Maternal periconceptional factors affect the risk of spina bifida-affected pregnancies: an Italian case-control study

Abstract Purpose Neural tube defects, including spina bifida and anencephaly, are the second most common birth defects with an incidence in Italy of 0.4-1/1,000. Information on factors playing a role in the pathogenesis of spina bifida is based on populations with different exposures, lifestyle, social and cultural habits compared to Italian people. Our objective was to fill this gap by using data from a casecontrol interview study carried out at the G. Gaslini Children's Hospital, Genoa, from 2000 to 2008. Methods We surveyed questionnaires from 133 case mothers and 273 control women providing information on periconceptional risk factors. Univariate and multivariate logistic regression analyses were used to estimate risks by odds ratios (ORs) and 95% confidence intervals (95% CIs). Results Univariate results suggest that birth order, low maternal educational level, age, smoking habits, alcohol consumption, high caffeine intake, lack of folate supplementation, low and high calorie diet, occasional consumption of fruit and vegetables, high emotional stress, and environmental pollution are associated with an increased spina bifida risk. Nevertheless, high caffeine intake (OR= 10.82; 95% CI, 3.78-31), low calorie diet (OR=5.15; 95% CI, 1.79-14), occasional consumption of fruit and vegetables (OR=3.38; 95% CI, 1.67-6.82), alcohol consumption (OR=3.05; 95% CI, 1.24-7.50) and, above all, lack of folate supplementation at any time of pregnancy (OR= 20.54; 95% CI, 5.41-77) mainly determined spina bifida risk in the multivariate analysis. Conclusion Our findings point out that a common underlying mechanism, a disturbed folate/homocysteine metabolism, may be causative for the burden of spina bifida in the Italian population

Supramolecular assemblies based on amphiphilic Mn2+-complexes as high relaxivity MRI probes

In the research field of MRI contrast agents (CAs), amphiphilic paramagnetic complexes are typically sought for the increased plasmatic half-life and high relaxivity values, but limited examples of amphiphilic Mn2+-based CAs have been reported to date. In this work the Mn2+-complexes of six original amphiphilic ligands (three EDTA-like ligands and three 1,4-DO2A derivatives) embodying one or two aliphatic chains were evaluated as potential MRI contrast agents and compared. Strong self-association into micelles resulted in a relaxivity (r1) enhancement (ca. 80% with respect to MnEDTA) as a consequence of the increased molecular tumbling rate of the supramolecular aggregate. In the case of bis-substituted systems the r1 gain is much higher due to the restricted local rotation of the chelates about the pendant aliphatic chains (r1 in the range 12.6\u201318.4 mM 121 s 121, 2\u20133 times higher than for the micelles obtained with single-chain EDTA systems). Furthermore, these amphiphilic chelates tightly bind to human serum albumin (HSA) with association constants KA in the range 104\u2013105 M 121. The resulting supramolecular adducts achieve remarkable relaxivity values, in the range 50\u201360 mM 121 s 121 for the MnEDTA-like chelates and 27\u201330 mM 121 s 121 for the 1,4-DO2A-like systems (at 298 K and 20 MHz), thanks to their fast water exchange rate

The perception of maternal and paternal rejection in anorexic patients

Aims. To study the relationship between: a) AN and perceived maternal and paternal feelings of rejection;b) AN clinical features and the perception of the sense of rejection. Methods.The study has cross-sectional design,the sample was selected among 92 consecutives in and out-patients, aged from 14-35 years referred to twoEating Disorder Services, 23 patients (25%, ME 20 ±5.7)completed the full assessment for AN and were enrolled for the study. The diagnosis of AN was assigned according to the DSM 5 criteria after an accurate psychiatric clinical evaluation, integrated with tools for EDs. Results. The 95% of the SS with AN reported a sense of maternal and paternal rejection. SS with normal or better BMI expresses more maternal/paternal sense of rejection; older SS reported more perceived sense of maternal refusal. Data suggest that: a) better organic conditions and age could allow a greater mentalization of the relational difficulties of AN SS with parental figures and the expansion of the themes of the psychological distress expressed; b) SS in better weight conditions are able to free themselves from the monothematic discomfort relating to body image; c) he sense of maternal rejection requires a greater age to be perceived than the sense of paternal rejection.Aims. To study the relationship between: a) AN and perceived maternal and paternal feelings of rejection;b) AN clinical features and the perception of the sense of rejection. Methods.The study has cross-sectional design,the sample was selected among 92 consecutives in and out-patients, aged from 14-35 years referred to twoEating Disorder Services, 23 patients (25%, ME 20 ±5.7)completed the full assessment for AN and were enrolled for the study. The diagnosis of AN was assigned according to the DSM 5 criteria after an accurate psychiatric clinical evaluation, integrated with tools for EDs. Results. The 95% of the SS with AN reported a sense of maternal and paternal rejection. SS with normal or better BMI expresses more maternal/paternal sense of rejection; older SS reported more perceived sense of maternal refusal. Data suggest that: a) better organic conditions and age could allow a greater mentalization of the relational difficulties of AN SS with parental figures and the expansion of the themes of the psychological distress expressed; b) SS in better weight conditions are able to free themselves from the monothematic discomfort relating to body image; c) he sense of maternal rejection requires a greater age to be perceived than the sense of paternal rejection.Aims. To study the relationship between: a) AN and perceived maternal and paternal feelings of rejection;b) AN clinical features and the perception of the sense of rejection. Methods.The study has cross-sectional design,the sample was selected among 92 consecutives in and out-patients, aged from 14-35 years referred to twoEating Disorder Services, 23 patients (25%, ME 20 ±5.7)completed the full assessment for AN and were enrolled for the study. The diagnosis of AN was assigned according to the DSM 5 criteria after an accurate psychiatric clinical evaluation, integrated with tools for EDs. Results. The 95% of the SS with AN reported a sense of maternal and paternal rejection. SS with normal or better BMI expresses more maternal/paternal sense of rejection; older SS reported more perceived sense of maternal refusal. Data suggest that: a) better organic conditions and age could allow a greater mentalization of the relational difficulties of AN SS with parental figures and the expansion of the themes of the psychological distress expressed; b) SS in better weight conditions are able to free themselves from the monothematic discomfort relating to body image; c) he sense of maternal rejection requires a greater age to be perceived than the sense of paternal rejection