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To evaluate the prevalence, types, and postnatal follow-up of congenital heart defects (CHDs) in a cohort of monochorionic (MC)/diamniotic (DA) twin pregnancies complicated by selective fetal growth restriction (sFGR) and to compare this population with an uncomplicated MC/DA population evaluated during the same period.We retrospectively analyzed all consecutive MC/DA pregnancies from 2009 to 2018, including those complicated by sFGR (group A) and uncomplicated (group B) cases. All inborns were screened for CHD before discharge. Discharge letters for all outborns were retrieved. Pregnancies with complications other than sFGR, or those without perinatal follow-up were excluded. The MC cases in group A were further divided into three types of sFGR according to the Gratacos classification.In total, 870 MC/DA twin pregnancies formed the study population: 296 in group A and 574 in group B. In group A, the CHD prevalence was 3.7% (22 of 592 twins), without significant differences between the three types of sFGR (type 1, 3.6%; type 2, 3.2%; type 3, 4.1%; p=0.55). Out of the five CHD in type 3 pregnancies, we had one case of pulmonary stenosis (PS) in the larger twin, with an isolated coarctation of the aorta in the smaller co-twin, while in other three cases with CHD, only PS was observed in the larger twins. Type 3 pregnancies in which only the smaller twin was affected by CHD was not observed in this study. In the larger twins, 10 of 11 CHD cases (91%) were right ventricular outflow tract abnormalities (RVOTA), and 1 (9%) was a ventricular septal defect. In the smaller twins, we identified 11 cases of CHD with a broad spectrum of cardiac abnormalities. In group B, the CHD prevalence was 1.1% (13 of 1148 twins), which was similar to the CHD prevalence in the general population according to the EUROCAT registry for the same years and geographical area of the study (0.96%; p=0.579). The CHD prevalence was significantly higher in group A than in group B [3.7% versus 1.1%; p=0.0002; odds ratio=3.57 (95% confidence interval: 1.78-7.22)]. In all group A and group B pregnancies, CHDs were discordant anomalies.In our experience, in MC/DA twin pregnancies, sFGR tripled the prevalence of CHD; hence, women with such pregnancies should be referred to a tertiary care hospital for prenatal and postnatal cardiac evaluation, treatment, and long-term follow-up. In the larger twins, the only major CHD was RVOTA, while a broad spectrum of CHDs was involved in the smaller twins. The higher risk of CHD in MC/DA pregnancies appears to be due to the typical complications of the MC pregnancy rather than to the MC nature of the pregnancy itself. This article is protected by copyright. All rights reserved.

The aim of this study was to evaluate the effects of Beta (?)-vinasse supplementation on the live weight (LW), live weight gain (LWG), feed intake (FI), feed conversion ratio (FCR), carcass yield, meat quality, and ilio-caecal bacteriological flora of quails. A total of 240 5-d-old Japanese (Coturnix coturnix Japonica) quails, including both males and females, were divided into 3 groups 80 quails and treated as follow: a control group (1) with 0 g ?-vinasse/ kg ration; (2) 15 g/kg ?-vinasse and (3) 30 g/kg ?-vinasse. The study lasted for 6 weeks. At the end of the experiment, supplementation with ?-vinasse did not have a significant effect on FI and FCR. Dietary supplementation with 30 g/ kg ?-vinasse significantly (P < 0.05) increased LW (21 d)and LWG (5 to 21 d). The dietary treatment of quails with different levels of ?-vinasse did not affect hot carcass weight, cold carcass weights, hot and cold carcass yields, and breast and thigh pH.The lightness (L*) and yellowness (b*) of breast values were significantly (P

To describe the long-term outcome of children with prenatally diagnosed isolated complete agenesis of the corpus callosum (cACC).In this single-center case series, we reviewed retrospectively the charts of fetuses referred to our fetal therapy unit from January 2004 to July 2020 for a suspected anomaly of the corpus callosum (CC). Cases with prenatally diagnosed isolated cACC were included. Fetal karyotype and comparative genomic hybridization microarray of amniotic fluid, in addition to fetal magnetic resonance imaging, were offered to all pregnant women with a diagnosis of fetal CC malformation. The surviving children were enrolled in the neurodevelopmental follow-up program at our institution, which included postnatal magnetic resonance imaging, serial neurological examinations and neurodevelopmental evaluations with standardized tests according to age. Families living in remote areas or far from our institution were offered a structured ad-hoc phone interview.A total of 128 pregnancies with fetal CC malformation were identified (mean gestational age at diagnosis, 24.5 (range, 21-34) weeks), of which 53 cases were diagnosed prenatally with apparently isolated cACC. Of these, 12 cases underwent termination of pregnancy, one resulted in intrauterine demise at 24 weeks of gestation and 13 cases were lost to follow-up. Of the remaining 27 children, one was excluded due to an associated chromosomal anomaly (8p21.3q11.21 mosaic duplication) diagnosed after birth, which could have been detected prenatally if the parents had consented to amniocentesis. In the 26 children included in the analysis, neurodevelopmental follow-up was available for a median of 3 (range, 1-16) years. Three (11.5%) infants had severe neurodevelopmental impairment, two of which were diagnosed postnatally with a genetic syndrome (Mowat-Wilson syndrome and Vici syndrome) that would not have been diagnosed prenatally. Seven (26.9%) children had mild neurodevelopmental impairment and 16 (61.5%) had normal neurodevelopmental outcome. The Full-Scale Intelligence Quotients of the three children with severe neurodevelopmental impairment were 50, 64 and 63, respectively, while that of the remaining children was in the normal range (median, 101; range, 89-119).In 88% of the children with cACC included in this study, neurodevelopment was not severely impaired. However, long-term follow-up is recommended in all cases of congenital isolated cACC to recognize subtle neurodevelopmental disorders as early as possible. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

The last few weeks of pregnancy are critical to a baby's health because important organs, including the brain and lungs, are not completely developed until the end of pregnancy. The adverse events during labor and childbirth can have very serious physical, psychological and financial consequences for the child, the family, health professionals and the whole community. These events can be reduced through interventions aimed at improving the safety and quality of care, based on evidence-based knowledge, guidelines and practices that must be widely and effectively applied. This work reports the experience of the Lombardy Region on improvement actions in the obstetric and gynecological procedures for the reduction of adverse events and sentinel events through the monitoring and management of the RCGS trigger tool.

This study is a single-center, retrospective analysis of postmenopausal women presenting with dyspareunia and vulvar pain, aiming to evaluate relative effectiveness of vestibular CO

Aim. Good nutrition and proper oral health care dur- ing pregnancy are essential for the oral and systemic health of mothers and children. Unfortunately pregnant women often receive poor guidance about preventive nutritional and oral health care measures. Moreover, ad- equate oral hygienic habits are mandatory to control the development of periopathogenic oral biofilms, well known as risk factors for adverse pregnancy outcomes. This study is aimed to describe self-reported sweet food consumption during pregnancy, tobacco habits, oral hy- giene habits, frequency of visits to a dentist as related to oral symptoms, dental caries and gingival disease in a cohort of postpartum women. Methods. 410 postpartum women who delivered at the obstetric/gynecological clinic of the University hospital in Milano were interviewed and examined bed- side within 5 days from delivery, through a custom developed questionnaire and a full oral examination. All women were informed of the aims of the study and consented to participation. A full mouth dental and peri- odontal examination was performed according to WHO guidelines. DMFT and periodontal indexes were record- ed. Data collection concerned demographical and edu- cational data; sweet food consumption habits, smoking habits; oral hygiene habits, self-reported oral symptoms during pregnancy; dental and periodontal health con- ditions. Descriptive statistics and relevant associations were estimated and analyzed with JMP 9.01 software. Results. The postpartum women were aged between 19 and 47 years (mean 32.9, IQR 3036); 31.5% had attained a degree, 66.8% had high school diploma, 7% completed the primary school. 62.4% of the subjects stated that they had never smoked while 37.6% were ex-smokers or current smokers. 71.1% of women sur- veyed reported taking sweet foods at least once a day. 53.6% of women were frequent brushers, performing oral hygiene at home after main meals. 34.8% of the women reported that they visit the dentist only in case of pain and 65.2% had dental professional control at least yearly. 79.7% of the women had at least one oral or dental symptom during the pregnancy: gingival bleeding, tooth mobility, bad breath. Mean BOP index was 9.7 (14.5 st.d.; 4.5 median; 0.9-12.5 IQR). Mean DMFT was 7.6 (4.1 st.d.; 7 median; 5-10 IQR). The statistical analysis highlighted the following main associations: oral pregnancy symptoms were slightly higher in smokers women (N.S.); BOP was higher in smokers (p

In this study, the authors aimed to investigate the role of oxidative stress on the hepatic damage caused by methotrexate (MTX) and the possible protective effects of beta-carotene against this damage. The rats were divided into four groups as control, MTX (20 mg/kg ip), beta-carotene (10 mg/kg/day ip) + MTX, and beta-carotene. Histopathologic alterations were evaluated for defining the liver damage. The tissue, malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GP-x) contents and serum aspartate aminotransferase (AST) and alanine aminotranferase (ALT) activities were also examined. Histopathologic damage for each group score findings have been determined as control: 0.66 +/- 0.33; MTX: 7.0 +/- 0.68; beta-carotene + MTX: 3.3 +/- 0.42; and beta-carotene: 0.5 +/- 0.3. In the MTX-treated group, MDA, AST, and ALT values were increased, while SOD and GP-x values were decreased compared with the control group. In the beta-carotene + MTX-treated group, AST and ALT values significantly decreased, while all other parameters were similar to the control group. This study shows that beta-carotene has a protective effect on MTX-induced oxidative hepatic damage. Consequently, it seems that an antioxidant agents like beta-carotene may be useful in decreasing the side effects of chemotherapy.

Nitric oxide (NO) is synthesized by NO synthase (NOS), and asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of NOS. We aimed to investigate l-arginine and ADMA levels in transient tachypnea of the newborn (TTN) and their relationship with systolic pulmonary artery pressure (PAP) and disease severity. Infants born at ⩾35 weeks gestational age with clinical signs and chest X-ray findings consistent with TTN were enrolled; controls were recruited at the same time. l-arginine and ADMA levels were measured at 12 to 24 h (first samples) and at 48 to 72 h (second samples). Systolic PAP was evaluated on the second day. Patients were divided according to the duration of tachypnea and designated as group A (duration ⩽72 h) and group B (duration >72 h). In the first samples, the ADMA levels were significantly higher in patients with TTN compared with controls (P

The aims of this study were to observe the changes in antioxidative defense enzymes and renal morphology after 7,12-dimethyl-benz[a]anthracene (7,12-DMBA) administration in mice and to investigate the possible protective effects of melatonin against 7,12-DMBA-induced renal damage in comparison with vitamin E + selenium (vit E + Se). Forty female mice were divided into four groups: control, DMBA, DMBA + vit E + Se and DMBA + melatonin. In the DMBA group, mice were given injections of 7,12-DMBA (20 mg/kg). DMBA + vit E + Se group mice received injections of 7,12-DMBA + vit E + Se (20 mg/kg + 90 mg/kg + 1.8 microg/kg). In the melatonin group, mice were given injections of 7,12-DMBA + melatonin (20 mg/kg + 4.2 mg/kg). The experiment lasted for 21 days. Mice were killed and the kidneys were taken for enzyme analyses and histologic examination. Catalase (CAT) and glutathione peroxidase (GSH-Px) activities were found significantly decreased in the DMBA group and in the DMBA + vit E + Se group when compared with the control group (P < 0.05), whereas CAT and GSH-Px activities were found significantly elevated in the DMBA + melatonin group when compared with the control (P < 0.05) and the DMBA group (P < 0.01). Exposure to DMBA resulted in tubular alterations in renal cortex. Morphometric analysis revealed proximal and distal tubular damage (P < 0.05). These alterations were found to be prevented by melatonin but not with vit E + Se administration. These results reveal that melatonin stimulates CAT and GSH-Px activities and prevents renal injury better than vit E + Se combination in mice kidneys.

To observe the changes in the antioxidative defense enzymes and to detect the alterations of renal microscopy after carbon tetrachloride (CCl4) administration in rats and to investigate the possible protective effects of betaine against CCl4-induced renal damage.Thirty-two adult Sprague-Dawley rats were divided into four groups as follows: control group, betaine group, CCl4 group, and CCl4 + betaine group. CCl4 was given subcutaneously at 1 mL/kg. In the CCl4 + betaine group, rats were pretreated with betaine, then exposed to CCl4 at the same dose. Betaine group rats received concentrated betaine solution. The rats were killed and the kidneys taken for enzyme analyses and histologic examination. Glutathione peroxidase, superoxide dismutase, and catalase activities were measured in right kidney homogenates. Left kidneys were processed for light microscopic evaluation.In the CCl4-treated group, significant increases in kidney superoxide dismutase and catalase activities and significant decrease in glutathione peroxidase activity were observed (P0.01). These changes were found to be normalized in the CCl4 + betaine group. Betaine did not change the enzyme activities. Exposure to CCl4 resulted in glomerular and tubular alterations in the renal cortex. These alterations were found to be prevented by betaine pretreatment.These results indicate that exposure to CCl4 leads to renal damage in rats and betaine exerts an improvement on nephrotoxic effects of CCl4.

The aim of the study was to describe the recent trends in antiretroviral treatment in late pregnancy and the sociodemographic changes among pregnant women with HIV over the last 6 years. Data from the National Program on Surveillance on Antiretroviral Treatment in Pregnancy in Italy were grouped per calendar year, and changes in antiretroviral treatment, population characteristics, maternal immunovirologic status and newborn clinical parameters were analyzed. A total of 981 HIV-infected mothers who delivered between 2002 and 2008 were evaluated. The proportion of women receiving at least three antiretroviral drugs at delivery increased significantly from 63.0% in 2002 to 95.5% in 2007-2008, paralleled by a similar upward trend in the proportion of women who achieved complete viral suppression at third trimester (from 37.3 in 2002 to 80.9 in 2007-2008; p < 0.001). The co-formulation of zidovudine plus lamivudine remained the most common nucleoside backbone in pregnancy, even if a significant increase in the use of tenofovir plus emtricitabine was observed in more recent years. Starting from 2003, nevirapine prescription declined, paralleled by a significant rise in the use of protease inhibitors (PI), which were present in more than 60% of regimens administered in 2007-2008. Nelfinavir was progressively replaced by ritonavir-boosted PIs, mainly lopinavir. No significant changes in preterm delivery, Apgar score, birth weight, and birth defects were observed during the study period, and the rate of HIV transmission remained below 2%. These data demonstrate a significant evolution in the treatment of HIV in pregnancy. Constant improvements in the rates of HIV suppression were observed, probably driven by the adoption of stronger and more effective regimens and by the increasing options available for combination treatment

Purpose: to evaluate the oral health conditions in postpartum women and the relationship to adverse pregnancy outcomes. Methods: a sample population of 750 post-partum women who had delivered at the University hospitals of three main italian cities were interviewed and examined bedside within 5 days from delivery. Data collection concerned (i) pregnancy outcomes (low birth weight, prematurity and other obstetric conditions), (ii) demography, education, systemic health, smoking habits, oral hygiene habits, self-reported oral symptoms, (iii) dental (DMFT), periodontal (PPD, CAL, BOP) and oral mucosal conditions. Simple and multiple regressions analysis were performed. Results: 14.6% (n=110) children were born premature, 11.2% (n=84) low birth weight and 49 (6.5%) were born premature and with low birth weight. In general, adverse outcomes were 230 (30.6%), and controls 520 (69.3%). Cases and controls did not significantly differ in mean age, birthplace, ethnicity, education and smoking habits nor in DMFT or periodontal indices. Less than 5% of the subjects showed oral mucosal diseases or conditions. Regression analysis indicated that there were no significant relationships between the presence and severity of oral diseases and conditions and adverse pregnancy outcomes. Conclusions and Relevance: No association was found between periodontal diseases in the mother and adverse pregnancy outcomes. However, our study population is different from previously reported case-control populations in both demographic factors and the level of periodontal disease. More data need to be collected in order to exclude the proposed potential link between periodontitis and the risk of pregnancy complications

Objectives. Periodontal disease could play a role during pregnancy as a source of chronic infection having so the potential to be the direct cause of an adverse effect, both on the mother, the placenta and the fetus. The aim of this study was to determine whether oral health conditions and attitudes correlate with adverse fetal and/or maternal outcomes. Methods. A multi-centric cross-sectional study was designed. 304 women were recruited and examined within 5 days postpartum through a standardised questionnaire and a full oral and periodontal examination. Case subjects (n=62) had premature delivery (n=25) and/or delivered SGA/IUGR (n=25) and/or experienced Preeclampsia /PIH (n=18) or PROM (n=6) during their pregnancies whereas control subjects (n=242) had normal pregnancies, delivered at or around term and had newborns with normal weights. Results. Cases and controls were similar in mean age, birthplace, ethnicity, educational level, smoking habits and in oral hygiene habits. The analyses of the periodontal health and disease variables (bleeding on probing, tooth attachment loss and probing depth score) showed no relevant differences between the two groups. There was no differences in proportion of smoking women in cases and controls (chi square = 0.3, p=0.60). No significant association was observed regarding cases and the level of periodontal disease (chi square for trend =1.19, p=0.27). The mean proportion of periodontal sites probing more than 4 mm observed in the case subjects compared to the controls failed to reach statistical significance. Conclusions. Our preliminary report failed to demonstrate a positive association between periodontal disease and adverse pregnancy outcomes. However, our study population is different from previously reported case-control populations in both demographic factors and the level of periodontal disease. More data need to be collected in order to exclude the proposed potential link between periodontitis and the risk of pregnancy complications. (Supported by the MUR-PRIN 2005 grant).

Purpose: The aim of this study was to determine the oral health conditions in postpartum women and the relation to adverse obstetric outcomes.Methods: 304 women were examined postpartum ≤5-days since delivery, through a standardised questionnaire and a full oral examination; DMFT and PSR and obstetric data were recorded. Case subjects (n=62) had Preterm Delivery (PD, < 37 weeks) and/or delivered Small for gestational age (SGA) newborns (birthweight 5 μm epigallocatechin-3-gallate (EGCG) to OEC-M1 cells suppressed the expression and activity of MMP-13. CONCLUSION: MMP-13 could be a potential tumor marker for OSCC. The effects of EGCG in tumor inhibition may act partially through the modulation of MMP-13.

In this study, the antiproliferative effects of the aromatase inhibitor anastrozole (arimidex®) was evaluated on estrogen receptor (ER) positive FM3A cell line originated from C3H mouse mammary carcinoma.For this purpose cell kinetic parameters including viability analysis, mitotic index and labelling index were used. Three different doses of anostrozole (D1= 0.01 μM, D2= 0.1μM, D3= 1μM) were applied to cells for 24 h to determine the most effective dose. A dose of 1μM dose was determined as the most effective and this was used in all subsequent applications for 0-72 h.The results showed that there was a significant decrease in viability, mitotic index and labelling index for all experimental groups. The differences between control and all experimental groups were statistically significant (p0.01) for all applications.Anastrozole offers a promising treatment modality in estrogen sensitive breast cancer.

We consider the at-the-money strike derivative of implied volatility as the maturity tends to zero. Our main results quantify the behavior of the slope for infinite activity exponential L\'evy models including a Brownian component. As auxiliary results, we obtain asymptotic expansions of short maturity at-the-money digital call options, using Mellin transform asymptotics. Finally, we discuss when the at-the-money slope is consistent with the steepness of the smile wings, as given by Lee's moment formula.

WOS: A1996UX54000012 PubMed: 8828970 …

Cancer stem cells (CSCs) possess several characteristics including self-renewal, pluripotency and tumorigenicity and constitute a rare population in a tumor mass. Because conventional cancer therapies can not kill CSCs, these cells are responsible for tumor relapse and metastasis. Currently, with advances in the identification of CSCs, the importance of these cells is increasing in the field of cancer diagnosis and prognosis. In addition, clarifying the mechanisms responsible for the maintenance of CSCs properties led to the development of CSC-targeted therapies.