Maternal smoking during pregnancy is associated with adverse fetal and perinatal outcomes and may also affect visual system development in offspring. Increasing evidence suggests that prenatal tobacco exposure may also be associated with abnormalities of visual system development in children. However, the extent to which these associations reflect direct effects of tobacco exposure versus indirect pathways mediated by adverse perinatal outcomes remains uncertain. This narrative review summarizes the available evidence regarding the association between prenatal tobacco exposure and visual abnormalities in children, with particular emphasis on retinopathy of prematurity, strabismus, refractive errors, retinal nerve fiber layer abnormalities, and optic nerve hypoplasia. The most consistent evidence concerns retinopathy of prematurity and strabismus, although interpretation is complicated by prematurity, fetal growth restriction, neonatal morbidity, and residual confounding. Evidence regarding refractive errors and amblyopia is less consistent, while data on structural visual pathway abnormalities remain limited. Proposed mechanisms include vascular dysfunction, altered cholinergic signaling, oxidative stress, inflammation, and impaired neurodevelopment. Conclusion: Prenatal tobacco exposure may be associated with selected functional and structural abnormalities of the developing visual system. The strength of evidence varies substantially by outcome, and available data do not establish that prenatal tobacco exposure independently causes all reported visual disorders. Future studies should use objective exposure biomarkers, longitudinal designs and analytical approaches that distinguish direct effects from pathways mediated by prematurity and fetal growth restriction. Smoking cessation during pregnancy remains an important preventive intervention. What is Known: • Maternal smoking during pregnancy is associated with prematurity, low birth weight, and adverse fetal neurodevelopment. • Prenatal tobacco exposure has been associated with selected pediatric visual disorders, particularly retinopathy of prematurity and strabismus, although the strength, consistency, and independence of these associations vary across studies and may be influenced by confounding and mediation through prematurity, fetal growth restriction, and neonatal morbidity. What is New: • Emerging evidence suggests that tobacco exposure may also be associated with structural abnormalities of the visual pathway, including retinal nerve fiber layer thinning and optic nerve abnormalities. • Recent genetic and mechanistic studies provide additional support for biological plausibility but do not eliminate the possibility of residual confounding or shared genetic and environmental influences. • The interpretation of associations with visual outcomes should distinguish potential direct effects of tobacco constituents from indirect pathways mediated by prematurity, fetal growth restriction, and neonatal morbidity.

Background: Neonatologists face a significant clinical challenge in balancing the life-saving effects of broad-spectrum antibiotics with an infant’s ability to develop long-term vaccine-induced immunity. During the critical neonatal window, the gut microbiota acts as an essential endogenous adjuvant that promotes immune maturation through Toll-like receptor signaling and the production of microbial metabolites such as short-chain fatty acids. Methods: This narrative review was based on a comprehensive search of the PubMed and Google Scholar databases for studies published between 2014 and 2025. The search focused on the relationships between neonatal antibiotic exposure, gut microbiome development, and vaccine-induced immune responses in infants. Results: Early-life antibiotic exposure disrupts immune maturation by causing a marked reduction in commensal bacteria, particularly Bifidobacterium and Bacteroides. Clinical and epidemiological evidence indicates that this antibiotic-driven dysbiosis leads to significantly lower antibody titers following routine vaccinations, including PCV13, Hib, and DTaP, with measurable effects persisting up to 15 months of age. While antibiotics may paradoxically enhance oral rotavirus vaccine responses in resource-constrained settings by reducing environmental enteric dysfunction, an undisturbed native microbiota remains the optimal foundation for robust immunological memory. Conclusions: These findings highlight the necessity of improving antibiotic stewardship and exploring microbiota-restoring interventions, such as targeted probiotics, to optimize infant vaccination schedules and protect long-term immune health. Empirical antibiotic treatment should be promptly terminated once sepsis has been clinically excluded to preserve the gut–immune axis.

The escalating global prevalence of myopia constitutes a significant public health challenge. This narrative review explores the role of dietary factors, specifically vitamin D and selected nutrients, in its development in children and young adults. Current research underscores a link between low serum vitamin D levels and increased myopia risk. While this association often reflects limited time spent outdoors, vitamin D also appears to exert a direct biological role in regulating ocular growth. The impact of other micronutrients remains ambiguous. Although vitamin A, zinc, and selenium are essential for retinal health and antioxidant defense, human studies regarding their specific capacity to prevent myopia are inconclusive. In contrast, emerging evidence suggests that omega-3 polyunsaturated fatty acids confer protective benefits against axial elongation. Conversely, diets high in refined carbohydrates are associated with an elevated risk of myopia, likely due to insulin-mediated mechanisms influencing scleral structure. Overall, vitamin D and omega-3 fatty acids demonstrate the greatest promise as modifiable protective factors. However, the roles of zinc, selenium, and vitamin A remain inconclusive. Future prevention strategies may benefit from considering nutritional optimization alongside increased outdoor activity as part of a broader strategy of reducing myopia progression.

Introduction: Postmenopausal osteoporosis is a common metabolic bone disease characterized by reduced bone mineral density (BMD) and an increased risk of fractures. Estrogen deficiency accelerates bone resorption, leading to progressive bone loss and impaired skeletal strength. Resistance training has gained attention as a non-pharmacological strategy for osteoporosis prevention due to its ability to stimulate bone remodeling through mechanical loading. Objective: To evaluate the effects of resistance training on bone mineral density, fracture risk, and musculoskeletal function in postmenopausal women based on current scientific evidence. Materials and methods: A narrative literature review was conducted using studies indexed in the PubMed database. Publications from 2015–2026 concerning resistance training and osteoporosis prevention in postmenopausal women were included. Earlier landmark studies were also considered when relevant. Results: The reviewed studies indicate that resistance training is an effective intervention for preventing postmenopausal osteoporosis. Most studies reported stabilization or modest increases in BMD, particularly in the lumbar spine and femoral neck. The effectiveness of training was influenced by exercise intensity, duration, and progressive overload. Moderate- to high-intensity, long-term programs produced the most favorable outcomes, whereas low-intensity or short-term interventions showed limited effects. Although evidence regarding fracture reduction remains inconclusive, improvements in muscle strength, balance, and fall prevention may indirectly decrease fracture risk. Conclusions: Resistance training appears to be a beneficial non-pharmacological approach for maintaining bone health in postmenopausal women. Regular participation may improve BMD and support fracture prevention. Further research is needed to establish standardized training protocols and optimize exercise recommendations.