Effects of Probiotic Supplementation during Chronic Rhinosinusitis on the Microbiome.

Probiotics are live microorganisms that induce health benefits to the host. The consumption of probiotics can result in both prophylactic and therapeutic effects. Chronic rhinosinusitis (CRS) is an inflammatory condition that has a significant health and economic impact worldwide. Despite its great burden on the health-care system and patients' quality of life, the variety of therapy options for CRS is currently limited. Inflammation, mucociliary dysfunction and changes in the microbial environment are thought to be the main factors causing the disease. Probiotics are a relatively new intervention, with a focus on the probiotic qualities and adaptive elements required for a bacterial strain to have a positive impact on CRS. The aim of this review was to review studies evaluating the potential beneficial effects of probiotics in the treatment of chronic rhinosinusitis. Future prospects and difficulties for probiotics in CRS are also highlighted.

Changes in the Gut Microbiome and Pathologies in Pregnancy.

Pregnancy is a special period in a woman's life when her organism undergoes multiple physiological changes so that the fetus has optimal conditions for growth and development. These include modifications in the composition of the microbiome that occur between the first and third trimesters of pregnancy. There is an increase in Akkermansia, Bifidobacterium, and Firmicutes, which have been associated with an increase in the need for energy storage. The growth in Proteobacteria and Actinobacteria levels has a protective effect on both the mother and the fetus via proinflammatory mechanisms. The aim of the study is to review the research on the relationship between the mother's intestinal microbiome and gestational pathologies. Changes in the maternal gut microbiome is probably one of the mechanisms that occurs in various pregnancy diseases such as preeclampsia, fetal growth restriction, gestational diabetes mellitus, excessive gestational weight gain, and premature birth. For this reason, it seems vital to pay attention to certain interventions that can benefit the affected patients both in the short term, by preventing complications during pregnancy, and in the long term, as one of the mechanisms occurring in various gestational diseases is dysbiosis of the maternal intestinal flora.

Effects of Probiotic Supplementation during Pregnancy on the Future Maternal Risk of Metabolic Syndrome.

Probiotics are live microorganisms that induce health benefits in the host. Taking probiotics is generally safe and well tolerated by pregnant women and their children. Consumption of probiotics can result in both prophylactic and therapeutic effects. In healthy adult humans, the gut microbiome is stable at the level of the dominant taxa: Bacteroidetes, Firmicutes and Actinobacteria, and has a higher presence of Verrucomicrobia. During pregnancy, an increase in the number of Proteobacteria and Actinobacteria phyla and a decrease in the beneficial species Roseburia intestinalis and Faecalibacterium prausnitzii are observed. Pregnancy is a "window" to the mother's future health. The aim of this paper is to review studies assessing the potentially beneficial effects of probiotics in preventing the development of diseases that appear during pregnancy, which are currently considered as risk factors for the development of metabolic syndrome, and consequently, reducing the risk of developing maternal metabolic syndrome in the future. The use of probiotics in gestational diabetes mellitus, preeclampsia and excessive gestational weight gain is reviewed. Probiotics are a relatively new intervention that can prevent the development of these disorders during pregnancy, and thus, would reduce the risk of metabolic syndrome resulting from these disorders in the mother's future.

Cytokine Storms in the Course of COVID-19 and Haemophagocytic Lymphohistiocytosis in Pregnant and Postpartum Women.

The term 'cytokine storm' (CS) applies to a pathological autoimmune reaction when the interactions that lead to cytokine production are destabilised and may even lead to death. CS may be induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this study, we present our analysis of certain pathological processes that induce a CS in pregnant and postpartum women. We draw our attention to the similarities between the severe course of Coronavirus Disease 2019 (COVID-19) and haemophagocytic lymphohistiocytosis (HLH). It is noteworthy that many of the criteria used to diagnose HLH are described as COVID-19 mortality predictors. Cytokine storms are considered to be an important cause of death in patients with the severe course of SARS-CoV-2 infection. Due to the fact that pregnant women are in an immunosuppressive state, viral pulmonary infections are more perilous for them-possible risks include miscarriage, intrauterine growth restriction or birth before the term; sometimes ventilation support is needed. HLH should be considered in pregnant and puerperal women suffering from moderately severe to severe COVID-19 and presenting with: fever unresponsive to antibiotic therapy, cytopenia, hepatitis and hyperferritinaemia. The HLH disorder is rare and difficult to diagnose; however, its early detection could reduce patient mortality.

The Possibility of Using Bioelectrical Impedance Analysis in Pregnant and Postpartum Women.

Pregnancy is a time of significant changes occurring in the composition of a woman's body in order to provide support for the growth and development of the foetus. Bioelectrical impedance analysis (BIA) is used to assess the body composition and hydration status. This technique represents a non-invasive, reliable, and fast clinical approach, which is well tolerated by patients. A segmental impedance measurement might be advantageous in pregnant women, particularly in late pregnancy. The purpose of this paper is to provide a review of different applications of BIA in pregnant and postpartum women. It seems that BIA has a better prognostic potential for gestational and post-partum outcomes than body mass index. The BIA method can be successfully used to study the effect of excessive gestational weight gain in pregnancy on the development of obstetric complications. Studying the mother's body composition and correlating it with her energy balance could facilitate the development of dietary recommendations for women. Evaluation of the body composition can provide important clues for diagnosis of gestational diabetes mellitus in pregnant women with a low risk of this disease. BIA is also used as one of the additional tests in assessing the risk of developing gestational hypertension and preeclampsia.

Is it too much for me? General self-efficacy and emotional reactions to infant's cry.

Objectives: In the three experimental conditions we examined the role of the exposure to recorded infant's cry (at high and at lower frequency) or laughter and the level of participants' general self-efficacy on emotional reactions to the infant's cry.Background: Infant's cry can trigger empathic, sensitive responses or elicit frustration and anxiety of the caregiver. General caregiver's self-efficacy serves as a predictor of more sensitive reactions to distress cues of a child.Method: An experimental study with three conditions - exposure to infant cry at high frequency, infant cry at lower frequency or infant laughter, was conducted on the sample of 192 childless undergraduates. Exposure to the selected stimulus was preceded by the General Self-Efficacy Scale and followed by the My Emotions Scale for the assessment of participants' emotional reactions to the presented infant crying or laughter.Results: Participants with high self-efficacy exposed to the child's cry at high frequency presented the highest level of child-oriented emotional reactions and lower level of self-oriented reactions as compared to participants with low self-efficacy.Conclusion: Results suggest that general self-efficacy can serve as a supportive factor in sensitive responding to the high-frequency cry. Improving caregivers' self-efficacy can reduce the risk of insensitive, disturbed parenthood.

HAEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS IN PREGNANT AND POSTPARTUM WOMEN.

OBJECTIVE: Introduction: Haemophagocytic lymphohistiocytosis (HLH) is an extremely rare, life-threatening disease, caused by uncontrolled activation of lymphocytes T and macrophages. This situation leads to cytokine storm, infiltration and internal organs failure. HLH can be categorised into either primary (familiar) or secondary which may be associated with infections, immunodeficiency syndromes, autoimmune diseases and malignancy. The secondary HLH is difficult to diagnose due to nonspecific symptoms and complicated differential diagnostics. The aim: To conduct a comparative analysis of pregnant and puerperal patients diagnosed with HLH. PATIENTS AND METHODS: Material and methods: Review of available literature on haemophagocytic lymphohistiocytosis during pregnancy and the puerperium. RESULTS: Results: Review of the latest literature shows that HLH can occur at any time during pregnancy and in the puerperium. Symptoms of the disease are non-specific: fever not responding to antibiotic therapy, sometimes hectic, hepatosplenomegaly, swelling, lymphadenopathy, disseminated intravascular coagulation, multi-organ failure and death. In laboratory tests, worsening bicytopenia or pancytopenia, increasing indicators of organ damage, hypertriglyceridemia, hypofibrinogenemia and abnormally high serumferritin levels are observed. CONCLUSION: Conclusions: HLH, due to non-specific symptoms and rarity, is often overlooked in the diagnostic process. Due to the high mortality and morbidity rates of HLH during pregnancy for mother and foetus, timely diagnosis and the inclusion of specialist treatment are particularly important. An interdisciplinary approach to the patient is necessary to make an accurate diagnosis. The assessment of serum ferritin concentrations facilitates diagnosis. The bone marrow is essential to diagnosis and should be performed as early as possible.