Septate uterus: nosographic overview and endoscopic treatment

To comment on the prevalence, diagnosis, and treatment of the septate uterus, with special reference to hysteroscopic metroplasty and its effect on reproductive outcome, we searched publications in PubMed and Embase. Original articles, meta-analysis, reviews, and opinion articles were selected. The studies suggest that the prevalence of the septate uterus is increased in women with repeated pregnancy loss and infertility. Reliable diagnosis depends on accurate assessment of the uterine fundal contour and uterine cavity by means of magnetic resonance and three-dimensional ultrasound. Pertinent published data comparing pregnancy outcome before and after hysteroscopic metroplasty indicated a marked improvement after surgery. Magnetic resonance and three-dimensional ultrasound represent the gold standard for diagnosis of septate uterus. Hysteroscopic metroplasty with its simplicity, minimal postoperative sequelae, and improved reproductive outcome is the gold standard for treatment, not only in patients with recurrent pregnancy loss and premature labor but also in patients with infertility, especially if in vitro fertilization is being contemplated

Stabilizing versus destabilizing the microtubules: A double-edge sword for an effective cancer treatment option?

Microtubules are dynamic and structural cellular components involved in several cell functions, including cell shape, motility, and intracellular trafficking. In proliferating cells, they are essential components in the division process through the formation of the mitotic spindle. As a result of these functions, tubulin and microtubules are targets for anticancer agents. Microtubule-targeting agents can be divided into two groups: microtubule-stabilizing, and microtubule-destabilizing agents. The former bind to the tubulin polymer and stabilize microtubules, while the latter bind to the tubulin dimers and destabilize microtubules. Alteration of tubulin-microtubule equilibrium determines the disruption of the mitotic spindle, halting the cell cycle at the metaphase-anaphase transition and, eventually, resulting in cell death. Clinical application of earlier microtubule inhibitors, however, unfortunately showed several limits, such as neurological and bone marrow toxicity and the emergence of drug-resistant tumor cells. Here we review several natural and synthetic microtubule-targeting agents, which showed antitumor activity and increased efficacy in comparison to traditional drugs in various preclinical and clinical studies. Cryptophycins, combretastatins, ombrabulin, soblidotin, D-24851, epothilones and discodermolide were used in clinical trials. Some of them showed antiangiogenic and antivascular activity and others showed the ability to overcome multidrug resistance, supporting their possible use in chemotherapy

Elevated Levels of Procalcitonin and Interleukin-6 are Linked with Postoperative Complications in Cardiac Surgery

Cardiac surgery-associated acute kidney injury is a frequent and serious postoperative complication of cardiac surgery and is associated with an increased risk of morbidity, mortality, and length stay. In this study, we hypothesized that persistent elevation in inflammation in the first 48\u2009h might be a powerful predictor of clinical outcome. Our aim was to elucidate the usefulness of interleukin-6 and procalcitonin postoperative levels in predicting mortality and renal complications in cardiac surgery patients

People with Down's syndrome:adolescence and the journey towards adulthood

Introduzione. La sessualit\ue0 nella persona con disabilit\ue0 viene affrontata con difficolt\ue0 e con inadeguatezza se non con franco rifiuto, con il risultato che le giovani persone disabili vengono, spesso, relegate ad un destino di solitudine e abbandono. E ci\uf2 si realizza ancora di pi\uf9 quando la condizione di disabilit\ue0 comporta ritardo mentale. Metodi. Sono stati reclutati 25 ragazzi di et\ue0 compresa tra 13 e 25 anni - 14 maschi (56%) e 11 femmine (44%) \u2013 insieme alle loro madri. Tutti frequentano l\u2019Associazione Famiglie Persone Down di Palermo. Le giovani persone con sindrome di Down sono state invitate a svolgere una attivit\ue0 di disegno libero, quindi, a descrivere ci\uf2 che avevano disegnato. Le madri, invece, hanno risposto ad una intervista semistrutturata i cui contenuti sono stati organizzati intorno a tre aree: - reazioni dei genitori di fronte alla comunicazione da parte dei medici della nascita del figlio Down; i genitori e la sessualit\ue0 dei figli Down; le aspettative dei genitori rispetto al futuro dei propri figli Down. Risultati. I disegni liberi e la loro descrizione hanno dimostrato il chiaro emergere di temi che riguardano la sessualit\ue0 in 6 protocolli su 25. In 9 casi su 25 il riferimento alla sessualit\ue0 si nasconde dietro disegni e descrizioni allusive. 6 protocolli testimoniano, sebbene non direttamente riferibili al tema della sessualit\ue0, l\u2019emergere del conflitto di autonomia, tipico dell\u2019adolescenza, a dimostrazione dell\u2019iniziato processo di transito verso l\u2019et\ue0 adulta. Soltanto in 4 situazioni il riferimento alla sessualit\ue0 non \ue8 interpretabile nelle produzioni dei ragazzi. L\u2019analisi qualitativa delle interviste alle madri, ha evidenziato come il tema della sessualit\ue0 nel figlio con disabilit\ue0 sia vissuto dal genitore in maniera conflittuale. Conclusioni. I risultati ottenuti ci spingono ad affermare che la \u201cquestione sessuale\u201d si pone in termini problematici dal punto di vista del genitore pi\uf9 che dal punto di vista del ragazzo. Ed in questa prospettiva, a vantaggio dei genitori, occorre pianificare gli interventi psicologico-clinici di educazione alla sessualit\ue0

Una nuova applicazione della Comparative Multiplex Dosage Analysis (CMDA)

La Comparative Multiplex Dosage Analysis (CMDA) \ue8 una tecnica utilizzata per l\u2019analisi di delezioni o duplicazioni di specifiche regioni del genoma (Gable et al. 2003 Hum Mutat 21:379-386). Il metodo si basa su di un\u2019analisi quantitativa delle aree dei picchi di un elettroferogramma ottenuto da elettroforesi capillare condotta su frammenti di DNA amplificati con PCR e marcati con specifici fluorocromi. La presenza di sbilanciamenti \ue8 , in particolare, accertata misurando il rapporto tra le aree dei picchi corrispondenti alla regione da analizzare e una regione del genoma la cui dose \ue8 nota. In studi precedenti noi abbiamo applicato questa tecnica all\u2019analisi di delezioni e duplicazioni di specifici esoni dei geni codificanti per la fenilalanina idrossilasi (PAH) e ubiquitin protein ligase E3A (UBE3A) in pazienti rispettivamente affetti da fenilchetonuria (Cal\uec et al 2010 Exp Mol Med. 42:81-6) e sindrome di Angelman (Cal\uec, et al. 2010 Exp Mol Med. 42:842-8). In questo studio noi mostriamo una nuova applicazione della CMDA per l\u2019analisi del gene ataxina 2 (ATXN2; localizzazione cromosomica: 12q24) nel quale espansioni della tripletta CAG, nell\u2019esone 1 del gene, possono causare l\u2019Atassia Spinocerebellare tipo 2 (SCA2), una malattia neurodegenerativa a trasmissione autosomica-dominante. Individui sani hanno 14-31 ripetizioni della tripletta CAG, mentre gli individui affetti hanno espansioni delle triplette nel range 35-500. Nella SCA2, vi \ue8 inoltre una correlazione inversa tra il numero di ripetizioni CAG e l'et\ue0 di esordio della patologia . La diagnosi molecolare di SCA2 \ue8 basata sull'uso della PCR convenzionale in grado di rilevare l\u2019ampiezza dell\u2019espansione CAG. Tuttavia, il limite di questo test \ue8 che la PCR potrebbe non amplificare un allele con un\u2019espansione di molte triplette, quest\u2019ultime presenti nelle forme di SCA2 a insorgenza infantile e giovanile portando a falsi negativi. In particolare, poich\ue8 l\u2019allele normale di 22 repeats ha una frequenza molto elevata nella popolazione (fino al 90%) individui eterozigoti per un allele normale ( 100 CAG repeats) verrebbero erroneamente diagnosticati come omozigoti per l\u2019allele # 22. L\u2019analisi CMDA permetterebbe di individuare questi falsi omozigoti rivelando la presenza di una singola dose dell\u2019allele normale. Noi proponiamo l\u2019analisi CMDA del gene ATXN2 per complementare metodi correntemente in uso per l\u2019individuazione di ampie espansioni delle triplette CAG quali la Triplet repeat primed PCR (Cagnoli et al., \u2026. e un metodo che utilizza la PCR, le\u2019elettroforesi, il Southern blotting e l\u2019ibridazione molecolare con sonde (CAG)n. L\u2019analisi CMDA pu\uf2 essere condotta in 1 giorno con costi molti contenuti e pu\uf2 rivelarsi particolarmente informativa nella diagnosi prenatale e presintomatica delle forme di SCA2 a insorgenza precoce

Effects of angiotensin II receptor inhibition on insulin-induced endothelial dysfunction in humans.

Effects of angiotensin II receptor inhibition on insulin-induced endothelial dysfunction in humans

Metabolic control analysis (MCA) of intravenous glucose tolerance in healthy humans.

We recently assessed 1st and 2nd phase f-cell insulin secretion by applying the same model of glucose-induced insulin secretion to plasma glucose and C-peptide curves during both IVGTTs and hyperglicemic clamps. In the present study we have extended the same modeling strategy to standard OGTT (time 0\u2019-120\u2019). We performed in 31 subjects (18 with normal glucose regulation [NGR], 7 with impared glucose regulation [IGR], and 6 with newly diagnosed type 2 diabetes [T2DM]) a standard OGTT (blood samples for plasma glucose/C-peptide were collected every 5\u2019-20\u2019 from 0\u2019 to 120\u2019), and an IVGTT (12 g per m2 of BSA; blood samples collected every 1\u2019-20\u2019 from 0\u2019 to 180\u2019-240\u2019) on 2 separate day. We have applied the same modeling strategy to both tests and obtained a fairly good fit of the data in both the IVGTT and the OGTT. We thus estimated first (\uf0731st) and second (\uf0732nd) phase insulin secretion during both tests. Results are normalized per m2 of BSA. In the pooled data, OGTT \uf0731st and \uf0732nd (2996\ub1299 e 96.1\ub17.37, respectively) were significantly higher (p<0.01) than IVGTT \uf0731st and \uf0732nd (467\ub167 e 43.8\ub14.3), reflecting the well known potentiating effect of oral glucose on \uf062-cell response. Moreover, OGTT \uf0731st and \uf0732nd were positively and significantly correlated to IVGTT \uf0731st and \uf0732nd (r=0.50 e r=0.52, respectively; p<0.01 for both). Finally, in NGR, IGR and T2DM subjects OGTT \uf0731st (3609\ub1430, 2439\ub1437 e 1807\ub1220) and \uf0732nd (112\ub19.5, 80.8\ub113 e 66.2\ub1 11.5, respectively) showed a similar declining pattern as the one observed with the IVGTT (624\ub183, 427\ub1112 and 42.8\ub127.8 for IVGTT \uf0731st; 44.8\ub16.5, 48.3\ub19.1 and 35.5\ub15 for IVGTT \uf0732nd, respectively). These data demonstrate that is feasible to assess 1st and the 2nd insulin secretion phase during a standard OGTT and provide a physiological tool to measure f-cell function in states of normal and/or altered glucose regulation

Assessement of 1th and snd phase of insulin secretion during OGTT and IVGTT

We recently assessed 1st and 2nd phase f-cell insulin secretion by applying the same model of glucose-induced insulin secretion to plasma glucose and C-peptide curves during both IVGTTs and hyperglicemic clamps. In the present study we have extended the same modeling strategy to standard OGTT (time 0\u2019-120\u2019). We performed in 31 subjects (18 with normal glucose regulation [NGR], 7 with impared glucose regulation [IGR], and 6 with newly diagnosed type 2 diabetes [T2DM]) a standard OGTT (blood samples for plasma glucose/C-peptide were collected every 5\u2019-20\u2019 from 0\u2019 to 120\u2019), and an IVGTT (12 g per m2 of BSA; blood samples collected every 1\u2019-20\u2019 from 0\u2019 to 180\u2019-240\u2019) on 2 separate day. We have applied the same modeling strategy to both tests and obtained a fairly good fit of the data in both the IVGTT and the OGTT. We thus estimated first (\uf0731st) and second (\uf0732nd) phase insulin secretion during both tests. Results are normalized per m2 of BSA. In the pooled data, OGTT \uf0731st and \uf0732nd (2996\ub1299 e 96.1\ub17.37, respectively) were significantly higher (p<0.01) than IVGTT \uf0731st and \uf0732nd (467\ub167 e 43.8\ub14.3), reflecting the well known potentiating effect of oral glucose on \uf062-cell response. Moreover, OGTT \uf0731st and \uf0732nd were positively and significantly correlated to IVGTT \uf0731st and \uf0732nd (r=0.50 e r=0.52, respectively; p<0.01 for both). Finally, in NGR, IGR and T2DM subjects OGTT \uf0731st (3609\ub1430, 2439\ub1437 e 1807\ub1220) and \uf0732nd (112\ub19.5, 80.8\ub113 e 66.2\ub1 11.5, respectively) showed a similar declining pattern as the one observed with the IVGTT (624\ub183, 427\ub1112 and 42.8\ub127.8 for IVGTT \uf0731st; 44.8\ub16.5, 48.3\ub19.1 and 35.5\ub15 for IVGTT \uf0732nd, respectively). These data demonstrate that is feasible to assess 1st and the 2nd insulin secretion phase during a standard OGTT and provide a physiological tool to measure f-cell function in states of normal and/or altered glucose regulation