Endometriosis: 10 keys points for MRI

Endometriosis is a chronic disease and a clinical problem in women of fertile age, with a high impact on quality of life, work productivity and health care management. Two imaging modalities are employed in the diagnosis and evaluation of extent of disease: ultrasound examination with endovaginal approach and magnetic resonance imaging (MRI). MRI, thanks to its high contrast and resolution characteristics, offers a high level of accuracy in the study of endometriosis and adenomyosis. We illustrate here 10 key MRI points for the detection and diagnosis of endometriosis

Energy expenditure and perceived exertion during active video games in relation to player mode and gender

Active video games (AVG) increase energy expenditure (EE) with respect to sedentary video games. Although several AVG consoles allow playing in single-player (SP) or multiplayer (MP) mode, few studies investigated differences in relation to game modality in men and women. Therefore, the aim of this study was to evaluate gender-related psycho-physiological responses during Zumba Fitness Rush (ZFR) played in SP vs. MP mode. Twenty-four college students (women: 14, men: 10; age: 24.6±2.0 years; body weight: 60.2±12.5 kg; body height: 167.8±11.5 cm; BMI: 21.2±2.1 kg·m-2) participated in two experimental sessions: SP (a subject playing ZFR alone) and MP (two subjects playing ZFR simultaneously). Heart rate (HR), oxygen consumption (VO2) and EE (MET and kcal∙min-1) were continuously measured and averaged every 10 seconds, while Rating of Perceived Exertion (RPE) was recorded 30 minutes after the end of each session. A two (gender: women vs. men) by two (modality: SP vs. MP) ANOVA for repeated measures was applied. No differences emerged in relation to gender and game mode for %HRmax, VO2, MET, and RPE. Conversely, a main effect (p=.0007) for gender was found in EE, with significantly (p<.004) higher values in men in SP (women: 5.5±0.6 kcal·min-1; men: 8.3±1.4 kcal·min-1) and MP (women: 5.3±0.7 kcal·min-1; men: 7.6±1.9 kcal·min-1). Present findings suggest that ZFR could be classified as a moderate physical activity, proving to be an alternative form to traditional exercise. Although an effect of number of players could be expected, different player modes did not affect EE, probably because the rhythm of the music imposes a time constraint, independently of the presence of other players

Evolution of congenital hypothyroidism in a cohort of preterm born children

Background: Congenital hypothyroidism (CH) is reported to be more common in preterm infants than in term infants, especially in sick preterm infants. Though a frequent possibility of transitory thyroidal alterations in this category of neonates, the evolution of CH to transient or permanent forms is unpredictable. Methods: We retrospectively analyzed medical records of 28 preterm infants (<37 weeks gestation) who had exhibited a positive screening for CH at birth during the period 2000–2015 followed in our Center. Children were divided into three groups: permanent CH (PCH) with thyroid dysgenesis, PCH with eutopic normal-sized thyroid gland, and transient CH (TCH) with eutopic normal-sized thyroid gland. In all groups we described clinical and biochemical characteristics. Secondly, we analyzed the differences between patients with thyroid dysgenesis and patients with eutopic normal-sized gland and we compared PCH and TCH groups with normal-sized thyroid gland in order to identify clinical or biochemical data for early detection of transient forms. Results: Of all patients, 21.4% showed thyroid dysgenesis while 78.6% presented eutopic normal-sized gland. Infants with thyroid dysgenesis had higher median (IQR) baseline s-TSH and levothyroxine (L-T4) dose per weight at 12 months (12 m-dose) than patients with eutopic normal-sized gland. At re-evaluation of the patients with eutopic normal-sized gland, 36% showed PCH and 64% had TCH. The age of the patients at the beginning of L-T4 treatment, gestational age (GA), birth weight, blood thyroid stimulating hormone levels (b-TSH) at first newborn screening (NBS), baseline serum thyroid stimulating hormone (s-TSH), and L-T4 12 m-dose were statistically different between the two groups. Conclusions: Our results demonstrate that factors as GA, birth weight, b-TSH levels at first NBS, baseline s-TSH, L-T4 12 m-dose and age at the start of the treatment may be considered useful predictive elements for the evolution of CH

Iron Deficiency and Iron Deficiency Anemia in Children

Iron deficiency anemia is considered the most common and widespread nutritional form of anemia in childhood. Red cells are hypochromic and microcytic with low mean corpuscular volume (MCV), low mean corpuscular hemoglobin (MCH) and low reticulocyte hemoglobin content (CHr). Red blood cell distribution width (RDW) is increased. Serum iron is reduced, transferrin is increased and serum ferritin is decreased. Prematurity, decreased dietary source, malabsorption and blood loss represent the most common causes of iron deficiency. Recommended oral dose of elemental iron is 2–6 mg/kg/day; when normal hemoglobin values are reached, treatment must be generally continued for 3 months in order to replenish iron stores. Rarely intravenous therapy is required. The pediatricians and other health care providers should strive to prevent and eliminate iron deficiency and iron-deficiency anemia

Distinct Roles of the Adaptor Protein Shc and Focal Adhesion Kinase in Integrin Signaling to ERK

It has been proposed that integrins activate ERK through the adaptor protein Shc independently of focal adhesion kinase (FAK) or through FAK acting on multiple target effectors, including Shc. We show that disruption of the actin cytoskeleton by cytochalasin D causes a complete inhibition of FAK but does not inhibit Shc signaling and activation of ERK. We have then generated primary fibroblasts carrying a targeted deletion of the segment of beta(1) subunit cytoplasmic domain required for activation of FAK. Analysis of these cells indicates that FAK is not necessary for efficient tyrosine phosphorylation of Shc, association of Shc with Grb2, and activation of ERK in response to matrix adhesion. In addition, integrin-mediated activation of FAK does not appear to be required for signaling to ERK following growth factor stimulation. To examine if FAK could contribute to the activation of ERK in a cell type-specific manner through the Rap1/B-Raf pathway, we have used Swiss-3T3 cells, which in contrast to primary fibroblasts express B-Raf. Dominant negative studies indicate that Shc mediates the early phase and peak, whereas FAK, p130(CAS), Crk, and Rap1 contribute to the late phase of integrin-dependent activation of ERK in these cells. In addition, introduction of B-Raf enhances and sustains integrin-mediated activation of ERK in wild-type primary fibroblasts but not in those carrying the targeted deletion of the beta(1) cytoplasmic domain. Thus, the Shc and FAK pathways are activated independently and function in a parallel fashion. Although not necessary for signaling to ERK in primary fibroblasts, FAK may enhance and prolong integrin-mediated activation of ERK through p130(CAS), Crk, and Rap1 in cells expressing B-Raf

Evaluation of the internal training load in fitness activities: Preliminary results

Ratings of perceived exertion (RPE) and session-RPE methods are widely used as estimate of exercise intensity and to quantify training load in sport activities. However, no information is available in fitness activities although people are often engaged in high intensity physical activities and monitoring individual responses to the training stimulus could provide important feedback on the adaptation to training. Therefore, the purpose of this study was to verify the use of session-RPE using Edwards’ summated heart rate (HR)-zone method as a criterion measure (Herman et al., 2006). After giving their informed consent of participations, 20 volunteers (M=5; F=15; mean age: 21±10 years) practicing regular group-based fitness activities (i.e., 3 weekly sessions of Fit-boxe), participated in the study. Heart rate during the fitness lessons and CR-10 Borg’s scale 30 minutes after the end of the exercise session were recorded. Edwards’ HR method was determined by expressing the HR recordings as percentages of the athlete’s theoretical maximal HR (220-age), multiplying by a specific factor the accumulated time (minutes) in 5 HR zones (50–60% of HRmax=1; 60–70% of HRmax=2; 70–80% of HRmax=3; 80–90% of HRmax=4; 90–100% of HRmax=5), and summating the scores. Session-RPE was calculated multiplying RPE value by the training duration (minutes). RPE recorded 30 minutes after the end of the lesson was 6.1±1.4 points. High and significant correlation (r = 0.72; 95% CI = 0.41-0.88; p = 0.0006) emerged between Edwards’ HR (145.5±32.6 AU) and the session-RPE (247.7±71.6 AU) methods. Results from this preliminary study show that session-RPE can be a useful and inexpensive tool to quantify internal training load in fitness activities, and instructors could use this instrument to monitor their clients, especially when considering the high inter-individual variability of group-based fitness activities

FERALGINE™ a New Oral iron Compound

Management of iron deficiency (ID) and iron deficiency anemia (IDA) is primarily focused to remove, when possible, the underlying cause of ID; subsequently its treatment is primary focused on iron stores repletion. Ferrous sulphate (FS) remains the mainstay of treatment and it is recommended as the first-line treatment of ID and IDA in children as in adults by all guidelines of scientific societies. However the effectiveness of FS is largely compromised by increased adverse effects, poor compliance and discontinuation of treatment. A new oral iron source named FERALGINE™ (FBC-A) has been recently developed. This new molecule is a patented co-processed one-to-one ratio compound between Ferrous Bysglicinate Chelate (FBC) and Sodium Alginate (AA), obtained by using a spray drying technology. The data presented in this short review highlight the efficacy and safety of the treatment with FBC-A and support its use in adult patients with IDA. Furthermore the present review also provides preliminary evidence to suggest FBC-A as first-line treatment for ID/IDA in patients with celiac disease (CD) or inflammatory bowel diseases (IBD)

Translating proteomic into functional data: An high mobility group A1 (HMGA1) proteomic signature has prognostic value in breast cancer

Cancer is a very heterogeneous disease, and biological variability adds a further level of complexity, thus limiting the ability to identify new genes involved in cancer development. Oncogenes whose expression levels control cell aggressiveness are very useful for developing cellular models that permit differential expression screenings in isogenic contexts. HMGA1 protein has this unique property because it is a master regulator in breast cancer cells that control the transition from a nontumorigenic epithelial-like phenotype toward a highly aggressive mesenchymal-like one. The proteins extracted from HMGA1-silenced and control MDA-MB-231 cells were analyzed using label-free shotgun mass spectrometry. The differentially expressed proteins were cross-referenced with DNA microarray data obtained using the same cellular model and the overlapping genes were filtered for factors linked to poor prognosis in breast cancer gene expression meta-data sets, resulting in an HMGA1 protein signature composed of 21 members (HRS, HMGA1 reduced signature). This signature had a prognostic value (overall survival, relapse-free survival, and distant metastasis-free survival) in breast cancer. qRT-PCR, Western blot, and immunohistochemistry analyses validated the link of three members of this signature (KIFC1, LRRC59, and TRIP13) with HMGA1 expression levels both in vitro and in vivo and wound healing assays demonstrated that these three proteins are involved in modulating tumor cell motility. Combining proteomic and genomic data with the aid of bioinformatic tools, our results highlight the potential involvement in neoplastic transformation of a restricted list of factors with an as-yet-unexplored role in cancer. These factors are druggable targets that could be exploited for the development of new, targeted therapeutic approaches in triple-negative breast cancer