Abstract: Abstract Background: Epilepsy and sleep have been reported to be closely associated. However, the mechanisms involved in this association remains unclear. Epileptic seizures during sleep may be misdiagnosed as parasomnias or movement disorders and can be associated with daytime sleepiness and poor quality of life. Nocturnal temporal lobe epilepsy (NTLE) has recently been recognized and is considered rare. Herein, we intend to present a case of a patient with NTLE with epileptic seizures occurring exclusively during sleep—initially diagnosed and treated as a sleep disturbance disorder. Case Presentation: A 24-year-old female reported to have been treated for disturbed sleep. A 24-hour video-electroencephalogram (V-EEG) was then performed, which showed acute waves, spikes, and complex spike-slow waves of great amplitude, isolated, and in outbreaks in the left temporal region, with abrupt choreoathetotic, generalized, and asymmetric body movements. Conclusion: The importance of this case lies in the presentation of exclusively nocturnal epileptic seizures, without personal or family history of epilepsy, with normal imaging findings along with V-EEG evidence of epileptic discharges in the left temporal lobe. Therefore, diagnosing NTLE is challenging and must be considered in patients presenting with paroxysmal motor sleep events. Additionally, detailed description of the seizures and V-EEG are fundamental factors that could aid in confirming the diagnosis.

Abstract: Background and Objectives: Anaesthesia is a medical procedure that involves the use of drugs to induce a state of unconsciousness or reduced awareness. A biomarker of patho-logical conditions is elevated S100β levels found in biological fluids. In order to investi-gate it, this study aims to differentiate brain injury in general along with spinal anaesthe-sia during C-section. Materials and Methods: The 60 parturient women underwent a C-section from July 1, 2021 to Dec 30, 2023 had been evenly distributed into 2 groups Gen-eral anaesthesia (n=30), and Spinal anaesthesia group (n=30). The prospective observa-tional study effectively compared the changes in the S100β brain damage biomarker ratio in maternal blood (preoperative and postoperative) and umbilical artery blood during a C-section, using either general or spinal anaesthesia. Results: S100β concentrations slight-ly increased once the C-section was over in both the SA and GA group, but without nota-ble differences. In the SA and GA groups, preoperative S100 β concentration in maternal blood was 195.1±36.2 ng/L, 193.0±54.3 ng/L, then increased to 200.9±42.9ng/L, 197.0±42.7 at the end of operation. Although there was no major statistical difference (p=0.86), S100B concentrations in the postoperative stage and umbilical artery in the spinal anaesthesia group clearly tended to be higher than that in the general anaesthesia group. Conclusions: S100β concentrations slightly increased after C-section in both groups. General anaesthe-sia faint impacts S100β levels in umbilical cord blood during C-section. Spinal and gen-eral anesthesia are considered safe for the maternal and fetal brain during cesarean sec-tions when administered appropriately, with no evidence suggesting harmful effects. Further studies is needed to study associations between anaesthesia, perioperative release of brain injury biomarker, and perioperative clinical outcomes.

Abstract: The current manuscript provides a comprehensive review of biogenic amines (BAs), with a special focus on those derived from herbal sources such as banana peels and their therapeutic potential in central nervous system (CNS) disorders. Biogenic amines, including dopamine, serotonin, epinephrine, and polyamines, are biologically active compounds that play significant roles in neurotransmission, physiological regulation, and plant defense. The review highlights plant sources rich in these compounds, particularly banana species, and discusses innovative extraction and identification methods, such as solid-phase extraction (SPE), HPLC, and GC-MS. Emphasis is placed on the valorization of agricultural waste as a sustainable source of neuroactive compounds, which supports a circular bioeconomy. Potential applications in treating neurodegenerative diseases such as Parkinson's and depression are discussed, along with the toxicological considerations of excessive BA accumulation. This review aims to provide insight into the isolation, application, and future potential of BAs from herbal and waste materials for therapeutic and ecological benefits.

Abstract: Background/Objectives: Guillain-Barré syndrome (GBS) is a rare autoimmune peripheral neuropathy that affects both the myelin sheaths and axons of the peripheral nervous system. It is the leading cause of acute neuromuscular paralysis worldwide, with an annual incidence of less than two cases per 100,000 inhabitants. Although most patients recover, a small proportion do not regain mobility and even remain dependent on mechanical ventilation. In this study, we refer to the analysis of samples collected from GBS patients at different defined time points during hospital recovery and performed by a medical or research group. Methods: The conditions for whole blood collection, peripheral blood mononuclear cell isolation, and serum collection from GBS patients and volunteer donors are explained. Aliquots of these human samples have been used for red blood cell phenotyping, transcriptomic and proteomic analyses, and serum biochemical parameter studies. Results: The initial sporadic preservation of human samples from GBS patients and control volunteers enabled the creation of a biobank collection for current and future studies related to the diagnosis and treatment of GBS. Conclusions: In this article, we describe the laboratory procedures and the integration of a GBS biobank collection, local medical services, and academic institutions collaborating in its respective field. The report establishes the intra-disciplinary and inter-institutional network to conduct long-term longitudinal studies on GBS.

Abstract: Background: Pulmonary hypertension (PH) is a progressive disease characterized by increased pulmonary vascular resistance and right heart failure. Despite advances in therapy, prognosis remains poor, highlighting the need for novel prognostic biomarkers. Objective: This scoping review aims to assess the prognostic value of catestatin and thrombospondin in patients with pulmonary hypertension and to examine how treatment escalation strategies affect patients' quality of life. Methods: This scoping review was conducted in accordance with the PRISMA-ScR guidelines. We searched databases such as PubMed, Scopus, Web of Science, and Embase for studies published between 2010 and 2024. The inclusion criteria encompassed original research articles evaluating the prognostic potential of catestatin and thrombospondin in PH patients. Data extraction focused on biomarker expression, survival outcomes, treatment escalation, and quality of life metrics. Results: Out of 348 records identified, 27 studies met the eligibility criteria. Both catestatin and thrombospondin showed significant correlations with clinical deterioration and right ventricular dysfunction. Several studies indicated that treatment escalation guided by biomarker levels contributed to better long-term outcomes and improved quality of life. Conclusions: Catestatin and thrombospondin may serve as promising prognostic biomarkers in pulmonary hypertension. Their utility in guiding treatment escalation warrants further clinical validation. Early identification of high-risk patients could improve prognosis and quality of life.

Abstract: Advanced prostate cancer (PCa) remains lethal despite standard therapies, and immune checkpoint inhibitors offer limited benefit in its "immune-cold" microenvironment. T cell engagers (TCEs)—bispecific antibodies linking CD3 on T cells to tumor-associated antigens (TAAs)—provide potent, MHC-independent cytotoxicity, overcoming a key resistance mechanism. While early PSMA-targeted TCEs established proof-of-concept, recent data, notably for Six transmembrane epithelial antigen of the prostate 1 (STEAP1)-targeting agents like Xaluritamig, demonstrate more substantial objective responses, highlighting progress through improved target selection and molecular design. This review synthesizes the evolving landscape of TCEs targeting PSMA, STEAP1, and DLL3 in PCa. We critically evaluate emerging clinical evidence, arguing that realizing the significant therapeutic potential of TCEs requires overcoming key challenges, including cytokine release syndrome (CRS), limited response durability, and antigen escape. We contend that future success hinges on sophisticated engineering strategies (e.g., affinity tuning, masking, multi-specific constructs) and rationally designed combination therapies tailored to disease-specific hurdles. Strategies for toxicity mitigation, the crucial role of biomarker-driven patient selection, and potential integration with existing treatments are also discussed. Accumulating evidence supports TCEs becoming a new therapeutic pillar for advanced PCa, but achieving these demands sustained innovation focused on optimizing efficacy and safety. This review critically connects molecular engineering advancements with clinical realities and future imperatives.

Abstract: Immunoglobulin A (IgA) vasculitis previously called Henoch-Schönlein Purpura represents the most common vasculitis of childhood, characterized by IgA1 deposition in small vessels of the skin, joints, gastrointestinal (GI) tract, and kidney (1). This case report presents an atypical presentation of IgA vasculitis in an eight-year-old girl, where the skin manifestations were predominated by urticarial rashes prior to the onset of the classical palpable purpura and was mistaken as a case of drug induced urticaria. She presented with an acute history of severe pain abdomen, urticarial rashes over buttocks, bilateral knee joint pain and difficulty in walking with burning sensation of both feet. She was being treated as a case of acute gastroenteritis with drug induced urticaria prior to presentation at our center. On detailed physical examination bilateral lower limb palpable purpura were noticed with prolonged capillary refill time in bilateral toes and feeble dorsalis pedis pulses. The diagnosis of IgA vasculitis was made clinically based on EULAR criteria, and she was treated with steroids and supportive management on which patient recovered well and remained asymptomatic during follow up. This case highlights the importance of considering a diagnosis of IgA vasculitis in children with atypical presentation like in our case where urticarial rashes preceded the classical palpable lower limb purpura. The multisystem presentation of disease with nonspecific symptoms and lack of definitive diagnostic tests, mandates a high index of suspicion in these children. Although the illness can be self-limiting, but the potential for late renal involvement and end-stage renal disease underscores the importance of early diagnosis and treatment.

Abstract: Kisspeptin, the product of the KISS1 gene and a ligand of the G-protein coupled receptor, KISS1R (also known as GPR54), is a relatively well-known hypothalamic neurohormone, the secretion of which is intrinsically linked to the kisspeptin, neurokinin B, and dynorphin (KNDy) neurons and is involved in the neuromodulation of gonadotropin-releasing hormone (GnRH) secretion, playing a key role in the central mechanism controlling the hypothalamic‒pituitary‒gonadal (HPG) axis. In contrast to our knowledge of the importance of kisspeptin neuronal signaling in regulating the onset of puberty and the control of fertility through its effects on the menstrual cycle, the importance of the extraneuronal pool of this hormone after fertilization and during early human pregnancy is far less complete. The very significant increase in the serum extrahypothalamic kisspeptin concentration in the first trimester of pregnancy, which originates from peripheral reproductive tissues, is accompanied by changes in local KISS1R expression. These findings suggest an important role of kisspeptin in the regulation of embryo implantation, trophoblast invasion, placentation and early pregnancy. The aim of this review is to present the current state of knowledge regarding the involvement of kisspeptin signaling in the physiology and pathophysiology of early pregnancy in humans. The diagnostic value of kisspeptin levels for early pregnancy outcomes will also be explored to identify potential related therapeutic targets.

Abstract: (1) Background: Gallbladder carcinoma (GBC) represents a tumor with an unfavorable prognosis because of late discovery and a 5-year survival of 5-10%; the diagnosis is based on CT scan or MRI, but half of the cases are accidentally discovered after cholecystectomy (occult cases). Transabdominal ultrasound (TUS) lacks sufficient accuracy for the diagnosis, however, high-resolution examination and the introduction of contrast-enhanced ultrasound (CEUS) has increased the performance in gallbladder carcinoma detection and characterization (2) Methods: We performed an observational, retrospective study that included all patients with gallbladder carcinoma admitted to the Craiova County Emergency Clinic Hospital between January 1, 2017, and December 31, 2024; patients with no pathological confirmation, and those with insufficient data were excluded. (3) Results: 40 cases of gallbladder carcinoma were diagnosed; TUS sensitivity was lower, but specificity was similar to that of the CT scan. CEUS was suggestive of GBC in 5 cases and was false positive in another case. The survival for gallbladder tumors was poor, with 32.5% 1-year and 10.5% 5-year survival. CDX2 immunostaining was positive in 50% of the 10 tested stage III carcinomas and was associated with a higher median survival. (4) Conclusions: Gallbladder carcinomas are rarely encountered (50% being occult cases) and harbor a dismal prognosis.

Abstract: We aim to assess endoscopic surgical correction of recti diastasis (RD), showing a novel approach for mini-abdominoplasty minimally invasive (MAMI) abdominal contouring. Ideas: Regarding European Hernia Society (EHS) classification of RD, a widening greater than 2 centimeters of the linea alba is typically considered for surgical correction. The latest trends MILA and SCOLA approach for RD are indicated for patients with a body mass index (BMI) up to 28, considering only height and weight. Nevertheless, some may find this insufficient for certain types of patients. Despite advancements in skin retraction, there is still no evidence of how the devices may affect postoperative outcomes when added to these procedures. Consequently, thin patients with skin flaccidity and a clinical or imaging diagnosis of RD could benefit from a Mini Abdominoplasty with Minimally Invasive Approach (MAMI). Discussion: The main purpose of this study is to address a possible misfit indication for endoscopic surgical correction of RD, based on the common presentation of this condition. Regarding our experience, Mini Abdominoplasty with a Minimally Invasive Approach (MAMI) has the potential to enhance outcomes, reducing pain and bulging after surgery for patients requiring RD correction with skin laxity. Conclusion: MAMI surgery has been shown to be a safe and reproducible approach for selected women who wish to restore the feminine characteristics of the body after childbirth and have a rapid recovery. It produces better aesthetic results than the traditional full abdominoplasty due to the minimized scar and due to the muscle plication that provides definition of the body contour.

Abstract: Background: Psychoanalytic concepts of destructiveness point to its deep, unconscious roots, related to primal emotional-motivational mechanisms. Traditional, psychiatric models of suicidal risk assessment focus on classic risk factors, limiting diagnostic and interventional options. This study verifies the neuropsychoanalytic basis of destructive tendencies, integrating the mechanisms of sublimation and evolutionary motivational systems, and redefining their role in the process of destruction. Material and methods: 480 illustrations were generated using artificial intelligence, evaluated by judges competent for interpretative accuracy. The final set was used in a projection task conducted online on a sample of 204 respondents, who also completed the sociodemographic part of the survey. Analyses included factorial exploration of the structure of the tool, assessment of psychometric properties (Cronbach α, ROC, AUC), logistic regression and analysis of intergroup differences. Results: Factor analysis identified eight subscales, six of which correspond to Panksepp's emotional systems, suggesting their subcortical basis. The other two – the pursuit of destruction and its sublimation – go beyond natural evolutionary mechanisms. The desire for destruction was best explained by depression and psychological pain (OR=1.385, p<0.001, AUC=0.783), aggression and impulsivity (OR=1.676, p<0.001, AUC=0.715), and anxiety and a sense of threat (OR=1.554, p<0.001, AUC=0.618). Significant predictors of sublimation of destruction were interest and curiosity (OR=3.152, p<0.001, AUC =0.900), closeness and love (OR=3.432, p<0.001, AUC =0.836), and pleasure and fun (OR=3.081, p<0.001, AUC=0.793). Analyses of intergroup differences showed a higher level of destructiveness in people receiving psychological and psychiatric help, with a previous diagnosis and learning compared to working people (p<0.05). Conclusions: The results indicate that the tool is characterized by high reliability (Cronbach's α>0.87) and diagnostic validity (ROC>0.7), which confirms its potential usefulness in the assessment of destructive and sublimation tendencies and in accordance with the neuropsychoanalytic approach to the theory of drives. Subsequent studies will focus on assessing the external validity of the tool and its application in clinical practice.

Abstract: Background: In burn injuries, wound healing effectiveness is complex and influenced significantly by the local biochemical environment and the physicochemical properties of topical preparations. pH lesions modulation can influence protection barrier integrity, inflammatory responses, and microbial colonization. Their antioxidant, antimicrobial, and anti-inflammatory properties, of the topical formulations enriched with plant extracts have demonstrated promising results. Objective: The aim of the study was to develop and characterize topical oleogel and hydrogel formulations containing ethanolic and hydroalcoholic extracts of medicinal plants (Boswellia serrata, Ocimum basilicum, Sambucus nigra, and Galium verum), and to evaluate the impact of their physicochemical properties, rheological behavior, in contrast with the wound pH modulation, and healing efficacy in an experimental burn model. Methods: Second-degree burns were induced uniformly on Wistar rats using the vali-dated RAPID-3D device. All formulations were applied daily for 21 days, and wound healing was assessed through several measurements specific to the wound surface, skin temperature, pH, and, last but not least, histological analyses. Formulations' physicochemical and rheological properties, including pH, viscosity, and spreadability, were also analyzed and systematically characterized. Results: Oleogel formulations demonstrated superior wound healing performance compared to hydrogels. Formulations containing Boswellia serrata and Ocimum basilicum extracts significantly reduced wound size, inflammation, and melanin production by days 9 and 21 (p &lt; 0.05). The beneficial outcomes correlated strongly with formulation acidity (pH &lt;6), high viscosity, and enhanced thixotropic behavior, indicating improved adherence and sustained bioactive compound release. Histological evaluations confirmed enhanced epithelialization and reduced inflammation. Conclusions: Particularly Boswellia serrata and Ocimum basilicum in oleogel formulations in ethanolic solvent effectively modulated wound pH, enhanced topical adherence, and improved burn wound healing. These findings highlight their potential clinical application and justify further clinical investigations.

Abstract: Since the initial reports of Long COVID symptoms, numerous pathophysiological mechanisms have been proposed to explain them; nevertheless, no consensus has been reached. Some of these mechanisms are directly linked to microcirculation, while others are related indirectly. Those with a direct connection involve the respiratory system (such as pulmonary embolism), the cardiovascular system (including cardiac arrest, heart failure, myocardial inflammation, stroke, endothelial dysfunction, and microangiopathy), hematological conditions (like coagulopathy, deep vein thrombosis, microclots, and endothelial irregularities), and brain function. However, few of these mechanisms are grounded in quantitative data and fundamental physiological principles. Furthermore, diagnostic and therapeutic methods remain inadequate. This report provides a brief overview of these processes, focusing primarily on quantitative data, recently proposed mechanisms, and advances in microcirculation, with a special emphasis on the tissue blood supply reduction (TBSR or SR in short) mechanism. Then the SR pathophysiological mechanism is assessed based on the total incidence rate of the Long COVID symptoms that can be directly attributed to this mechanism. The proposed SR mechanism can account for 7 principal Long COVID symptoms with a total incidence of 88%.

Abstract: Background/Objectives: The primary objective of PE repair is to relieve compression exerted on the cardiac and pulmonary structures and enhance the thoracic cavity volume. However, the volumetric study of the thoracic cavity, including the heart and lung volumes were scarce. This study seeks to systematically evaluate the volumetric changes in these structures to assess the physiological impact obtained by PE repair. Methods: A retrospective analysis was conducted on 63 patients who underwent PE repair using the XI bar technique from April 2023 to February 2024. Volumetric changes were measured preoperatively and postoperatively using SYNAPSE 3D imaging software (Fujifilm, Tokyo, Japan). Cardiac and pulmonary volumes were quantified, and CT indexes (Haller index, Depression index) were assessed. Complication rates, reoperation rates, and length of hospital stay were also analyzed. Results: The mean cardiac volume increased significantly from 458.25 ml preoperatively to 499.13 ml postoperatively (p=0.018), reflecting an 8.9% increase. Pulmonary volumes, however, showed no statistically significant change, remaining stable at approximately 4371.31ml preoperatively and 4266.87ml postoperatively (p=0.57). Conclusions: Repairing PE markedly enhances cardiac volume, emphasizing its importance in relieving mediastinal compression. Pulmonary volumes remain largely unaffected, suggesting that PE primarily impacts cardiac structures. Our approach with the volumetric measurements provide valuable insights into the physiological outcomes of chest wall remodeling and considered to be a good modality for future studies to enhance our understanding of the functional benefits of PE repair.

Abstract: Candida auris (C. auris) is an emerging multidrug-resistant fungal pathogen recognized by the World Health Organization (WHO) as a critical global health threat. Its rapid transmission, high mortality rate, and frequent misidentification in clinical laboratories present significant challenges for diagnosis and infection control. This review provides a comprehensive overview of current and emerging diagnostic methods for C. auris detection, including culture-based techniques, biochemical assays, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), and molecular diagnostics such as PCR and loop-mediated isothermal amplification (LAMP). We evaluate each method’s sensitivity, specificity, turnaround time, and feasibility in clinical and surveillance settings. While culture remains the diagnostic gold standard, it is limited by slow turnaround and phenotypic overlap with related species. Updated biochemical platforms and MALDI-TOF MS with expanded databases have improved identification accuracy. Molecular assays offer rapid, culture-independent detection. Antifungal susceptibility testing (AFST), primarily using broth microdilution, is essential for guiding treatment, although standardized breakpoints remain lacking. This review proposes an integrated diagnostic workflow and discusses key innovations and gaps in current practice. Our findings aim to support clinicians, microbiologists, and public health professionals in improving early detection, containment, and management of C. auris infections.

Abstract: Background: Amid growing healthcare complexities, there is an increasing need to evaluate and integrate traditional, technological, and alternative medical systems. This study compares the diagnostic and treatment accuracy of three distinct approaches—general diagnostics, generative AI-driven care, and homoeopathic physician-led treatments—using a standardized, five-level evaluation scale.Objectives: The research aims to assess (1) diagnostic accuracy, (2) the degree of personalization in treatment planning, and (3) the long-term efficacy of each modality. It also explores the potential of a hybrid healthcare model that leverages both AI precision and classical homoeopathic depth.Methods: A qualitative five-point scale was developed to categorize healthcare performance from Level 1 (Poor) to Level 5 (Excellent). Each level defines specific criteria in diagnostic accuracy, personalization, and relapse rates. The study then mapped general diagnostics, AI systems, and homoeopathic treatments against these benchmarks.Results: General diagnostics typically performed at Level 2 (Fair) to Level 3 (Good), offering standardized but less personalized care. Generative AI demonstrated a wide range of performance, from Level 1 to Level 5, depending on data integration and algorithm maturity. Homoeopathic treatment outcomes ranged from Level 1 in inexperienced practice to Level 5 in expert-led, individualized care.Discussion: Findings reveal a strong correlation between personalization and therapeutic success. Advanced AI systems and experienced homoeopaths achieved the highest accuracy and patient satisfaction. The research underscores the potential of integrating AI’s analytical power with homoeopathy’s holistic framework to build a next-generation, patient-centric care model.Conclusion: This study introduces a novel evaluation scale that provides a measurable framework for comparative analysis and development across diagnostic and therapeutic systems. It offers valuable insights for clinicians, AI developers, educators, and policymakers, paving the way for future interdisciplinary innovation and ethically sound healthcare evolution.

Abstract: Background: Previous syntheses on the neural effects of alcohol have been restricted to tasks assessing craving, cognitive control, and reward processing. Despite extensive research, a comprehensive synthesis of functional magnetic resonance imaging (fMRI) findings in alcohol use disorder (AUD) remains lacking. This study aimed to identify consistent brain activation alterations across all cognitive and emotional tasks administered to individuals with AUD, while distinguishing between short-term and long-term abstinence, and using Activation Likelihood Estimation meta-analysis. Sub-analyses on task types were performed. Methods: A systematic review identified 67 fMRI studies in participants with an AUD. Results: The meta-analysis revealed significant alterations in brain activity, including both hypo- and hyperactivation in the left putamen across all AUD participants. These alterations were observed more frequently during decision-making and reward tasks. Short-term abstinent individuals exhibited hypoactivation in the right middle frontal gyrus (MFG), corresponding to the dorsolateral prefrontal cortex. In contrast, long-term abstinent individuals displayed hypoactivation in the right superior frontal gyrus (SFG) and dorsal anterior cingulate cortex (dACC). This meta-analysis highlights critical neural alterations in AUD, particularly in regions associated with reward processing (putamen), executive functions (MFG and SFG), and attentional salience (dACC). Putamen changes were predominantly observed during short-term abstinence, and in decision-making as well as reward processing tasks. The dACC and SFG hypoactivation were specific to long-term abstinence, while the MFG hypoactivation was specific to short-term abstinence. Conclusions: These findings support prior research indicating a motivational imbalance and persistent executive dysfunctions in AUD. Standardizing consumption metrics and expanding task diversity in future research is essential to further refine our understanding of the neural effects of AUD.

Abstract: Uterine leiomyoma (uterine fibroids, UF) are benign myometrium tumors, that affect up to 70% of the female population and may lead to severe clinical symptoms. Despite the high prevalence, pathogenesis of UF is not understood and involves cytokines, steroid hormones and growth factors. Additionally, an increased deposition and remodelling of the extracellular matrix is characteristic for UF. Vitamin D seems to play a new role in UF. Interestingly, hypovitaminosis D correlates with a higher prevalence of myomas and the severity of the myomas. Administration of vitamin D in insufficient women (serum level &lt;30 ng/mL) proved to restore the vitamin D status and reduce the mild symptoms of myomas. In addition, inflammatory processes may play also a role. In the past years it has become clear, that cessation of inflammation is an active process driven by a class of lipid mediator molecules called specialized pro-resolving mediators (SPM). Inadequate resolution of inflammation is related to several chronic inflammatory diseases and several studies have proven the crucial role of SPMs in improving these diseases. In this review, we will give the overview on processes involved in UF growth and will give an overview on the modern view regarding the concept of inflammation and the role of SPMs in resolution of inflammation, especially in chronic inflammatory diseases.

Abstract: Background/Objectives: Urinary tract infections (UTIs) can predispose women to preeclampsia and prematurity, which are common causes of maternal and neonatal morbidity and mortality. In low-middle-income countries (LMICs), the capacity for screening and treating UTIs is limited. In sub-Saharan Africa, AMR surveillance data are scarce, especially in vulnerable populations such as pregnant women. The aim of this study was to determine the prevalence and antimicrobial resistance patterns of community-acquired urinary tract infections among pregnant women attending the antenatal clinics of three hospitals in Gambia. Methods: This was a hospital-based, cross-sectional, multicenter study conducted between November 2022 and January 2023. Patient information was obtained via a pre-tested questionnaire. The urine samples were analyzed via Gram staining and biochemical tests to determine the causative organisms. We also used antibiotic sensitivity testing to identify resistance patterns. The data collected were analyzed via SPSS version 20 and tested for associations at a significance level of p ≤ 0.05. Results: The prevalence of significant bacteriuria was 5% (n=100). Escherichia coli (40%) and Staphylococcus aureus (40%) were the most common uropathogens. The prevalence of resistance was found for trimethoprim/sulfamethoxazole and ampicillin, and multi-drug resistance was detected in only one isolate (Citrobacter freundii). Conclusion: This study revealed bacterial isolates with prevalent resistance to commonly prescribed drugs for community-acquired UTIs in pregnant women and suggested alternatives such as ceftriaxone, nitrofurantoin, erythromycin, and nalidixic acid as empirical treatment options. We recommend consistent health to combat drug resistance caused by inappropriate antibiotic use.

Abstract: Obstructive Sleep Apnea is a highly prevalent respiratory disease linked with increased morbidity and mortality, reduced quality of life and increased economic costs if not treated. Oral Appliances are an emerging treatment option for Obstructive Sleep Apnea. This review concludes that many oral appliances marketed as “custom” include modifications and prefabricated items, and therefore do not meet the definition of “custom” oral appliances. This misclassification could hinder accurate characterization and appropriate utilization of oral appliances that do fulfill the definition of custom. To better inform clinical utilization of custom oral appliances, we propose further refining the custom oral appliance classification into semi-custom and precision-custom.