Search

Plasticisers are small organic molecules added to polymer composites to modify their processability by adsorbing on the filler's surface or dispersing into the polymer matrix. Here we show how just small topological changes to the molecule’s structure affect miscibility.

Leveraging the anisotropic shape of DNA-functionalized nanoparticles holds potential for shape-directed crystallization of a wide collection of superlattice structures. Using coarse-grained molecular dynamics simulations, we study the self-assembly of a binary mixture of cubic gold nanoparticles, which are functionalized by complementary DNA strands. We observe the spontaneous self-assembly of simple cubic (SC), plastic body-centered tetragonal (pBCT), and compositionally disordered plastic body-centered tetragonal (d-pBCT) phases due to hybridization of the DNA strands. We systematically investigate the effect of length, grafting density, as well as rigidity of the DNA strands on the self-assembly behavior of cubic nanoparticles. We measure the potential of mean force between DNA-functionalized nanocubes for varying rigidity of the DNA strands and DNA lengths. Using free-energy calculations, we find that longer and flexible DNA strands can lead to a phase transformation from SC to the pBCT phase due to a gain in entropy arising from the orientational degrees of freedom of the nanocubes in the pBCT phase. Our results may serve as a guide for self-assembly experiments on DNA-functionalized cubic nanoparticles.

After allogeneic hematopoietic transplantation, a limited skin a-GVHD (Grade 1 a-GVHD) is usually managed by topical treatment and the criteria to start systemic immunosuppressive therapy are not established. We performed a prospective observational study on 102 consecutive adult patients who underwent allogeneic HSC transplantation. Eighty-two presented a skin rash (80.3%) and thirty-one of them (37.8%) progressed to Grade 2- some within 48 hours (Group 1) while others within days 3–7 (Group 2). Fifty-one patients (62.2%) did not have progression to Grade 2 GVHD within 7 days (Group 3). These patients were followed up. The Group 3 patients were subdivided into Group 3A (these had a stable or fading rash from the day of appearance to day 8) and Group 3B (these had a worsening rash from appearance to day 8). In group 3A the clinical results were significantly superior compared to results obtained in group 3B patients. In Group 3A versus Group 3B, Overall Survival at 2 years was 75.1% vs 39.8% (p = 0.03), Treatment Related mortality was 10.4% vs 39.2% (p = 0.05), need for secondary anti-GVHD treatment was 46.6% vs 76.4% (p = 0.002). The dynamic of skin rash during the first week from appearance marks patients with different prognosis.

Ruxolitinib is a JAK1/2 inhibitor that has revolutionized the approach to myelofibrosis. On the one side, this drug can rapidly improve the symptoms related to the hematological disease; on the other side, the inhibition of JAK1/2 can lead to immunosuppression which may increase the risk of infections, due to a change in the cytokine balance in favor of anti-inflammatory cytokines, to direct inhibition of immune cells, and to the suppression in the production of specific antibodies. In this patient setting, much is known about possible viral and bacterial infections, while little is reported in the literature concerning parasitic infections, specifically leishmaniasis. Leishmania is a parasitic infection that can cause serious problems in immunosuppressed patients. The parasite can invade the bloodstream and cause a wide range of symptoms, including fever, weight loss, and anemia. In severe cases, it can lead to multi-organ failure and, rapidly, death. Early diagnosis and prompt treatment are essential especially for these patients, unable to respond adequately. In this case and the following review of the existing literature, the cytokine kinetics and the production of specific anti-Leishmania antibodies represent characteristic aspects capable of providing a more in-depth understanding of the mechanisms underlying these complex clinical cases in an immunocompromised patient.

Pregnancy represents a crucial period in which several exposures—and especially maternal diet—might shape children’s health. Thus, identifying how maternal dietary intakes early affect biological aging in children represents a public health mission. We aimed to assess the relationship between maternal intake of nutrients in early pregnancy and telomere length of cell-free circulating DNA (cfDNA) from amniotic fluid. We used data and samples from the ongoing prospective “Mamma & Bambino” study, which recruits mother–child pairs from Catania at the first prenatal visit. Maternal nutrient intakes were assessed using a Food Frequency Questionnaire, while relative telomere length of cfDNA was assessed by real-time polymerase chain reaction. Our analysis included 174 mother–child pairs. The intakes of iron, vitamin B1, and magnesium were positively correlated with relative telomere length (p-values

A maternal diet, before and during pregnancy, plays a key role in ensuring maternal and newborn health. The COVID-19 pandemic, however, may have compromised dietary habits in the general population and in specific subgroups of individuals. Here, we evaluated the impact of COVID-19 on the diet of pregnant women, using data from two mother-child cohorts in Sicily (Italy). Dietary data were collected using a food frequency questionnaire and analyzed through the Mediterranean diet (MD) score and principal component analysis (PCA). The comparison of maternal dietary consumption before and during the COVID-19 pandemic showed differences in terms of vegetables (p < 0.001), fruit (p < 0.001), dairy products (p < 0.001), fish (p < 0.001), and legumes (p = 0.001). Accordingly, after adjusting for covariates, mothers enrolled during the pandemic were more likely to report low adherence to MD than those enrolled before (OR = 1.65; 95%CI = 1.12–2.42; p = 0.011). A similar result was obtained by analyzing the adherence to a prudent dietary pattern, derived through PCA and characterized by high intake of cooked and row vegetables, legumes, fruit, fish, and soup. Overall, these findings suggested that the COVID-19 pandemic may have influenced maternal diet during pregnancy. However, further efforts are needed to investigate the main causes and consequences of this change.

Using a simple and efficient way to optimize a chemically specific bead-and-spring model for polymer/surface systems, we analyze the structural properties of high molecular weight polyisoprene (PI) in contact with graphite. We find that in the vicinity of the graphite the adsorbed PI chains assume a pancake structure and are highly packed and highly entangled. The addition of plasticizers even with moderate surface affinity guarantees an almost complete surface coverage and forces the polymer chains to detach from the surface and to become less entangled. The softening effect of the plasticizers is observed also in bulk when they are added to the system but are not adsorbed on the surface. Finally, we show that the definition of the thickness of the interface is not unambiguous but depends on the observable used to characterized the melt: it is function of the polymer molecular weight if defined looking at the chain conformation, but it becomes independent of the polymer chain length if defined looking at the entanglement density.

Background In the first 1,000 days of life, from conception to two years of age, a variety of exposures could shape children's health. Identifying what maternal factors early affect biological aging in children represents a major public health mission. The present study aims to assess the relationship between maternal intake of nutrients in early pregnancy and telomere length of cell-free circulating fetal DNA (cffDNA) from amniotic fluid. Methods We used data and samples from the ongoing prospective “Mamma & Bambino” study, which recruits mother-child pairs from Catania (Italy) at the first prenatal visit. Maternal nutrient intakes were assessed using a Food Frequency Questionnaire referred to one-month prior the recruitment. Relative telomere length of cffDNA was assessed by real-time polymerase chain reaction, among those women who underwent amniocentesis. Results The study included 174 mother-child pairs (mean maternal age = 35.7 years) recruited from 4th to 20th gestational week. The intakes of iron, vitamin B1, and magnesium were positively correlated with relative telomere length (p-values based on Spearman's test = 0.05). However, only the intake of magnesium was positively associated with relative telomere length (β = 0.002; SE = 0.001; p = 0.024), after applying a linear regression model which included maternal age, smoking, pregestational body mass index, and total energy intake. Magnesium deficiency was negatively associated with relative telomere length after adjusting for the same covariates (β = -0.467; SE = 0.176; p = 0.009). Conclusions To our knowledge, this is the first evidence of a relationship between maternal nutrient intake and telomere length of cffDNA. The positive effect observed for magnesium is consistent with previous studies conducted in other settings. However, further efforts are needed to translate the transgenerational effect of maternal behaviors to effective public health strategies. Key messages It is crucial to understand the early effect of maternal diet on biological aging in children. The intake of magnesium positively modulates telomere length, a promising marker of aging before birth.

According to the evidence demonstrating vaccines’ safety and effectiveness in anticipation of and during pregnancy, several countries have established immunization programs during the periconceptional period. Here, we evaluated vaccination status among 220 mother–child pairs, using data from the ‘Mamma & Bambino’ cohort. The self-reported data were evaluated at delivery, and with planned follow-ups at 1–2 years after delivery. In general, we noted that the vaccination status among the women was heterogeneous, ranging from 8.3% (vaccine against Human Papillomavirus, HPV) to 65.6% (vaccine against Diphtheria Tetanus and Pertussis, DTaP). Excluding the women who contracted the diseases in the past, the main ground for refusal was the lack of information. We also demonstrated that increasing age was associated with higher odds of not being vaccinated against Measles-Mumps-Rubella (MMR; OR = 1.12; 95% CI = 1.04–1.21; p = 0.004), HPV (OR = 1.20; 95% CI = 1.08–1.33; p = 0.001) and DTaP (OR =1.09; 95% CI = 1.01–1.18; p = 0.040). As expected, we showed that the proportion of newborns vaccinated with the Hexavalent and Pneumococcal vaccines was high (99.5% and 98.6%, respectively), while the vaccination coverage against MMRV did not reach the auspicated threshold (84.1%). Overall, these results underlined the need for the improvement of women’s knowledge about the recommendations for vaccination, especially during pregnancy.

Background and objectives: The World Health Organization (WHO) recommends women (1) to initiate breastfeeding within one hour of birth; (2) to exclusively breastfeed for the first six months; and (3) to continue breastfeeding until two years of age. However, women do not always adhere to these recommendations, threatening the health of their children. The present study aims to evaluate breastfeeding status and the main maternal factors associated with exclusive breastfeeding for six months among women from the “Mamma & Bambino” study, a prospective cohort settled in Catania, Italy. Materials and Methods: We used data from 220 women (median age = 37 years) enrolled in the “Mamma & Bambino” cohort during prenatal obstetric counselling. Self-reported breastfeeding status was collected during the follow-up interviews at 1 and 2 years, referring to breastfeeding status (i.e., yes or no) and type of breastfeeding (i.e., exclusive or predominant). We also collected data about duration of breastfeeding to classify women into those who adhered to the WHO recommendation and those who did not. Results: In the general population, we noted that the proportion of women who have breastfed increased with increasing educational level. Accordingly, logistic regression analysis demonstrated that medium (OR = 3.171; 95% CI = 1.285–7.822; p = 0.012) and high educational levels (OR = 4.549; 95% CI = 1.525–13.570; p = 0.007) were positively associated with breastfeeding if compared to low educational level. Among women who have breastfed, instead, the proportion of adherents to the WHO recommendation was higher among those with medium–high educational level and those who were employed. In line with this, we demonstrated that full-time employment (OR = 2.158; 95% CI = 1.033–4.508; p = 0.041) and medium educational level (OR = 4.632; 95% CI = 1.227–17.484; p = 0.024) were positively associated with exclusive breastfeeding for the first six months. Conclusions: Socio-demographic factors should be taken into account through public health strategies for improving maternal knowledge about health benefits of exclusive breastfeeding.

The dispersion of inorganic particles within polymeric materials is an extensively used method to enhance their mechanical properties. One of the major challenges in the simulation of polymer composites is to model the uneven surface of the fillers which strongly affects the dynamics of the adsorbed polymers and consequently the macroscopic mechanical properties of the final composite. Here we propose a new multiscale approach that, using experimental adsorption data, constructs the filler surface to statistically reproduce the surface defects. We use this approach to analyse the structure and dynamics of highly entangled polyisoprene melt in contact with different realistic carbon black samples. We show that the presence of the heterogeneous surface has a negligible influence on the structure of the polymer chains but a major effect on their dynamics and the surface wettability.

Elastomeric compounds are reinforced with fillers such as carbon-black and silica to improve mechanical, dynamical, and tribological properties. The stability and physical properties of these materials are dominated by the intermolecular interactions occurring at the polymer/particles interface that determine the magnitude of the polymer/particles adhesion. Using molecular dynamics simulations, in this work, we evaluate the solid–liquid interfacial tension and the corresponding work of adhesion for a system composed of graphite/Polyisoprene 100% cis-1,4 within a range of molar masses and temperatures. We employ a simulation strategy for estimating the surface tension of fluid/vacuum and fluid/solid interfaces that use directly the local stress fields in the Irving–Kirkwood formalism. Using such procedure, we decompose the stress field into the individual components of the stress tensor and correlate them with the values of the work of adhesion in the different systems analyzed.

The study evaluated the effect of DHA 625 mg in women who experience menopausal symptoms, on sexuality and quality of life (QoL), and on the auditory brainstem response (ABR). Forty-two perimenopausal women were enrolled. The Kupperman Index (KI) was used to evaluate menopause symptoms. The Short Form-36 (SF-36), Female Sexual Function Index (FSFI), and the Female Sexual Distress Scale (FSDS) were used to assess QoL, sexual function, and sexual distress, respectively. Auditory evoked potentials to measure the ABR. The study had one follow-up at 6 months. The women reported an improvement in the KI total score (p .001). Moreover, women reported QoL improvements in all the psychological categories (p .001), but not in physical categories (p = NS). FSFI and FSDS total scores increased (p .01) and the FSDS score decreased (p .01), mainly due to arousal (p .03) and lubrication (p .05) sexual aspects. The ABR wave latencies were lower than the baseline values (p .05). DHA could be effective in modulating some perimenopausal symptoms in women and, consequently could contribute to improve their QoL and sexual life. Finally, DHA seems to have a direct activity on the neuronal conduction time into the audiological system.

Congenital anomalies of the kidney and urinary tract (CAKUT) include isolated kidney malformations and urinary tract malformations. They have also been reported in Prune-Belly syndrome (PBS) and associated genetic syndromes, mainly 13, 18 and 21 trisomy. The AA focuses on bladder and urethral malformations, evaluating the structural and histological differences between two different cases of megacystis. Both bladders were examined by routine prenatal ultrasound screening and immunohistochemistry, comparing the different expression of smooth muscular actin (SMA), S100 protein and WT1c in megacystis and bladders of normal control from fetuses of XXI gestational age. Considering the relationship between the enteric nervous system and urinary tract development, the AA evaluated S100 and WT1c expression both in bladder and bowel muscular layers. Both markers were not expressed in the bladder and bowel of PBS associated with anencephaly. In conclusion, megacystis could be considered only a macroscopic definition, concerning the size of the fetal bladder rather than the embryologic origin, it may be a single or multiple malformation, the possible association with the bowel and/or encephalic malformations will decide the outcome and prognosis in fetal megacystis.

Using molecular dynamics simulations, we analysed the polymer dynamics of chains of different molecular weights entrapped at the interface between two immiscible liquids. We showed that on increasing the viscosity of one of the two liquids the dynamic behaviour of the chain changes from a Zimm-like dynamics typical of dilute polymer solutions to a Rouse-like dynamics where hydrodynamic interactions are screened. We observed that when the polymer is in contact with a high viscosity liquid, the number of solvent molecules close to the polymer beads is reduced and ascribed the screening effect to this reduced number of polymer–solvent contacts. For the longest chain simulated, we calculated the distribution of loop length and compared the results with the theoretical distribution developed for solid/liquid interfaces. We showed that the polymer tends to form loops (although flat against the interface) and that the theory works reasonably well also for liquid/liquid interfaces.

Several studies—albeit with still inconclusive and limited findings—began to focus on the effect of drinking alcohol on telomere length (TL). Here, we present results from a systematic review of these epidemiological studies to investigate the potential association between alcohol consumption, alcohol-related disorders, and TL. The analysis of fourteen studies—selected from PubMed, Medline, and Web of Science databases—showed that people with alcohol-related disorders exhibited shorter TL, but also that alcohol consumption per se did not appear to affect TL in the absence of alcohol abuse or dependence. Our work also revealed a lack of studies in the periconceptional period, raising the need for evaluating this potential relationship during pregnancy. To fill this gap, we conducted a pilot study using data and samples form the Mamma & Bambino cohort. We compared five non-smoking but drinking women with ten non-smoking and non-drinking women, matched for maternal age, gestational age at recruitment, pregestational body mass index, and fetal sex. Interestingly, we detected a significant difference when analyzing relative TL of leukocyte DNA of cord blood samples from newborns. In particular, newborns from drinking women exhibited shorter relative TL than those born from non-drinking women (p = 0.024). Although these findings appeared promising, further research should be encouraged to test any dose–response relationship, to adjust for the effect of other exposures, and to understand the molecular mechanisms involved.

Objective: To investigate the potential value of uterine artery Doppler at 30 34 weeks’ gestation in the prediction of adverse perinatal outcome. Methods: Screening study in 30,780 singleton pregnancies at 30 34 weeks. Uterine artery pulsatility index (PI) was measured and the values were converted to multiples of the median (MoM) after adjustment from variables in maternal characteristics and medical history that affect the measurements. Multivariable logistic regression analysis was used to determine if uterine artery PI had a significant additional contribution to maternal characteristics, medical history and obstetric factors in predicting adverse outcome. The detection rate (DR) and false positive rate (FPR) of screening by uterine artery PI were estimated for stillbirth, cesarean section for fetal distress, umbilical arter ial cord blood pH 95 th percentile in screening for each adverse outcome was poor with DR of 6 16% and FPR of 5 6%. T he DR of high uterine artery PI for adverse outcome was higher in the SGA than non SGA groups, including 24% vs. 13% for stillbirth , 15% vs. 5% for cesarean section for fetal distress, 22% vs. 9% for low cord blood pH and 20% vs. 3% for low Apgar score. Conclusion: High uterine artery PI at 30 34 weeks’ gestation may be useful in the prediction of adverse perinatal outcome in pregnancies with SGA fetuses, but not in those with non SGA fetuses.

Objective To investigate the potential value of biophysical and biochemical markers at 30–34 weeks' gestation in the prediction of adverse perinatal outcome. Methods This was a screening study in 8268 singleton pregnancies at 30–34 weeks' gestation. Estimated fetal weight (EFW), uterine artery (UtA) pulsatility index (PI), umbilical artery (UA) PI, fetal middle cerebral artery (MCA) PI, mean arterial pressure (MAP), serum placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured. The detection rate (DR) and false-positive rate (FPR) of screening by each biomarker were estimated for stillbirth, pre-eclampsia, delivery of small-for-gestational-age (SGA) neonate, Cesarean section for fetal distress before or during labor, umbilical arterial cord blood pH ≤7.0 or umbilical venous cord blood pH ≤7.1, 5-min Apgar score < 7 and admission to the neonatal unit (NNU). Results Multivariable regression analysis demonstrated that significant prediction of PE was provided by PlGF, sFlt-1, MAP and MCA-PI, with a DR of 98% for PE delivering < 37 weeks' gestation and 56% for those delivering ≥ 37 weeks, at a 10% FPR. Prediction of SGA was provided by EFW, PlGF, sFlt-1, UtA-PI, UA-PI and MCA-PI, with a DR of 88% for SGA delivering < 37 and 51% for those delivering ≥ 37 weeks' gestation, at a 10% FPR. Prediction of stillbirth was provided by EFW, UtA-PI and MCA-PI, with DR of 30% at 10% FPR. Prediction of Cesarean section for fetal distress before labor was provided by EFW, sFlt-1, UtA-PI and UA-PI, with a DR of 90% at a 10% FPR. Prediction of fetal distress in labor was provided by EFW and sFlt-1, with a DR of 16% at a 10% FPR. There were no significant differences from the normal outcome group in any of the biomarkers for low cord blood pH, low Apgar score or NNU admission for cases other than those with PE and/or SGA. Conclusion At 30–34 weeks' gestation, biomarkers of impaired placentation and fetal hypoxemia provide good prediction of PE, SGA and fetal distress before labor, but poor or no prediction of stillbirth and adverse events in labor or after birth. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

Objective To investigate the potential value of biophysical and biochemical markers at 35–37 weeks' gestation in the prediction of adverse perinatal outcome. Methods This was a screening study in 3953 singleton pregnancies at 35–37 weeks' gestation. Estimated fetal weight (EFW), uterine artery pulsatility index (UtA-PI), umbilical artery (UA)-PI, fetal middle cerebral artery (MCA)-PI, mean arterial pressure (MAP), serum placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured. The detection rate (DR) and false-positive rate (FPR) of screening by each biomarker were estimated for pre-eclampsia (PE), delivery of small-for-gestational-age (SGA) neonates, Cesarean section for fetal distress before or during labor, umbilical arterial cord blood pH ≤ 7.0 or umbilical venous cord blood pH ≤ 7.1, 5-min Apgar score < 7 and admission to the neonatal unit (NNU). Results Multivariable regression analysis demonstrated that significant prediction of PE was provided by PlGF, sFlt-1 and MAP, with a DR of 73% at a 10% FPR. Prediction of SGA was provided by EFW, PlGF and UtA-PI, with a DR of 63% at a 10% FPR. Prediction of Cesarean section for fetal distress before labor was provided by EFW and UA-PI with DR of 100% at 10% FPR. Prediction of fetal distress in labor was provided by EFW and sFlt-1, with a DR of 15% at a 10% FPR. There were no significant differences between those with a normal outcome and those with low cord blood pH, low Apgar score or NNU admission for any of the biomarkers assessed. Conclusion At 35–37 weeks' gestation biomarkers of impaired placentation and fetal hypoxemia provide good prediction of PE, SGA and fetal distress before labor, but poor or no prediction of adverse events in labor or after birth. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

A 33-year-old woman with a dichorionic diamniotic twin pregnancy was admitted to the Obstetrics and Gynecological Department of Policlinico G. Rodolico University Hospital (Catania, Italy), because...

Objectives OAB is a common finding in postmenopausal women. Hypoestrogenism is the root cause of many signs and symptoms of Genitourinary Syndrome of Menopause (vaginal dryness, atrophy, dyspareunia, urinary disorders, etc.). As such the aim of this study was to evaluate the urodynamic effects of ultralowdose estriol vaginal gel formulation to treat women with Genitourinary Syndrome of Menopause and Overactive Bladder Syndrome. Study design This open-labeled, single center, prospective study involved 37 women with OAB recruited in our Urogynecological Unit between January and July 2016. They received estriol 50 mcg/g vaginal gel, one applicator-dose per day for 3 weeks followed by one dose twice a week for 12 weeks. Objective and subjective parameters were evaluated before and after treatment through the urodynamic examination, Overactive Bladder symptom score and Short Form Health Survey-36 questionnaires. Results Vaginal atrophy symptoms and signs as well as the overactive bladder subjective symptom parameter improved significantly. Urodynamic evaluation showed significant improvement in first desire to void and maximum cystometric capacity after estriol usage. Patients who had detrusor overactivity did not show any improvement for this parameter after treatment. The voiding function parameters did not significantly change. Short form-36 showed a better quality of life after treatment especially for the emotional role, as well as mental and general health. Conclusions A local ultra-low dose concentration of estriol could be effective in women with vaginal atrophy and Overactive Bladder Syndrome for improving both subjective symptoms and urodynamic parameters of storage function not affecting voiding function.

Background: Bacterial vaginosis is the most frequent condition associated to the vaginal microbiota imbalance, affecting about the 40–50% of women in the world. Even if antibiotics are effcetive for bacterial vaginosis treatment a long-term recurrence rates, higher than 70%, is recorded. Lactoferrin is an iron-binding glycoprotein with bacteriostatic and bactericidal properties. It owns the ability to protect the host against infection, by binding and regulating the iron needed for the bacterial proliferation. Objective: The present study was an open prospective randomized trial (registration no. SHI-EVE-2014.01) aimed at characterizing the bacterial biota of women affected by bacterial vaginosis (BV) and assessing the effects of two different lactoferrin concentrations (100 mg and 200 mg vaginal pessaries) on the composition and dynamics of the vaginal bacterial biota. Design: Sixty women with BV were recruited and randomized into two groups to receive lactoferrin pessaries for 10 days. Clinical evaluation was based on Amsel criteria and Nugent scores. Culture-dependent methods and Ion Torrent PGM sequencing of the 16S rRNA gene were applied to study in depth the overall structure of the vaginal bacterial biota and its dynamics during the treatment. Results: Vaginal lactoferrin administration modified the vaginal microbiota composition in patients with BV. During treatment, both 100 mg and 200 mg lactoferrin vaginal pessaries significantly decreased the occurrence of bacteria associated with BV, such as Gardnerella, Prevotella, and Lachnospira, and increased the occurrence of Lactobacillus species. The bacterial biota balance was maintained up to 2 weeks after treatment only in women treated with 200 mg lactoferrin pessaries. Conclusions: This study indicates that lactoferrin could be proposed as an alternative therapeutic approach for BV. Our data showed, for the first time, the dominance of Lactobacillus helveticus species during and after vaginal lactoferrin treatment.

To evaluate the effects of different subtypes of urinary incontinence (UI) on sexual function and quality of life (QoL).Ninety-three women with UI were enrolled in the observational study. By the urodynamic findings, 32 women (34.5 %) were diagnosed with stress urinary incontinence (SUI), 35 (37.6%) with urgency urinary incontinence (UUI), and 26 (27.9%) with mixed urinary incontinence (MUI). The Short Form-36 questionnaire was used to investigate the QoL, and the Female Sexual Function Index and Female Sexual Distress Scale questionnaires were used to study sexual function and sexual distress, respectively.Low mean total Female Sexual Function Index scores and high mean Female Sexual Distress Scale total scores were obtained for each group. However, women with MUI showed a significantly higher impairment of female sexual function (P .05) compared with others. Women with MUI and UUI had more orgasmic disorder than those with SUI, and women with MUI and SUI had mainly lower sexual desire than those with UUI. QoL was worse in women of all groups, particularly in those with UUI and MUI.UI, whatever its nature, has a significant impact on sexual function; notwithstanding, the subgroups of UI, namely SUI, UUI, and MUI, may have their sexual function affected in different ways. All subtypes of UI can have severe consequences on perception of QoL, but when compared, a significantly high impairment of QoL was observed in the MUI and the UUI groups.

Objective This study reports on the clinical implementation of cell-free DNA (cfDNA) testing, contingent on the results of the combined test, in screening for fetal trisomies 21, 18 and 13 in two UK National Health Service hospitals. Women with a combined-test risk of ≥ 1:100 (high risk) were offered the options of chorionic villus sampling (CVS), cfDNA testing or no further testing and those with a risk of 1:101 to 1:2500 (intermediate risk) were offered cfDNA or no further testing. The objective of the study was to examine the factors affecting patient decisions concerning their options. Methods Combined screening was performed in 6651 singleton pregnancies in which the risk for trisomies was high in 260 (3.9%), intermediate in 2017 (30.3%) and low in 4374 (65.8%). Logistic regression analysis was used to determine which factors among maternal characteristics, fetal nuchal translucency thickness (NT) and risk for trisomies were significant predictors of opting for CVS in the high-risk group and opting for cfDNA testing in the intermediate-risk group. Results In the high-risk group, 104 (40.0%) women opted for CVS; predictors for CVS were increasing fetal NT and increasing risk for trisomies, while the predictor against CVS was being of Afro-Caribbean racial origin (r = 0.366). In the intermediate-risk group, 1850 (91.7%) women opted for cfDNA testing; predictors for cfDNA testing were increasing maternal age, increasing risk for trisomies and university education, while predictors against cfDNA testing were being of Afro-Caribbean racial origin, smoking and being parous (r = 0.105). Conclusions This study has identified factors that can influence the decision of women undergoing combined screening in favor of or against CVS and in favor of or against cfDNA testing. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

Amniotic cavity contains amniotic fluid which plays an important role to guarantee fetal movements (essential for the skeletal development), fetal chest and lungs development and to protect against umbilical cord compression, fetal trauma and infections. Premature rupture of membranes (PROM) is the rupture of the chorioamniotic membrane before the onset of labor (1). It complicates approximately 2% of pregnancies and it determines a significantly increasing of neonatal morbidity and mortality because in the 40% of cases it causes preterm delivery. The management of PPROM requires a careful evaluation of benefits of prolongation of the pregnancy and risks of intra-amniotic infection, in order to minimize maternal and fetal complications. There are a few possibilities: expectant management, amnioinfusion, sealing techniques; termination of pregnancy is proposed to women in case of high risks of maternal sepsis and very poor fetal outcome. In this paper we report the case of a woman with iatrogenic PPROM post amniocentesis at 17th week of gestation treated by amniopatch. At the end of the procedure maternal and fetal conditions were good and amniotic fluid was restored. The procedure was repeated twice and the patient gave birth at 32 weeks. Currently, due to the lack of evidence in the scientific literature, there is no evidence of the superiority of a therapeutic option over the others. The management of PPROM should be based on the clinical evaluation of the specific case. We suggest considering transabdominal sealing technique when the expectant management failed.

Objective: To evaluate whether the new bipolar resectoscope (BR) 22 Fr (Karl Storz) represents a reliable improvement in operative hysteroscopy and to compare the new device to the 26 Fr BR (Karl Storz). Material and methods: A prospective observational study. From June 2010 through May 2011, 158 consecutive patients treated with bipolar resectoscope 22 Fr and 26 Fr for endocavitary pathologies were registered. Data analysis included patients'characteristics, surgical indications, operative time and complications. 140 patients were eligible. Results: 115/140 (82.1%) patients were treated by BR 22; 55 (39.2%) metroplastics, 34 (24.2%) polipectomies, 25 (17.8%) myomectomies and one (0.71%) sinechiolisis were performed. 25/140 (17.8%) patients were treated by BR 26; 6 (4.2%) polipectomies and 19 (13.5%) myomectomies were performed. Mean time of cervical dilatation by Hegar series was 57 sec for BR 22 Fr and 102 sec for BR 26 Fr (p = 0.034). 4/25 (16%) with 26BR and 1/115 (0.8%) with 22BR complications were observed (p = 0.002) : One uterine perforation, two post operative bleedings > 7 days, one intravasation syndrome and one cervical laceration. Conclusion: Bipolar resectoscopy is feasible and safe. The new device BR 22 Fr is preferable to 26 Fr because it requires lower cervical dilatation limiting operative time and complications.

Lactoferrin (Lf) is an approximately 80-kDa iron-binding glycoprotein, belonging to the transferrin family, with well-known bacteriostatic and bactericidal properties. It is produced and stored in specific (secondary) neutrophil granules and released during neutrophil activation and degranulation. Nowadays, Lf has a well-known therapeutic indication for combating iron deficiency anemia (IDA) in pregnant women. Studies suggest that Lf plays an important role against cervicovaginal infections by decreasing cytokines levels, such as interleukin (IL)-6, in cervicovaginal fluid. The aim of this preliminary trial was to evaluate the effectiveness of Lf in preventing preterm delivery caused by cervical infections and ripening. From November 2009 to August 2010, 21 pregnant women (26-32 weeks pregnant), aged between 22 and 36 years, suffering from IDA, at risk of preterm delivery, were prospectively enrolled in the study. One group (N=14) received 100 mg of recombinant human lactoferrin (bLf) [corrected] (lattoferrina; AG-pharma) twice a day before meals, for one month. The other group (N=7) received 520 mg of ferrous sulfate (Ferro-Grad; Abbott Laboratories, USA) once a day. The patients underwent transvaginal ultrasound to evaluate cervical length and funneling, and vaginal swabs were used to detect infections and cervicovaginal fluid sample collection to determine IL-6 levels. The results showed a correlation between the oral administration of 200 mg of bLf [corrected] with both the normalization of vaginal flora (vaginal infection disappearance) and the decrease in IL-6 cervicovaginal fluid levels in women at risk of preterm delivery.

The aim of this study is to show the safety and efficacy of the double transobturator approach, a new technique for anterior vaginal wall prolapse, using several different kinds of meshes (synthetic and biological).This is a retrospective study of 74 women treated between 2005 and 2007. The patients underwent a 3, 6 and 12 month follow-up. The anatomical cure rate, defined as grade of prolapse

OBJECTIVES: To evaluate the objective and subjective midterm outcomes of transobturator tape (TOT) in the treatment of female stress urinary incontinence (SUI). MATERIALS AND METHODS: A total of 114 consecutive patients affected by stress urinary incontinence (mean age 59±10 years), who underwent the TOT procedure between July 2004 and May 2008 (46 patients received the Safyre, 30 patients the PelviLace, 20 patients the Monarc, 10 patients the DynaMesh and 8 the Align sling), were assessed in June 2008. An evaluation of the patients, based on history, physical examination, stress test, urodynamic tests, and the compilation of two specific quality of life questionnaires, was performed before and after surgery. RESULTS: The therapeutic midterm failure rate for the TOT procedure was 4.4% (5 of 114 patients). The midterm cure rate was 95.6% (109 of 114 patients), 7 (6.1%) of those patients only improved, still with minimal residual urinary leakage. Clinical signs for bowel, urethral, or bladder injuries were undetectable. Intraoperative bleeding, postoperative field infections, or postoperative pelvic floor relaxations were not noted. Three patients (2.6%) presented a little small area of mesh erosion within 6 months from surgery. We also noticed a few obstructive symptoms and irritative symptoms: 4 of 114 (3.,5%) patients showed urge de novo urge symptoms. A high grade degree of satisfaction was assessed reported by QoL questionnaires ( p

After the publication of the article, the authors noted that they had made an error regarding certain data in their manuscript. The error relates to the use of recombitant human lactoferrin (rhLf), as opposed to bovine lactoferrin (bLf). Throughout the article, rhLf should be replaced with bLf, and recombitant human lactoferrin (rhLf) with bovine lactoferrin (bLf). [the original article was published in the Molecular Medicine Reports 5: 162-166, 2012 DOI: 10.3892/mmr.2011.584].

We report the wetting behavior of graphitic surface−water interfaces through the calculation of the local stress tensor based on the Irving−Kirkwood− Noll theory using detailed atomistic molecular dynamics simulations. We compare the interfacial properties of fully wetted and partially wetted graphene (i.e., in contact with water on one side and vacuum on the other) and observe that the wettability is the result of a fine balance between van der Waals (vdW) and electrostatic interactions. Such a balance is partially perturbed in the case in which graphene is in contact with water on one side and with vacuum on the other. In this scenario, the presence of vacuum and the intrinsic hydrophobic nature of graphene cause water molecules in the proximity of the surface to rearrange the network of hydrogen bonds dominated by pentagonal rings that allow for enhanced packing and diffusion. Our analyses indicate that the surface tension of the fully wetted graphene layers is ca. 8 mNm−1 lower than that of the graphene layers wetted on only one side and this difference only mildly decreases upon adding graphene layers. We rationalize these observations by investigating how the number of graphene layers affects the topology of the hydrogen bond network in the proximity of the graphene surface in both systems. We find that water molecules on one side of the graphene layers in the fully wetted system interact with the water molecules on the other side creating a more stable hydrogen bond network. The investigation of the wettability of graphene and graphite is an important aspect for predicting the behavior of aqueous solutions under nanoconfinement, the permeability of porous materials, the interactions among graphitic surfaces, and their dispersion in aqueous environments. Therefore, our results can be applied to interface-related phenomena to better understand the interface where the local energy varies at the nanoscale.

Objective. We report an unusual case of ectopic pregnancy in a woman with right annessiectomy and left tubal ligation. Case report. A 35-year old woman underwent laparotomy right annessiectomy and left tubal ligations, because of a mature cystic teratoma attached to the right annex. She arrived in emergency three years later with lower abdominal pain, amenorrhea and a positive level of beta hCG (Beta subunit of human chorionic gonadotropin). An urgent videolaparoscopy was performed, with a left salpingectomy with the removal of the ectopic pregnancy in the distal remain tube. The pathologic report confirmed the diagnosis of ectopic pregnancy. The patient’s postoperative recovery was normal. Conclusion. The analysis of the literature/published data shows that the partial salpingectomy increases the risk of ectopic pregnancy, so total salpingectomy is the preferred option over partial salpingectomy, in order to reduce the risk of recurrent ectopic pregnancy.