Cervical cancer ranks third among malignant diseases of the female reproductive system and progressively develops through a series of pathological changes known as cervical intraepithelial neoplasia (CIN). Despite being extremely aggressive and causing increased mortality, the main treatment options include surgery or a combination of chemotherapy and radiotherapy, often based on cisplatin-based chemotherapy and external beam radiotherapy or brachytherapy. Cervical dysplasia is an abnormal growth of cells on the surface of the cervix that could lead to cervical cancer. CIN most commonly occurs at the squamocolumnar junction of the cervix, a transitional zone between the squamous epithelium of the vagina and the columnar epithelium of the endocervix. The primary cause of CIN is chronic infection of the cervix with Human Papillomavirus (HPV). Oxidative stress (OS) and chronic inflammation are associated with HPV-induced cervical dysplasia. Reactive oxygen species (ROS) facilitate the progression of CIN through DNA damage, immune evasion, and cellular mutations. Thus, the inflammatory environment, characterized by increased expression of proinflammatory cytokines, contributes to epithelial transformation. Given these mechanisms, antioxidants, including vitamins A, C, D, E, polyphenols, and carotenoids, are being investigated for their potential as adjunctive therapies in CIN management. This review aims to provide a comprehensive analysis of the influence of oxidative stress, antioxidants, and inflammation on cervical cancer.

Background/Objectives: Multidrug-resistant urinary tract infections (MDR UTIs) constitute an important public health problem, especially in pregnant patients. The aim of this retrospective study was to characterize the bacterial spectrum and the profile of microbial resistance in cases of UTIs occurring in pregnant women, as well as their impact on obstetrical and neonatal outcomes. Methods: A total of 371 pregnant patients with UTIs were included in the analysis and were segregated into the following groups based on the type of bacterial resistance to antibiotics: MDR UTIs (70 patients, group 1), UTIs resistant to one class of antibiotics (108 patients, group 2), UTIs resistant to two classes of antibiotics (102 patients, group 3), and sensitive UTIs (91 patients, group 4). We used descriptive statistics for characterizing and comparing the microbial spectrum and the clinical characteristics of the patients. A multinomial logistic regression model for evaluating the relationship between the type of urinary tract infection and adverse obstetric or neonatal outcomes was employed. Results: In the case of MDR UTIs, the bacterial spectrum mainly included Escherichia coli, Enterococcus faecalis, and Klebsiella species. We found almost universal resistance to ampicillin. Our data confirmed an increased risk of preterm birth, premature rupture of membranes, neonatal respiratory distress syndrome, and neonatal intensive care unit admission for patients with MDR infections. Conclusions: The increased incidence of pathogens resistant to commonly used antibiotic classes in pregnancy suggests the need for the development of local and national protocols that adapt therapeutic and prophylactic regimens to clinical realities.

Background: In this study, we evaluated the effects of the nonavalent Gardasil^® vaccine in a heterogeneous cohort of women who underwent conization or LLETZ for various degrees of CIN, aiming to assess the adjuvant effect of vaccination on HPV clearance. Methods: We conducted a three-year prospective study with a two-year follow-up of 219 patients presenting to our facility for cervical dysplasia. All patients underwent HPV genotyping and were divided into HPV-vaccinated and non-vaccinated groups. Results: We detected a significant association between the final outcome and vaccination timing (p-value = 0.005). All women vaccinated before conization achieved viral clearance; 94.9% of those vaccinated at the time of conization/LLETZ and 68.6% of those vaccinated after the excisional procedure became HPV-negative. Logistic regression showed that, with increasing age, the likelihood of healing after vaccination decreased by approximately 9% per additional year, and non-16/18 HPV-positive women had a 5.5-fold higher chance of healing after vaccination compared with those HPV-positive for 16 and 18 genotypes. Conclusions: Adjuvant prophylactic HPV vaccination in the context of surgical treatment for cervical precancerous lesions is significantly associated with a reduced risk of lesion recurrence and HPV persistence/reinfection when administered prior to or at the same time as the excisional procedures.

Cervical intraepithelial neoplasia (CIN) is a multifactorial pathology mainly determined by persistent infection with high-risk human papillomavirus (HPV) genotypes and modulated by both immunological and psychological factors. This mixed bibliometric and empirical study integrates psychoneuroimmunological concepts with clinical data from a cohort of 150 patients (aged 18–55 years) from northern Romania. Seventy percent tested positive for high-risk HPV by self-sampling and all completed the PHQ-9 and GAD-7 scales that were subsequently assessed. Symptoms of depression and anxiety were prevalent, with anxiety being reported by 43% of participants who performed self-sampling at home.Fifty women with cytologically diagnosed HSIL underwent a comparative evaluation using both, classical colposcopy and the artificial intelligence-assisted EVA system (MobileODT, Israel). Artificial intelligence-based colposcopy demonstrated higher sensitivity (92% versus 82%) and higher diagnostic concordance (88%) with histopathological confirmation, suggesting superior accuracy and clinical feasibility.These results support the integration of psychoneuroimmunological and artificial intelligence-assisted diagnostic parameters into cervical cancer prevention frameworks, highlighting the importance through which artificial intelligence could complement neoplasia prevention, addressing psychological profile and biological markers to improve personalised risk stratification.

Background: Pyelonephritis during pregnancy represents a significant maternal–fetal risk, particularly in the context of increasing multidrug-resistant (MDR) bacterial infections. This study aimed to characterize the microbiological profiles and antimicrobial resistance patterns of MDR pathogens causing pyelonephritis in pregnancy. Secondary objectives included the evaluation of patient characteristics, associated risk factors, and pregnancy outcomes. Methods: A retrospective comparative study was conducted including 171 pregnant patients hospitalized with acute pyelonephritis between 1 January 2017 and 30 April 2025. Thirty-four patients with MDR bacterial infections were compared with 137 patients with infections caused by pathogens with conserved antibiotic susceptibility (Non-MDR). Results: Patients with MDR pyelonephritis were significantly older than those with Non-MDR infections (mean age 27.76 vs. 25.30 years, p = 0.03). MDR infections were more frequently diagnosed in the third trimester of pregnancy (58.8% vs. 29.9%, p = 0.003) and affected multiparous women more often (44.1% vs. 19.7%, p = 0.006). No statistically significant differences were observed between groups regarding clinical presentation or laboratory parameters (p > 0.05). Prior antibiotic exposure was significantly more common in the MDR group (85.29% vs. 26.61%, p < 0.001), as was a history of urological procedures, including urinary catheterization (29.41% vs. 15.10%, p = 0.009). For multivariate analysis, two factors were predictive for pyelonephritis with MDR pathogens: previous antibiotic treatment—OR 20.37 (95% CI 2.19–189.88) and urological procedures—OR 13.23 (95% CI 2.24-78-22). Escherichia coli was the predominant pathogen in both groups but was isolated more frequently in the Non-MDR cohort (81.75% vs. 58.82%, p = 0.015), followed by Klebsiella pneumoniae, which appeared more frequently in the study group (23.53% vs. 10.22%, p = 0.011). MDR isolates demonstrated significantly higher resistance rates to all tested antibiotics (p < 0.05). Complete resistance to ampicillin was observed in the MDR group (100%), compared with 58.01% in the Non-MDR group, indicating markedly reduced efficacy of this agent. Adverse neonatal outcomes were more frequent in the MDR group, with higher rates of Apgar scores < 7 at admission (23.5% vs. 8.8%, p = 0.01) and increased neonatal intensive care unit admission (20.6% vs. 7.3%, p = 0.02). For multivariate analysis, pyelonephritis with MDR pathogens was predictive for Neonatal Intensive Care Unit (NICU) admission (OR 8.17, 95% CI 2.41–27.67). Conclusions: These findings highlight the need for the periodic revision of empirical antibiotic protocols and risk-adapted therapeutic strategies in pregnant patients in order to reduce maternal and fetal morbidity.

Introduction: Upper urinary tract infections (UUTIs) are among the most common serious infections during pregnancy and may be associated with maternal and fetal complications. The increasing prevalence of multidrug-resistant pathogens has led to the use of broader-spectrum antibiotics, including meropenem. However, data regarding the safety and efficacy of meropenem in pregnant women remain limited. The aim of this study was to evaluate the indications, efficacy, and safety of meropenem treatment in pregnant women with UUTIs and its impact on maternal and fetal outcomes. Methods: We conducted a retrospective study over a 12-year period including pregnant women hospitalized with UUTIs who received meropenem. The control group consisted of pregnant women with UUTIs who were treated with ceftriaxone during the same period. Results: Pregnant women treated with meropenem were more frequently diagnosed in the third trimester of pregnancy (p = 0.01) and were more often multiparous (p = 0.006). Sepsis and septic shock occurred significantly more frequently in the study group (p < 0.01), and multivariate analysis identified them as the main indications for meropenem administration (OR 10.54, 95% CI 3.30–33.70 for sepsis; OR 3.28, 95% CI 1.01–10.62 for septic shock). Patients in the study group had a higher rate of transfer to the obstetrics clinic (p = 0.032), a longer duration of antibiotic therapy (p = 0.031), and a longer hospital stay (p < 0.01). No maternal deaths were reported in either group. The rate of adverse pregnancy outcomes was similar between the two groups, except for the Apgar score, which was lower in the meropenem group (p = 0.007). Escherichia coli and Klebsiella pneumoniae were the most frequently isolated pathogens in both groups. Conclusions: Meropenem therapy in pregnant women with UUTIs was mainly indicated in cases of sepsis and septic shock and was associated with favorable maternal clinical evolution, even in patients with severe infections. The rate of adverse pregnancy outcomes was similar between the two groups, although a lower Apgar score was observed in the meropenem group; the severity of illness in the meropenem group should be considered when interpreting the lower Apgar scores. Further prospective multicenter studies are needed to better evaluate the safety and clinical effectiveness of meropenem during pregnancy.