Effects of progestogens in women with preterm premature rupture of membranes

Different strategies have been adopted for prevention of spontaneous preterm birth, including use of progestogens. So far, five randomized trials have been published evaluating the efficacy of progestogens in women with PPROM, including a total of 425 participants. All the five trials enrolled pregnant women with singleton pregnancies randomized between 20 and 34 weeks of gestation. In four trials women were randomized to either weekly intramuscular 250 mg 17α-hydroxyprogesterone-caproate or placebo, while Mirzaei et al. was a three arms trials in which women received weekly intramuscular 250 mg 17α-hydroxyprogesterone-caproate, or rectal progesterone 400 mg daily, or no treatment. In all the trials, latency antibiotics were used, and tocolysis was used permitted for first 48 hours at discretion of attending physician. Recently a meta-analysis including the five trials has been published. They found that when compared to placebo weekly intramuscular 250 mg 17α-hydroxyprogesterone-caproate did not alter the latency period to delivery in singleton gestations with PPROM. Additionally, there was no difference in gestational age at delivery between groups or in mode of delivery. No significant differences were reported in maternal or neonatal outcomes, with latency not significantly altered in sensitivity analyses. So far, no trials have been published evaluating natural vaginal progesterone in women with PPROM

Dose and image quality in X-ray phase contrast breast imaging

Nowadays, mammographic examination is the gold standard technique for detecting breast cancer in asymptomatic women. However, it presents some limitations, mainly due to the superimposition of the tissues in the 2D mammograms, which may hide tumor lesions. Partially (digital breast tomosynthesis) and fully (CT dedicated to the breast) 3D breast imaging techniques have been developed in order to have a better tissues separation and to overcome such a limitation. Along with 3D breast imaging, the use of the X-ray beam phase shift, via so-called phase-contrast imaging techniques, has been shown to be a promising method in order to increase the image contrast between glandular tissue and tumor lesions. Indeed, in phase-contrast the image contrast is due to the X-ray wave phase-shift between different imaged materials, while in conventional imaging the image contrast arises from the different attenuation they introduce. Among all phase-contrast techniques, propagation based phase-contrast imaging does not need any special optical elements in the beam path, but only an X-ray beam with a certain degree of coherence and enough distance between imaged object and detector. It can be implemented either with synchrotron radiation source or with a compact X-ray tube. The 3D propagation based phase-contrast breast imaging devices are not yet employed in the routine clinical exams but they are available only at experimental level, and appropriate evaluations of image quality and dose are necessary. This is needed in order to optimize the various techniques and to understand the corresponding dose limitations. In this thesis, the dose paradigms in X-ray breast imaging are revisited and specific Monte Carlo simulation codes have been developed. A part of this work focuses on the breast dose aiming at studying the adopted breast models and the effects of the breast partial irradiation on the dose estimates, as occurs in 2D spot mammography clinical examinations as well as by adopting a narrow beam produced via synchrotron radiation. The second part of this work focuses on the image quality obtainable in 3D images of the breast by adopting propagation based phase-contrast imaging. We present the CT scanner dedicated to the breast developed within the SYRMA-CT project at Elettra synchrotron radiation facility. We evaluate its imaging performance in terms of spatial resolution, image noise properties and capability of showing breast lesions and microcalcification clusters. Finally, the CT scanner dedicated to the breast, developed at the University of Naples, which relies on compact X-ray source with a 7-μm focal spot is presented and its image performance at dose comparable to that adopted in two-view digital mammography is explored together with its capability of producing phase-contrast effects. This scanner was developed and studied in order to compare a scanner which is clinical feasible in terms of cost, setup dimension and scan time to the results obtainable via the high flux and monochromatic X-ray beam synchrotron based experimental scanner

Patient-specific Monte Carlo-based organ dose estimates in spiral CT via optical 3D body scanning and adaptation of a voxelized phantom dataset: proof-of-principle

: Objective. We present a method for personalized organ dose estimates obtained before the CT exam, via 3D optical body scanning and Monte Carlo (MC) simulations.Approach. A voxelized phantom is derived by adapting a reference phantom to the body size and shape measured with a portable 3D optical scanner, which returns the 3D silhouette of the patient. This was used as an external rigid envelope for incorporating a tailored version of the internal body anatomy derived from a phantom dataset (National Cancer Institute, NIH, USA) matched for gender, age, weight, and height. The proof-of-principle was conducted on adult head phantoms. The Geant4 MC code provided estimates of the organ doses from 3D absorbed dose maps in voxelized body phantom.Main results. We applied this approach for head CT scanning using an anthropomorphic voxelized head phantom derived from 3D optical scans of mannequins. We compared the estimates of head organ doses with those provided by the NCICT3.0 software (NCI, NIH, USA). Head organ doses differed up to 38% using the proposed personalized estimate and MC code, with respect to corresponding estimates calculated for the standard (non-personalized) reference head phantom. Preliminary application of the MC code to chest CT scans is shown. Real-time pre-exam personalized CT dosimetry is envisaged with adoption of a GPU-based fast MC code.Significance. The developed procedure for personalized organ dose estimates before the CT exam, introduces a new approach for realistic description of size and shape of patients via voxelized phantoms specific for each patient

Long-Term Field Evaluation of Conventional vs. Micropropagated Plants of Chrysanthemum cinerariifolium

Pyrethrum is a perennial herbaceous plant endemic to the eastern coast of the Adriatic Sea, and introduced in large areas of nearly all continents, where it is cultivated for the industrial extraction of pyrethrins. Pyrethrins are a group of six closely related monoterpene esters, widely used as natural insecticides. The world production of natural pyrethrins is lower than the market demand, and a wider introduction of this crop within the Mediterranean agrosystems could be an appealing opportunity for farmers and manufacturers. The availability of adequate amounts of selected plant material to bring into cultivation is, however, one of the major issues. Therefore, the in vitro propagation of elite pyrethrum genotypes could be a suitable alternative to conventional propagation methods. In this paper, we present the results of a 9-year field comparison between pyrethrum plants coming from an in vitro propagation protocol and plants obtained by cutting from the same mother plants. Furthermore, since plantlets derived from in vitro regeneration may experience ploidy changes, we evaluated the stability of the ploidy level of pyrethrum micropropagated plants by flow cytometry (FCM) analysis. FCM screening revealed no differences among the morphotypes and between them and the mother plant. Likewise, the field evaluation of plants gave no significant differences between flower yields in both groups. Hence, micropropagation was confirmed as an easy, efficient and reproducible method to obtain large quantities of selected pyrethrum genotypes

Water-Mediated Nanostructures for Enhanced MRI: Impact of Water Dynamics on Relaxometric Properties of Gd-DTPA

Recently, rational design of a new class of contrast agents (CAs), based on biopolymers (hydrogels), have received considerable attention in Magnetic Resonance Imaging (MRI) diagnostic field. Several strategies have been adopted to improve relaxivity without chemical modification of the commercial CAs, however, understanding the MRI enhancement mechanism remains a challenge. Methods: A multidisciplinary approach is used to highlight the basic principles ruling biopolymer-CA interactions in the perspective of their influence on the relaxometric properties of the CA. Changes in polymer conformation and thermodynamic interactions of CAs and polymers in aqueous solutions are detected by isothermal titration calorimetric (ITC) measurements and later, these interactions are investigated at the molecular level using NMR to better understand the involved phenomena. Water molecular dynamics of these systems is also studied using Differential Scanning Calorimetry (DSC). To observe relaxometric properties variations, we have monitored the MRI enhancement of the examined structures over all the experiments. The study of polymer-CA solutions reveals that thermodynamic interactions between biopolymers and CAs could be used to improve MRI Gd-based CA efficiency. High-Pressure Homogenization is used to obtain nanoparticles. Results: The effect of the hydration of the hydrogel structure on the relaxometric properties, called Hydrodenticity and its application to the nanomedicine field, is exploited. The explanation of this concept takes place through several key aspects underlying biopolymer-CA's interactions mediated by the water. In addition, Hydrodenticity is applied to develop Gadolinium-based polymer nanovectors with size around 200 nm with improved MRI relaxation time (10-times). Conclusions: The experimental results indicate that the entrapment of metal chelates in hydrogel nanostructures offers a versatile platform for developing different high performing CAs for disease diagnosis

Phenolic Profiles, Antioxidant and Anti-Inflammatory Activities of Hydrodistillation Wastewaters from Five Lamiaceae Species

Distillation is the most widely used method to obtain an essential oil from plant material. The biomass used in the process is returned as a solid residue together with variable amounts of water rich in water-soluble compounds, which currently are not addressed to any further application. The scope of this work was to evaluate the phytochemical composition of wastewaters coming from hydrodistillation (DWWs) of five aromatic plants belonging to the Lamiaceae family, and to assess their in vitro antioxidant and anti-inflammatory activities. The phenolic profiles of the DWWs were determined by HPLC-DAD and HPLC-ESI/MS. Free radical scavenging ability, oxygen radical antioxidant capacity and superoxide dismutase mimetic activity of the samples under study were measured. Moreover, to investigate the anti-inflammatory activity of the DWWs, an in vitro experimental model of intestinal inflammation was used. The DWW samples' phytochemical analysis allowed the identification of 37 phenolic compounds, all exhibiting good antioxidant and anti-inflammatory activity. Our study contributes to the knowledge on the polyphenolic composition of the DWWs of five aromatic plants of the Lamiaceae family. The results highlight the presence of compounds with proven biological activity, and therefore of great interest in the pharmaceutical and nutraceutical fields

Monte Carlo and experimental evaluation of a Timepix4 compact gamma camera for coded aperture nuclear medicine imaging with depth resolution

Purpose: We designed a prototype compact gamma camera (MediPROBE4) for nuclear medicine tasks, including radio-guided surgery and sentinel lymph node imaging with a 99mTc radiotracer. We performed Monte Carlo (MC) simulations for image performance assessment, and first spectroscopic imaging tests with a 300 μm thick silicon detector. Methods: The hand-held camera (1 kg weight) is based on a Timepix4 readout circuit for photon-counting, energy-sensitive, hybrid pixel detectors (24.6 × 28.2 mm2 sensitive area, 55 μm pixel pitch), developed by the Medipix4 Collaboration. The camera design adopts a CdTe detector (1 or 2 mm thick) bump-bonded to a Timepix4 readout chip and a coded aperture collimator with 0.25 mm diameter round holes made of 3D printed 1-mm thick tungsten. Image reconstruction is performed via autocorrelation deconvolution. Results: Geant4 MC simulations showed that, for a 99mTc source in air, at 50 mm source-collimator distance, the estimated collimator sensitivity (4 × 10-4) is 292 times larger than that of a single hole in the mask; the system sensitivity is 0.22 cps/kBq (2 mm CdTe); the lateral spatial resolution is 1.7 mm FWHM. The estimated axial longitudinal resolution is 8.2 mm FWHM at 40 mm distance. First experimental tests with a 300 μm thick Silicon pixel detector bump-bonded to a Timepix4 chip and a high-resolution coded aperture collimator showed time-over-threshold and time-of-arrival capabilities with 241Am and 133Ba gamma-ray sources. Conclusions: MC simulations and validation lab tests showed the expected performance of the MediPROBE4 compact gamma camera for gamma-ray 3D imaging