Search Results (650)

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. Full article

Introduction: Urinary incontinence (UI) is one of the most common pelvic floor disorders after childbirth and depends on hormonal changes, anatomical damage that occurs after childbirth, muscle and connective tissue weakness, fascia and nerves. UI is distinguished into three subtypes, including stress urinary incontinence (SUI), urgent urinary incontinence (UUI) and mixed urinary incontinence (MUI). Aim: The purpose of this review is to collect and summarize the results of studies related to the risk factors of urinary incontinence, to disseminate this information to scientists so that this major issue can be prevented, identified and managed. Methodology: This review followed the methodology of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and PECO eligibility criteria were used. We included studies published up to 2025 and not before 2019. The review was limited to studies published within the last six years in order to reflect contemporary diagnostic criteria, assessment tools and current postpartum care practices related to urinary incontinence. We searched PubMed, Google Scholar and Scopus for studies concerning the relationship between risk factors and postpartum UI. Results: A total of 1321 citations were identified. Following our exclusion criteria, 36 papers were selected to identify the risk factors for UI. All the research focused on the associated factors of any type of urinary incontinence. Vaginal and instrumental delivery, obesity, maternal age and the neonate’s birth weight were the main risk factors. The multiparity and incontinence symptoms before and during pregnancy were also strong risk factors. Heterogeneity across studies in assessment tools, in outcome measures and timing of postpartum assessment are some of the limitations of the study. Restriction to English-language publications and the absence of protocol registration were some of the additional limitations of the study. Conclusions: This problem affects the inclusion of women in society, the family, limits social activities and even their ability to work. Detection of the type of urinary incontinence by healthcare professionals, lifestyle modifications, monitoring women’s body weight and encouraging them to follow a program of pelvic floor muscle exercises should be a priority for professionals. The strategy of developing prognostic models in the coming years will be the only way to ensure the early identification and follow-up of women at high risk for urinary disorders. Full article

The aim of this study was to evaluate the effect of the linoleic–α-linolenic acid ratio (LA:ALA) on cyclicity, oocyte quality, early pregnancy parameters, milk yield, and composition. Holstein cows were randomized to a 6:1-LA:ALA diet (Low-OMG3: n = 3 pens; 11 primiparous, 14 multiparous) or a 2:1-LA:ALA diet (High-OMG3: n = 3 pens; 10 primiparous, 14 multiparous). Diets were isocaloric and isonitrogenous and fed between 15 and 140 days in milk (DIM). Data were compared using linear mixed models. As expected, omega-3 concentrations in milk and blood increased in the High- compared to Low-OMG3 cows. No effect of diet was observed on cyclicity by 45DIM or oocyte quality at 50DIM. High-OMG3 cows had larger corpus luteum size (11–32 d post-timed artificial insemination [TAI]) and greater blood flow (32–60 d post-TAI) than Low-OMG3 cows. However, there was no effect of diet on progesterone, pregnancy-associated glycoproteins, or conceptus size. High-OMG3 cows produced more milk throughout the study, had greater lactose, and tended to have greater protein yield at 50DIM. In conclusion, decreasing the LA:ALA dietary ratio in lactating dairy cows did not provide evidence of effects on cyclicity, oocyte quality, or other early pregnancy-related parameters, but affected corpus luteum size and blood flow, enhanced milk production, and partially increased protein and lactose yields. Full article

Background/Objectives: To construct and compare multivariable prediction models for the early prediction of large-for-gestational-age (LGA) neonates, using ultrasound biometry and maternal characteristics. Methods: This retrospective cohort study analyzed data from singleton pregnancies that underwent routine ultrasound examinations at 30⁺⁰–34⁺⁰ weeks of gestation. Ultrasound parameters included fetal abdominal circumference (AC), head circumference (HC), femur length (FL), HC-to-AC ratio, mean uterine artery pulsatility index (mUtA-PI), and presence of polyhydramnios. LGA neonates were defined as those having a birthweight > 90th percentile. Logistic regression was used to evaluate associations between ultrasound markers and LGA after adjusting for the following maternal and pregnancy-related covariates: maternal age, body mass index, parity, gestational diabetes mellitus (GDM), pre-existing diabetes, previous cesarean section (PCS), assisted reproductive technology (ART) use, smoking, hypothyroidism, and chronic hypertension. Associations were expressed as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Three prognostic models were developed utilizing the following predictors: (i) biometric ultrasound measurements including AC, HC-to-AC ratio, FL, UtA-PI, and polyhydramnios (Model 1), (ii) a combination of biometric ultrasound measurements and clinical–maternal data (Model 2), and (iii) only the estimated fetal weight (EFW) (Model 3). Results: In total, 3808 singleton pregnancies were included in the analyses. The multivariable analysis revealed that AC (aOR 1.07, 95% CI [1.06, 1.08]), HC to AC (aOR 1.01, 95% CI [1.006, 1.01]), FL (aOR 1.01, 95% CI [1.009, 1.01]), and the presence of polyhydramnios (aOR 4.97, 95% CI [0.7, 58.8]) were associated with an increased risk of LGA, while a higher mUtA-PI was associated with a reduced risk (aOR 0.98, 95% CI [0.98, 0.99]). Maternal parameters, such as GDM, pre-existing diabetes, elevated pre-pregnancy BMI, absence of uterine artery notching, mUtA-PI, and multiparity, were significantly higher in the LGA group. Both models 1 and 2 showed similar performance (AUCs: 84.7% and 85.3%, respectively) and outperformed model 3 (AUC: 77.5%). Bootstrap and temporal validation indicated minimal overfitting and stable model performance, while decision curve analysis supported potential clinical utility. Conclusions: Models using biometric and Doppler ultrasound at 30–34 weeks demonstrated good discriminative ability for predicting LGA neonates, with an AUC up to 84.7%. Adding maternal characteristics did not significantly improve performance, while the biometric model performed better than EFW alone. Sensitivity at conventional thresholds was low but increased substantially when lower probability cut-offs were applied, illustrating the model’s threshold-dependent flexibility for early risk stratification in different clinical screening needs. Although decision curve analysis was performed to explore potential clinical utility, external validation and prospective assessment in clinical settings are still needed to confirm generalizability and to determine optimal decision thresholds for clinical application. Full article

Prompt identification of clinical signs and early treatment of hoof problems are essential to effectively manage and reduce lameness in dairy farms. This study aimed to evaluate the influence of days in milk (DIM), parity, and milk yield (MY) on the mean temperature (MT) of the hind hooves in healthy cows, with the perspective of implementing infrared thermography (IRT) as an automated tool for early lameness detection. Thermal images were collected from 156 milking cows, capturing both cranial and caudal surfaces of each hind foot. Significant differences were found between primiparous and multiparous cows across all analyzed surfaces. Moreover, cows with higher milk production exhibited significantly higher MT in the caudal left hoof and on both cranial surfaces. The variable DIM (group 1 = cows with ≤202 DIM; group 2 = cows with >202 DIM) did not significantly affect MT on caudal surfaces; however, on the cranial view, MT of the right hoof was higher in group 2, while group 1 tended to show higher MT in the left hoof (p = 0.051). In conclusion, hoof MT increases in multiparous and high-producing cows. Additionally, during the first 200 days of lactation, cranial hoof surface temperatures tend to rise. Future studies should include continuous monitoring using automated systems to record variations throughout the day. Full article

Background/Objectives: Mothers expecting a second child experience the parenting of multiple children for the first time, differing from first-time motherhood. This highlights the need for childbirth preparation education tailored to families expecting a second child. Parental self-efficacy influences maternal mental health, child development, and parent–child interactions. This non-randomized pilot exploratory study aimed to examine the association between childbirth preparation education for families expecting a second child and maternal parental self-efficacy at 1-month postpartum, focusing on a family-based, single-session program actively involving firstborn children. Methods: The intervention group (n = 18) received childbirth preparation education during pregnancy and completed questionnaires and semi-structured interviews at 1-month postpartum. The control group (n = 34) completed questionnaires only at 1-month postpartum. Questionnaires included the Parenting Sense of Competence Scale, Rosenberg Self-Esteem Scale, Maternal Attachment Inventory, Edinburgh Postnatal Depression Scale, and demographic information. Semi-structured interviews explored participants’ experiences and feelings after attending the childbirth preparation class. Results: Compared to the control group, the intervention group had higher Parenting Sense of Competence Scale scores; mothers in the intervention group reported smoother family-wide adaptation to life with a second child, greater confidence in child-rearing, recognition of the firstborn’s growth into an older sibling, and effective use of hands-on experiences from the class. Conclusions: Childbirth preparation education for families expecting a second child may be associated with higher maternal parental self-efficacy at 1-month postpartum. This association may reflect collective family preparation and adjustment supporting adaptation to life with a second child. Full article

This study examined the effects of long-term Saccharomyces cerevisiae supplementation on feed intake, milk production, milk composition, and selected reproductive indicators in lactating dairy cows. Twenty-four multiparous Holstein–Friesian crossbred cows were blocked by parity and randomly allocated to three treatments: a control group without supplementation (CON; n = 7), live yeast supplementation for 60 days (YS-60; n = 10), and live yeast supplementation for 90 days (YS-90; n = 7). Dry matter intake and body weight gain were significantly higher in cows receiving live yeast, with the greatest responses observed in the YS-90 group (p < 0.05). Milk yield and energy-corrected milk were increased by supplementation, particularly in YS-90 cows (p < 0.01), along with higher milk fat and lactose concentrations. Somatic cell count was consistently lower in YS-90 cows throughout the 14-week experimental period. Body condition score differed among treatments (p < 0.01), with higher values observed in yeast-supplemented cows. Feed efficiency did not differ among treatments. Reproductive parameters, including estrus detection and pregnancy rate, were not significantly affected by live yeast supplementation, although plasma progesterone concentration was higher in supplemented cows (p < 0.05). Given the limited number of animals per treatment, reproductive outcomes should be interpreted cautiously. Overall, extended live yeast supplementation improved production performance and udder health, while its effects on reproductive performance warrant further investigation. Full article

The objective of this study was to evaluate the responses of the reproductive performance, milk composition, and blood profile of sows, as well as the performance of their offspring when their dietary soybean meal is partially replaced by black soldier fly Hermetia illucens larva meal (BSFLM). A total of 18 multiparous (Landrace × Yorkshire) Duroc mated sows were randomly allocated to one of three dietary treatments based on parity from gestation to lactation on day 21. Each treatment has six replications. The dietary treatments were as follows: CON, basal diet based on corn-soybean meal; BSFLM1, basal diet soybean meal partially replaced with BSFLM (0.5% of diet); BSFLM2, basal diet soybean meal partially replaced with BSFLM (1.0% of diet). Our results revealed that sows fed with 0.5% of BSFLM had significantly increased (p < 0.05) BW at the initial and weaning period. Also, the BSFLM2 group sows showed significantly increased (p < 0.05) backfat thickness at weaning. Compared to CON, piglets born from the BSFLM group sows showed a tendency (p > 0.1) of having increased BW (at initial and at weaning) and ADG. Furthermore, sows fed with 0.5% BSFLM showed a tendency (p > 0.1) of having increased protein and fat % in milk at week 1. The serum concentration of IGF-1 was significantly (p < 0.05) increased in the BSFLM1 group sows compared to the BSFLM 2 group sows initially and it was equalized at weaning. In summary, partial replacement of soybean meals with 0.5% and 1% BSFLM could be beneficial for improving the reproductive traits, milk composition, and health status of sows and their offsprings. Full article

The objective of this study was to evaluate how parity (primiparous vs. multiparous) influences metabolic profile, performance, and offspring growth in grazing Nellore cows, and to explore potential associations among key metabolic traits, milk yield, and performance indicators. Thirty-four pregnant Nellore cows at approximately 230 ± 20 days of gestation were sorted by parity group and randomly allocated into one of six Uruchloa decumbens pastures, totaling 17 multiparous cows (597.8 ± 39 kg; age = 4 to 6 yrs) and 17 primiparous cows (407 ± 33 kg, age = 2 to 3 yrs). Considering calving day as day 0, cow full BW and BCS were collected on days −63, −21, −7, 0, 7, 21, 63, 91, 140 and 203. Cow blood samples were collected on days −21, −14, −7, 0, 7, 14, 21, 42, 63, 91, 140 and 203. Milk yield was measured in the following day after all blood collections. Primiparous cows had higher glucose on days −7 and 0 (p = 0.04), greater NEFA concentration from −14 to 63 days (p < 0.001), and lower IGF-1 concentration from days 7 to 42 but higher on days 140 and 203 (p < 0.001). They also exhibited lower total proteins, albumin, and globulins, but higher serum urea N concentration (p < 0.001). Primiparous cows also had lower milk yield (p = 0.02), calf birth (p = 0.02) and weaning weights (p = 0.01) compared with multiparous cows. Pearson correlation analysis revealed distinct metabolic and physiological interrelationships across gestational and lactational stages in multiparous and primiparous cows. Overall, multiparous cows showed a less catabolic metabolic profile during the periparturient period to lactation. Primiparous cows experienced a more intense mobilization of body reserves during the early lactation period, but a more positive nutritional status towards late lactation, evidenced by recovery of IGF-1 levels and body weight gain. Full article

This study evaluated milking characteristics and milk productivity of a domestically developed automatic milking system (AMS-K) and compared its performance with a commercially imported AMS (AMS-C), under identical farm management conditions. Milking performance of AMS-K was monitored over a three-month operating period, and a comparative analysis was subsequently conducted using a total of 50 Holstein cows, with 25 cows allocated to each system based on similar parity, days in milk, and milk yield. During the three-month operation of AMS-K, milk yield per milking significantly increased in from 13.81 kg in the 1st month to 15.99 kg in the 3rd month, and daily milk yield increased by 4.01–7.52% compared with the initial operating period. Milking frequency decreased from 2.53 to 2.27 times per day, but remained higher than conventional twice-daily milking. Average milking interval increased from 9.37 to 10.34 h, which was within the optimal range (9–10 h) for AMS operation. Milking stall occupancy and teat-cup attachment times gradually increased, whereas milking time showed no significant change. Somatic cell count initially increased but stabilized after three months. Milking efficiency ranged from 2.44 to 2.56 kg/min. In the system comparison, AMS-C showed shorter milking stall occupancy time, higher milking frequency, and higher milking efficiency than AMS-K, whereas AMS-K showed higher milk yield per milking, associated with longer milking interval. Across both systems, multiparous cows exhibited longer milking intervals and higher milk yields than primiparous cows in both AMSs. Theoretical milking capacity per AMS was 54.45 cows (primiparous) and 37.77 cows (multiparous) for AMS-K, sufficient for an average Korean dairy farm. Our results demonstrate that AMS-K achieved stable milking performance, milk quality, and operational efficiency comparable to the imported AMS. AMS-K shows great potential for practical applications and commercialization in Korean dairy farms. Full article

Including soybean hulls (SH) in ruminant diets increase the carbon circularity of livestock systems. We evaluated whether SH could partially replace corn grain (CG) in the diet of lactating cows (≈7.5% of the total diet). Six Holstein multiparous cows were fed a 50:50 (dry matter basis) corn-silage to concentrate diet for two 25-day periods in three replicated 2 × 2 Latin Squares using linear mixed models. Feed intake, milk yield and composition, N excretion, CH₄ production, and ruminal microbial profiles were measured. Enteric CH₄ was measured in respiration chambers. The DMI of cows fed SH (28 kg DM/d) was greater (p = 0.034) than those fed CG (26 kg DM/d), but no differences were observed in milk production (p = 0.557) or enteric CH₄ emission intensity (g/kg milk, p = 0.387). Enteric CH₄ emissions tended to be greater in SH-fed cows (484 g/d) than CG-fed cows (456 g/d; p = 0.075), and N excretion was significantly greater in SH than CG cows (p < 0.001). No mayor shifts in ruminal microbiota or overall ruminal environment were observed. In conclusion, SH can partially replace CG in diets of lactating dairy cows without affecting production, but potential negative environmental impacts should be considered. Full article

Background/Objectives: To relate types of Urinary Incontinence (UI) with obstetric, age, and ethnic factors of interest—a cross-sectional study Methods, in the northern provinces of Ecuador. Methods: A descriptive, cross-sectional study was conducted with a study population of 2039 women with urinary incontinence (UI), recruited between October and November 2022 across different areas of the provinces of Imbabura, Carchi, and Esmeraldas. Data were collected using a characterization questionnaire and the International Consultation on Incontinence Questionnaire–Short Form (ICIQ-IU-SF). The data were analyzed using descriptive and inferential statistics. To quantify the association between risk factors and urinary incontinence, p-values and Odds Ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: A significant association with higher risk was observed between stress urinary incontinence (SUI) and women with a history of cesarean section (13.1%; OR = 1.34; p = 0.021). Likewise, SUI was more frequent among nulliparous women (22.6%; OR = 66.2; p < 0.001), young adults (34.4%; OR = 4.45; p < 0.001), and those of Karanki ethnicity (7.5%; OR = 2.74; p < 0.001). In contrast, urge urinary incontinence (UUI) was associated with vaginal delivery (93.9%; OR = 1.41; p < 0.001), multiparity (75.5%; OR = 1.78; p < 0.001), older age (41%; OR = 2.50; p < 0.001), and Awá ethnicity (12.7%; OR = 1.41; p = 0.009). Finally, mixed urinary incontinence (MUI) showed strong associations with cesarean section (21.8%; OR = 2.09; p < 0.001), grand multiparity (41.3%; OR = 4.54; p < 0.001), advanced age (31.1%; OR = 188.1; p < 0.001), and white women (24%; OR = 2.30; p < 0.001). Conclusions: Urinary incontinence in women is statistically associated with obstetric, age-related, and ethnic risk factors. These findings contribute scientific evidence specific to the Ecuadorian population, supporting the development of prevention and health promotion programs, as well as early interventions aimed at reducing the impact on women’s quality of life, health, and the economic well-being of their families. Full article

Several solutions are being explored to reduce methane intensity in dairy farms, but there is no consensus for commercial pastoral dairy systems in temperate zones. We evaluated the effects of essential oils (EO) supplementation on CH₄ intensity and performance in dairy cows within a commercial pasture-based system in southern Chile. Thirty multiparous cows were randomly assigned to a control group and a treated group, with a general average yield of 22.3 ± 5.37 kg/d and an average parity of 3.42 ± 1.13. The treated group received concentrate supplemented with a mixture of EOs. Enteric CH₄ emissions were measured using GreenFeed^®. Milk yield (kg/d), composition (% fat, % protein, urea, somatic cells), plasma biochemistry, and grassland proximal analysis (NIRs) were also evaluated. Results showed a significant increase in fat-corrected milk production (4.6 kg) in the treated group during the first trial period where the grassland was highly nutritious, offering 19.8% crude protein as well as a pool of long-chain fatty acids. Additionally, CH₄ intensity was significantly lower in the treated group (1.3 gCH₄/ECM) during the first phase. EO supplementation strategies represent a suitable non-invasive intervention suitable for commercial grassland-based systems in southern Chile that is strongly influenced by pasture quality. Full article

Harnessing the powerful antioxidant and anti-inflammatory properties of Scutellaria baicalensis and Lonicera japonica (SL), SL extract emerges as a natural and effective dietary strategy to enhance sow reproductive performance and overall health. In this study, 100 multiparous Duroc × Landrace × Yorkshire sows were assigned to either a control diet or a diet supplemented with 0.05% SL extract (n = 100), beginning on day 85 of gestation and continuing until day 21 of lactation, with 50 sows in each group. Duroc boars were the source of semen for artificial insemination. While SL supplementation did not affect litter size, birth weight, or milk composition, it significantly reduced piglet mortality during lactation, from 13.11% to 9.72% (p < 0.05). Compared with the control group, feed intake of sows in the SL group increased from 4.56 kg to 4.70 kg (p < 0.01) during lactation. Furthermore, SL extract enhanced the antioxidant capacity of the sows, reduced malondialdehyde and levels of IL-1β, IL-6, and TNF-α, and increased the plasma soluble cluster of differentiation 14 (sCD14) concentrations (p < 0.05). In vitro, pretreatment of mammary epithelial cells with SL extract (2 μg/mL for 24 h) before lipopolysaccharide stimulation significantly upregulated antioxidant markers, suppressed pro-inflammatory cytokine mRNA expression, and inhibited activation of the NF-κB and MAPK pathways (p < 0.05). These findings highlight the potential of SL extract as a natural feed additive to mitigate oxidative stress and inflammation, ultimately supporting improved reproductive performance and health in sows. Full article

The aim of this study was to evaluate the relationship between cows’ hepatic lipid content (HLC) at 10 days in milk (DIM) and their metabolic status, health, and production during transition and early lactation periods. HLC was determined in 103 cows from a grazing Chilean dairy herd via cytologic examination of the liver through fine needle biopsies, categorized as mild, moderate, or severe. Blood metabolites were evaluated in the transition period, together with diseases in the postpartum period and milk production during the first 90 DIM. In pre-partum and postpartum periods, primiparous cows with severe HLC showed higher plasma cholesterol than multiparous cows with mild HLC. Postpartum, cows with severe HLC had higher serum non-esterified fatty acids (NEFAs) and NEFA/cholesterol ratios than those with mild HLC. Similarly, cows with moderate and severe HLC presented higher plasma β-hydroxybutyrate and greater risk of subclinical ketosis than cows with mild HLC. Additionally, cows with severe HLC had higher milk production and lower milk protein content than those with mild HLC. These results indicate that moderate to severe HLC at 10 DIM was associated with negative energy balance and subclinical ketosis, whereas severe HLC was associated with increased milk production and decreased milk protein content. Full article