Risk Factors for Spontaneous Abortion

A case-control study was conducted to evaluate risk factors for spontaneous abortions. Cases were 94 women with two or more unexplained miscarriages (after exclusion of genetic, endocrine and Müllerian factors) and no term pregnancy, controls were 176 women admitted for normal delivery to the same clinic where cases were identified. Questions were asked about personal characteristics and habits, and gynaecological history. A family history of recurrent miscarriage was more common among women with spontaneous miscarriages than among the controls (13 cases versus 8 controls, relative risk (RR) =3.2, 95% confidence interval (CI) = 1.3-8.1). Compared to women whose menarche occurred at age 11 or younger, the RRs were 0.8 when menarche occurred at age 12-13 and 0.5 at age 14 or more: this trend in risk was statistically significant. Compared with never smokers, current smokers had about a 40% increased risk of miscarriage and the risk increased with number of cigarettes per day. No association emerged with socio-demographic characteristics (e.g. education, marital status, age of the partner), reproductive history (age at first pregnancy), type of contraceptive used and other general lifestyle habits (e.g. alcohol or coffee consumption

Risk Factors for Spontaneous Abortion

A case-control study was conducted to evaluate risk factors for spontaneous abortions. Cases were 94 women with two or more unexplained miscarriages (after exclusion of genetic, endocrine and M\ufcllerian factors) and no term pregnancy, controls were 176 women admitted for normal delivery to the same clinic where cases were identified. Questions were asked about personal characteristics and habits, and gynaecological history. A family history of recurrent miscarriage was more common among women with spontaneous miscarriages than among the controls (13 cases versus 8 controls, relative risk (RR) = 3.2, 95% confidence interval (CI) = 1.3-8.1). Compared to women whose menarche occurred at age 11 or younger, the RRs were 0.8 when menarche occurred at age 12-13 and 0.5 at age 14 or more: this trend in risk was statistically significant. Compared with never smokers, current smokers had about a 40% increased risk of miscarriage and the risk increased with number of cigarettes per day. No association emerged with sociodemographic characteristics (e.g. education, marital status, age of the partner), reproductive history (age at first pregnancy), type of contraceptive used and other general lifestyle habits (e.g. alcohol or coffee consumption)

The Covid-19 explosion in the state of Amapá: how is the most preserved region in the Brazilian Amazon currently fighting the SARS-COV 2 pandemic?

The state of Amapá is located in the extreme north of Brazil, within the Amazon rainforest and is crossed by the Equator. It has a hot and humid climate with rains that last 8 months a year and 4 months of unrelenting sun that melts rubber from car seals, fries eggs on the floor and even cooks a whole egg tub, in case you forget in a car exposed to the sun . It was believed that with this potent solar incidence, the Sars-COV 2 virus would not have so much impact in this region, a terrible mistake! Today Amapá has the highest incidence of Covid-19 in the whole of Brazil, with a maid of 600 cases per hundred thousand inhabitants and in the Amazon it is the 3rd in deaths and loses in this item only to the state of Amazonas and Pará.The state of Amapá is located in the extreme north of Brazil, within the Amazon rainforest and is crossed by the Equator. It has a hot and humid climate with rains that last 8 months a year and 4 months of unrelenting sun that melts rubber from car seals, fries eggs on the floor and even cooks a whole egg tub, in case you forget in a car exposed to the sun . It was believed that with this potent solar incidence, the Sars-COV 2 virus would not have so much impact in this region, a terrible mistake! Today Amapá has the highest incidence of Covid-19 in the whole of Brazil, with a maid of 600 cases per hundred thousand inhabitants and in the Amazon it is the 3rd in deaths and loses in this item only to the state of Amazonas and Pará

Grossansätze zur Herstellung von α,α,α',α'-Tetraaryl-1,3-dioxolan-4,5-dimethanolen (TADDOLe): Nützliche Hilfsstoffe für die EPC-Synthese und ihre Struktur im Festkörper

The large-scale preparation of α,α,α',α'-tetraaryl-1,3-dioxolan-4,5-dimethanol derivatives is described. It consists of acetalization of dimethyl tartrate and Grignard addition. The diols 2–12 thus obtained are crystalline and stable. They are useful as versatile auxiliaries for enantioselective reactions and for resolutions by clathrate formation. The X-ray crystal structure of the inclusion compound from one of the TADDOLs and CCl4 is described (6·2 CCl4) and compared with the structures of analogous derivatives, including C2-symmetrical diphosphines. Reference is given to other chiral auxiliaries containing the diaryl-methanol group

The CRACK programme: a scientific alliance for bridging healthcare research and public health policies in Italy

Healthcare utilisation databases, and other secondary data sources, have been used with growing frequency to assess health outcomes and healthcare interventions worldwide. Their increased popularity as a research tool is due to their timely availability, the large patient populations covered, low cost, and applicability for studying real-world clinical practice. Despite the need to measure Italian National Health Service performance both at regional and national levels, the wealth of good quality electronic data and the high standards of scientific research in this field, healthcare research and public health policies seem to progress along orthogonal dimensions in Italy. The main barriers to the development of evidence-based public health include the lack of understanding of evidence-based methodologies by policy makers, and of involvement of researchers in the policy process. The CRACK programme was launched by some academics from the Lombardy Region. By extensively using electronically stored data, epidemiologists, biostatisticians, pharmacologists and clinicians applied methods and evidence to several issues of healthcare research. The CRACK programme was based on their intention to remove barriers that thwart the process of bridging methods and findings from scientific journals to public health practice. This paper briefly describes aim, articulation and management of the CRACK programme, and discusses why it might find articulated application in Italy

Number of Nevi at a Specific Anatomical Site and Its Relation to Cutaneous Malignant Melanoma

The risk of cutaneous malignant melanoma (CMM) is strongly associated with total number of nevi. Scanty information is available on the association between CMM at a specific anatomical site and number of nevi at the same site. We analyzed data from a case–control study conducted in Italy between 1992 and 1994, on 542 cases of CMM and 538 hospital controls. Cases and controls were examined by trained dermatologists who counted the number of melanocytic nevi. We derived multivariate odds ratios (ORs) and 95% confidence intervals (95% CIs) of site-specific risk of CMM for high versus low number of nevi at the corresponding site. The ORs of CMM for the highest versus the lowest tertile of number of nevi at the corresponding site was 1.4 (95% CIs: 0.7–2.8) at face and neck, 2.3 (95% CIs: 1.1–4.9) at anterior trunk, 4.9 (95% CIs: 2.9–8.4) at posterior trunk, 2.9 (95% CIs: 1.2–6.6) at upper limbs and 5.0 (95% CIs: 2.9–8.5) at lower limbs. In a case–case analysis, comparing CMM cases at a specific site and CMM cases at all other sites, the only excess risk was found for the posterior trunk, the ORs being 2.1 (95% CIs: 1.2–3.6) for the highest versus the lowest tertile of number of nevi. Our data do not support the hypothesis of a specific effect of nevi at each single anatomical site

Agreement on classification of clinical photographs of pigmentary lesions: exercise after a training course with young dermatologists.

Smartphone apps may help promoting the early diagnosis of melanoma. The reliability of specialist judgment on lesions should be assessed. Hereby, we evaluated the agreement of 6 young dermatologists, after a specific training. Clinical judgment was evaluated during 2 online sessions, 1 month apart, on a series of 45 pigmentary lesions. Lesions were classified as highly suspicious, suspicious, non-suspicious or not assessable. Cohen's and Fleiss' kappa were used to calculate intra- and inter-rater agreement. The overall intra-rater agreement was 0.42 (95% confidence interval - CI: 0.33-0.50), varying between 0.12-0.59 on single raters. The inter-rater agreement during the first phase was 0.29 (95% CI: 0.24-0.34). When considering the agreement for each category of judgment, kappa varied from 0.19 for not assessable to 0.48 for highly suspicious lesions. Similar results were obtained in the second exercise. The study showed a less than satisfactory agreement among young dermatologists. Our data point to the need for improving the reliability of the clinical diagnoses of melanoma especially when assessing small lesions and when dealing with thin melanomas at a population level

Performance evaluation of the high sensitive troponin I assay on the Atellica IM analyser

The Fourth Universal Definition of Myocardial Infarction Global Taskforce recommends the use of high sensitive troponin (hs-Tn) assays in the diagnosis of acute myocardial infarction. We evaluated the analytical performance of the Atellica IM High-sensitivity Troponin I Assay (hs-TnI) (Siemens Healthcare Diagnostics Inc., Tarrytown, USA) and compared its performance to other hs-TnI assays (Siemens Advia Centaur, Dimension Vista, Dimension EXL, and Abbott Architect (Wiesbaden, Germany)) at one or more sites across Europe. Precision, detection limit, linearity, method comparison, and interference studies were performed according to Clinical and Laboratory Standards Institute protocols. Values in 40 healthy individuals were compared to the manufacturer’s cut-offs. Sample turnaround time (TAT) was examined. Imprecision repeatability CVs were 1.1–4.7% and within-lab imprecision were 1.8–7.6% (10.0–25,000 ng/L). The limit of blank (LoB), detection (LoD), and quantitation (LoQ) aligned with the manufacturer’s values of 0.5 ng/L, 1.6 ng/L, and 2.5 ng/L, respectively. Passing-Bablok regression demonstrated good correlations between Atellica IM analyser with other systems; some minor deviations were observed. All results in healthy volunteers fell below the 99th percentile URL, and greater than 50% of each sex demonstrated values above the LoD. No interference was observed for biotin (≤ 1500 µg/L), but a slight bias at 5.0 g/L haemoglobin and 50 ng/L Tn was observed. TAT from was fast (mean time = 10.9 minutes) and reproducible (6%CV). Real-world analytical and TAT performance of the hs-TnI assay on the Atellica IM analyser make this assay fit for routine use in clinical laboratories

OUTCOMES OF ELDERLY PATIENTS WITH ST-ELEVATION OR NON-ST-ELEVATION ACUTE CORONARY SYNDROME UNDERGOING PERCUTANEOUS CORONARY INTERVENTION

Acute coronary syndromes have been classified according to the finding of ST-segment elevation on the presenting ECG, with different treatment strategies and practice guidelines. However, a comparative description of the clinical characteristics and outcomes of acute coronary syndrome elderly patients undergoing percutaneous coronary intervention during index admission has not been published so far