Tenascin Expression in Human Placentas during FGR Affected Pregnancies and Umbilical Doppler Velocimetry Correlation

Objective: The aim of this study was to evaluate the expression of some non collagenous extracellular matrix proteins, in particular tenascin, in human placentas of intrauterine growth restricted fetuses with abnormal umbilical Doppler velocimetry. Study Design: Study group (group A) consisted of 23 pregnant women with intrauterine growth restricted fetuses, with or without preeclampsia. Control group (group B) consisted of 10 pregnant women with appropriate fetal weight for gestational age. Placental specimens were collected from biopsies obtained after cesarean delivery. Umbilical artery Doppler velocimetry was performed within four hours from delivery in all patients. Tenascin expression was studied by immunohistochemistry and western blot techniques. Results: A difference in birth weight and placental weight was found in the two groups, being lower in the study group. Umbilical artery Doppler velocimetry showed abnormal patterns in the study group and normal findings in the control one. Tenascin was strongly expressed in placentas from growth restricted fetuses, as shown by immunohistochemistry and by RT-PCR, while it was almost absent in placentas from group B. Conclusion: A relationship between abnormal Doppler patterns and tenascin distribution in growth restricted fetuses has been observed. The presence of tenascin might be considered as a placental compensatory mechanism in FGR fetuses with abnormal umbilical artery Doppler velocimetry

Systemic importance of financial institutions: regulations, research, open issues, proposals

In the field of risk management, scholars began to bring together the quantitative methodologies with the banking management issues about 30 years ago, with a special focus on market, credit and operational risks. After the systemic effects of banks defaults during the recent financial crisis, and despite a huge amount of literature in the last years concerning the systemic risk, no standard methodologies have been set up to now. Even the new Basel 3 regulation has adopted a heuristic indicator-based approach, quite far from an effective quantitative tool. In this paper, we refer to the different pieces of the puzzle: definition of systemic risk, a set of coherent and useful measures, the computability of these measures, the data set structure. In this challenging field, we aim to build a comprehensive picture of the state of the art, to illustrate the open issues, and to outline some paths for a more successful future research. This work appropriately integrates other useful surveys and it is directed to both academic researchers and practitioners

Caracterização da qualidade acústica de salas de aula para prática e ensino musical

Resumo O músico necessita perceber adequadamente o som nos recintos destinados ao estudo e prática musical, o que é possível quando estes locais estão acusticamente preparados e permitem o desenvolvimento e aprimoramento da percepção sonora musical. Neste trabalho três salas de estudo e três salas de aula coletiva, destinadas ao ensino e prática de Música de uma universidade, foram caracterizadas acusticamente através da opinião dos músicos usuários e de medições da sua resposta impulsiva. As salas descritas pelos músicos como secas tiveram, nas bandas de frequência de oitava de 500 a 1000 Hz, um Tempo de Reverberação em torno de 0,3 segundos, entre 14 e 22 dB de Clareza e entre 88% a 96% de Definição. As salas caracterizadas como reverberantes tiveram um tempo ao redor de 1,5 segundos, Clareza de 1 dB e Definição de 40%. A opinião dos músicos permitiu compreender as preferências da qualidade acústica das salas e as informações fornecidas pelos músicos se mostraram coerentes com os dados das medições

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Vero come la finzione. La Psicopatologia al Cinema. Volume 1

Il libro contiene centinaia di schede cinematografiche, suddivise in capitoli dedicati ad aree psicopatologiche specifiche, in cui gli autori analizzano i sintomi psicopatologici, i meccanismi psichici e le storie cinematografiche che illustrano la sofferenze psichica, con l'obiettivo di utilizzare a scopo didattico e culturale lo strumento cinematografico per l'apprendimento della psicopatologi

THE ROLE OF PARTOSURE™ TEST IN PREDICTING IMMINENT PRETERM BIRTH

INTRODUCTION An accurate risk assessment of preterm birth is clinically important in pregnancies with threatened preterm labor. This is particulary true with respect to both the administration of corticosteroids, as well as the transfer of patients to a tertiary care center capable of caring for the birth of premature infants. Clinical evaluation alone, with the measurement of cervical length and dilatation, are not sufficiently predictive of imminent delivery. Currently available biomarker tests, such as the detection of fetal fibronectin, have extramely poor predictive value form imminent delivery. The PartoSure™ test is a rapid, qualitative immunochromatographic test for the in vivo detection of placental alpha microglobulin-1 (PAMG-1) in vaginal secretions of pregnant women. PAMG-1 is a protein found in high concentrations in the amniotic fluid. METHODS We conducted a prospective observational study from March to June 2016. We enrolled 20 symptomatic patients between 24-34 week of gestation with singleton pregnancy, irregular uterine activity and/or lower abdominal pain and pelvic pressure, intact membranes, cervical length < 20 mm and funneling. Patients were initially managed according to the internal protocol: prophylactic corticosteroid betamethasone i.m. 12 mg/day for 2 days and primary tocolysis for 48 hours. 7 days after the therapy, we evaluated all the patients: 2 patients had delivered and 3 patients were excluded for premature rupture of membranes. In the final analysis, we included 15 patients. The PartoSure™ test was performed for these patients. The result was interpreted once two lines were visible, or after 5 min elapsed since the insertion of the test strip into the sample vial. The patients were divided in two groups: the test was positive for two patients (Group A) and was negative for 13 patients (Group B). All patients had been revaluated after 7 and 14 days from the execution of the test. RESULTS In group A, a patient delivered within 7 days, while the others delivered within 14 days from presentation. In group B, a patient delivered within 7 days, while 12 patients were still pregnant after 14 days. CONCLUSIONS In our study, the positive and negative predictive value of the PartoSure™ test seems to be high within 7 and 14 days (PPV 100%, NPV 92%). However, our conclusions are based on a small sample, so further studies are needed. If our results will be confirmed, the device could be considered an excellent test to rapidly assess the risk of preterm delivery within 7 or 14 days from time of collection of cervicovaginal sample in pregnant women with signs and symptoms of early preterm delivery, intact membranes and minimal expansion. A positive PartoSure™ test in these patients indicates with a high degree of accuracy that spontaneous preterm delivery will occur within 7 days. A negative result indicates that spontaneous preterm delivery within 14 days is highly unlikely