rss_2.0Journal of Biomedical and Clinical Research FeedSciendo RSS Feed for Journal of Biomedical and Clinical Research of Biomedical and Clinical Research 's Cover Procedure in an Outpatient Setting: Applicability and Cost-Effectiveness<abstract> <title style='display:none'>Summary</title> <p>We present the applicability and cost-effectiveness of the large loop excision of the transformation zone (LLETZ) procedure in outpatient settings – anesthesia, postoperative pain, postoperative stay, and complications such as intraoperative bleeding, early postoperative bleeding, infection, late cervical canal stenosis, spotting, incomplete epithelialization, inadequate colposcopy). From Jan 1, 2017, to Jul 31, 2021, 189 patients underwent LLETZ at Medical Center “Prof. Kornovski”. The methodology includes the indications for performing the LLETZ procedure, the preparation of the patients, a description of the procedure, tools, technical parameters, the operation technique, and the postoperative period. We present the duration of the procedure; analgesics in terms of intraoperative bleeding; postoperative pain; postoperative stay; early postoperative complications (bleeding, infection); late postoperative complications (stenosis of the cervical canal, incomplete epithelialization, spotting before menstruation, and inadequate colposcopy). The LLETZ procedure is applicable in outpatient practice with low intra- and postoperative complications and minimum stay. Two main factors determine its cost efficiency in outpatient practice: the use of local anesthesia instead of general anesthesia requiring an anesthesiologist, anesthesiology nurse, anesthetic for short-term venous anesthesia, and the daily cost for an occupied bed – a financial factor in-hospital care versus the lack of daily cost per occupied bed in outpatient care.</p> </abstract>ARTICLE2022-07-13T00:00:00.000+00:00A Retrospective Analysis of Treatment of Covid-19 with Favipiravir<abstract> <title style='display:none'>Summary</title> <p>One of the potential therapeutic agents for treating COVID-19 is favipiravir (FPV). This retrospective study compared the treatment of COVID-19 with (FVP group) or without (control group) favipiravir. Demographic characteristics and initial clinical indicators in the two groups were comparable. The level of oxygen saturation, respiratory rate, and prevalence of chest pain in the FVP group returned to normal significantly earlier (on the seventh day) compared to the control group (p&lt;0.05). Improvement of patients’ condition in the FVP group occurred significantly earlier than in the control group (p &lt;0.001). In conclusion, FVP treatment’s efficacy was higher than the control management strategy and established an individualized set of therapeutic agents. However, more detailed studies are needed to evaluate the efficacy of COVID-19 treatment with favipiravir fully.</p> </abstract>ARTICLE2022-07-13T00:00:00.000+00:00Demodicosis Cutis and Metabolic Disturbances<abstract> <title style='display:none'>Summary</title> <p>Cutaneous demodicosis (CD) is a pilosebaceous unit disease, overlapping clinically with other facial dermatoses, mainly rosacea, and acne. It is usually improved by acaricidal monotherapy. This study investigates the association of CD with metabolic disturbances. It was conducted with 141 patients with primary and secondary CD. The study investigated the correlation between CD and dyslipidemia based on disturbances in total cholesterol (TC) and Low-Density Lipoproteins (LDL) and between CD and impaired glucose tolerance, diagnosed with elevated fasting blood sugar levels, 120 minutes blood sugar levels in oral glucose tolerance test (OGTT) and the mathematically calculated Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index. The study results were verified with control groups. It was established that patients with CD do not show statistically significant deviations in serum lipoproteins compared with the control group. However, the patients with CD tended to have impaired glucose tolerance, demonstrated with elevated fasting glucose levels and elevated HOMA-IR, compared to the control group. Interestingly enough, the tendency towards prediabetes and diabetes was not confirmed by the 120 minutes blood glucose levels of the OGTT. The presented data confirm the need for testing impaired glucose tolerance in every patient with cutaneous demodicosis. Based on the presented evidence, it is recommended to perform the screening by evaluating fasting glucose levels and fasting insulin levels, followed by calculating the HOMA-IR index.</p> </abstract>ARTICLE2022-07-13T00:00:00.000+00:00Medical Review and Analysis of Canned Food Production Safety<abstract> <title style='display:none'>Summary</title> <p>Food safety is an essential and integral part of public health policies in developed countries. Canned foods play a significant role in modern human nutrition. Improving the safety of internal control in production is additional prevention of the potential risks of consuming contaminated food. The present study aims to perform a health assessment and medical analysis of the Internal Control System and a canning company’s Hazard Analysis and Critical Control Points (HACCP) plan. Our study also aimed to find potential mechanisms to increase the safety in producing this type of ready-to-eat foods and possible new approaches in avoiding and managing risks. An audit algorithm was developed to analyze the existing food safety systems in the enterprise to achieve the study’s goal. The algorithm was based on the Codex Alimentarius methodology, presented in the document “Food Quality and Safety Systems - A Training Manual on Food Hygiene and the Hazard Analysis and Critical Control Point (HACCP) System. A medical analysis of the Internal Control System was performed, based on the prerequisite programs, technical documentation, and the company’s HACCP-plan. The analysis of the documentation and the critical remarks made can provide more reliable conditions for producing products safe for consumers’ health. The proposed corrections in the Good Hygiene Practices (GHP), the Good Manufacturing Practices (GMP), and the HACCP plan, mainly through adequately naming authentic hazards of a biological nature, are the basis for more professional verification of the processes and ensuring food safety.</p> </abstract>ARTICLE2022-07-13T00:00:00.000+00:00Intravesical Therapy of Superficial Urothelial Bladder Cancer with BCG and Epirubicin 50 Mg - Comparative Analysis<abstract> <title style='display:none'>Summary</title> <p>Bladder cancer is a heterogeneous disease in molecular, histological and clinical aspects. Treatment should also be considered from different angles - surgery, intravesical chemo- or immunotherapy, radiation therapy and lifestyle changes. Intravesical treatment of superficial bladder cancer with Еpirubicin or Bacillus Calmette-Guérin (BCG) is a continuation of surgical treatment to reduce or eliminate further recurrence.</p> </abstract>ARTICLE2022-07-13T00:00:00.000+00:00Cryptosporidiosis: History, Etiology, Biology, Pathogenesis and Pathoanatomy - A Review<abstract> <title style='display:none'>Summary</title> <p>Cryptosporidiosis is a protozoan disease, usually asymptomatic. However, in some cases, the infection can progress to gastroenteritis and, more rarely, to colitis. Intensive studies on the biology of <italic>Cryptosporidium</italic> started in the 20th century after the outbreak of a major waterborne epidemic. The interest in this parasitosis increased after the WHO identified it as an opportunistic parasitosis - an indicator of AIDS. In this regard, the purpose of this article is to provide a scientific overview of this parasitosis, analyzing the state and development of modern research in a global and national aspect.</p> </abstract>ARTICLE2022-07-13T00:00:00.000+00:00Embryological Aspects and Anatomical Variations of the Inferior Vena Cava – Its Importance in Gynecologic Oncology Surgery<abstract> <title style='display:none'>Summary</title> <p>Surgical procedures of the retroperitoneum are often performed in gynecologic oncology surgery clinics. The most complex among them is paraaortic lymphadenectomy. It is generally performed in cases of bulky lymph nodes in ovarian carcinomas and sarcomas to achieve optimal cytoreduction. In the early stages of ovarian cancer, type II non-endometrioid endometrial cancer, and in advanced stages of cervical cancer, paraaortic lymphadenectomy is an integral part of staging. Moreover, the retroperitoneum is approached in cases of retroperitoneal gynecologic sarcomas. The largest vessels of the human body – the inferior vena cava and the abdominal aorta are localized in the retroperitoneum. Therefore, iatrogenic vessel injury during oncogynecological surgery is more likely to affect the inferior vena cava. Anatomical variations of the vein additionally increase the risk of vascular lesions. Therefore, surgeons should be aware of possible anatomical variations. The present article aimed to highlight the heterogeneity of anatomical variations of the inferior vena cava related to gynecologic oncology surgery. Embryogenesis of the vein and its variations are also discussed. Additionally, some anomalies of the ureter, associated with the embryogenesis of the inferior vena cava, are mentioned.</p> </abstract>ARTICLE2022-07-13T00:00:00.000+00:00Two Clinical Cases of Secondary Neoplasia After Remission of Hodgkin’s Disease<abstract> <title style='display:none'>Summary</title> <p>Hodgkin’s disease is one of the most common lymphomas in young people. In such cases, long-lasting hematological remissions are achievable using therapeutic regimens, including combined radiotherapy and chemotherapy. This publication aims to present clinical cases from our practice in patients with Hodgkin’s disease in whom the occurrence of second neoplasia is probably causally related to the treatment of Hodgkin’s lymphoma. We present two clinical cases of women with established secondary neoplasia (breast carcinoma, diffuse large B cell lymphoma) 20 years after treatment for Hodgkin’s disease had been completed. The probability of developing another neoplastic disease, leading to increased mortality in these patients, requires updating the recommendations for secondary prevention in oncology.</p> </abstract>ARTICLE2022-07-13T00:00:00.000+00:00Treating Chronic Pain Syndrome After Vaginal Surgery with a Pudendal Nerve Block<abstract> <title style='display:none'>Summary</title> <p>Chronic pain syndrome is a severe condition that has been recently recognized, and many methods for treating it have been developed. We present a case of using a pudendal nerve block for treating chronic pain after Bartholin cyst removal. A 46-year-old female presented with chronic pain syndrome, lasting eight months following Bartholin cyst removal. Treatment with non-steroid anti-inflammatory drugs and opioids was unsuccessful, and pudendal nerve block was performed with dexamethasone and ropivacaine. The follow-up continued for a year, and no pain was reported. In cases of pudendal neuralgia, a peripheral pudendal nerve block is effective. Chronic pain syndrome is a complex problem, and a multidisciplinary approach is often required. This case represents the efficacy of pudendal nerve block in chronic pain syndrome after Bartholin cyst removal.</p> </abstract>ARTICLE2022-07-13T00:00:00.000+00:00Development of Nursing Research–Directions and Best Practices in the USA and Europe: A Narrative Review<abstract> <title style='display:none'>Summary</title> <p>Nursing research is a relatively new area of professional development that began firstly in the USA and made significant progress during the second half of the 19th century. Nursing research has made significant progress in European countries, mainly developed countries. This article aimed to review publications describing the evolution of nursing research, the directions of development, and best practices in the USA and Europe. Different databases were searched according to selected criteria, and a narrative literature review was conducted. Forty-two articles from the USA and Europe were identified and included as the most appropriate in the analysis, published in 22 journals. During the analysis, five basic directions of developing nursing research were identified - nursing research education, organizational structures for nursing research and collaboration with clinical professionals, research dissemination and journals, trends and priorities, and funding nursing research. To increase research capacity and respond to the growing research culture and the requirements of the scientific community, nursing research education is needed at every educational level. Establishing organizational structures has proved the importance of supporting and encouraging nurses to participate in and conduct studies. Funding research in teams is more likely to occur at any organization or centеr than looking for funding sources from individuals. Encouraging nurses and midwives to conduct research in clinical practice and publish results from scientific studies will help achieve sustainable implementation of evidence-based practice.</p> </abstract>ARTICLE2022-07-13T00:00:00.000+00:00The Role of Three Plasma Proteins in the Diagnosis of Ovarian Tumors<abstract> <title style='display:none'>Summary</title> <p>Ovarian cancer is not common, but it is still the fifth leading cause of death from malignant diseases among women worldwide. More than 200,000 women are diagnosed with ovarian cancer each year globally. Due to its asymptomatic course, most patients are diagnosed at a late stage. Therefore, ovarian cancer (OC) has the highest mortality among gynecological malignancies. Unfortunately, there is no adequate screening program for the early detection of ovarian cancer, and as a result, this diagnosis escapes clinicians. The protocol for early diagnosis of OC is currently a combination of elevated cancer antigen 125 (CA 125) and transvaginal ultrasonography (TVUS). However, it does not meet the necessary cost-effectiveness criteria and is therefore not recommended by any working group to screen ovarian cancer in the general population. The biomarkers with the highest informative value should be selected individually or combined in multi-biomarker panels from the many biomarkers strongly associated with OC. Numerous such panels of biomarkers and algorithms have been developed for the early diagnosis and differentiation of OC from other benign ovarian diseases. These panels or biomarkers need to be sufficiently reliable and show measurable changes in non-invasive samples obtained from patients with early-stage OC. Their reliability would significantly reduce mortality from this aggressive disease and improve the patient’s prognosis.</p> </abstract>ARTICLE2022-07-13T00:00:00.000+00:00First Fifty Cases with En-Bloc Holmium Laser Enucleation of the Prostate<abstract> <title style='display:none'>Summary</title> <p>In the last decade, the Holmium Laser Enucleation of the Prostate (HoLEP) has become the new gold standard for surgical treatment of benign prostatic hyperplasia (BPH). This treatment has several modifications, and the latest one is en bloc (single piece) enucleation. This new method reduces the operative time and risk of early incontinence. The long-term effect is much better than transurethral resection of the prostate (TURP). We applied an effective method for treating benign prostatic hyperplasia with maximum safety, minimal hospital stays, short operative time, and minimal complications. We operated on 50 patients with BPH with a prostate volume between 30-120 cc. Transrectal ultrasound, uroflowmetry, PSA test, IPSS (International Prostate Symptom Score), residual urine, digital rectal examination, and laboratory blood and urine tests were performed preoperatively. We used Holmium laser (Auriga XL) 50 W, 600 μm fiber and morcellator (Richard Wolf PIRANHA). During the procedure, the laser’s operating power was 36 W. En bloc Holmium enucleation was performed in all patients, followed by morcellation of the prostatic tissue. The time for enucleation was 11-52 min, morcellation time - 1-10 min, the weight of the enucleated tissue - 15-100 g, enucleation efficiency - 0.67-3.03 g/min, postoperative catheterization time - 24-72h, and hospital stay was 1 to 3 days. One blood transfusion was required. There were no patients with postoperative incontinence or other complications. We conclude that еn bloc Holmium enucleation in BPH is an effective method of treatment that offers maximum performance combined with short operative time, shorter hospital stays, and minimal risk of complications. The learning curve requires at least twenty cases. The recommended prostate gland size for the initial trial should be between 50-60 cc. Starting with small-sized glands increases the risk of capsule perforation, and the enucleation plane is more difficult to find.</p> </abstract>ARTICLE2022-07-13T00:00:00.000+00:00Carrier Screening for Single-Gene Disorders – A Brief Review<abstract> <title style='display:none'>Summary</title> <p>Carrier screening (CS) is an approach to pre-reproductive identification of couples at risk of having offspring with a single-gene disorder (SGD). The goal of CS is to facilitate reproductive autonomy and informed decision-making of the revealed risk couples. Initially, CS was introduced in the 1970s among the Ashkenazi Jewish population in the USA with a high incidence of Tay-Sachs disease. Until recently, CS had a limited application, mainly among individuals of a particular ethnicity or family history of SGD, and a limited number of conditions are included. Implementing the revolutionary technology of next-generation sequencing revealed a much more comprehensive range of possibilities for CS. The expanded alternative variant introduced a new concept that allows screening for hundreds to thousands of SGDs without pre-selection of individuals based on their ancestry or family history. Furthermore, the number of detected pathogenic variants is much higher compared to the traditional CS. Currently, there is insufficient experience with the application of expanded CS, and the lack of uniform guidelines is a major problem when it comes to massive implementation. Nevertheless, the significant potential of the expanded CS has given rise to a growing interest in it and provoked in-depth discussions about the opportunities of widespread application in practice.</p> </abstract>ARTICLE2022-01-18T00:00:00.000+00:00Single-Dose Cold Modified Bretschneider Solution for Myocardial Protection in the Surgical Treatment of Patients with Aortic Valve Stenosis and Left Ventricular Hypertrophy<abstract> <title style='display:none'>Summary</title> <p>Aortic valve stenosis (AS) is predominantly caused by degenerative calcification in patients over 70 years. It obstructs the left ventricular outflow tract. The result is concentric left ventricular hypertrophy (LVH) wall stress and ischemia-induced myocardial fibrosis. [1] According to the European Association of Cardiothoracic Surgery, all high-grade AS patients are indicated for Aortic valve intervention [2]. One of the most recommendable methods for myocardial protection during surgical aortic valve replacement is antegrade delivery of cold crystalloid cardioplegia. Our retrospective study included 173 operated patients with AS and LVH. We observed the MB fraction of the enzyme creatine phosphokinase (CPK-MB) as a postoperative marker for myocardial hypoprotection in different patients. Our results showed that a single dose of modified Bretschnaider solution provided safe and long enough myocardial protection during conventional and minimally invasive aortic valve replacement in patients with AS and LVH [3].</p> </abstract>ARTICLE2022-01-18T00:00:00.000+00:00Relationship between Elevated Maternal Serum Podocalyxin Concentrations with Blood Pressure Values and Routine Laboratory Parameters in Preeclampsia<abstract> <title style='display:none'>Summary</title> <p>Podocalyxin (PCX) is a glycoprotein member of the CD34 transmembrane sialomucin family and covers the surface of podocytes. It is assumed to be a marker of glomerular endothelial injury. In conditions, podocalyxin excretion in the urine is increased as a result of podocyte injury. Recent studies show that PCX is expressed not only in kidneys but also in the endothelial cells of other organs. Preeclampsia (PE) is characterized by new-onset hypertension, generalized endothelial injury, and glomerular alteration. Having this in mind, in the present study, we aimed to: (1) determine circulating PCX levels in sera of women with preeclampsia and normal pregnancy; (2) explore for an association between PCX and blood pressure and (3) investigate a possible relationship between PCX and routine laboratory markers of cardiac and renal injury/dysfunction. Fifty-five women with preeclampsia were examined. The mean age of patients was 24.9±6 years, and the mean age of the control group of 35 women with normal pregnancies was 24.7±5.4 years. The enzyme-linked immunosorbent assay (ELISA) was used to determine concentrations of PCX. Levels of serum PCX in preeclamptic women were statistically significantly higher than those in women with normal pregnancy: 2.66±0.67 vs. 2.40±0.33 ng/ml (p=0.03). Podocalyxin correlated with SBP (r=0.30; p=0.004), DBP (r=0.35; p=0.0007), uric acid (r=0.32; p=0.002), CPK (r=0.22; 0.03) and its isoenzyme CK-MB (r=0.21; p=0.04). Our results showed significantly higher levels of serum PCX in women with preeclampsia than in healthy pregnancy. Elevated podocalyxin levels are associated with an increase in blood pressure in preeclampsia. We found a relationship between PCX and routine laboratory indicators of cardiac (CPK and CK-MB) and renal injury/dysfunction (uric acid). PCX has the potential as a future preeclampsia diagnostic biomarker.</p> </abstract>ARTICLE2022-01-18T00:00:00.000+00:00A Review of Results from Clinical Trials Based on Co-Variants of the R-CHOP Regimen in Untreated Patients with Diffuse Large B-cell Lymphoma<abstract> <title style='display:none'>Summary</title> <p>Since 2000, new drugs for treating lymphoproliferative diseases have been introduced in haematology, and their initial indications have been gradually expanded. Some of the so-called „target molecules“ have shown good efficacy when treating some malignant non-Hodgkin lymphomas. The possibility of achieving therapeutic disease control in some indolent non-Hodgkin lymphomas using drugs with a different mechanism of action from that of cytostatics has logically raised the question of a change in therapeutic management in other lymphoproliferative diseases. Since 2010, clinical trials have been initiated with untreated patients with aggressive non-Hodgkin‘s lymphoma - diffuse large B-cell lymphoma as the primary target. The key aim of most clinical trials has been to compare the efficacy of the so-called „gold standard“ - rituximab, cyclophosphamide, doxorubicin, oncovin, prednisolone (R- CHOP) versus its derivatives. The review discusses the results of completed clinical trials published on the Internet. These trials covered covariants of the R-CHOP regimen used as first-line treatment of patients with diffuse large B-cell lymphoma. The review also includes drugs registered in Bulgaria for the last ten years but with a different clinical indication at present. The results of five clinical trials in which obinotuzumab, venetoclax, lenalidomide, bortezomib, and ibrutinib were used are presented.</p> </abstract>ARTICLE2022-01-18T00:00:00.000+00:00Study of the Content of Heavy Metals in Foods in Bulgaria<abstract> <title style='display:none'>Summary</title> <p>Food safety is a priority for the European Union (EU). EU food safety policy covers all sectors of the food chain. In recent years, numerous studies have been conducted in Bulgaria on contaminants in plant and animal foods as one of the priority areas of food safety policy. Metals are part of the chemical pollutants in the environment. People are exposed to metals from the environment and food and water contaminated with metals. Researchers have found that the intake of metals with food is different and that food exposure is the primary way of metal exposure.</p> </abstract>ARTICLE2022-01-18T00:00:00.000+00:00Review on Anastomotic Leak Rate after ICG Angiography during Minimally Invasive Colorectal Surgery<abstract> <title style='display:none'>Summary</title> <p>Colorectal cancer is the 3<sup>rd</sup> most common type of cancer worldwide. The most devastating complication after colorectal surgery remains the anastomotic leak (AL). Many techniques have been developed to reduce its rate. One such new method is perfusion angiography using indocyanine green (ICG). A literary search in PUBMED on 1.03.2021 for full-text English articles published between 2014 and 2021 was performed. ICG, colorectal cancer, and angiography were the keywords we used. The review was performed following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The literature search yielded 27 results when searching the database of PUBMED with the above keywords. Twenty-one out of 27 identified articles were included. Six were excluded from the analysis – four case reports, one review on the evolution of treating gastrointestinal cancers, and one containing no information on AL rate with ICG. One included article was RCT, sixteen were cohort studies, and four were meta-analyses or reviews. All articles reported a reduction in the anastomotic leak rate. However, the reduction was significant only in nine of them. Anastomotic leak is a severe complication and a subject of extensive research. Perfusion angiography with ICG is a step towards predicting and preventing AL, although it does not guarantee success in all cases.</p> </abstract>ARTICLE2022-01-18T00:00:00.000+00:00Effect of Aminosteroid U74389G in a Model of Inflammatory Bowel Disease in Rats<abstract> <title style='display:none'>Summary</title> <p>Lazaroid U-74389G is a synthetic 21-aminosteroid with free radical-scavenging and anti-inflammatory effects. This study was designed to evaluate the anti-inflammatory activity of U-74389G on experimental 2,4-dinitrobenzene sulfonic acid hydrate (DNBS)-induced colitis in Wistar rats. Five experimental groups were formed: a sham control group, a control group, treated with 0.25 ml of 50% ethanol intrarectally (n=8), a group treated with DNBS (30 mg in 0.25 ml of 50% ethanol administered intrarectally, (n=8), a group treated with DNBS and U-74389G at a daily dose of 15 mg/kg i.p. (n=8), and a group treated with DNBS and sulfasalazine, orally, at a dose of 300 mg/kg. During the experiment, the bodyweight of the rats, food intake, stool consistency, and presence of blood in the stool were recorded as markers of clinical condition. On day 6, colonic tissues were excised and scored for macroscopic and histological damage. Blood samples were taken to measure levels of cytokines by ELISA methods. DNBS decreased significantly body weight (from 237.00±2.52 g to 212.50±6.25 g, p=0.04). The rats treated with U-74389G showed greater food intake and weight gain. U-74389G reduced ulceration index: the U-74389G score was 1.25±0.25, and the DNBS score –3.87±0.61; p&lt;0.05. All other macroscopic parametersassessed were significantly improved in rats treated with U-74389G. The levels of inflammatory cytokines IL-1, IL-6, and TNF-α, were significantly lower than those of the DNBS group, while U-74389G significantly elevated the level of anti-inflammatory IL-10. These findings indicate that U-74389G significantly inhibits colonic inflammatory damages in a rat model of inflammatory bowel disease.</p> </abstract>ARTICLE2022-01-18T00:00:00.000+00:00The Role of Uterine Infection in Pregnancy Outcome: A Case Report<abstract> <title style='display:none'>Summary</title> <p>It was believed in the past that only the lower genital tract is inhabited by microorganisms, and the cervix was considered as a perfect barrier against the ascension of microbes. Nowadays, many studies using new sequencing technologies examining microbiomes with low biomass show that the microorganisms are gradually changing from the lower to the upper genital tract with decreasing bacterial abundance and increasing bacterial diversity. It is well documented that the endometrium is a non-sterile area, and in healthy women, the Lactobacillus spp. is the dominant flora. Lactobacillus - as a dominant endometrial microbiome, has a crucial role in implantation, early pregnancy development. It is also essential for a good pregnancy outcome. Non-Lactobacillus-dominant microbiome is associated with poor reproductive outcomes (recurrent implantation failure, recurrent miscarriages, outgoing pregnancy). This association is evidence of its significance for reproductive health.</p> <p>We present a case of unsuccessful first pregnancy with concurrent bacterial endometrial infection. A definitive antibiotic treatment resulted in a successful full-term second pregnancy. We present the influence of pathogenic microorganisms on uterine function and pregnancy development, current possibilities for diagnosis and treatment.</p> </abstract>ARTICLE2022-01-18T00:00:00.000+00:00en-us-1