Probiotic Supplementation during Pregnancy: Evaluating the Current Clinical Evidence Against Gestational Diabetes Mellitus.

BACKGROUND: Gestational diabetes mellitus (GDM) constitutes a common metabolic disorder that could lead to deleterious short- and long-term complications in both the mother and her infant. Probiotic supplementation seems to exert diverse, healthy effects by acting as a preventive agent against various human diseases, including GDM. OBJECTIVE: The purpose of the current narrative review was to critically summarize and scrutinize the available clinical studies during the last 15 years (2008-2023) concerning the use of probiotic supplementation during pregnancy as a protecting agent against GDM. METHODS: A thorough and in-depth search was performed in the most accurate scientific databases, e.g., PubMed., Scopus, Web of Science, and Google Scholar applying effective, and relevant keywords. RESULTS: There are currently some clinical studies suggesting the potential beneficial impact of probiotic supplementation in the prevention and/or co-treatment of GDM. Nevertheless, there is a high heterogeneity amongst the available clinical studies concerning the dosage, the administration duration, the probiotic species types, the method designs and protocols, and the study populations. CONCLUSION: Probiotic supplementation at conventional dosages and in combination with a balanced healthy diet, and lifestyle seems to reduce the the risk of developing GDM, while ameliorating the severity of its symptoms. Further clinical studies taking into account the above considerations should be performed to establish conclusive results, while the future meta-analyses should include studies with the feasibly lowest heterogeneity.

Association of Gestational Hypertension with Sociodemographic and Anthropometric Factors, Perinatal Outcomes, Breastfeeding Practices, and Mediterranean Diet Adherence: A Cross-Sectional Study.

Background and Objectives: Gestational hypertension has been associated with several pregnancy short-term and long-term complications, affecting both the mother and her infant's health. The present study aims to assess the potential association of gestational hypertension with sociodemographic and anthropometry factors, perinatal outcomes, breastfeeding habits, and Mediterranean diet (MD) compliance. Materials and Methods: This is a cross-sectional study conducted on 5271 mothers that was carried out after delivery. The anthropometry characteristics and perinatal outcomes were retrieved from the mothers' medical records. Sociodemographic characteristics, MD adherence, and breastfeeding habits were assessed via one-to-one interviews of the assigned women with qualified staff. Results: Maternal older age, being employed, family history of gestational hypertension, overweight/obesity before gestation, and abnormal gestational weight gain (GWG) independently increased the risk of developing gestational hypertension. Moreover, gestational hypertension was independently related with a greater incidence of abnormal childbirth body weight and preterm birth, not exclusively breastfeeding, and lower levels of MD adherence. Conclusions: This study highlights the importance of informing future mothers about the risk factors of gestational hypertension, underlining also that a healthy lifestyle, which simultaneously includes a healthy nutritional pattern such as MD, may decrease the risk of developing gestational hypertension and the subsequent pregnancy complications.

Association of Maternal Risk Factors with the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study.

In the last few years, there has been a gradually increasing rate of caesarean section deliveries worldwide that negatively affects both mothers' and children's health. The present survey intended to explore the relations of common maternal risk factors with the prevalence of caesarean sections. This is a cross-sectional study including 5182 healthy mothers from geographically diverse regions of Greece, which has applied relevant inclusion and exclusion criteria. An elevated 56.4% incidence of caesarean sections was noted. The prevalence of caesarean section deliveries was estimated to be 51.5% in private hospitals and 48.5% in public hospitals. Maternal age, pre-pregnancy overweight/obesity, excess gestational weight gain, preterm birth, financial status, smoking habits, and private type of birth hospital were considerably associated with a high probability of caesarean section, regardless of several confounders. In conclusion, caesarean section rates are constantly increasing, and various maternal risk factors additively elevate its incidence, which additionally enhances the likelihood of postpartum complications for both the mothers and their infants. Public health procedures and approaches are strongly recommended to notify future mothers of the potential risk factors that may result in adverse pregnancy outcomes of caesarean section delivery, highlighting its use only for emergency medical reasons and also promoting healthier nutritional and lifestyle habits that may reduce the increasing prevalence of caesarean section deliveries.

Caesarean Section Delivery Is Associated with Childhood Overweight and Obesity, Low Childbirth Weight and Postnatal Complications: A Cross-Sectional Study.

Background and Objectives: In the last decades, simultaneously increasing trends have been recorded for both caesarean section delivery and childhood overweight/obesity around the world, which are considered serious public health concerns, negatively affecting child health. Aim: The present study aims to investigate whether caesarean section is associated with the increased rates of childhood overweight/obesity, low childbirth anthropometric indices and postnatal complications in pre-school age. Materials and Methods: This is a cross-sectional study in which 5215 pre-school children aged 2-5 years old were enrolled from nine different Greek regions after applying specific inclusion and exclusion criteria. Non-adjusted and adjusted statistical analysis was performed to assess the impact of caesarean section in comparison to vaginal delivery. Results: Children delivered by caesarean section were significantly more frequently overweight or obese at the age of 2-5 years, also presenting a higher prevalence of low birth weight, length and head circumference. Caesarean section was also associated with higher incidence of asthma and diabetes type I at the age of 2-5 years. In a multivariate analysis, caesarean section increased the risk of childhood overweight/obesity and low childbirth anthropometric indices even if adjusting for several childhood and maternal confounding factors. Conclusions: Increasing trends were recorded for both caesarean section delivery and childhood overweight/obesity, which are considered serious public health concerns. Caesarean section independently increased childhood overweight/obesity in pre-school age, highlighting the emergent need to promote health policies and strategies to inform future mothers about its short and long-term risks and that this mode of delivery should preferably be performed only when there are strong medical recommendations in emergency obstetric conditions.

Childhood Mediterranean Diet Adherence Is Associated with Lower Prevalence of Childhood Obesity, Specific Sociodemographic, and Lifestyle Factors: A Cross-Sectional Study in Pre-School Children.

BACKGROUND: The Mediterranean diet (MD) has been related with a decreased probability of overweight/obesity as well as central obesity at all stages of the human life, decreasing the risk of diverse disease states and improving quality of life. Over the last few years, the prevalence of childhood overweight/obesity and especially abdominal obesity has highly increased worldwide, being associated with a higher likelihood of overweight/obesity as well as central obesity at the next stages of the life during adulthood. The purpose of the present study was to explore the relationship of MD compliance with sociodemographic, anthropometry and lifestyle features in pre-school children aged 2-5 years old. METHODS: This is a cross-sectional study, which includes 5188 pre-school children from diverse regions of Greece. Relevant questionnaires were applied to evaluate the sociodemographic features of the enrolled children. Anthropometric parameters were measured by relevant techniques. Qualified questionnaires were utilized for assessing several lifestyle factors such as physical activity, quality of life, breastfeeding practices, MD adherence, as well as the prevalence of childhood asthma and diabetes mellitus type I. RESULTS: Of the enrolled children, 41.7% showed low MD compliance and 36.4% of them indicated moderated compliance, while only 21.9% of them showed a high MD adherence. Overweight/obesity was noted in 24.2% of the assigned children, while abdominal obesity was noticed in 18.2% of them. Higher MD compliance was related with an elevated prevalence of sex (boys, p = 0.0005), Greek nationality (p = 0.0088), rural type of residence (p = 0.0099), childhood overweight/obesity (p < 0.0001) and abdominal obesity (p < 0.0001), lower childbirth weight (p < 0.0001), increased physical activity (p = 0.0041), improved quality of life (p = 0.0008), exclusive breastfeeding (p < 0.0001), childhood asthma (p = 0.0001) and diabetes mellitus type 1 (p = 0.0002). CONCLUSIONS: A higher MD adherence is associated with specific sociodemographic, better anthropometric, and beneficial lifestyle factors in pre-school children. However, MD compliance remains low or moderate in the vast majority of children aged 2-5 years old. Thus, future public strategies and policies should be performed to inform parents of the potential beneficial effects of MD against obesity and related chronic diseases at the next stage of their children's lives.

Elevated Hu-Antigen Receptor (HuR) Expression is Associated with Tumor Aggressiveness and Poor Prognosis but not with COX-2 Expression in Invasive Breast Carcinoma Patients.

Hu-antigen R (HuR), a RNA-binding protein, is considered to play a crucial role in tumor development and progression by stabilizing or regulating a group of cellular mRNAs of cancer-related genes, such as cyclooxygenase-2 (COX-2). The present study aimed to evaluate the clinical significance of HuR and COX-2 expression in invasive breast carcinoma. HuR and COX-2 protein expression was assessed immunohistochemically on paraffin-embedded breast cancer tissue sections obtained from 121 patients and was statistically analyzed with clinicopathological parameters, estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2), as well as with tumor cells' proliferative capacity and overall and disease-free patients' survival. High HuR expression was positively associated with larger tumor size and advanced disease stage (p = 0.0234 and p = 0.0361, respectively), being more frequently observed in ER negative cases (p = 0.0208). High COX-2 expression was negatively associated with histological (p < 0.0001) and nuclear (p = 0.0033) grade and tumor cells' proliferative rate (p = 0.0015), being more frequently observed in luminal-A compared to other molecular subtypes (p = 0.0221). High HuR expression was associated with poor overall and disease-free patients' survival at both univariate (log-rank test, p = 0.0092 and p = 0.0004, respectively) and multivariate (Cox-regression analysis, p = 0.0223 and p = 0.0004, respectively) level. On the other hand, high COX-2 expression was associated with favorable overall and disease-free patients' survival merely at univariate level (log-rank test, p = 0.0389 and p = 0.0154, respectively). HuR expression was not associated with COX-2 expression (Spearman R = 0.1489, p = 0.1032). The present data support evidence that HuR is associated with tumor aggressiveness and poor prognosis in breast carcinoma, reinforcing its potential as promising therapeutic target in this type of neoplasia.

Higher adherence to Mediterranean diet prior to pregnancy is associated with decreased risk for deviation from the maternal recommended gestational weight gain.

The present retrospective study was conducted on 1482 women in order to evaluate whether their pre-pregnancy adherence to the Mediterranean diet may affect maternal gestational weight gain (GWG). For this purpose, the study population was classified according to the Institute of Medicine (IOM) recommendations concerning GWG. Pre-pregnancy adherence to the Mediterranean diet was assessed with 11 food patterns groups based on their contribution in the Mediterranean diet pyramid. Women with high adherence to the Mediterranean diet were more frequently characterised by GWG inside the IOM recommendations. In multivariate analysis, women with low Mediterranean diet adherence were almost twice at risk in presenting deflection from recommended GWG regardless of various confounding factors. These findings suggested that high pre-pregnancy adherence to the Mediterranean diet may be associated with reduced risk for GWG outside the IOM recommendations. However, larger prospective studies are strongly recommended in order for more precise conclusions to be drawn.

Prognostic and predictive value of thymidylate synthase expression in colon cancer.

Thymidylate synthase (TS) is an enzyme responsible for DNA synthesis. Its competitive inhibition constitutes the major mechanism of the antitumor effect of 5-fluorouracil (5-FU) therapy, which significantly improves the survival rate of colon cancer patients. The aim of our study was to examine the clinical importance of TS expression in colon cancer patients and to correlate its expression with various clinicopathological parameters, tumor proliferative capacity, cell cycle-related molecules' expression and patients' survival. Of the 71 colon cancer patients studied, 51 (71.8%) tested positive for TS, with the positive result being statistically significantly correlated with patients' gender (P = 0.012), tumor histological grade (P = 0.032), vascular invasion (P = 0.017) and the expression of cyclin E, pRb and p16 (P = 0.042, P = 0.001 and P = 0.001, respectively). The overall 5-year survival rate was 40% for TS-positive patients and 68.6% for TS-negative ones (P = 0.0134); in patients aged >70 years, this was 30 and 77.8%, respectively (P = 0.0008). In a multivariate analysis of survival, TS expression proved to be of prognostic significance (P = 0.0174). Our findings support evidence for the clinical importance of TS expression in colon cancer patients and define it as an independent prognostic risk factor.