Impact of SARS-CoV-2 on pregnancy outcomes (Review).

The impact of the pandemic outbreak associated with coronavirus 2019 disease (COVID-19) on pregnant women is of interest to obstetricians and gynecologists due to the vulnerability of this target group. In pregnant women and their infants, an exceptional clinical management is warranted. Current epidemiological findings provide information regarding the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on pregnant patients and potential adverse perinatal outcomes. Overall, these findings are a strong indication that an increased antenatal surveillance for pregnant patients infected with COVID-19 is warranted. The aim of the present narrative review was to summarize the data obtained to date regarding the health of women during pregnancy, as well as that of the fetus associated with the risk of severe infection due to COVID-19. The present review aimed to provide further insight into the effects of this pandemic on pregnancy, also providing the experience of the authors on this matter as an example.

Reactivation of resolved hepatitis B virus infection after immunosuppression: is it time to adopt pre-emptive therapy?

New therapeutic options like monoclonal antibodies (anti-CD20/rituximab) and hematopoietic stem cell transplantation (HSCT) have increased both the effectiveness of therapies and the risk for reactivation of Hepatitis B virus (HBV). We describe two cases with serological evidence of resolved HBV infection (hepatitis B surface antigen (HBsAg) negative/antibody to hepatitis B core antigen (anti-HBc) and antibody to hepatitis B surface antigen (anti-HBs) positive), who developed reverse seroconversion (clearance of HBsAb/appearance of HBsAg) with active HBV infection after treatment with combination of conventional chemotherapy, rituximab and autologous HSCT for hematological malignancies. Review of the literature highlights the increasing incidence of HBV reactivation in patients with resolved infection and raises concerns as to whether current guidelines for pre-chemotherapy screening with sensitive HBV-DNA assays and serial monitoring for anti-HBs titres should be implemented also for patients with resolved infection. Future studies should aim at clarifying the cost-benefit from administration of nucleoside analogues in these patients.

Nasal polyps: heredity, allergies, and environmental and occupational exposure.

OBJECTIVE: To determine the role of heredity, allergies, smoking, and environmental and occupational exposure in the epidemiology of nasal polyposis. STUDY DESIGN: A case-control study comprising 100 patients with nasal polyps admitted to three Athens hospitals and 102 controls from the general population. Gender, educational level, family history, allergies, smoking, occupational activities, and environmental exposure were examined as eventual determinants. The prevalence of each determinant was compared between cases and controls using multiple logistic regression, and odds ratios (ORs) were estimated. RESULTS: A total of 13.3% of the patients and none of the controls had a history of polyps in the family. According to multiple logistic regression, the OR for certain allergies was 19.1 and for probable allergy was 9.0, with the prevalence among patients being 64% and 12%, respectively. The OR for certain environmental exposures was 15.0 and for occupational exposures was 21.4. Occupational exposure to chemicals was a predominant factor among patients. No significant difference was found between nasal polyps and educational level or smoking habits. CONCLUSIONS: The development of nasal polyps seems to be strongly related to family history and a history of allergies, but the role of smoking remains controversial. Occupational and environmental exposures probably enhance the appearance of the disease on the basis of genetic predisposition.