Search Results (3,145)

Background and Clinical Significance: Warty (condylomatous) squamous cell carcinoma (SCC) of the uterine cervix is a rare papillary variant of SCC, usually associated with good prognosis. Case Presentation: We report the clinical case of a postmenopausal woman with vaginal bleeding, anemia, and an enlarged, exophytic tumor mass protruding from the cervix. MRI showed a solid–necrotic cervical–uterine mass with invasion of bladder, rectum, both parametria, and the left ureter, with regional lymphadenopathy and FIGO IVA stage was established. Biopsies from the cervical tumor revealed invasive, well-differentiated SCC with conspicuous koilocytic atypia in superficial and deep nests, consistent with warty (condylomatous) SCC. Immunohistochemistry showed p16 overexpression, an intermediate nuclear proliferation rate, and a non-mutational pattern for p53 immunostaining. Radiotherapy was recommended but the patient’s condition deteriorated rapidly and she died three months after initial diagnosis. Due to the rarity of this type of tumor, we conducted a search on PubMed, Scopus, and Web of Science from inception to 31 July 2025 and we identified ten reports available for evaluation. A total of 32 cases were identified, usually with FIGO stage I or II, mostly with low-risk HPV infection and with good prognosis. Conclusions: The advanced stage and limited tolerance for therapy in this case emphasize the importance of HPV vaccination and HPV-based screening to prevent late, non-curable presentations. Accurate distinction from condyloma acuminatum and verrucous or papillary SCC is clinically relevant because management and outcomes differ. Since some of the cases reported in the literature had a worse clinical course, with shorter disease-free survival and overall survival, including our case, further research is mandatory in the future to unravel those features which might predict a poor outcome. Full article

Human mpox, caused by the mpox virus, is a reemerging viral zoonosis that has gained global attention due to recent Clade IIb outbreaks outside of Africa, as well as ongoing Clade Ia and Ib outbreaks in the Democratic Republic of Congo (DRC) and surrounding regions. Since the start of these outbreaks in 2022, approximately 160,000 people have been affected across more than 100 countries. People with human immunodeficiency virus (HIV; hereafter referred to as PWH) have been disproportionately affected, accounting for approximately 50% of all cases. Mpox is typically a self-limiting illness causing smallpox-like symptoms lasting 2–4 weeks, which can cause significant pain and morbidity. People with uncontrolled or advanced HIV face an elevated risk of severe mpox, secondary complications, and worse outcomes. Vaccination with second- and third-generation vaccinia-based smallpox vaccines has emerged as an important tool in mpox prevention, alongside behavioural modification to mitigate risk. However, only the third-generation, live-attenuated, non-replicating vaccine, modified vaccinia Ankara (MVA-BN [Bavarian Nordic]), is approved for use in PWH. Real-world estimates suggest that two doses of MVA-BN administered as pre-exposure prophylaxis confers vaccine effectiveness in the range of 66–90%. Additionally, MVA-BN has been widely demonstrated to have an acceptable safety profile. This narrative review explores the changing epidemiology, clinical manifestations, and outcomes of mpox in PWH. We also summarise evidence from the Clade IIb outbreaks on the effectiveness and safety of MVA-BN among PWH. Despite progress in our understanding, knowledge gaps persist regarding vaccine performance in individuals with advanced immunosuppression. Furthermore, due to the emergent nature of outbreaks in the DRC and surrounding areas, limited information is available regarding implications for PWH in the context of Clade Ia and Ib. We aim to provide healthcare providers, community stakeholders, and researchers with a foundational understanding of mpox in PWH and the role of MVA-BN in mpox prevention among this group, while highlighting areas of uncertainty. These insights may be helpful in the planning of future research and to inform strategies for the prevention and management of mpox among PWH, particularly those with advanced or uncontrolled HIV. Full article

Background: Chilean salmon aquaculture, a sector crucial for global food security, faces persistent challenges from bacterial pathogens, particularly Piscirickettsia salmonis, resulting in substantial antimicrobial use (351.1 tons in 2024). Objective and methods: To address this issue, the “Sustainable Management of Aquaculture Bacterial Diseases” workshop convened 27 experts to develop a roadmap for prudent antimicrobial stewardship, with the goal of informing public policies and industry best practices. Discussions focused on four critical areas. Results: Antimicrobial Resistance Prevention recognized aquaculture’s dual role in antimicrobial resistance development, underscoring its ecological dimension, the need for international collaboration, proactive policy design, and the establishment of comprehensive “One Health” surveillance systems guided by expert committees. Communication and Education identified critical gaps in specialized veterinary aquaculture training and public outreach, advocating for interdisciplinary teams and clear communication strategies, with a projected timeline of a decade for effective implementation. Therapeutic Alternatives acknowledged current limitations of vaccines against P. salmonis but underscored promising Chilean innovations, including the use of plant extracts, gut-microbiota modulation, and passive immunotherapy, as well as the importance of early intervention. Finally, environmental impact discussions revealed data deficiencies in aquatic ecosystems, emphasizing the need for advanced molecular tools, adaptive regulatory frameworks, and harmonized requirements for environmental risk-assessment procedures. Conclusions: The workshop’s findings provide a vital framework for advancing sustainable antimicrobial use within the Chilean salmon industry as a case study. The insights and lessons derived from this sector can significantly contribute to global aquaculture’s transition toward sustainability, providing a solid foundation for developing a comprehensive roadmap and universally applicable recommendations for stakeholders across aquaculture and other animal-farming industries worldwide. This roadmap, with its essential components, is designed to enhance the understanding of AMU in farmed salmon through a One Health approach, incorporating global guidance for all aquaculture stakeholders. Full article

Biotechnology is reshaping dental public health by providing new tools for prevention, diagnosis, and treatment of oral diseases at scale. Salivary biomarkers enable non-invasive, early detection of caries, periodontitis, and oral cancer. Tissue engineering and regenerative approaches, driven by stem cell signaling and bioactive scaffolds, offer biologically integrated repair. Genomic discoveries now allow polygenic risk profiling to complement social determinants in identifying vulnerable groups, while novel biomaterials, probiotics, and vaccine research expand options for sustainable caries prevention. These innovations are underpinned by molecular mechanisms such as inflammatory signaling, stem cell differentiation pathways, and antimicrobial activity. Their translation into public health practice requires attention to affordability, regulation, equity, and workforce integration. Harnessed effectively, biotechnology can help shift oral health systems toward more preventive and equitable models of care. Full article

Acute chest syndrome (ACS) is a life-threatening complication of sickle cell disease (SCD) with complex infectious and non-infectious etiologies. Bacterial pathogens, including Streptococcus pneumoniae, Haemophilus influenzae, and atypical organisms such as Mycoplasma pneumoniae, play crucial roles in ACS pathogenesis, particularly in immunocompromised SCD patients with functional asplenia. Despite the importance of infectious triggers, regional data on pathogen identification rates and antimicrobial management strategies in ACS remain limited, especially from high-prevalence SCD regions. This study aimed to investigate the infectious etiologies, pathogen identification patterns, and antimicrobial management outcomes of ACS in adult SCD patients in Eastern Saudi Arabia. A five-year retrospective analysis was conducted on patients aged ≥14 years with SCD who were admitted with ACS to Dammam Medical Complex between 2018 and 2022. Comprehensive microbiological evaluation included blood cultures, sputum cultures, and atypical pathogen testing (Mycoplasma pneumoniae, Chlamydia pneumoniae). Data on antimicrobial regimens, pathogen identification rates, vaccination status against encapsulated bacteria, and clinical outcomes were systematically analyzed. Empirical antibiotic strategies and their effectiveness in this immunocompromised population were evaluated. A total of 60 adult SCD patients experiencing 80 episodes of ACS were included. Despite comprehensive microbiological workup, specific infectious pathogens were identified in only 8 (10.0%) episodes, highlighting the complex multifactorial etiology of ACS. Blood cultures yielded pathogens in 5 (6.3%) cases, sputum cultures in 4 (5.0%) cases, and Mycoplasma pneumoniae was identified in 3 (3.8%) episodes. All patients received empirical broad-spectrum antimicrobial therapy, with ceftriaxone and azithromycin combination being the most frequent regimen (76 cases, 95.0%), providing coverage for both typical and atypical bacterial pathogens. Antibiotic escalation was required in 16 (20.0%) episodes. Vaccination rates against Streptococcus pneumoniae were suboptimal at 30 (50.0%), representing a significant risk factor for invasive bacterial infections in this functionally asplenic population. The intensive care unit (ICU) admission rate was 15 (18.8%), and in-hospital mortality was 3 (3.8%), with infectious complications contributing to severe outcomes. In this cohort of SCD patients, ACS demonstrated low rates of specific pathogen identification despite systematic microbiological investigation, supporting the multifactorial infectious and non-infectious etiology of this syndrome. The predominant use of broad-spectrum antimicrobial therapy targeting both typical and atypical bacterial pathogens proved effective in this immunocompromised population. However, suboptimal vaccination rates against encapsulated bacteria represent a critical gap in infection prevention strategies. These findings emphasize the importance of empirical antimicrobial coverage for suspected bacterial pathogens in ACS management and highlight the urgent need for enhanced vaccination programs to prevent infectious complications in functionally asplenic SCD patients. Full article

In 2014, Duck Adenovirus type 3 (DAdV-3) emerged in Muscovy ducks and has since spread rapidly across China, causing significant economic losses to the duck industry. Given this situation, the development of reliable diagnostic tools is crucial for effective disease control. In this study, a neutralizing monoclonal antibody (mAb) 2F12 specific to DAdV-3 was generated, which showed a blocking rate of over 70% and a neutralization titer of up to 1:794. A blocking enzyme-linked immunosorbent assay (b-ELISA) was further developed based on mAb 2F12 to efficiently detect neutralizing antibodies against DAdV-3. The cut-off values of percent inhibition (PI) were set based on testing 84 negative duck serum samples, with a value below 16.79% (mean ($\overline{X}$) + 2 standard deviations (SD)) for negative sera and over 21.62% ($\overline{X}$ + 3SD) for positive sera. The b-ELISA exhibited a high specificity, reacting exclusively with DAdV-3 positive serum and showing no cross-reactivity with other representative positive sera tested. Additionally, the b-ELISA showed significantly higher sensitivity than the serum neutralization test (SNT), detecting antibodies 16-fold greater than the endpoint dilution of the SNT. The established b-ELISA, validated with 90 field serum samples from six duck farms, was well-suited for clinical detection of DAdV-3 antibodies and for monitoring post-vaccination antibody levels, representing a significant advancement in DAdV-3 detection and prevention. Full article

Introduction: The COVID-19 pandemic disrupted social interactions, family dynamics, and economic stability, disproportionately affecting vulnerable populations. Tuberculosis and leprosy perpetuate poverty and, once manifested, hinder socioeconomic development due to their high potential for disability. Methodology: This study analyzed the impact of the COVID-19 pandemic using DATASUS health data and assessed the influence of socioeconomic interventions (SAGICAD data) on tuberculosis and leprosy case notifications in Brazil. A correlation analysis was performed between regional diagnoses and variables such as Bolsa Família (a national social welfare program), BCG vaccination coverage, and COVID-19 immunization rates, applying Pearson’s correlation test. Results: No significant correlations were found between COVID-19 vaccination rates and tuberculosis/leprosy diagnoses. However, a strong negative correlation (p < 0.05) was observed between BCG (Bacillus Calmette–Guérin) vaccination coverage and leprosy incidence in the Northern region. The findings also suggest that social assistance programs such as Bolsa Família play a pivotal role in preventing infectious diseases in vulnerable areas. Conclusions: Understanding the complex interplay between socioeconomic determinants and public health outcomes is essential for guiding future research and informing health policies, including potential revisions to social programs and vaccination protocols. Full article

African swine fever virus (ASFV) is a high-consequence pathogen that causes African swine fever (ASF), for which mortality rates can reach 90–100%, with death typically occurring within 14 days. ASF is currently a highly contagious pandemic disease responsible for extensive losses in pig production in multiple affected countries suffering from extended outbreaks. While a limited number of vaccines to prevent ASF are in use in south-east Asia, vaccines are not widely available, are only effective against highly homologous strains of ASFV, and must be used prior to an outbreak on a farm. Currently, there is no treatment for ASF and culling affected farms is the only response to outbreaks on farms to try and prevent spreading. CRISPR/Cas systems evolved as an adaptive immune response in bacteria and archaea that function by cleaving and disrupting the genomes of invading bacteriophage pathogens. CRISPR technology has since been leveraged into an array of endonuclease-based systems used for nucleic acid detection, targeting, genomic cleavage, and gene editing, making them particularly well-suited for development as sequence-specific therapeutic modalities. The programmability of CRISPR-based therapeutics offers a compelling new way to rapidly and specifically target pathogenic viral genomes simply by using different targeting guide RNAs (gRNA) as an adaptable antiviral modality. Here, we demonstrate for the first time a specific CRISPR/Cas9 multiplexed gRNA system that targets the African swine fever viral genome, resulting in sequence-specific cleavage, leading to the reduction in the viral load in infected animals, and subsequent recovery from an otherwise lethal dose of ASFV. Moreover, animals that recovered had protective immunity to subsequent homologous ASFV infection. Full article

Background: Preconception care (PCC) is a key element of preventive reproductive health, aiming to optimise maternal and child outcomes by addressing biomedical, behavioural, psychosocial, and genetic risks before conception. International frameworks provide clear guidance, yet implementation in many low- and middle-income countries remains inconsistent. Methods: A structured narrative review was conducted across PubMed, Web of Science, Cochrane Library, and Google Scholar, focusing on literature published between 2010 and 2025. Eligible sources included empirical studies, clinical guidelines, policy documents, and high-quality grey literature from health authorities. Quality, relevance, and applicability were assessed, with particular emphasis on European and Bulgarian contexts. Results: Evidence from diverse settings demonstrates that PCC interventions—such as chronic disease management, vaccination, lifestyle optimisation, and expanded carrier screening (ECS)—can reduce adverse pregnancy outcomes and prevent severe genetic disorders. Effective international models integrate PCC into primary care, leverage digital health tools, and ensure equitable access through public funding. In Bulgaria, PCC remains underdeveloped: genetic screening is not part of routine care, there are no national guidelines or surveillance systems, and only ~4% of women initiate folic acid supplementation before pregnancy. NGOs and EU-funded digital initiatives provide partial outreach but cannot replace state-supported services. Conclusions: Bulgaria urgently requires a coordinated national PCC strategy, incorporating standardised guidelines, provider training, digital platforms, and phased ECS introduction. Strengthening PCC delivery can reduce preventable maternal and neonatal morbidity, advance reproductive justice, and enhance the long-term sustainability of public health systems. These findings support the development of a publicly funded, guideline-driven national PCC strategy with phased introduction of expanded carrier screening under NHIF to improve equity and long-term system sustainability. Full article

Viral zoonoses represent a critical intersection of global health, ecology, and ethical issues. Pathogens that pass from animals to humans. This review examines the complex landscape of viral zoonoses, including their mechanisms, impact, and mitigation strategies. We begin with insights into the historical context and significance of these diseases and then explore spillover mechanisms influenced by genetic, ecological, and anthropogenic factors. This review covers the host range, transmission dynamics, and immunological barriers, including viral detection, adaptation, and immune evasion. Genomic insights have revealed the genetic determinants of host switching and adaptation, illuminating the dynamics of viral spillover events. We emphasize the anticipation and prevention of zoonotic events, highlighting surveillance, early warning systems, and the “One Health” approach. Using case studies of outbreaks such as Ebola, avian influenza, and COVID-19, this review examines the real-world consequences of zoonotic diseases. We then discuss interventions, including mitigation strategies and vaccination, and their ethical and social implications. Drawing on past outbreaks, we provide recommendations for the future, aiming to balance human health, conservation, and animal welfare. This review aims to inform professionals, academics, and policymakers by offering a multidisciplinary perspective on the complex world of viral zoonoses and strategies to protect global health. Full article

Equine herpesvirus (EHV) infections represent a significant global veterinary and economic challenge affecting both horses and donkeys across all inhabited continents. This narrative review comprehensively examines the nine distinct EHV species (EHV-1 through EHV-9), their taxonomic classification within Alphaherpesvirinae and Gammaherpesvirinae subfamilies, and their diverse host tropism patterns. The complex molecular pathogenesis involves sophisticated viral glycoproteins (gK, gB, gC, gH, gM, gL, gG, gD, gI, gE) that orchestrate cellular invasion, immune evasion, and intercellular transmission. Clinical manifestations vary considerably, ranging from respiratory diseases and reproductive failures to severe neurological disorders, with EHV-1 demonstrating the most severe presentations including myeloencephalopathy. Global distribution analysis reveals widespread circulation across Europe, Asia, Africa, the Americas, and Oceania, with species-specific clinical patterns. Current therapeutic options remain largely supportive, with experimental compounds like berbamine and cepharanthine, celastrol, blebbistatin, and hyperoside showing promise in preclinical studies. Vaccination programs demonstrate limited effectiveness, failing to prevent transmission at population levels despite inducing individual immune responses. The sophisticated immune evasion strategies employed by EHVs, including the “Trojan horse” mechanism utilizing infected leukocytes, highlight the complexity of host–pathogen interactions and underscore the urgent need for innovative prevention and treatment strategies. Full article

Objectives: Bovine coronaviruses (BCoV) are endemic worldwide, causing diarrhea, winter dysentery, and bovine respiratory disease in newborn calves. These lead to higher calf mortality, reduced growth of fattening cows, and lower milk production in adult cows, resulting in significant losses to the cattle industry. Since commercial preventive drugs are not available in China, and existing treatments can only reduce the mortality of sick calves without fundamental control, the development of safe and effective vaccines is crucial. Methods: Two mRNA vaccines targeting the BCoV spiny receptor-binding domain (S-RBD) were prepared: XBS01 and XBS02. These two mRNAs, optimized for coding by AI and encapsulated in lipid nanoparticles (LNPs), were injected intramuscularly into mice (10 μg per mouse, twice, 2 weeks apart); a blank control group was not immunized. Serum antibodies, memory B/T cell activation and cytokine secretion were assessed by ELISA, flow cytometry and ELISpot. Results: Both vaccines induced humoral and cellular immunity:anti-S-RBD IgG titers were higher than those of the control group, and there was memory B-cell production and T-cell activation. XBS02 was superior to XBS01 in terms of peak antibody, memory B-cell frequency, T-cell activation rate, and IFN-γ/IL-2 secretion, and showed a stronger Th 1 response. Conclusions: Both BCoV S-RBD mRNA vaccines had good immunogenicity, with XBS02 providing better protection. This study supports the optimization and application of BCoV mRNA vaccines and accumulates data for mRNA technology in veterinary practice. Full article

The World Health Organization and the Centers for Disease Control and Prevention recommend seasonal influenza vaccination for all individuals aged 6 months and older. Despite high national immunization rates, the influenza vaccination coverage among Saudi children remains unclear. Parental knowledge and attitudes significantly impact children’s vaccination rates. Purpose: This study aims to evaluate parental knowledge, awareness, and attitudes regarding influenza vaccination and identify barriers to vaccination uptake among children in Al-Madinah City, Saudi Arabia. Methods: The population includes parents having children aged 6 months to 14 years. A cross-sectional survey utilizing a 33-item validated questionnaire was conducted to evaluate parental awareness, knowledge, and attitudes toward the influenza vaccine. Inferential statistics were employed to evaluate demographic factors influencing parental knowledge and attitudes toward vaccination. Results: This study surveyed 407 parents from Al-Madinah, focusing on their awareness, knowledge, and attitudes towards seasonal influenza vaccination. The sample was primarily Saudi (86.7%), with a mean age of 34 years. Most parents (95.6%) were aware of the vaccine, primarily through media and campaigns. Despite this, only 44.5% had vaccinated themselves or their children, citing perceptions of influenza as mild, vaccine ineffectiveness, and availability issues as primary reasons for non-vaccination. Knowledge about influenza varied, with most parents aware of its contagiousness (64.4%) and symptoms, but misconceptions persisted, such as believing the vaccine could cause the flu. Parental attitudes towards vaccination were mostly positive, with high trust in health information sources and a mean attitude score of 22.48 out of 35. Positive attitudes were correlated with better knowledge and more frequent infection control practices. Age, education, and medical profession status significantly influenced knowledge, while vaccine attitudes were most favorable among those vaccinated (p < 0.001). Conclusions: Most parents in Al-Madinah recognize the importance of vaccination; however, misconceptions about vaccine safety, perceived low need, and barriers such as vaccine availability persist. Sociodemographic factors, including education, income, and profession, are linked to better knowledge and more positive attitudes toward vaccination. Full article

Background/Objectives: Patients with rheumatic diseases have an increased burden of infection owing to biological disease-modifying antirheumatic drug (bDMARD) therapy. Therefore, vaccination is crucial for the prevention of infection in these patients. In this case–control study, we aimed to evaluate vaccine response to hepatitis B, pneumococcus, and measles using antibody titers in patients undergoing biological therapy. Methods: This study included 16 patients aged 5–18 years of age who received bDMARD treatment and 20 healthy controls. Serum samples of the patients were collected at baseline and subsequently on the 3rd and 6th months after bDMARD therapy, and IgG antibodies against pneumococcal capsular polysaccharide antigen (PCP), measles, and hepatitis B were measured. Results: There were no statistically significant differences in mean anti-HBsAg, anti-PCP, and anti-measles antibody titers between the study and control groups. The percentages of patients with anti-HbsAg, anti-PCP, and anti-measles protective antibodies were 68.8% (n = 11/16), 100% (n = 16/16), and 56.25% (n = 9/16), respectively. There were no statistically significant differences in the mean antibody titers at baseline and 3rd month. Only the anti-measles IgG titer level decreased below 200 (mIU/mL) in one patient in the 3rd month and in two patients in the 6th month. Conclusions: Patients with low or declining hepatitis B and measles antibody titers before or during bDMARD treatment may require close monitoring to ensure adequate protection against vaccine-preventable diseases. Regular screening and follow-up are essential in this patient population. Full article

Today, vaccines play a crucial role in ensuring personal safety and are the most effective method for preventing related diseases. The ages over which vaccines are efficacious, from infancy to the old, is of utmost importance. With the recent outbreak of COVID-19 in 2019, the demand for vaccines and their usage has significantly increased. This surge in demand has led to issues such as vaccine counterfeiting and related problems, which have raised concerns among the public regarding vaccine administration. As a result, this has also resulted in a lack of trust in vaccine manufacturing companies and raised doubts about production processes. To address these concerns, this study proposed a vaccine production supervision system with Internet of Things (IoT) device based on blockchain. By utilizing IoT devices, vaccine-sensitive production data can be collected and encrypted and leaks that could lead to great benefit losses for vaccine manufacturing companies can also be prevented. This system adopts a digital signature technique to import immutable characteristics to the data, offering conclusive evidence in case any issues occur with the vaccine in the future. Finally, the system also integrates with the Inter Planetary File System (IPFS) with a blockchain solution, storing manufacturing plant vaccine production records in a secure, publicly accessible, and decentralized storage space, and also enabling public verification. Full article