Top-Down Impacts of Sea Nettles (Chrysaora quinquecirrha) on Pelagic Community Structure in Barnegat Bay, New Jersey, U.S.A.

Coastal communities are substantially affected by human activities and create environments conducive to opportunistic species and structural changes in food webs. The Mid-Atlantic coast of the United States is highly urbanized with significant landscape modification and elevated pollutant loads. The appearance and development of resident populations of the Atlantic sea nettle (Chrysaora quinquecirrha) in Barnegat Bay, New Jersey demonstrates a successful establishment to this estuary. This research indicates that two species of gelatinous zooplankton (Mnemiopsis leidyi, C. quinquecirrha) play important structuring roles in the pelagic community. Specifically, M. leidyi exerts significant top-down control of calanoid copepods, cladocerans, fish eggs, and fish larvae, whereas C. quinquecirrha’s impact is felt through control of M. leidyi, whose density is two orders of magnitude greater. It was expected that if C. quinquecirrha exerted top-down control of M. leidyi, then a trophic cascade would result. However, no trophic cascade was observed, as C. quinquecirrha demonstrated broad control of pelagic community structure as a nonspecific, generalist predator. Consequently, the strength of M. leidyi’s ability to exert predation pressure is mediated by the development of the C. quinquecirrha bloom, but pelagic community structure is broadly defined by the combined impact of these predators within the system

A Case of Advanced Tubal Ectopic Pregnancy after Emergency Contraception

Ectopic pregnancy is a relatively common condition and an important cause of morbidity in women of childbearing age. The most frequent implantation site is the fallopian tube. Most cases are diagnosed in an early gestational period. Patients come to the attention of clinicians for pelvic pain and vaginal blood loss, and consequent diagnosis is made through clinical presentation, laboratory tests, and ultrasound. Other rarer implantation sites such as the abdominal cavity give space for ectopic pregnancy to grow until later gestational ages, delaying diagnosis. This is a rare case of a healthy 41-year-old woman with an advanced ectopic pregnancy after emergency contraception with Ulipristal Acetate. The patient went to visit for amenorrhea after taking a contraceptive. Evaluation with ultrasound demonstrated a 10 + 4 weeks’ unruptured tubal pregnancy with fetal heart rate. The patient underwent laparoscopic salpingectomy without complication. This is the first case of such an advanced ectopic pregnancy in a woman who performed emergency contraception with Ulipristal Acetate

Biotechnological Transformation of Hydrocortisone into 16α-Hydroxyprednisolone by Coupling Arthrobacter simplex and Streptomyces roseochromogenes

16α-Hydroxyprednisolone, an anti-inflammatory drug, could be potentially obtained from hydrocortisone bioconversion by combining a 1,2-dehydrogenation reaction performed by Arthrobacter simplexATCC31652 with a 16α-hydroxylation reaction by Streptomyces roseochromogenes ATCC13400. In this study we tested, for the first time, potential approaches to couple the two reactions using similar pH and temperature conditions for hydrocortisone bioconversion by the two strains. The A. simplex capability to 1,2-dehydrogenate the 16α-hydroxyhydrocortisone, the product of S. roseochromogenes transformation of hydrocortisone, and vice versa the capability of S. roseochromogenes to 16α-hydroxylate the prednisolone were assessed. Bioconversions were studied in shake flasks and strain morphology changes were observed by SEM. Whole cell experiments were set up to perform the two reactions in a sequential mode in alternate order or contemporarily at diverse temperature conditions. A. simplex catalyzed either the dehydrogenation of hydrocortisone into prednisolone efficiently or of 16α-hydroxyhydrocortisone into 16α-hydroxyprednisolone in 24 h (up to 93.9%). Surprisingly S. roseochromogenes partially converted prednisolone back to hydrocortisone. A 68.8% maximum of 16α-hydroxyprednisolone was obtained in 120-h bioconversion by coupling whole cells of the two strains at pH 6.0 and 26 °C. High bioconversion of hydrocortisone into 16α-hydroxyprednisolone was obtained for the first time by coupling A. simplex and S. roseochromogenes

Postoperative streptococcus constellatus bacteremia in a 75-year-old patient with pyometra: A case report

Background: Pyometra is an accumulation of pus in the uterine cavity. It is rare in the general population but more common in elderly women. If diagnosed in the early stage, life-threating conditions may be avoided. The most common etiological microorganisms of pyometra are Escherichia coli, Bacteroides species, Staphylococci (eg, epidermid-is) and Streptococci. Occasionally, atypical bacteria may be the cause. Case Report: We present the case of a 75-year-old woman, with multiple risk factors, admitted to the Gynecology Department with a 15-day history of yellowish-brown vaginal discharge. Because of rapid enlargement of the uterine cavi-ty, the patient underwent to endometrial curettage. Three hours after surgery, she developed a high-grade fe-ver, and Streptococcus constellatus was isolated in her blood cultures. A specific antibiotic therapy was admin-istered for a total of 14 days, resulting in complete resolution of the infection. Conclusions: This case report describes a rare case of bacteremia caused by Streptococcus constellatus, that resulted from a pyometra. The classic triad of symptoms (postmenopausal bleeding, vaginal discharge, and lower abdominal pain) may be helpful for diagnosis; however, 50% of patients are asymptomatic. An early recognition of the con-dition is important to avoid rare but risky consequences, such as perforation of the uterus itself. Nevertheless, surgery can cause dangerous complications such as bacteremia. A different spectrum of bacteria may be in-volved in the development of pyometra, even in atypical cases, mostly when multiple comorbidities are pres-ent. A correct evaluation and management of the patient is essential to guarantee a good prognosis in this rare infection

Large Pelvic Mass in a Female Adolescent: Atypical Presentation and Successful Treatment of Extraskeletal Ewing Sarcoma

Extraskeletal Ewing sarcoma is a rare soft tissue tumor primarily affecting pediatric patients. The treatment is currently based on a multidisciplinary approach which allows, in cases of localized disease, good survival rates. We report the case of a 15-year-old female patient with a rapidly growing suspected pelvic mass misdiagnosed following the preliminary radiological exams, which assessed the findings as a mass of ovarian origin. The girl underwent surgery and, thanks to histopathological, immunohistochemical and real-time polymerase chain reaction (RT-PCR) examinations, it was possible to make the right diagnosis and to administer the best treatment in terms of surgery, chemotherapy and radiotherapy, obtaining a long disease-free interval and no recurrence to date

Towards personalized medicine: Non-coding rnas and endometrial cancer

Endometrial cancer (EC) is the most frequent female cancer associated with excellent prognosis if diagnosed at an early stage. The risk factors on which clinical staging is based are constantly updated and genetic and epigenetic characteristics have recently been emerging as prognostic markers. The evidence shows that non-coding RNAs (ncRNAs) play a fundamental role in various biological processes associated with the pathogenesis of EC and many of them also have a prognosis prediction function, of remarkable importance in defining the therapeutic and surveillance path of EC patients. Personalized medicine focuses on the continuous updating of risk factors that are identifiable early during the EC staging to tailor treatments to patients. This review aims to show a summary of the current classification systems and to encourage the integration of various risk factors, introducing the prognostic role of non-coding RNAs, to avoid aggressive therapies where not necessary and to treat and strictly monitor subjects at greater risk of relapse

Robotic Single-Port da Vinci Surgical System (SP1098) in Gynecologic Surgery: A Systematic Review of Literature

Background: Recently, new surgical systems less invasive than standard laparoscopy have been developed. Among these, robotic single site surgery is playing a pivotal role. In this field, the da Vinci SP (Single-Port) Surgical System (SP1098) is one of the newest surgical technology that presents innovative characteristics that may lead to better surgical outcomes. Few groups have already published their experience and results with this system in gynecology. Methods: The aim of the present systematic review was to provide a comprehensive overview of the status and applications of da Vinci SP1098 in gynecologic surgery. A systematic review of the literature was performed. Studies were identified until September 2022. Results: Six studies were included, reporting a total of 211 patients. The indication for surgery was both benign and malignant disorders. In terms of operative outcomes, the mean/median docking time varied from 2.1 to 5 min while mean/median operating time from 86.5 to 245 min. There was no conversion to multi-port laparoscopy or laparotomy and no major complications related to SP surgery. Conclusions: In conclusion, the preliminary and limited data available regarding the da Vinci SP1098 Surgical System suggest the technical feasibility and safety for its use in gynecologic surgery, with minimal alteration of the surgical technique

Primary flap closure of perineal defects to avoid empty pelvis syndrome after pelvic exenteration in gynecologic malignancies: An old question to explore a new answer

: Pelvic exenteration (PE) is a radical oncological surgical procedure proposed in patients with recurrent or persistent gynecological cancers. The radical alteration of pelvic anatomy and of pelvic floor integrity can cause major postoperative complications. Fortunately, PE can be combined with reconstructive procedures to decrease complications and functional and support problems of pelvic floor, reducing morbility and mortality and increasing quality of life. Many options for reconstructive surgery have been described, especially a wide spectrum of surgical flaps. Different selection criteria have been proposed to select patients for primary perineal defect flap closure without achieving any strict indication of the best option. The aim of this review is to focus on technical aspects and the advantages and disadvantages of each technique, providing an overview of those most frequently used for the treatment of pelvic floor defects after PE. Flaps based on the deep inferior epigastric artery, especially vertical rectus abdominis musculocutaneous (VRAM) flaps, and gracilis flaps, based on the gracilis muscle, are the most common reconstructive techniques used for pelvic floor and vaginal reconstruction. In our opinion, reconstructive surgery may be considered in case of total PE or type II/III PE and in patients submitted to prior pelvic irradiation. VRAM could be used to close extended defects at the time of PE, while gracilis flaps can be used in case of VRAM complications. Fortunately, numerous choices for reconstructive surgery have been devised. As these techniques continue to evolve, it is advisable to adopt an integrated, multi-disciplinary approach within a tertiary medical center