Although immunomodulators have established benefit against the new coronavirus disease (COVID-19) in general, it is uncertain whether such agents improve outcomes without increasing the risk of secondary infections in the specific subgroup of previously immunocompromised patients. We assessed the effect of immunomodulators on outcomes of immunocompromised patients hospitalized for COVID-19. The protocol was prospectively registered with PROSPERO (CRD42022335397). MEDLINE, Cochrane Central Register of Controlled Trials and references of relevant articles were searched up to 01-06-2022. Authors of potentially eligible randomized controlled trials were contacted to provide data on immunocompromised patients randomized to immunomodulators vs control (i.e., placebo or standard-of-care). Eleven randomized controlled trials involving 397 immunocompromised patients hospitalized for COVID-19 were included. Ten trials had low risk of bias. There was no difference between immunocompromised patients randomized to immunomodulators vs control regarding mortality [30/182 (16.5%) vs 41/215 (19.1%); RR 0.93, 95% CI 0.61–1.41; p = 0.74], secondary infections (RR 1.00, 95% CI 0.64–1.58; p = 0.99) and change in World Health Organization ordinal scale from baseline to day 15 (weighed mean difference 0.27, 95% CI -0.09–0.63; p = 0.15). In subgroup analyses including only patients with hematologic malignancy, only trials with low risk of bias, only trials administering IL-6 inhibitors, or only trials administering immunosuppressants, there was no difference between comparators regarding mortality. Immunomodulators, compared to control, were not associated with harmful or beneficial outcomes, including mortality, secondary infections, and change in ordinal scale, when administered to immunocompromised patients hospitalized for COVID-19. 10.13039/501100013209 Hellenic Foundation for Research and Innovation .

Background/Objectives: Human colostrum plays a crucial role in early microbial colonization, immune development, and gut health of newborns. Its microbiota is highly dynamic and influenced by numerous factors, yet the determinants remain poorly understood. This systematic review aims to investigate the composition of colostrum microbiota and the intrinsic and extrinsic factors that influence its diversity and abundance. Methods: PubMed and Scopus were systematically searched using a prespecified search phrase. Data on microbial composition, diversity, and influencing factors were extracted and analyzed. The systematic review is registered in PROSPERO (CRD42025644017). Results: A total of 44 eligible studies involving 1982 colostrum samples were identified. Colostrum microbiota consists predominantly of Firmicutes and Proteobacteria, with core genera including Staphylococcus, Streptococcus, Lactobacillus, and Bifidobacterium. Some studies reported higher diversity in colostrum compared to mature milk, while others noted elevated bacterial abundance in the former. Factors influencing colostrum microbiota include maternal BMI, delivery mode, gestational age, diet, gestational diabetes mellitus (GDM), maternal stress, maternal age, secretor status, perinatal antibiotic exposure, neonatal gender, geographic location, feeding type, milk collection method, and mastitis. Conclusions: Colostrum hosts a diverse and dynamic microbiota shaped by multiple maternal, neonatal, and environmental factors. Understanding these influences is crucial for optimizing infant health outcomes, emphasizing the need for further research on the functional roles of colostrum’s microbiota.

Background/Objectives: Breast cancer diagnosis in lactating women is relatively uncommon. The term Pregnancy-Associated Breast Cancer (PABC) refers to breast cancer diagnosed during pregnancy or within the first year postpartum. There are several factors that limit the ability to breastfeed. Despite emerging evidence suggesting that breastfeeding may be feasible and should be supported in women with PABC, there is still limited evidence regarding the percentage of them who attempt breastfeeding, and the challenges they may encounter. This study aims to systematically reviewing the literature on the available evidence regarding breastfeeding in women diagnosed with PABC. Methods: PubMed and Scopus were systematically searched for studies on breastfeeding in PABC until 26 June 2025. Data on breastfeeding outcomes and diagnostic challenges in relation to PABC were extracted. The systematic review is registered in PROSPERO (CRD420251043141). Results: A total of 15 studies met the inclusion criteria and were included in this review. The results showed a scarcity of literature regarding the percentage of women with PABC who breastfeed. Existing data revealed that a small percentage successfully breastfeed. A common occurrence throughout the studies was the concern of breastfeeding during cancer treatment. In almost all cases, reduced milk production was reported, along with the co-administration of formula as a substitute for breast milk. Conclusions: Management of women with PABC should not be limited to oncologic treatment but should also encompass structured breastfeeding counseling and multidisciplinary support, ideally within specialized breast cancer centers. Such integrated care has the potential to optimize maternal health outcomes, improve quality of life, and promote a more favorable pregnancy and postpartum experience.

Background/Objectives: Childbirth is a natural and joyfully anticipated life event for parents and relatives. Yet, in some cases, it can be a medical emergency requiring immediate intervention, i.e., neonatal resuscitation. The majority of newborns breathe spontaneously; a small number, though, may receive basic life support (assisted transition), and an even smaller but clinically significant number require advanced life support (resuscitation). Within the context of family-centered care, the presence of parents during resuscitation has emerged as a factor with potential implications for emotional adjustment, communication with healthcare providers, and early parent–infant bonding. However, the presence of family members during neonatal resuscitation remains a subject of ongoing debate among healthcare professionals (HCPs). Despite increasing recognition of its potential benefits, HCPs’ views on parental presence during such critical procedures have not been extensively investigated in Greece. This study aims at developing and validating a tool to assess healthcare professionals’ views on parental presence during neonatal resuscitation. Methods: A preliminary questionnaire was developed based on the principles of family-centered care and adapted to the Greek population. The first phase included expert assessment of validity, clarity, and relevance using a modified Delphi method. Item Content Validity Index (I-CVI) and Scale CVI (S-CVI) were calculated. Pilot testing was conducted to assess test–retest reliability. Reliability was assessed using the Intraclass Correlation Coefficient (ICC) and Bland–Altman analyses. The study followed the principles of the Declaration of Helsinki, ensuring anonymity, informed consent, and confidentiality. Results: The questionnaire includes 37–50 items allocated in four sections. It demonstrated excellent content validity (CVI = 1.00) and good test–retest reliability (ICC = 0.86). Qualitative feedback indicated that the tool is user-friendly and comprehensive. Interestingly, participants expressed genuine concerns regarding the implementation of parental presence in neonatal resuscitation. Conclusions: The questionnaire development process led to a comprehensive tool, ready for large-scale testing in order to further establish its validity and internal consistency.

Background/Objectives: Gestational hypertension is associated with increased maternal and fetal morbidity. The DASH diet is designed to reduce blood pressure and improve cardiovascular health. Our aim is to evaluate the efficacy of adherence to the DASH dietary pattern during pregnancy on the incidence of GH. Methods: PubMed, Scopus, Web of Science, Cochrane Library and Embase were systematically searched. All studies including data on the effect of the DASH diet on GH were included in this review. The study is registered in PROSPERO (CRD420251044348). Results: A total of five studies were included in our study. The meta-analysis reported a pooled relative risk (RR) of 1.03 (CI: 0.86–1.23) for the effect of the DASH diet on gestational hypertension. In the subgroup analysis for preeclampsia, the overall relative risk estimate was 0.78 (95% CI: 0.60–1.02). Both analyses did not yield statistical significance. Conclusions: Current evidence, although showing a favorable trend, does not conclude that the DASH diet reduces the risk of gestational hypertension, as the results did not achieve statistical significance. Although potential benefits have been observed, the limited number of available studies does not allow for definitive conclusions. More randomized and multicenter studies are needed to thoroughly investigate the relationship between the DASH diet and gestational hypertension in order to implement this dietary program instead of general dietary recommendations for GH.

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection (LRTI) and hospitalization in infants and young children worldwide, with the highest disease burden occurring in otherwise healthy term infants during the first 6 months of life. The recent introduction of long-acting monoclonal antibodies and maternal RSV vaccination has fundamentally changed preventive strategies against severe RSV disease. Evidence from randomized clinical trials and large real-world studies consistently demonstrates that a single dose of Nirsevimab provides season-long protection against RSV-associated LRTI and reduces hospitalization rate across diverse infant populations, while maintaining an excellent safety profile. Emerging data also support its effectiveness in routine clinical practice, although important uncertainties remain regarding long-term epidemiological effects, viral evolution, resistance, comparative effectiveness with maternal immunization, and optimal implementation across different healthcare settings. Current evidence supports Nirsevimab as a major advance in infant RSV prevention. However, continued surveillance, comparative effectiveness studies, and equitable global implementation will be essential to maximize its long-term public health impact. This narrative review summarizes current evidence on Nirsevimab, with emphasis on its clinical efficacy, safety, real-world effectiveness, resistance, implementation challenges, cost-effectiveness, and its role alongside maternal RSV vaccination.