Crystal state conformation of three model monomer units for the β-bend ribbon structure

The molecular and crystal structures of three compounds, representing the repeating units of the β-bend ribbon (an approximate 310-helix, with an intramolecular hydrogen-bonding donor every two residues), have been determined by x-ray diffraction. They are Boc-Aib-Hib-NHBzl, Z-Aib-Hib-NHBzl, and Z-L-Hyp-Aib-NHMe (Aib, α-aminoisobutyric acid; Bzl, benzyl; Boc, t-butyloxycarbonyl; Hyp, hydroxyproline Hib, α-hydroxyisobutyric acid; Z, benzyloxycarbonyl). The two former compounds are folded in a -bend conformation: type III (III′) for Boc-Aib-Hib-NHBzl, while type II (II′) for the Z analogue. Conversely, the structure of Z-L-Hyp-Aib-NHMe, although not far from a type II β-bend, is partially open

Adherence to Mediterranean Diet and Its Association with Maternal and Newborn Outcomes

Background: Pregnancy is a crucial stage in a woman’s life and can be affected by epigenetic and environmental factors. Diet also plays a key role in gestation. This study aimed to evaluate how a greater or lesser adherence to the Mediterranean Diet (MD) influences specific parameters of mother and newborn. Methods: After delivery, the women participating in the study answered a questionnaire: demographic information; anthropometric data (pre-pregnancy weight, height, and gestational weight gain); dietary habits information (adherence to MD before and during pregnancy, using the validated Mediterranean Diet Adherence Screener (MEDAS), quality of protein intake); pregnancy information (onset of complications, cesarean/vaginal delivery, gestational age at birth, birth weight, birth length); and clinical practitioner for personalized dietary patterns during pregnancy. Results: A total of 501 respondents have been included in the study, and 135 were excluded for complications. Women who followed the advice of clinical nutritionists showed better adherence to MD (p = 0.02), and the baby’s birth weight was higher (p = 0.02). Significant differences in gestational weight gain (p < 0.01) between groups with dissimilar diet adherence were demonstrated. Conclusion: Our data demonstrate a significant relationship between adherence to MD and birthweight

Outcome reporting across randomized trials and observational studies evaluating treatments for twin–twin transfusion syndrome: systematic review

Objective Twin–twin transfusion syndrome (TTTS) is associated with significant mortality and morbidity. Potential treatments for the condition require robust evaluation. The aim of this study was to evaluate outcome reporting across observational studies and randomized controlled trials assessing treatments for TTTS. Methods Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE were searched from inception to August 2016. Observational studies and randomized controlled trials reporting outcome following treatment for TTTS in monochorionic–diamniotic twin pregnancy and monochorionic–triamniotic or dichorionic–triamniotic triplet pregnancy were included. Outcome reporting was systematically extracted and categorized. Results Six randomized trials and 94 observational studies were included, reporting data from 20 071 maternal participants and 3199 children. Six different treatments were evaluated. Included studies reported 62 different outcomes, including six fetal, seven offspring mortality, 25 neonatal, six early childhood and 18 maternal/operative outcomes. Outcomes were reported inconsistently across trials. For example, when considering offspring mortality, 31 (31%) studies reported live birth, 31 (31%) reported intrauterine death, 49 (49%) reported neonatal mortality and 17 (17%) reported perinatal mortality. Four (4%) studies reported respiratory distress syndrome. Only 19 (19%) studies were designed for long‐term follow‐up and 11 (11%) of these reported cerebral palsy. Conclusions Studies evaluating treatments for TTTS have often neglected to report clinically important outcomes, especially neonatal morbidity outcomes, and most are not designed for long‐term follow‐up. The development of a core outcome set could help standardize outcome collection and reporting in TTTS studies. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd

Possibili applicazioni dell’ecografia 3D/4D in medicina prenatale: esperienza di un singolo centro

Lo scopo del nostro studio è stato quello di dimostrare e confermare l’utilità dell’ampio spettro di metodiche fornite dalla tecnologia ecografica tridimensionale e quadridimensionale, nel diagnosticare, monitorare, prevedere o studiare determinate patologie ostetriche. Il nostro studio ha coinvolto patologie perinatali che risultano essere ancora di problematica gestione. In particolare si è cercato di approfondire la diagnosi e la previsione delle patologie cromosomiche, della pre-eclampsia e della pre-eclampsia grave tale da richiedere l’espletamento del parto prima di 32 settimane di gestazione, di alcune malformazioni cardiache quali la Trasposizione completa e corretta dei Grossi Vasi, lo studio della funzionalità cardiaca in feti normali e con ritardo di crescita intrauterino. Per tutti gli esami effettuati è stato utilizzato un ecografo Voluson 730 (G. E. Healthcare). La tecnica ultrasonografica utilizzata è stata quella tradizionale bidimensionale con la misurazione di distanze (valvole cardiache, biometria fetale), con l’uso del Doppler colore e pulsato (visualizzazione di vasi sanguigni quali le arterie uterine e l’arteria ombelicale, dei flussi sanguigni intracardiaci, la visualizzazione dei diagrammi di flusso dei vasi uterini, la misurazione del PI, TVI, dei flussi trans-valvolari cardiaci). La tecnica tradizionale è stata integrata e confrontata con quella tridimensionale e quadridimensionale. Gli apparecchi ecografici tridimensionali acquisiscono un singolo volume di voxels mediante una “spazzolata” del fascio ultrasonoro attraverso l’area di interesse, e ciò permette l’approccio standard per lo studio tridimensionale delle strutture non-cardiovascolari. L’immagine così ottenuta è un’immagine statica. La tecnologia 4D aggiunge l’elemento movimento ed in particolare lo Spatio-Temporal Image Correlation (STIC) permette di ottenere una sequenza di un singolo ciclo cardiaco, come fosse un esame bidimensionale condotto dal vivo ed in tempo reale. La sovrapposizione del colore è invece particolarmente utile per verificare la normale emodinamica cardiaca o la presenza di eventuali anomalie. L’utilizzo del power Doppler tridimensionale ha permesso di studiare gli indici di vascolarizzazione placentare quali vascularization index (VI), flow index (FI) e vascularization flow index (VFI). Per studiare il volume di un tessuto, di un organo o di una cavità (nel caso specifico dell’intera placenta o delle cavità cardiache) è stata utilizzata la tecnica VOCAL (Virtual Organ Computer-Aided anaLysis), che permette di ottenere una sequenza di diverse sezioni dopo una rotazione di alcuni gradi rispetto alla precedente. In ogni piano il contorno è stato tracciato manualmente. Il computer ha poi eseguito la ricostruzione e calcolato il volume. Per studiare le scansioni utili a diagnosticare malformazioni cardiache quali la Trasposizione dei grossi vasi è stata utilizzata la metodica SonoVCAD (Sonographically based Volume Computer-AideD) che ricostruisce automaticamente le scansioni cardiache diagnostiche da un volume quadridimensionale del torace fetale ottenuto tramite STIC. Le tecniche descritte sono state utilizzate nella ricerca clinica, permettendo la stesura dei quattro studi analizzati di seguito.The aim of this study was to demonstrate and confirm the utility of the wide spectrum of methods provided by the 3D and 4D ultrasound technology, in increasing the detection rate, monitoring, predicting and studying several obstetrical pathologies. Our study involved perinatal pathologies where management could be difficult. In particular we tried to go into diagnosis and prediction of chromosomal abnormalities, pre-eclampsia and severe pre-eclampsia requiring delivery prior to 32 weeks of gestation, some cardiac defect like complete and correct trasposition of the great arteries and the study of cardiac function in normal and growth restricted fetuses. Every scan was performed using a Voluson 730 ultrasound machine.(G. E. Healthcare). We used the traditional bidimensional ultrasound technology to measure distances (cardiac valves, fetal biometry), with color and pulsed Doppler use (blood vessels visualization like uterin arteries and umbilical artery, intracardiac blood flow, uterin arteries waveform visualization, measure of PI, TVI and cardiac trasvalvular flows). T raditional technique was integrated and comparated to the tridimensional and quadridimensional ones. Ultrasound 3D machines acquire a single volume of voxels by a sweep of ultrasound troughout the interest area, and this allows the 3D approach for the study of non-vascular structures. This provides a static image. The 4D technology adds movement and in particular the STIC software (Spatio-Temporal Image Correlation) allows to obtain a sequence of a single cardiac cicle, like a bidimensional examination in real time. Adding color is useful to verify the cardiac flows and the presence ofe several abnormalities. 4D Power Doppler use allowed study of placental vascularization indices like vascularization index (VI), flow index (FI) e vascularization flow index (VFI). The VOCAL software was used to study the volume of a tissue, organ or cavity (for exemple the whole placenta or cardiac cavities) producing a sequence of several sections of the heart, each obtained after a rotation from the previous one. In each plane the contour was traced manually, and at the end, the computer provided the reconstruction of the ventricle and calculated its volume. To detect cardiac malformations such Trasposition of the great arteries we used the SonoVCAD software (Sonographically based Volume Computer-Aided anaLysis) that automatically retrieves diagnostic cardiac planes from a 4-dimensional volume of the fetal chest obtained with spatiotemporal image correlation (STIC). We finnally concluded that the 3D/4D technique provides several benefits, because the study of the volumes is possible offline, after sacnning and can be repeated by different operators or several times by the same operator, giving the possibility of double-blinded studies. The automatic approach shows good retrieval of diagnostic cardiac planes in fetuses with TGA, which may improve diagnostic efficacy for this disease. There is a good agreement between SV measured either by 2D Doppler or by 4D STIC. The 4D STIC represents a simple and rapid technique to estimate fetal SV and promises to become the method of choice. The combination of abnormal uterine artery Doppler and low placental volume at 11–14 weeks achieves better results than does either test alone in the prediction of pre-eclampsia. We provide normal ranges of placental vascular indices between 11 + 0 and 13 + 6 weeks of gestation, which may be useful in future research on placental vascularity in certain at-risk pregnancies. Additional studies are needed to further validate these methods and it’s very important to remember that to obtain a quality volume we need to have a good bidimensional image

Possibili applicazioni dell’ecografia 3D/4D in medicina prenatale: esperienza di un singolo centro

Lo scopo del nostro studio è stato quello di dimostrare e confermare l’utilità dell’ampio spettro di metodiche fornite dalla tecnologia ecografica tridimensionale e quadridimensionale, nel diagnosticare, monitorare, prevedere o studiare determinate patologie ostetriche. Il nostro studio ha coinvolto patologie perinatali che risultano essere ancora di problematica gestione. In particolare si è cercato di approfondire la diagnosi e la previsione delle patologie cromosomiche, della pre-eclampsia e della pre-eclampsia grave tale da richiedere l’espletamento del parto prima di 32 settimane di gestazione, di alcune malformazioni cardiache quali la Trasposizione completa e corretta dei Grossi Vasi, lo studio della funzionalità cardiaca in feti normali e con ritardo di crescita intrauterino. Per tutti gli esami effettuati è stato utilizzato un ecografo Voluson 730 (G. E. Healthcare). La tecnica ultrasonografica utilizzata è stata quella tradizionale bidimensionale con la misurazione di distanze (valvole cardiache, biometria fetale), con l’uso del Doppler colore e pulsato (visualizzazione di vasi sanguigni quali le arterie uterine e l’arteria ombelicale, dei flussi sanguigni intracardiaci, la visualizzazione dei diagrammi di flusso dei vasi uterini, la misurazione del PI, TVI, dei flussi trans-valvolari cardiaci). La tecnica tradizionale è stata integrata e confrontata con quella tridimensionale e quadridimensionale. Gli apparecchi ecografici tridimensionali acquisiscono un singolo volume di voxels mediante una “spazzolata” del fascio ultrasonoro attraverso l’area di interesse, e ciò permette l’approccio standard per lo studio tridimensionale delle strutture non-cardiovascolari. L’immagine così ottenuta è un’immagine statica. La tecnologia 4D aggiunge l’elemento movimento ed in particolare lo Spatio-Temporal Image Correlation (STIC) permette di ottenere una sequenza di un singolo ciclo cardiaco, come fosse un esame bidimensionale condotto dal vivo ed in tempo reale. La sovrapposizione del colore è invece particolarmente utile per verificare la normale emodinamica cardiaca o la presenza di eventuali anomalie. L’utilizzo del power Doppler tridimensionale ha permesso di studiare gli indici di vascolarizzazione placentare quali vascularization index (VI), flow index (FI) e vascularization flow index (VFI). Per studiare il volume di un tessuto, di un organo o di una cavità (nel caso specifico dell’intera placenta o delle cavità cardiache) è stata utilizzata la tecnica VOCAL (Virtual Organ Computer-Aided anaLysis), che permette di ottenere una sequenza di diverse sezioni dopo una rotazione di alcuni gradi rispetto alla precedente. In ogni piano il contorno è stato tracciato manualmente. Il computer ha poi eseguito la ricostruzione e calcolato il volume. Per studiare le scansioni utili a diagnosticare malformazioni cardiache quali la Trasposizione dei grossi vasi è stata utilizzata la metodica SonoVCAD (Sonographically based Volume Computer-AideD) che ricostruisce automaticamente le scansioni cardiache diagnostiche da un volume quadridimensionale del torace fetale ottenuto tramite STIC. Le tecniche descritte sono state utilizzate nella ricerca clinica, permettendo la stesura dei quattro studi analizzati di seguito.The aim of this study was to demonstrate and confirm the utility of the wide spectrum of methods provided by the 3D and 4D ultrasound technology, in increasing the detection rate, monitoring, predicting and studying several obstetrical pathologies. Our study involved perinatal pathologies where management could be difficult. In particular we tried to go into diagnosis and prediction of chromosomal abnormalities, pre-eclampsia and severe pre-eclampsia requiring delivery prior to 32 weeks of gestation, some cardiac defect like complete and correct trasposition of the great arteries and the study of cardiac function in normal and growth restricted fetuses. Every scan was performed using a Voluson 730 ultrasound machine.(G. E. Healthcare). We used the traditional bidimensional ultrasound technology to measure distances (cardiac valves, fetal biometry), with color and pulsed Doppler use (blood vessels visualization like uterin arteries and umbilical artery, intracardiac blood flow, uterin arteries waveform visualization, measure of PI, TVI and cardiac trasvalvular flows). T raditional technique was integrated and comparated to the tridimensional and quadridimensional ones. Ultrasound 3D machines acquire a single volume of voxels by a sweep of ultrasound troughout the interest area, and this allows the 3D approach for the study of non-vascular structures. This provides a static image. The 4D technology adds movement and in particular the STIC software (Spatio-Temporal Image Correlation) allows to obtain a sequence of a single cardiac cicle, like a bidimensional examination in real time. Adding color is useful to verify the cardiac flows and the presence ofe several abnormalities. 4D Power Doppler use allowed study of placental vascularization indices like vascularization index (VI), flow index (FI) e vascularization flow index (VFI). The VOCAL software was used to study the volume of a tissue, organ or cavity (for exemple the whole placenta or cardiac cavities) producing a sequence of several sections of the heart, each obtained after a rotation from the previous one. In each plane the contour was traced manually, and at the end, the computer provided the reconstruction of the ventricle and calculated its volume. To detect cardiac malformations such Trasposition of the great arteries we used the SonoVCAD software (Sonographically based Volume Computer-Aided anaLysis) that automatically retrieves diagnostic cardiac planes from a 4-dimensional volume of the fetal chest obtained with spatiotemporal image correlation (STIC). We finnally concluded that the 3D/4D technique provides several benefits, because the study of the volumes is possible offline, after sacnning and can be repeated by different operators or several times by the same operator, giving the possibility of double-blinded studies. The automatic approach shows good retrieval of diagnostic cardiac planes in fetuses with TGA, which may improve diagnostic efficacy for this disease. There is a good agreement between SV measured either by 2D Doppler or by 4D STIC. The 4D STIC represents a simple and rapid technique to estimate fetal SV and promises to become the method of choice. The combination of abnormal uterine artery Doppler and low placental volume at 11–14 weeks achieves better results than does either test alone in the prediction of pre-eclampsia. We provide normal ranges of placental vascular indices between 11 + 0 and 13 + 6 weeks of gestation, which may be useful in future research on placental vascularity in certain at-risk pregnancies. Additional studies are needed to further validate these methods and it’s very important to remember that to obtain a quality volume we need to have a good bidimensional image

Differences arising in human neutrophil activation passing from N-formyl to N-acetyl-oligopeptides.

N-formyl- and N-acetyl-peptides were synthesized and compared in order to understand which features can best elicit biological responses. The behavior of N-formyl-peptides confirms the previously found sequential obligations in the residues, while acetyl-derivatives do not seem suitable for an efficacious stimulation of human neutrophils