Advances in the medical management of bowel endometriosis

Endometriosis infiltrating the bowel can be treated medically in accurately selected women not seeking conception and without overt obstructive symptomatology. When the rectosigmoid junction is involved, the probabilities of intestinal symptoms relief, undergoing surgery after treatment failure, and developing bowel obstruction during hormonal treatment are around 70%, 10%, and 1-2%, respectively. When the lesion infiltrates exclusively the mid-rectum, thus in cases of true rectovaginal endometriosis, the probabilities of intestinal symptoms relief and undergoing surgery are about 80% and 3%, respectively. Endometriotic obstructions of the rectal ampulla have not been reported. A rectosigmoidoscopy or colonoscopy should be performed systematically before starting medical therapies, also to rule out malignant tumours arising from the intestinal mucosa. Progestogens are safe, generally effective, well-tolerated, inexpensive, and should be considered as first-line medications for bowel endometriosis. Independently of symptom relief, intestinal lesions should be checked periodically to exclude nodule progression during hormonal treatment

Surgery versus hormonal therapy for deep endometriosis : is it a choice of the physician?

Deep endometriosis, occurring approximately in 1% of women of reproductive age, represents the most severe form of endometriosis. It causes severe pain in the vast majority of affected women and it can affect the bowel and the urinary tract. Hormonal treatment of deep endometriosis with progestins, such as norethindrone acetate or dienogest, or estroprogestins is effective in relieving pain in more than 90% of women at one year follow up. Progestins and estroprogestins can be safely administered in the long-term, may be not expensive and are usually well tolerated. Therefore, they should represent the first-line treatment of deep endometriosis associated pain in women not seeking natural conception. However, hormonal treatment is ineffective or not tolerated in about 30% of women, the most common side effects being erratic bleeding, weight gain, decreased libido and headache. Surgical excision of deep endometriosis is mandatory in presence of symptomatic bowel stenosis, ureteral stenosis with secondary hydronephrosis, and when hormonal treatments fail. Surgical treatment is similarly effective as compared to hormonal treatment in relieving dismenorhea, dyspareunia and dyschezia at one year follow up in more than 90% of women with deep endometriosis. Surgical removal of the nodules may require resection of the bowel, ureter or bladder, with possible severe complications such as rectovaginal or ureterovaginal fistula and anastomotic leakage. A thorough counsel with the patient is necessary in order to pursue a therapeutic plan centered not on the endometriotic lesions, but on the patient's symptoms, priorities and expectations

Physiological and Biochemical behaviours and antioxidant response of Helianthus annuus under Lanthanum and Cerium Stress

The continuous progress of global manufacturing and anthropogenic activities has resulted in excessive environmental metallic pollution, particularly with rare earth elements (REEs) which have become a prevalent issue of global concern due to their high toxicity and widespread existence. REEs-contaminated soils could ruin agriculture by inducing plant physiology disturbances in various crops that are considered the principal link of the human food chain. The main purpose of the present work is to assess the phytotoxicity of two light REEs, lanthanum (La) and cerium (Ce), in Helianthus annuus after 14 days of exposure to different concentrations of La and Ce (0, 1, 2.5, 5, and 10 µM). Plants showed different variations in shoot and root lengths at the end of the trial period. The accumulation of photosynthetic pigments, such as chlorophylls and carotenoids, as well as the photosynthetic efficiency, the non-photochemical quenching, the photosynthetically active radiation, and the electron transport rate, increased in the two REE treatments. Hydrogen peroxide significantly increased in all applied concentrations of La and Ce. A significant increase in malondialdehyde content was noticed only when plants were exposed to 2.5 µM La and 10 µM Ce. Results also demonstrated that La and Ce induced an increase in the activity of superoxide dismutase, peroxidase, and catalase (only the highest concentration of La decreased catalase activity). The exposure to different REE concentrations induced the accumulation of La and Ce in the plants, mainly in roots. Helianthus annuus showed an effective resistance behaviour facing La- and Ce-induced stresses

Efecto de procesos de ahumado frío y caliente y la adición de extracto polifenólico natural de Dunaliella salina sobre la calidad bioquímica y la vida útil de filetes de Sander lucioperca almacenados durante 90 días

The effects of cold and hot smoking and the addition of Dunaliella salina polyphenol extract on the biochemical quality and shelf-life of Sander lucioperca fillets after storage for 90 days at 0-4 °C were examined. The results showed a significant increase in protein, lipid, free fatty acid, and 1,1-diphenyl-2-picrylhydrazyl contents, and a decrease in peroxide and thiobarbituric acid reactive substances, and volatile base nitrogen levels in cold (CSF) and hot (HSF) smoked fillets covered with or without extract and stored for 1, 20, and 90 days compared to fresh fillets (FF). Saturated and monounsaturated fatty acids exhibited a significant increase in FF and CSF and HSF covered with or without extract. The total polyunsaturated fatty acids revealed a significant decrease in FF and CSF and HSF with or without extract. Therefore, cold and hot smoking and polyphenol extract improved the biochemical quality and storage shelf-life of fillets for 90 days at 0-4 °C.Se examinaron los efectos del ahumado en frío y en caliente y la adición de extracto de polifenoles de Dunaliella salina sobre la calidad bioquímica y la vida útil de filetes de Sander lucioperca almacenados durante 90 días a 0-4 °C. Los resultados mostraron un aumento significativo en los contenidos de proteínas, lípidos, ácidos grasos libres y 1,1-difenil-2-picrilhidrazilo, y una disminución en las sustancias reactivas de peróxido y ácido tiobarbitúrico, y los niveles de nitrógeno básico volátil en frío (LCR) y caliente (HSF) de filetes ahumados cubiertos con o sin extracto y almacenados durante 1, 20 y 90 días en comparación con los filetes frescos (FF). Los ácidos grasos saturados y monoinsaturados exhibieron un aumento significativo en FF y LCR y HSF cubiertos con o sin extracto. Los ácidos grasos poliinsaturados totales revelaron una disminución significativa en FF y CSF y HSF con o sin extracto. Por lo tanto, el ahumado en frío y en caliente y el extracto de polifenoles mejoraron la calidad bioquímica y la vida útil durante el almacenamiento de los filetes durante 90 días a 0-4 °C

Evidence of the Generation of Isosaccharinic Acids and Their Subsequent Degradation by Local Microbial Consortia within Hyper-Alkaline Contaminated Soils, with Relevance to Intermediate Level Radioactive Waste Disposal

The contamination of surface environments with hydroxide rich wastes leads to the formation of high pH (>11.0) soil profiles. One such site is a legacy lime works at Harpur Hill, Derbyshire where soil profile indicated in-situ pH values up to pH 12. Soil and porewater profiles around the site indicated clear evidence of the presence of the α and β stereoisomers of isosaccharinic acid (ISA) resulting from the anoxic, alkaline degradation of cellulosic material. ISAs are of particular interest with regards to the disposal of cellulosic materials contained within the intermediate level waste (ILW) inventory of the United Kingdom, where they may influence radionuclide mobility via complexation events occurring within a geological disposal facility (GDF) concept. The mixing of uncontaminated soils with the alkaline leachate of the site resulted in ISA generation, where the rate of generation in-situ is likely to be dependent upon the prevailing temperature of the soil. Microbial consortia present in the uncontaminated soil were capable of surviving conditions imposed by the alkaline leachate and demonstrated the ability to utilise ISAs as a carbon source. Leachate-contaminated soil was sub-cultured in a cellulose degradation product driven microcosm operating at pH 11, the consortia present were capable of the degradation of ISAs and the generation of methane from the resultant H2/CO2 produced from fermentation processes. Following microbial community analysis, fermentation processes appear to be predominated by Clostridia from the genus Alkaliphilus sp, with methanogenesis being attributed to Methanobacterium and Methanomassiliicoccus sp. The study is the first to identify the generation of ISA within an anthropogenic environment and advocates the notion that microbial activity within an ILW-GDF is likely to influence the impact of ISAs upon radionuclide migration

Measurement of the (90,91,92,93,94,96)Zr(n,gamma) and (139)La(n,gamma) cross sections at n_TOF

Open AccessNeutron capture cross sections of Zr and La isotopes have important implications in the field of nuclear astrophysics as well as in the nuclear technology. In particular the Zr isotopes play a key role for the determination of the neutron density in the He burning zone of the Red Giant star, while the (139)La is important to monitor the s-process abundances from Ba up to Ph. Zr is also largely used as structural materials of traditional and advanced nuclear reactors. The nuclear resonance parameters and the cross section of (90,91,92,93,94,96)Zr and (139)La have been measured at the n_TOF facility at CERN. Based on these data the capture resonance strength and the Maxwellian-averaged cross section were calculated

New measurement of neutron capture resonances of 209Bi

The neutron capture cross section of Bi209 has been measured at the CERN n TOF facility by employing the pulse-height-weighting technique. Improvements over previous measurements are mainly because of an optimized detection system, which led to a practically negligible neutron sensitivity. Additional experimental sources of systematic error, such as the electronic threshold in the detectors, summing of gamma-rays, internal electron conversion, and the isomeric state in bismuth, have been taken into account. Gamma-ray absorption effects inside the sample have been corrected by employing a nonpolynomial weighting function. Because Bi209 is the last stable isotope in the reaction path of the stellar s-process, the Maxwellian averaged capture cross section is important for the recycling of the reaction flow by alpha-decays. In the relevant stellar range of thermal energies between kT=5 and 8 keV our new capture rate is about 16% higher than the presently accepted value used for nucleosynthesis calculations. At this low temperature an important part of the heavy Pb-Bi isotopes are supposed to be synthesized by the s-process in the He shells of low mass, thermally pulsing asymptotic giant branch stars. With the improved set of cross sections we obtain an s-process fraction of 19(3)% of the solar bismuth abundance, resulting in an r-process residual of 81(3)%. The present (n,gamma) cross-section measurement is also of relevance for the design of accelerator driven systems based on a liquid metal Pb/Bi spallation target.Comment: 10 pages, 5figures, recently published in Phys. Rev.

Measurement of the neutron capture cross section of the s-only isotope 204Pb from 1 eV to 440 keV

The neutron capture cross section of 204Pb has been measured at the CERN n_TOF installation with high resolution in the energy range from 1 eV to 440 keV. An R-matrix analysis of the resolved resonance region, between 1 eV and 100 keV, was carried out using the SAMMY code. In the interval between 100 keV and 440 keV we report the average capture cross section. The background in the entire neutron energy range could be reliably determined from the measurement of a 208Pb sample. Other systematic effects in this measurement could be investigated and precisely corrected by means of detailed Monte Carlo simulations. We obtain a Maxwellian average capture cross section for 204Pb at kT=30 keV of 79(3) mb, in agreement with previous experiments. However our cross section at kT=5 keV is about 35% larger than the values reported so far. The implications of the new cross section for the s-process abundance contributions in the Pb/Bi region are discussed.Comment: 8 pages, 3 figures, article submitted to Phys. Rev.

Impact of endometriosis on obstetric outcome after natural conception: a multicenter Italian study

Purpose To evaluate obstetric outcome in women with endometriosis who conceive naturally and receive standard obstetric care in Italy. Methods Cases were consecutive women with endometriosis managed in eleven Italian referral centers. Controls were women in whom endometriosis was excluded. All women filled in a questionnaire addressing previous natural pregnancies. Marginal logistic regression models were fitted to evaluate the impact of endometriosis on obstetric outcome. A post hoc analysis was performed within the endometriosis group comparing women with severe adenomyosis versus women with absent or mild adenomyosis. Results Three hundred and fifty-five pregnancies in endometriosis group and 741 pregnancies in control group were included. Women with endometriosis had a higher risk of preterm delivery < 34 weeks (6.4% vs 2.8%, OR 2.42, 95% CI 1.22–4.82), preterm delivery < 37 weeks (17.8% vs 9.7%, OR 1.98, 95% CI 1.23–3.19), and neonatal admission to Intensive Care Unit (14.1% vs 7.0%, OR 2.04, 95% CI 1.23–3.36). At post hoc analysis, women with endometriosis and severe adenomyosis had an increased risk of placenta previa (23.1% vs 1.8%, OR 16.68, 95% CI 3.49–79.71), cesarean delivery (84.6% vs 38.9%, OR 8.03, 95% CI 1.69–38.25) and preterm delivery < 34 weeks (23.1% vs 5.7%, OR 5.52, 95% CI 1.38–22.09). Conclusion Women with endometriosis who conceive naturally have increased risk of preterm delivery and neonatal admission to intensive care unit. When severe adenomyosis is coexistent with endometriosis, women may be at increased risk of placenta previa and cesarean delivery. Trial registration Clinical trial registration number: NCT03354793

Measurements of high-energy neutron-induced fission of (nat)Pb and (209)Bi

This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial License 3.0, which permits unrestricted use, distribution, and reproduction in any noncommercial medium, provided the original work is properly citedThe CERN Neutron Time-Of-Flight (n_TOF) facility is well suited to measure low cross sections as those of neutron-induced fission in subactinides. The cross section ratios of (nat)Pb and (209)Bi relative to (235)U and (238)U were measured using PPAC detectors and a fragment coincidence method that allows us to identify the fission events. The present experiment provides first results for neutron-induced fission up to 1 GeV. Good agreement is found with previous experimental data below 200 MeV. The comparison with proton-induced fission indicates that the limiting regime where neutron-induced and proton-induced fission reach equal cross sections is close to 1 GeV