Sexual violence against women: a multidisciplinary integrated care model

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Approaching the seismogenic source of the Calabria 8 September 1905 earthquake: New geophysical, geological and biochemical data from the S. Eufemia Gulf (S Italy)

Recognizing the seismogenic source of major historical earthquakes, particularly when these have occurred offshore, is a long-standing issue across the Mediterranean Sea and elsewhere. The destructive earthquake (M ~7) that struck western Calabria (southern Italy) on the night of 8 September 1905 is one such case. having various authors proposed a seismogenic source, with apparently diverse hypotheses and without achieving a unique solution. To gain novel insight into the crustal volume where the 1905 earthquake took place and to seek a more robust solution for the seismogenic source associated with this destructive event, we carried out a well-targeted multidisciplinary survey within the Gulf of S. Eufemia (SE Tyrrhenian Sea), collecting geophysical data, oceanographic measurements, and biological, chemical and sedimentary samples. We identified three main tectonic features affecting the sedimentary basin in the Gulf of S. Eufemia: 1) a NE-SW striking, ca. 13-km-long, normal fault, here named S. Eufemia Fault; 2) a WNW-striking polyphased fault system; and 3) a likely E-W trending lineament. Among these, the normal fault shows evidence of activity witnessed by the deformed recent sediments and by its seabed rupture along which, locally, fluid leakage occurs. Features in agreement with the anomalous distribution of prokaryotic abundance and biopolymeric C content, resulted from the shallow sediments analyses. The numerous seismogenic sources proposed in the literature during the past 15 years make up a composite framework of this sector of western Calabria, that we tested against a) the geological evidence from the newly acquired dataset, and b) the regional seismotectonic models. Such assessment allows us to propose the NE-SW striking normal fault as the most probable candidate for the seismogenic source of the 1905 earthquake. Re-appraising a major historical earthquake as the 1905 one enhances the seismotectonic picture of western Calabria. Further understanding of the region and better constraining the location of the seismogenic source may be attained through integrated interpretation of our data together with a) on-land field evidence, and b) seismological modeling

Psychological impact and health-related quality-of-life outcomes of Mayer-Rokitansky-Küster-Hauser syndrome : A systematic review and narrative synthesis

Mayer-Rokitansky-K\ufcster-Hauser syndrome causes absence or underdevelopment of uterus and vagina, but women's subjective experience remains understudied. This systematic review was conducted to examine the psychological and health-related quality-of-life outcomes of Mayer-Rokitansky-K\ufcster-Hauser syndrome. In total, 22 articles identified through electronic search matched the inclusion criteria and were included in our review. Mayer-Rokitansky-K\ufcster-Hauser syndrome may be associated with psychological symptoms and impaired quality of life, but especially with poor sexual esteem and genital image. Women may experience difficulties managing intimacy and disclosing to partners. Mothers may be perceived as overinvolved, with consequent negative emotions in women with the disease

Impact of delivery mode on the colostrum microbiota composition.

BACKGROUND: Breast milk is a rich nutrient with a temporally dynamic nature. In particular, numerous alterations in the nutritional, immunological and microbiological content occur during the transition from colostrum to mature milk. The objective of our study was to evaluate the potential impact of delivery mode on the microbiota of colostrum, at both the quantitative and qualitative levels (bacterial abundance and microbiota network). METHODS: Twenty-nine Italian mothers (15 vaginal deliveries vs 14 Cesarean sections) were enrolled in the study. The microbiota of colostrum samples was analyzed by next generation sequencing (Ion Torrent Personal Genome Machine). The colostrum microbiota network associated with Cesarean section and vaginal delivery was evaluated by means of the Auto Contractive Map (AutoCM), a mathematical methodology based on Artificial Neural Network (ANN) architecture. RESULTS: Numerous differences between Cesarean section and vaginal delivery colostrum were observed. Vaginal delivery colostrum had a significant lower abundance of Pseudomonas spp., Staphylococcus spp. and Prevotella spp. when compared to Cesarean section colostrum samples. Furthermore, the mode of delivery had a strong influence on the microbiota network, as Cesarean section colostrum showed a higher number of bacterial hubs if compared to vaginal delivery, sharing only 5 hubs. Interestingly, the colostrum of mothers who had a Cesarean section was richer in environmental bacteria than mothers who underwent vaginal delivery. Finally, both Cesarean section and vaginal delivery colostrum contained a greater number of anaerobic bacteria genera. CONCLUSIONS: The mode of delivery had a large impact on the microbiota composition of colostrum. Further studies are needed to better define the meaning of the differences we observed between Cesarean section and vaginal delivery colostrum microbiota

A woman's worth: The psychological impact of beliefs about motherhood, female identity, and infertility on childless women with endometriosis

In this study, we examined whether beliefs regarding motherhood, female identity, and infertility affected the psychological health of 127 childless endometriosis patients. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale, while self-esteem was assessed using the Rosenberg Self-Esteem Scale. A set of six Likert-type items (1\u2009=\u2009"Not at all"; 5\u2009=\u2009"To a very great extent") was developed to explore women's beliefs. Women who were more likely to believe that childless and infertile women were less appreciated by others reported poorer psychological health. Patients' beliefs should be explored during psychological counseling. Dysfunctional beliefs about female identity, especially as regards others' perceptions, should be restructured to improve patients' psychological health

Favorable Trend of Implantable Cardioverter-Defibrillator Service Life in a Large Single-Nation Population: Insights From 10-Year Analysis of the Italian Implantable Cardioverter-Defibrillator Registry

Background: Implantable cardioverter-defibrillators (ICDs) are widely employed for the prevention of sudden cardiac death. Despite technological improvements, patients often need to undergo generator replacement, which entails the risk of periprocedural complications. Our aim was to estimate the service life of ICDs over a 10-year interval and to assess the main causes of replacement on the basis of data from the National ICD Registry of the Italian Society of Arrhythmology and Cardiac Pacing (AIAC). Methods and Results: The registry includes data from over 400 hospitals in Italy. We included all patients who underwent device replacement from calendar years 2007 to 2016. The median service life of the ICDs and its trend over the years was estimated across the 3 types of devices (single-chamber, dual-chamber, cardiac resynchronization therapy defibrillator) and the indication to implantation. The causes of replacement were also analyzed. We included 29 158 records from 27 676 patients (80.9% men; mean age at device replacement 65.8±12.0 years). The median service life was 57.3 months (interquartile range 27.8 months). Over the years, service life showed an increasing trend. The majority of patients underwent elective replacement because of battery end of life, and over the years there was a significant reduction of replacement for recalls, erosion/infections, and cardiac resynchronization therapy upgrading. Conclusions: Our data from a large single-nation population showed that the trend of ICD service life, independently from ICD type, indication, and settings, significantly improved over time. Moreover, there was a striking reduction of interventions for upgrading and infection/erosion. This favorable trend has important clinical, organizational, and financial implications

The SHOX gene and the short stature. Roundtable on diagnosis and treatment of short stature due to SHOX haploinsufficiency: How genetics, radiology and anthropometry can help the pediatrician in the diagnostic process padova (April 20th, 2011)

The growth of the human body depends from a complex interaction between nutritional, environmental and hormonal factors and by a large number of different genes. One of these genes, short stature homeobox (SHOX), is believed to play a major role in growth. SHOX haploinsufficiency is associated with a wide spectrum of conditions, all characterized growth failure such as Leri-Weill dyschondrosteosis , Turner syndrome, short stature with subtle auxological and radiological findings and the so called “idiopathic short stature” (short stature with no specific findings other than growth failure). The document was prepared by a multidisciplinary team (paediatric endocrinologists, paediatrician, radiologist, geneticist and epidemiologist) to focus on the investigation of children with suspected SHOX- deficiency (SHOX-D) for an early identification and a correct diagnostic work - up of this genetic disorder. On the basis of a number of screening studies, SHOX-D appears to be a relatively frequent cause of short stature. The following recommendations were suggested by our multidisciplinary team: (i) a careful family history, measurements of body proportions and detection of any dysmorphic features are important for the suspect of a genetic disorder ,(ii)the presence of any combination of the following physical findings, such as reduced arm span/ height ratio, increased sitting height/height ratio, above average BMI, Madelung deformity, cubitus valgus, short or bowed forearm, dislocation of the ulna at the elbow, or the appearance of muscular hypertrophy, should prompt the clinician to obtain a molecular analysis of the SHOX region, (iii) it is of practical importance to recognise early or mild signs of Madelung deformity on hand and wrist radiographs, (iv) growth hormone ,after stimulation test, is usually normal . However, treatment with rhGH may improve final adult height; the efficacy of treatment is similar to that observed in those treated for Turner syndrome

Psychosexual consequences of female genital mutilation and the impact of reconstructive surgery : a narrative review

Purpose: We aim to provide a comprehensive overview of the health consequences of female genital mutila- tion/cutting (FGM/C), with a particular focus on the psychosexual implications of this practice and the overall impact of reconstructive plastic surgery. Methods: A MEDLINE search through PubMed was performed to identify the best quality evidence published studies in English language on long-term health consequences of FGM/C. Results: Women with FGM/C are more likely to develop psychological disorders, such as post-traumatic stress disorder, anxiety, somatization, phobia, and low self-esteem, than those without FGM/C. Most studies showed impaired sexual function in women with FGM/C. In particular, women with FGM/C may be physiologically less capable of becoming sexually stimulated than uncut women. Reconstructive surgery could be beneficial, in terms of both enhanced sexual function and body image. However, prospective studies on the impact of re- constructive surgery are limited, and safety issues should be addressed. Conclusion: Although it is clear that FGM/C can cause devastating immediate and long-term health conse- quences for girls and women, high-quality data on these issues are limited. Psychosexual complications need to be further analyzed to provide evidence-based guidelines and to improve the health care of women and girls with FGM/C. The best treatment approach involves a multidisciplinary team to deal with the multifaceted FGM/C repercussions