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Meningitis and encephalitis are a group of neuroinfectious diseases that require both correct and early diagnosis and etiopathogenic treatment, because their potential for severe evolution, is often being associated with sequelae. In addition to the detailed anamnesis and clinical examination, it is important to know the specific neurological manifestations at the beginning in order to decide properly the indication to perform the lumbar puncture for identifying an etiopathogenic agent in order to administer a targeted treatment. We present the approach both in terms of diagnosis and treatment, in case of an elderly patient with a favourable evolution, towards healing, without associating neurological sequelae. At the same time, we present a synthesis of the novelties of diagnostic and treatment methods in infectious meningitis and encephalitis.

Stem cells are precursor cells capable of self-renew and of generating numerous mature cell types. As the field of human embryonic stem cells harvesting has been put under questionable ethic issues, other sources are under investigation and present tremendous potential: tissue specific progenitor stem cells, mesenchymal stem cells, umbilical cord cells, bone marrow stem cells, and induced pluripotent stem cells. Stem cells interest different departments of regenerative medicine as well as conservative wildlife. Stem cells might be a viable option for the treatment of pathologies such as spinal injuries, cardiovascular disease, diabetes, liver injuries or even osteoarthritis. Scientists are looking forward to developing molecules that can activate tissue specific stem cells, promote stem cells to migrate to the side of tissue injury, and promote their differentiation to tissue specific cells, so that many health issues could have an alternative and efficient treatment and or even be cured.

Aim. Because the COVID-19 pandemic is a topic of interest in the literature due to its information dynamics and, also, to its impact on the population health status; we wanted to highlight the connection between pandemic and lifestyle, with an emphasis on eating habits. Material and methods. A questionnaire with 20 items about sociodemographic data and information about eating habits was distributed. Results. Data collected reflected how COVID-19 pandemic influenced the employment status, level of income, smoker status, consumption of fruits, vegetable, candies, sweets, chocolate and fast-food of the respondents. The reported dietary changes were reflected both positively by more regular meals, a slight increase in the consumption of fruits and vegetables, lower consumption of fast food and higher cooked food, and negatively by a higher intake of sweets, candies and chocolate and as a result of an increasing in the habit of compulsive eating. Conclusion. The trait that easily weighed on all the activities of this period is the perceived level of stress and anxiety.

Gastroschisis is a congenital anterior abdominal wall defect that occurs in 4 to 5 in 10,000 births, consisting in the evisceration of bowel in the amniotic cavity without a membranous covering. Gastroschisis cases can be detected during the first trimester using ultrasonography or at the beginning of the second trimester with a detection rate of 100%. Although an isolated condition in most of the cases, further complications such as malrotation, atresia, stenosis, perforation or volvulus can be associated. Periodic monitoring is required to assess the progress of the pregnancy with measurements of the level of amniotic fluid, fetal biometry and bowel diameters at every ultrasound examination. Gastroschisis is most frequently associated with oligohydramnios, intrauterine fetal growth restriction, increased bowel wall thickness and bowel dilatation. The outcome of the disease is favourable with a survival rate of around 90% for born infants. The long time on ventilator and multiple intestinal surgeries that delay the moment of oral feeding with a long-term use of total parental nutrition and short bowel syndrome are the most important comorbidities. Delivery is recommended at 38 weeks of gestation, preserving caesarean delivery for complicated gastroschisis. Although a complex pathology, gastroschisis is associated with normal intellectual development and few to none long-term complications.

The most frequent eating disorders are anorexia nervosa, binge eating and bulimia nervosa. They are frequently aggravated during pregnancy or postpartum and because they impair the general health and psychosocial functioning of the patients, it is fundamental to be carefully managing these pathologies in a multidisciplinary team. The common association with menstrual irregularities, even with secondary amenorrhea, lead to unplanned pregnancy following the patients’ belief that they are infertile, and this represents a risk factor for both mother and fetus. Carefully attention should be paid in the patients’ assessment due to the concealment behaviors adopted in order to hide the maladaptive patterns or the eventual use of certain potential drugs that are thought to prevent weight gain or an excessive appetite and, moreover, in the postpartum period patient should be carefully investigated for an eventual anxiety or depression syndrome that may arise as a result of the postpartum body shape or weight gain from the pregnancy period.

Fluoride represents an essential element in dental development and safety. Fluoride deficiency is associated with dental cavities. The main dietary source of fluoride is in water, followed by fluoridated toothpaste, tea, seafood, canned sardines or shells as well as medicinal supplements. The adequate intake ranges from 0.7 mg/day for toddlers, to 3 mg/day for adult females and 4 mg/day for adult males. The fluoride intake can present a difficulty in assessment, especially during pregnancy, so the question remains: is fluoride supplementation recommended during pregnancy to prevent dental cavities in the offspring? The correct answer is ‘No’. Fluoride supplementation during pregnancy does not reduce the incidence of caries in offspring. Centers for Disease Control and Prevention (CDC) does not recommend fluoride supplementation due to its action mechanism; fluoride has beneficial effects only after the tooth eruption takes place through a topical mechanism. Fluorosis (fluoride toxicity) in offspring has not been described secondary to excessive ingestion of fluoride of the mother during pregnancy, but there are studies correlating neurotoxic effects in the infants from mothers who received fluoride supplementation.

In this study, we explore the “why?”, and “how?”, monitoring the pH of the fetal scalp is used, and show its limitations. In addition, we review the development of new devices based on the modern physics and nanomaterials serving this topic. Most of the works we found in our search have focused on improving the prognostic of fetal heart rate monitoring, because it is the “golden standard” in determining fetal distress. Although the best-known screening method, it can only provide limited information about the actual status of the fetus. The best predictive assessment, with the highest reproducibility, states that a normal fetal heart rate is indicative of a healthy baby. However, its excellent sensitivity is much reduced when identifying the actual “distress”. This is when second-line monitoring methods come into play to guide the diagnostics and direct the obstetrician towards an action plan. Although a historic method, fetal scalp pH sampling is still under review as to its efficiency and place in the current obstetrics. Continuous surveillance of the fetal parameters is important, especially for the fetuses undergoing intrauterine growth restricted (IUGR). Since fetal scalp blood sampling is still under research and is a randomized controlled trial, which compares the relevance of pH and lactates to the obstetrical situation, the maternal-fetal medicine could greatly benefit from the introduction of engineered nanomedicines to the field.

Background: Uterine arteries embolization (UAE) is a minimally invasive procedure with good results when it is used as interventional treatment for patients diagnosed with benign or malignant uterine tumors. The main gynecological malignancies that are complicated by hemorrhages and would benefit from UAE are cervical cancer and endometrial cancer in late inoperable stages or following surgery. Methods: During five years, in the Bucharest University Emergency Hospital’s Obstetrics and Gynecology Department, from 605 patients to whom trans-catheter embolization of the uterine arteries was performed, 33 (5.45%) were diagnosed with cervical cancer (n = 31) and endometrial cancer (n = 2) in the advanced stage addressed for heavy acute vaginal bleeding and secondary anemia. Results: For those patients, UAE was used as palliative treatment. The average age of the patients in the evaluated group was 48.7 ± 8.3 years, and the average number of days of hospitalization was 4.72 ± 2.97 (range 1–11). The benefits of UAE include cessation of bleeding in up to 100% of cases and expanding the window of opportunity for secondary anemia correction. The most common side effects (pain, nausea) could be managed with mild analgesics and easily-accessible antiemetics. Conclusions: Considering these patients’ fragile advanced oncological status, surgical ligation should be adopted only in centers where UAE is not available. The article strengthens the need for interventional radiology departments in all regional emergency centers.

Hemivertebra is a common cause of congenital scoliosis and results from a lack of formation of one-half of the vertebral body. This condition is very rare and can present as solitary or as a syndrome component: i.e., the split notochord syndrome, which often implies vertebral defects, from a bifid vertebra to hemivertebrae, or fused vertebrae. We describe a case of supernumerary lateral hemivertebra detected prenatally at 12 weeks of gestation and the ultrasonography specifics that lead to early and accurate diagnosis, monitoring during pregnancy, and follow-up at the 4-year period. The case is presented to specify the importance of an early assessment of fetal spine and diagnosis of various conditions, including hemivertebrae, considering the significant association with other anomalies (cardiovascular, urinary, skeletal, gastrointestinal, and central nervous systems), which are most commonly involved. Moreover, the need to counsel future parents on the risks implied by this anomaly is important for the obstetrician. We underline the inclusion of these types of congenital conditions in high-risk pregnancy because of the frequent association with high cesarean delivery rates, growth restriction, delivery before term, and higher morbidity rates.

Umbilical cord abnormalities are not rare, and are often associated with structural or chromosomal abnormalities, fetal intrauterine growth restriction, and poor pregnancy outcomes; the latter can be a result of prematurity, placentation deficiency or, implicitly, an increased index of cesarean delivery due to the presence of fetal distress, higher admission to neonatal intensive care, and increased prenatal mortality rates. Even if the incidence of velamentous insertion, vasa praevia and umbilical knots is low, these pathologies increase the fetal morbidity and mortality prenatally and intrapartum. There is a vast heterogeneity among societies’ guidelines regarding the umbilical cord examination. We consider the mandatory introduction of placental cord insertion examination in the first and second trimester to practice guidelines for fetal ultrasound scans. Moreover, during the mid-trimester scan, we recommend a transvaginal ultrasound and color Doppler assessment of the internal cervical os for low-lying placentas, marginal or velamentous cord insertion, and the evaluation of umbilical cord entanglement between the insertion sites whenever it is incidentally found. Based on the pathological description and the neonatal outcome reported for each entity, we conclude our descriptive review by establishing a new, clinically relevant classification of these umbilical cord anomalies.

Vertical mother-to-fetus transmission of hepatitis B virus (HBV) is a concern of public health global policies. The transmission rate can be substantially influenced by the good function of the maternal screening programs and by the vaccination of newborns as well. Also, the appropriate treatment of pregnant women and the administration of anti-HBV immunoglobulin immediately after birth come up with the decrease of HBV transmission rate. Acute viral hepatitis during pregnancy constitutes the main cause of jaundice recognized in pregnant women. It has generally a mild course during pregnancy, without significantly influencing the health state of the mother. In the context of immunological adaptation in pregnancy, the condition of the pregnant woman with chronic HBV infection without notable hepatic dysfunction generally has a good evolution. However, there are some possible clinical consequences like hepatic flares and progression of liver disease. The paper presents a review of literature and guideline proposals to prevent vertical transmission of hepatitis B virus and to provide the best possible care for pregnant women with hepatitis B infection.

First-trimester screening is focused on both markers of aneuploidies and structural abnormalities detection. In the past ten years, clinicians have been increasingly interested in using Doppler ultrasound in the first trimester of pregnancy. Doppler examination can help estimate the risk of aneuploidy and early diagnose severe fetal malformations. The purpose of this article is to highlight the importance of color Doppler ultrasound examination of the fetus in the first trimester. Color Doppler examination also has a great significance in studying maternal-fetal circulation. According to the ISUOG guidelines, several vascular territories should be covered: uterine arteries, umbilical artery, and ductus venosus. The nowadays first trimester Doppler examination not only identifies specific ultrasonographic markers for aneuploidy but also aids in the identification and analysis of many anatomical structures.

Ocular toxoplasmosis is a retinochoroiditis caused by Toxoplasma gondii infection, the most common cause of posterior infectious uveitis worldwide. Main features: it is a unilateral recurrent focal retinochoroiditis infection, with early manifestation after primary systemic infection, or with late manifestation after reactivation of intraretinal infectious cysts. The diagnosis is mainly clinical, being supported paraclinically by laboratory tests. Associated features: the most common is a unilateral focal ocular pathology, with multiple and bilateral active lesions occurring in a recently acquired infection or in immunocompromised patients. Ocular toxoplasmosis is characterized by posterior, intermediate, and anterior ocular damage; is a retinochoroiditis infection with significant involvement of the vitreous, with increased inflammation, retinal vasculitis, optic disc edema and anterior uveitis. Therapeutic management includes antiparasitic medication and corticosteroid therapy. Regarding pregnancy, it is essential to screen and capture the moment of maternal acute infection during pregnancy in patients with negative IgGs in order to treat the infection, to minimize or even prevent transplacental passage.

Cesarean scar defect, niche or isthmocele represents a poor healing in the anterior uterine wall after performing a cesarean section. The cesarean scar defect can be asymptomatic, or the patient could present abnormal uterine bleeding, chronic pelvic pain, dysmenorrhea, dyspareunia, cesarean scar pregnancy or abnormal placenta. Abnormal uterine bleeding caused by cesarean scar defect presents as a postmenstrual spotting and has become more and more common among women with a history of minimum one cesarean section delivery. The most studied risk factors are: multiple cesarean section deliveries, single layer suture, locked suture, retroflexed uterus and cesarean section delivery performed during active labor with a cervical dilatation of 5 cm. There have been described several surgical approaches: hysteroscopic, laparoscopic or vaginal. From our experience, we have treated successfully symptomatic patients with cesarean scar defect with the levonorgestrel-releasing intrauterine system. Although the therapeutic indications do not include this specific use, we have obtained significant improvement of abnormal uterine bleeding due to cesarean scar defect in our patients. Our results sustain the necessity of extensive interventional studies.

Sacrococcygeal teratomas complicate approximatively 1 in 27,000 pregnancies, being the most common congenital germ cell tumors in infants. The diagnosis is suspected using ultrasonographic examination and confirmed after a pathology report is performed. The main issue complicating fetuses with sacrococcygeal teratomas is represented by the rapid growth and the great need of blood supply captured by the tumor that interferes with the fetal growth and fetal wellbeing, generating heart failure and, unfortunately, increasing neonatal mortality. Thus, ultrasonographic monitoring is fundamental, to diagnose, closely monitor the growth and vascularization of the tumor and to ameliorate the neonatal prognosis by establishing the proper time of birth. There are specialized healthcare centers that could perform in utero surgery with the aim to aid the normal growth and development of the fetus until term, when a curative surgery is performed to the newborn. In cases complicated with heart failure leading to fetal hydrops, pregnancy termination could be a valuable option for the mothers, as soon as the etiology and the stage of heart decompensation are known. We present a case of a fetal sacrococcygeal teratoma in a 36-year-old pregnant woman, an uninvestigated pregnancy that had a dreadful outcome with neonatal death.

Goldenhar syndrome, also known as oculo-auriculo-vertebral syndrome, represents a rare congenital complex of anomalies, involving the development of the first and second brachial arches during the first embrionary stage. In addition to the craniofacial disorders, Goldenhar syndrome can include central nervous system, heart, skeleton or kidneys pathologies as well as vertebral defects. We present the case of a Goldenhar syndrome whose first pathologic sign was tetralogy of Fallot, with associated cardiovascular disorders (atrial septal defect type ostium secundum, and single umbilical artery) and bilateral microtia, with malformation of auditory canal, mandibular hypoplasia and a single epibulbar dermoid. The Goldenhar syndrome was diagnosed after birth, the article emphasizing the difficulties of prenatal diagnosis.