Porins and lipopolysaccharide induce apoptosis in human spermatozoa

Treatment of human spermatozoa with porins or lipopolysaccharide (LPS) increases spontaneous apoptosis in these cells. Porins and LPS were extracted from Salmonella enterica serovar Typhimurium and Pasteurella multocida and were mixed with human spermatozoa for detection of levels of apoptosis

Gestational diabetes mellitus in Italy: A multicenter study

Objective: This prospective study evaluated the impact of gestational diabetes on maternal and fetal outcome in a large cohort of women with gestational diabetes mellitus (GDM) followed up using standardized clinical criteria. Study design: Between 1999 and 2003, we collected 3465 GDM women from 31 Italian regional obstetric or diabetes centers, recording the time and mode of delivery, gestational hypertension, pre-eclampsia, eclampsia, congenital malformations, and neonatal mortality, comparing findings with the Italian general pregnant population. Results: The rate of cesarean sections was 34.9% and macrosomia 8.7% (33.2 and 7.4%, respectively, in the general population, p = ns). The stillbirth and neonatal mortality rates were no different in GDM patients and normal pregnancies (0.34% vs. 0.30%, p = 0.176 and 0.29% vs. 0.32%, p = 0.748), but the former had twice as many newborn with congenital malformations (2.05% vs. 0.89%, p < 0.01; Cl 1.64-2.62). A prognostic model for the outcome of pregnancy was built and the concurrent occurrence of several conditions was deemed as a positive outcome. Pregnancies which did not meet one or more of the above criteria were classified as "complicated". On multivariate logistic analysis, only the week of gestation when GDM was diagnosed and prepregnancy BMI were independent predictors of a complicated pregnancy. Conclusion: When correctly diagnosed and treated during pregnancy, women with GDM have a pregnancy outcome similar to the general pregnant population, except for a greater likelihood of congenital malformations in the newborn, probably due to unrecognized prior diabetes. Prepregnancy obesity plays an important part in raising the risk of adverse perinatal outcomes in GDM patients. (C) 2009 Elsevier Ireland Ltd. All rights reserved

From pediatric to adult care: a survey on the transition process in type 1 diabetes mellitus and the diabetes services in Italy

AimsThe present study assessed the transitioning process of young adults with type 1 diabetes mellitus (T1D) in Italy.Materials and methodsWe asked Pediatric Diabetes Centers (PDC) and Adult Diabetes Centers (CAD) to fill in a web-based survey on the current state of services, the number of transitioning adolescents with T1D within the last year, observations on limitations, and future directions.Results93 centers (46 PDCs, 47 CADs) joined the study. The total number of subjects with T1D being followed by a PDC was 16,261 (13,779 minors and 2483 young adults), while CADs had 25,500 patients. The survey showed an uneven situation. Only some services had a dedicated diabetes team (78% of PDCs, 64% of CADs). 72% of PDCs and 58% of CADs reported a protocol dedicated to transition. The median age for transition was 19 (range 16-25 years); the time required for preparing transition, indicated by both PDCs and CADs, was 5.5 months. A high percentage of CADs (80%) confirmed receiving sufficient clinical information, mainly through paper or computerized reports. The transition process is hampered by a lack of resources, logistical facilities, and communication between services. While some services have a protocol, monitoring of results is only carried out in a few cases. Most specialists expressed the need to enhance integration and continuity of treatment.ConclusionsThe current situation could be improved. Applying standard guidelines, taking into consideration both clinicians' and patients' necessities, would lead to a more successful transition process