Purpose: To evaluate whether subchorionic hematoma (SCH) in early pregnancy is associated with a higher frequency of preeclampsia, preterm birth, small for gestational age (SGA) newborns, placental abruption, and other outcomes related to placental dysfunction. Material/Methods: A prospective observational study was conducted from December 2020 to July 2025. A total of 460 pregnant women were analyzed, including 178 with SCH and 282 controls without ultrasound evidence of SCH. The frequencies of preeclampsia, preterm birth, SGA, intrapartum complications, and selected associations with SCH size and location were evaluated. Categorical variables were compared using the chi-square test and Fisher’s exact test. A value of p<0.05 was considered statistically significant. Results: Preeclampsia occurred in 24.2% of women with SCH compared with 7.8% in controls, p=0.001. Preterm birth was observed in 20.2% versus 2.1%, p<0.001. SGA occurred in 37.1% versus 7.1%, p<0.001. Intrapartum complications were more frequent in women with SCH, 11.2% versus 2.8%, p<0.001. Placental abruption accounted for the main difference, 6.7% versus 0.7%, p<0.001. Within the SCH group, a larger hematoma size was significantly associated with preterm birth. Conclusions: SCH in early pregnancy was associated with a higher frequency of preeclampsia, preterm birth, SGA, and placental abruption. These findings suggest that SCH may identify pregnancies with increased risk of placental dysfunction-related outcomes. Due to the observational design, the results should be interpreted as associations rather than evidence of causality.
Introduction: Hysterectomy is a surgical intervention that a large part of the female population undergoes. The postoperative period is associated with a number of complications, some of which are infections, severe pain, adhesions, pelvic floor dysfunction, etc. Postoperative physiotherapy is used to prevent all of them, which is widely described in the scientific literature, however, the role of preoperative physiotherapy in such patients remains unclear, and the literature data on it are scarce and insufficient. The aim of the present study is to study the effect of preoperative physiotherapy on pain and functional capabilities of patients in the early postoperative period who underwent total abdominal hysterectomy. Materials and methods: In the period September 2024 - May 2025, a total of 30 women who underwent total abdominal hysterectomy were studied, divided into two groups of 15 each. The working group performed preoperative physiotherapy, and the control group did not. Postoperative physiotherapy was applied to both groups during the hospital stay. Results: Comorbidities and age were recorded. Pain intensity at rest and during movement was examined in patients from both groups at the 12th, 24th, and 48th postoperative hours. Regarding the Barthel Index, the following results were obtained when it was measured on the 1st and 3rd postoperative days. Postoperative recovery using the Standing and Sitting Test was assessed, too. Discussion: The observed pattern suggests that preoperative physiotherapy may facilitate early postoperative recovery primarily by improving pain-related mobility and basic functional performance. The significant advantages in sit-to-stand ability and walking capacity, together with the absence of a clear effect on the Barthel Index, indicate that its earliest benefits may be more specific to movement-related tasks than to broader activities of daily living. Conclusion: The present study demonstrated that preoperative physiotherapy leads to effective and rapid functional recovery in patients undergoing total abdominal hysterectomy. The presented physiotherapy program model and its algorithm are suitable for in clinical application to improve early postoperative functional recovery.
Purpose: The first months of life are a critical period for brain development. This study assessed neurodevelopment in 6-month-old infants using the Ages and Stages Questionnaire, Third Edition (ASQ-3), and examined variability across developmental domains. Material/Methods: A cross-sectional observational study was conducted in Bulgaria between August and December 2025. A total of 146 term infants aged 6 months (±2 weeks) were assessed with the 6-month ASQ-3, covering communication, gross motor, fine motor, problem-solving, and personal-social development. Descriptive statistics, chi-square tests with post-hoc standardized residuals, and independent-samples t-tests were applied. Results: The highest mean scores were observed in Problem Solving (54.0 ± 8.2) and communication (51.0 ± 7.5), while Gross Motor had the lowest mean score (41.1 ± 11.9). The Gross Motor domain also had the highest proportion of infants requiring monitoring or further assessment (31.5%). Item-response distributions differed significantly within all domains (all p < 0.001), with greater variability in several more complex skills. No statistically significant sex differences were found. Conclusions: Neurodevelopment at 6 months shows substantial domain-specific variability, with basic skills generally more established than complex abilities. Standardized screening with ASQ-3 may support early identification of infants requiring monitoring or further assessment.
Purpose: This study examines the international and European legal framework governing integration in education, with a particular focus on higher education institutions and the protection of students with disabilities and other vulnerable groups. The study traces the evolution of integration from a social concept to a legally recognized principle based on equality, accessibility, participation, and non-discrimination. Materials and Methods: The study employs a comprehensive normative, historical, and comparative legal methodology. International legal instruments, including the Convention on the Rights of Persons with Disabilities, UNESCO and UNICEF standards, European Union law, and the case law of the European Court of Human Rights and the Court of Justice of the European Union, were analyzed to assess legal standards regarding inclusive education and reasonable accommodations. Results: The analysis shows that inclusive education has become an essential element of the right to education under international and European human rights law. The case law of the ECHR establishes that the lack of reasonable accommodations, accessibility, and individualized support may constitute discrimination and a violation of the right to education. Conclusion: Inclusive education is evolving into a multidimensional legal standard that requires not only formal equality but also effective participation, institutional support, an accessible environment, and systemic measures aimed at ensuring equal educational opportunities for all students in higher education.
Purpose: This in vitro study evaluated the antimicrobial effectiveness of 5.25% sodium hypochlorite (NaOCl) alone and combined with the commercially available Dual Rinse HEDP (Medcem, Switzerland), which contains etidronic acid (1-hydroxyethylidene-1,1-diphosphonic acid, HEDP) in powder form, against Enterococcus faecalis. Materials and methods: The study involved preparing bacterial cultures of Enterococcus faecalis, which were grown on esculin base agar and Luria-Bertani (LB) agar, then suspended in sterile saline to a concentration of approximately 8×108 CFU/ml. These cultures were spread in Petri dishes, followed by punching wells, adding test solutions (Group I – 5.25% NaOCl; Group II – Dual Rinse HEDP dissolved in 5.25% NaOCl; Group III – Dual Rinse HEDP dissolved in ultra-pure water; Group IV – ultra-pure water, control), and incubating at 37°C for 48 hours to assess antimicrobial activity by measuring inhibition zones. The experiment was repeated in six independent experiments (n = 6 per group), and the data were analyzed with SPSS using the Shapiro–Wilk test, one-way ANOVA and Tukey’s post hoc test. Results: The largest inhibition zones were recorded for 5.25% NaOCl (17.8 ± 0.9 mm), followed by Dual Rinse HEDP in NaOCl (16.3 ± 1.1 mm) and Dual Rinse HEDP in ultra-pure water (8.5 ± 0.6 mm); no inhibition was observed in the control group. The difference between NaOCl alone and NaOCl combined with HEDP was small (1.5 mm) but statistically significant (p = 0.027), and both NaOCl-containing solutions produced significantly larger zones than HEDP in water (p < 0.001). Conclusion: Under the conditions of this agar diffusion model, the addition of HEDP to 5.25% NaOCl resulted in a small but statistically significant reduction of the inhibition zone against E. faecalis, while the mixture retained high antimicrobial activity. HEDP alone showed limited antimicrobial activity.
