight surviving infants; brain lesions were detected through brain ultrasound or MRI in nine out of forty-two episodes (21%). Conclusions: Preterm infants have higher rates of BM, brain lesions or case fatalities. Early diagnosis and prompt antibiotic treatment are critical to improve outcomes. [ABSTRACT FROM AUTHOR]

Background: People with osteoarthritis place a huge burden on society. Early diagnosis is essential to prevent disease progression and to select the best treatment strategy more effectively. In this study, the aim was to examine the diagnostic features and clinical value of peripheral blood biomarkers for osteoarthritis., Objective: The goal of this project was to investigate the diagnostic features of peripheral blood and immune cell infiltration in osteoarthritis (OA)., Methods: Two eligible datasets (GSE63359 and GSE48556) were obtained from the GEO database to discern differentially expressed genes (DEGs). The machine learning strategy was employed to filtrate diagnostic biomarkers for OA. Additional verification was implemented by collecting clinical samples of OA. The CIBERSORT website estimated relative subsets of RNA transcripts to evaluate the immune-inflammatory states of OA. The link between specific DEGs and clinical immune-inflammatory markers was found by correlation analysis., Results: Overall, 67 robust DEGs were identified. The nuclear receptor subfamily 2 group C member 2 (NR2C2), transcription factor 4 (TCF4), stromal antigen 1 (STAG1), and interleukin 18 receptor accessory protein (IL18RAP) were identified as effective diagnostic markers of OA in peripheral blood. All four diagnostic markers showed significant increases in expression in OA. Analysis of immune cell infiltration revealed that macrophages are involved in the occurrence of OA. Candidate diagnostic markers were correlated with clinical immune-inflammatory indicators of OA patients., Conclusion: We highlight that DEGs associated with immune inflammation (NR2C2, TCF4, STAG1, and IL18RAP) may be potential biomarkers for peripheral blood in OA, which are also associated with clinical immune-inflammatory indicators., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Humans can be exposed to endocrine disruptors (EDs) in numerous ways. EDs can interfere with endogenous hormones at different levels, resulting in numerous adverse human health outcomes, including immunotoxicity. In this regard, this study aimed to investigate in vitro the possible effects of EDs on immune cells and possible gender differences. Peripheral blood mononuclear cells from healthy humans, both males and females, were exposed to 6 different EDs, namely atrazine (herbicide), cypermethrin (insecticide), diethyl phthalate (plasticizer), 17α-ethynylestradiol (contraceptive drug), perfluorooctanesulfonic acid (persistent organic pollutant), and vinclozolin (fungicide). We evaluated the effect of EDs on RACK1 (receptor for activated C kinase 1) expression, considering it as a bridge between the endocrine and the immune system, and putatively used as screening tool of immunotoxic effects of EDs. The exposure to EDs resulted at different extent in alteration in RACK1 expression, pro-inflammatory activity, natural killer lytic ability, and lymphocyte differentiation, with sex-related differences. In particular, diethyl phthalate and perfluorooctanesulfonic acid resulted the most active EDs tested, with gender differences in terms of effects and magnitude. The results from our study evidenced the ability of EDs to directly affect immune cells., (© 2023. The Author(s).)

Among the most abundantly available bioresources, lignocellulosic biomass offers a 'green renewable' alternative resource for producing high-value biomaterials suitable for acoustic applications. In this study, a systemic process is developed to fabricate sound absorbing material using refined cellulosic microfibrils generated from natural deep eutectic solvent (NADES) pretreated rice straw. Physico-chemical characterization using FTIR and FESEM analysis confirmed substantial removal of the hemicellulose and lignin from the extracted cellulosic microfibrils. Moreover, the surface area after NADES pretreatment increased to 12.55 m2/g from 2.18 m2/g of raw rice straw, suggesting the enhanced potential of sound dissipation within the biomaterial. The noise reduction coefficient (NRC) of the NADES pretreated rice straw was increased to 0.55 compared to 0.41 with untreated rice straw. Sound absorption performance shows an increasing trend with the increase in sample thickness (25 mm to 50 mm); however, no significant improvement in sound absorption was observed with an air gap of more than 20 mm. Overall, the tested biomaterial shows comparable NRC to commercially available synthetic sound absorbing materials. [ABSTRACT FROM AUTHOR]

Objective: Osteoarthritis (OA) is a degenerative disease of the joints characterized by inflammation and cartilage degeneration. Zinc finger E-box binding homeobox 2 (ZEB2) contains various function domains that interact with multiple transcription factors involved in various cellular functions. However, the function of ZEB2 in OA has not been clearly illustrated. Method: Interleukin-1β (IL-1β) was used to establish an OA model in vitro. We quantified the ZEB2 expression in cartilage tissues from OA patients and IL-1β-induced chondrocytes through reverse transcription–quantitative polymerase chain reaction and Western blot. We then used functional assays to explore the function of ZEB2 during OA progression. Results: ZEB2 expression was increased in OA cartilage tissues and chondrocytes. The silencing of ZEB2 increased aggrecan and collagen II levels, and reduced the content of matrix metalloproteinase-3 (MMP-3), MMP-9, and MMP-13. ZEB2 knockdown inhibited the effects of IL-1β on the production of nitric oxide and prostaglandin E2, and the expression of inducible nitric oxide synthase and cyclooxygenase-2. ZEB2 inhibition also suppressed the levels of IL-6 and tumour necrosis factor-α, and increased the IL-10 level in IL-1β-treated cells. Mechanically, ZEB2 knockdown blocked the activation of the Wnt/β-catenin pathway in chondrocytes. Conclusion: Knockdown of ZEB2 alleviated IL-1β-induced cartilage degradation and the inflammatory response through the Wnt/β-catenin pathway in chondrocytes. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have demonstrated that hypothermia in preterm infants correlates with increased morbidity and mortality, especially among those with very low or extremely low birth weights (VLBW/ELBW). An increasing number of healthcare facilities are implementing quality improvement (QI) bundles to lower the incidence of hypothermia at birth in this vulnerable population. However, the effectiveness and safety of these interventions have yet to be fully assessed. A meta-analysis is necessary to evaluate the efficacy and safety of QI bundles in reducing hypothermia at birth among VLBW/ELBW infants. Methods: We searched PubMed, Embase, the Cochrane Library and Web of Science through April 22nd, 2024. Study selection, data extraction, quality evaluation and risk bias assessment were performed independently by two investigators. Meta-analysis was performed using Review Manager 5.4.1. Results: A total of 18 studies were included for qualitative analysis and 12 for meta-analysis. For VLBW infants, meta-analysis revealed a reduction in hypothermia and an increase in hyperthermia following the introduction of QI bundles (mild hypothermia, OR 0.22, 95% CI [0.13–0.37]; moderate hypothermia, OR 0.18, 95% CI [0.15–0.22]; hyperthermia, OR 2.79, 95% CI [1.53–5.09]). For ELBW infants, meta-analysis showed a decrease in hypothermia but no increase in hyperthermia after implementing QI bundles (mild hypothermia, OR 0.46, 95% CI [0.26–0.81]; moderate hypothermia, OR 0.21, 95% CI [0.08–0.58]; hyperthermia, OR 1.10, 95% CI [0.22–5.43]). Conclusion: QI bundles effectively reduce hypothermia in VLBW/ELBW infants, but they may also increase hyperthermia, especially in VLBW infants. [ABSTRACT FROM AUTHOR]

This review aimed to identify newly discovered bacteria from individuals with periodontal/peri-implant diseases and organize them into new clusters (GF-MoR complexes) to update Socransky's complexes (1998). For methodological development, the PCC (Population, Concept, Context) strategy was used for the focus question construction: "In patients with periodontal and/or peri-implant disease, what bacteria (microorganisms) were detected through laboratory assays?" The search strategy was applied to PubMed/MEDLINE, PubMed Central, and Embase. The search key terms, combined with Boolean markers, were (1) bacteria, (2) microbiome, (3) microorganisms, (4) biofilm, (5) niche, (6) native bacteria, (7) gingivitis), (8) periodontitis, (9) peri-implant mucositis, and (10) peri-implantitis. The search was restricted to the period 1998–2024 and the English language. The bacteria groups in the oral cavity obtained/found were retrieved and included in the GF-MoR complexes, which were based on the disease/condition, presenting six groups: (1) health, (2) gingivitis, (3) peri-implant mucositis, (4) periodontitis, (5) peri-implantitis, and (6) necrotizing and molar–incisor (M-O) pattern periodontitis. The percentual found per group refers to the number of times a specific bacterium was found to be associated with a particular disease. A total of 381 articles were found: 162 articles were eligible for full-text reading (k = 0.92). Of these articles, nine were excluded with justification, and 153 were included in this review (k = 0.98). Most of the studies reported results for the health condition, periodontitis, and peri-implantitis (3 out of 6 GF-MoR clusters), limiting the number of bacteria found in the other groups. Therefore, it became essential to understand that bacterial colonization is a dynamic process, and the bacteria present in one group could also be present in others, such as those observed with the bacteria found in all groups (Porphyromonas gingivalis, Tannarela forsythia, Treponema denticola, and Aggregatibacter actinomycetemcomitans) (GF-MoR's red triangle). The second most observed bacteria were grouped in GF-MoR's blue triangle: Porphyromonas spp., Prevotela spp., and Treponema spp., which were present in five of the six groups. The third most detected bacteria were clustered in the grey polygon (GF-MoR's grey polygon): Fusobacterium nucleatum, Prevotella intermedia, Campylobacter rectus, and Eikenella corrodens. These three geometric shapes had the most relevant bacteria to periodontal and peri-implant diseases. Specifically, per group, GF-MoR's health group had 58 species; GF-MoR's gingivitis group presented 16 bacteria; GF-MoR's peri-implant mucositis included 17 bacteria; GF-MoR's periodontitis group had 101 different bacteria; GF-MoR's peri-implantitis presented 61 bacteria; and the last group was a combination of necrotizing diseases and molar–incisor (M-I) pattern periodontitis, with seven bacteria. After observing the top seven bacteria of all groups, all of them were found to be gram-negative. Groups 4 and 5 (periodontitis and peri-implantitis) presented the same top seven bacteria. For the first time in the literature, GF-MoR's complexes were presented, gathering bacteria data according to the condition found and including more bacteria than in Socransky's complexes. Based on this understanding, this study could drive future research into treatment options for periodontal and peri-implant diseases, guiding future studies and collaborations to prevent and worsen systemic conditions. Moreover, it permits the debate about the evolution of bacterial clusters. [ABSTRACT FROM AUTHOR]

Key Clinical Message: It is important to consider the diagnosis of Sump syndrome in patients with a history of open cholecystectomy, particularly in those who migrate from developing countries where alternative biliary interventions may be limited. The presentation may range from acute severe, mimicking acute ascending cholangitis, to chronic recurrent abdominal pain without evidence of inflammation. Management is a case‐by‐case decision, with principal management aims to decompress the biliary tract and address any underlying sepsis. Sump syndrome is a rare and often long‐term complication of choledochoduodenostomy (CDD). The presentation and severity are variable, and management should be tailored to each patient based on several factors. Herein, we report three cases of sump syndrome, each demonstrating unique diagnostic dilemmas and therapeutic modalities. Case I describes a woman presenting with acute cholangitis, managed with percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP). Case II illustrates a similar presentation complicated by myocardial infarction, necessitating urgent biliary decompression via PTC and subsequent unsuccessful endoscopic stenting. Case III highlights the diagnostic difficulty in a stable patient with inconclusive diagnostic imaging. This case series emphasizes the importance of considering sump syndrome diagnosis in patients with a history of CDD or open cholecystectomy, especially in elderly patients and those who come from regions where alternative biliary interventions may be limited. [ABSTRACT FROM AUTHOR]

Objectives: To assess whether continuous non-invasive pCO2 monitoring by transcutaneous pCO2 monitor (TCpCO2) among extremely low birth weight (ELBW) premature infants, during the first week of life, will decrease the rate of high-grade intraventricular hemorrhage (IVH) or periventricular leukomalacia (PVL) or the combined outcome of IVH/PVL and death. Methods: This was a prospective, observational, multicenter study. Due to ethical constraints, allocation was based on TCpCO2 monitor availability. ELBW infants were either monitored by TCpCO2 monitor (Sentec, Therwil, Switzerland) (study group), or recruited to the control group if a TCpCO2 monitor was not available. Results: A total of 132 ELBW infants participated in the study. The size of the study group (106 infants) and the control group (26 infants) differed because monitor availability increased during the study period reflecting change in standard of care. The groups had comparable gestational age and baseline characteristics. No difference was found in the rate of IVH/PVL in the study vs. control groups (10% vs. 4%; p = 0.7, respectively), or in the combined outcome of PVL/IVH and death (16% vs. 15%; p = 1.0, respectively). Conclusions: This study demonstrates the challenges in conducting a prospective controlled trial in a rapidly evolving medical field. While the study began with a clear equipoise, this balance shifted as the care team gained more experience with TCpCO2 monitoring among the study population, despite the absence of new clinical evidence to justify such a shift. Consequently, the small control group limited our ability to draw definitive conclusions regarding the study's objective. However, our findings may increase awareness of continuous non-invasive pCO2 monitoring in extremely premature infants. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Implementing hepatitis B vaccination is an important strategy to reduce hepatitis B virus infection and disease burden. Suboptimal adult hepatitis B vaccination coverage limits the further reduction of hepatitis B virus infection. Methods A multistage stratified random sampling method was adopted to survey the permanent population aged 1–59 in 2006 and 2024. We calculated the vaccination coverage rate, hepatitis B surface antibody (HBsAb)–positive rate, rate difference, and their 95% confidence intervals (CIs) of the 2 survey populations, and used the 95% CI and χ2 test to determine whether the difference in rate was statistically significant. Results Six hundred twenty-three people were surveyed in 2006 and 606 people were surveyed in 2024. From 2006 to 2024, the hepatitis B vaccination coverage among people aged 1–59 years increased from 54.1% to 78.9%, and the HBsAb-positive rate increased from 46.2% to 57.6%. There was no significant difference in vaccination coverage in the population <15 years of age, but the antibody-positive rate increased significantly. The vaccination coverage rate of the 15–59 age group increased significantly, but there was no statistical difference in the antibody positivity rate of the 15–49 age group, and the antibody positivity rate of the 50–59 age group increased significantly. Conclusions Hepatitis B vaccination coverage among adults was still insufficient. Hepatitis B vaccine-mediated immunity was low in adults aged 30–49 years. It is recommended to update the guidelines for hepatitis B vaccination of adults in China, cancel the assessment of risk factors and prevaccination serological screening, and emphasize universal vaccination of all unvaccinated adults to increase coverage. [ABSTRACT FROM AUTHOR]

Neonatal sepsis is a severe medical condition that contributes significantly to neonatal mortality. However, early diagnosis and treatment can help manage the condition effectively. Predictive analytics can assist neonatal sepsis diagnosis and treatment and offer a reassuring solution. This study presents a systematic literature review of various predictive analytics methods for neonatal sepsis diagnosis and treatment. It thoroughly reviews 16 studies between 2014 and 2024, including retrospective and prospective data and utilizing various predictive modeling techniques, such as Machine Learning (ML) and Deep Learning (DL). The review unveils that the Predictive analytics models can rapidly detect early and late-onset neonatal sepsis. This detection aids clinicians in decision-making and improves healthcare management for neonates, especially in low-resource settings. This study lays the groundwork for utilizing advanced analytics technologies to address challenges in this domain. It inspires further research in innovative and unexplored methods for neonatal sepsis diagnosis. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) stands as the leading cause of morbidity and mortality among children, as evidenced by the most contemporary statistics. Undernutrition in pediatric TBI (PTBI) leads to increased mortality, heightened infectious complications, and more severe neurological consequences. Therefore, timely and effective nutritional therapy is crucial in managing PTBI to improve patient prognosis and outcomes. Limited investigations have been conducted on the nutritional requirements specific to these patients and management often relies on data from adults with TBI for guidance. We have meticulously searched different databases to compile a broad range of the most up-to-date clinical research. This review analyses the challenges associated with providing nutritional support to children with TBI and provides a clearer understanding of the current evidence-based recommendations for optimal nutritional therapy. The review primarily focuses on recommendations and suggestions for energy requirements, nutritional assessment, initiation of nutrition, various feeding methods offered, identification of malnutrition, the impact of malnutrition on patient outcomes, and areas of further research. [ABSTRACT FROM AUTHOR]

Objective: Oxidative stress has crucial roles in the pathogenesis of periodontal disease. The balance between oxidant and antioxidant biochemical parameters is detrimental in the progression of periodontal diseases. This study aims to assess the levels of myeloperoxidase (MPO), glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA) in serum and saliva samples from patients who have periodontal disease. Methods: The study enrolled on 88 individuals divided into 4 groups: (1) periodontally healthy, (2) gingivitis, (3) stage I-II periodontitis, and (4) stage III-IV periodontitis. The participants had their serum and saliva samples taken. Clinical periodontal parameters were measured to determine the periodontal status. Then MPO, MDA, CAT, SOD, and GSH expressions were analyzed with appropriate methods. Results: Salivary-MPO levels improved in parallel with the periodontal disease's severity. The healthy patients had the highest serum-MDA expressions, which decreased as the severity of the disease increased. Glutathione and SOD concentrations were similar in each group. Catalase expressions in serum reached the highest level in stage I-II periodontitis patients. Nonetheless, there were no significant differences between the groups. Conclusion: In conclusion, our results revealed that GSH, SOD, MDA, CAT, and MPO levels are not affected by the progression of periodontal diseases. [ABSTRACT FROM AUTHOR]

Copyright of Acta Pediatrica de Mexico is the property of Instituto Nacional de Pediatria (INP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/Aim: The frequency rate of injection site reactions (ISR) due to fosaprepitant meglumine (Fos APR) has been shown to vary depending on the types of combined anticancer drug. This study aimed to elucidate the impact of Fos APR on ISR in patients receiving paclitaxel and carboplatin, with and without bevacizumab therapy (TC±Bev). Patients and Methods: This study focused on patients with gynecologic cancer (n=93) who received TC±Bev administration at Fujita Health University Hospital from March 2016 to February 2020, and monitored up to six cycles. The patients were randomly assigned to the Fos APR group (n=47) and the Aprepitant (APR) group (n=46). Using Visual Infusion Phlebitis (VIP) scores, ISR was evaluated by comparing the VIP scores of all cycles using a linear mixed model. The risk factors that contribute to the occurrence of vascular pain throughout all cycles were also examined. Results: The VIP scores of all cycles showed a near significant intergroup difference (p=0.071). Factors that affected the development of vascular pain included Fos APR and age (p=0.027 and 0.049, respectively). Regarding age, patients aged <65 years had a higher risk. Four patients underwent a switch from the originally assigned neurokinin- 1 receptor antagonist; in all of these cases, Fos APR was changed to APR for vascular pain. Conclusion: Fos APR may increase the risk for ISR associated with TC±Bev therapy for gynecological cancer. [ABSTRACT FROM AUTHOR]

Candida spp. is rarely found in neonatal early-onset sepsis (EOS) etiology. However, candidemia is associated with increased mortality and morbidity, as in late-onset sepsis. Congenital candidiasis may present as a mucocutaneous infection or, more rarely, as a systemic infection in term and preterm infants. This paper presents case reports of two cases of congenital systemic candidiasis (CSC) caused by Candida albicans and a review of the data in the literature. An electronic search of PubMed, Scopus, and Google Scholar was performed to identify publications on congenital candidiasis. Both neonates were male, born vaginally, with risk factors for congenital candidiasis. One of the infants was born at term and presented with an almost generalized maculopapular rash at birth and congenital candidemia; parenteral fluconazole was used successfully. The other infant was born prematurely at 28 weeks of gestation; blood culture, gastric aspirate, and maternal vaginal cultures sampled at birth were positive for C. albicans. Liver and kidney involvement became apparent on the third day of life, while lung involvement was clinically evident on the fourth day. Prolonged parenteral fluconazole was administered due to multiple organ involvement and persistent candidemia. Our experience with the presented cases, similar to data in the literature, suggests that CSC may occur at any gestational age, with various clinical pictures, sometimes mimicking bacterial sepsis, and even in the absence of the rash. Careful anamnesis and a high index of suspicion are important for the prompt recognition and treatment of CSC, optimizing the short- and long-term outcomes. Further research should focus on CSC to improve its diagnosis. [ABSTRACT FROM AUTHOR]

Mechanisms resulting from the physiological immaturity of the digestive system in children delivered before 32 weeks of gestation and, in particular, different interactions between the microbiome and the body have not been fully elucidated yet. Next-generation sequencing methods demonstrated the presence of bacterial DNA in the placenta and amniotic fluid, which may reflect bacterial populations that initiate intestinal colonization in utero. Numerous studies confirmed the hypothesis stating that intestinal bacteria played an important role in the pathogenesis of necrotizing enterocolitis (NEC) early- and late-onset neonatal sepsis (EONS and LONS). The model and scale of disorders within the intestinal microbiome are the subject of active research in premature infants. Neonatal meconium was primarily used as an indicator defining the environment in utero, as it is formed before birth. Metagenomic results and previous data from microbiological bacterial cultures showed a correlation between the time from birth to sample collection and the detection of bacteria in the neonatal meconium. Therefore, it may be determined that the colonization of the newborn's intestines is influenced by numerous factors, which may be divided into prenatal, perinatal, and postnatal, with particular emphasis put on the mode of delivery and contact with the parent immediately after birth. Background: The aim of this review was to collect available data on the intrauterine shaping of the fetal microbiota. Methods: On 13 March 2024, the available literature in the PubMed National Library of Medicine search engine was reviewed using the following selected keywords: "placental microbiome", "intestinal bacteria in newborns and premature infants", and "intrauterine microbiota". Results: After reviewing the available articles and abstracts and an in-depth analysis of their content, over 100 articles were selected for detailed elaboration. We focused on the origin of microorganisms shaping the microbiota of newborns. We also described the types of bacteria that made up the intrauterine microbiota and the intestinal microbiota of newborns. Conclusions: The data presented in the review on the microbiome of both term newborns and those with a body weight below 1200 g indicate a possible intrauterine colonization of the fetus depending on the duration of pregnancy. The colonization occurs both via the vaginal and intestinal route (hematogenous route). However, there are differences in the demonstrated representatives of various types of bacteria, phyla Firmicutes and Actinobacteria in particular, taking account of the distribution in their abundance in the individual groups of pregnancy duration. Simultaneously, the distribution of the phyla Actinobacteria and Proteobacteria is consistent. Considering the duration of pregnancy, it may also be concluded that the bacterial flora of vaginal origin dominates in preterm newborns, while the flora of intestinal origin dominates in term newborns. This might explain the role of bacterial and infectious factors in inducing premature birth with the rupture of fetal membranes. [ABSTRACT FROM AUTHOR]