The physical, psychological, and social day-to-day experience of women living with endometriosis compared to healthy age-matched controls — a mixed-methods study

Background: Endometriosis is characterized by lesions of endometrial tissue outside the uterus. Chronic pain is considered as main symptom, but challenges can relate to various physical, mental, and social aspects of the women's lives. The aim of our study was to gain a holistic understanding of the everyday reality of women with endometriosis compared to healthy controls. Methods: The total sample comprised 12 hormone-free endometriosis patients (EP) and 11 age-matched healthy women (HC). A mixed-methods design was used comprising semi-structured interviews, standardized questionnaires and a comprehensive diary to assess pain ratings and various mental and physical symptoms over the course of a menstrual cycle. Interviews were recorded, transcribed, and evaluated according to phenomenological analysis using the MAXQDA software. Results: Interviews showed that living with endometriosis was associated with an impairment in everyday life. Physical strains, especially pain, high levels of psychological distress, and social limitations have been reported. Living with endometriosis affected the patients' personality and they “no longer felt like themselves.” Physical and psychological symptoms were reported to interfere with social interaction and participation. Evaluation of the standardized questionnaires revealed significant impairments in EP compared to HC in regard to anxiety and depression scores (both p < 0.001; Hospital Anxiety and Depression Scale), mental and physical quality of life (both p < 0.001; Short-Form Health Survey-12), stress ratings (p < 0.001; Patient Health Questionnaire-15) and functional well-being (p < 0.001; Functional Well-being-7). The highest levels of mean pelvic pain and dyschezia were observed in EP during menstruation, but mean pain ratings and dyschezia were increased in EPs compared to HP during the whole cycle. EP reported mental symptoms (e.g., depressed mood or anxiety) mainly during menstruation, while HC did not show any mental symptoms during the cycle. In addition, physical symptoms were elevated during the entire cycle in EPs (all p < 0.01). Discussion: The mixed-methods approach enabled to interpret the interviews, the standardized questionnaires, and the symptom diary in a broader context of everyday life. The symptoms do not appear to act independently, but rather influence each other. This leads to a complex interplay of physical, mental, and social impairments, with pain often being the starting point

Phase and chemical composition analysis of pigments used in Cucuteni Neolithic painted ceramics

Two analytical methods – 241Am-based X-Ray Fluorescence (XRF) and Synchrotron Radiation X-ray Diffraction (SR-XRD) – were used to investigate the elemental and mineralogical composition of pigments which decorate some Cucuteni Neolithic ceramic sherds. Local hematite and local calcite were the main components for red and white pigments, respectively. For black pigments, iron oxides (e.g. magnetite) were used. They were often mixed with manganese oxides (e.g. jacobsite), which originated from Iacobeni manganese minerals deposits on the Bistrita River. Taking into account the results of the experiments, several conclusions regarding manufacturing procedures employed, and potential trade routes during the Neolithic were drawn.Za določanje elementarne in mineraloške sestave pigmentov, s katerimi so okrašene nekatere keramične posode kulture Cucuteni, sta bili uporabljeni dve analitski metodi – 241Am X-Ray Fluorescence (XRF) in Synchrotron Radiation X-ray Diffraction (SR-XRD). Lokalni hematit in kalcit sta bila glavni komponenti rdečih oziroma belih pigmentov. Za črne pigmente so uporabljali železove okside (magnetit). Pogosto so jih zmešali z manganovimi oksidi (jakobsitom), ki izvirajo iz Iacobeni manganovih mineralnih depozitov reke Bistrita. Če upoštevamo rezultate poizkusov, lahko potegnemo več zaključkov o uporabljenih proizvodnih postopkih in o možnih trgovskih poteh v času neolitika

Synthesis, molecular modelling and anticancer evaluation of new pyrrolo[1,2-b]pyridazine and pyrrolo[2,1-a]phthalazine derivatives

Two new series of heterocyclic derivatives with potential anticancer activity, in which a pyrrolo[1,2-b]pyridazine or a pyrrolo[2,1-a]phthalazine moiety was introduced in place of the 3′-hydroxy-4′-methoxyphenyl ring of phenstatin have been synthesised and their structure-activity relationship (SAR) was studied. Fourteen of the new compounds were evaluated for their in vitro cytotoxic activity by National Cancer Institute (NCI) against 60 human tumour cell lines panel. The best five compounds in terms of in vitro growth inhibition were screened in the second stage five dose-response studies, three of them showing a very good antiproliferative activity with GI50<100 nM on several cell lines including colon, ovarian, renal, prostate, brain and breast cancer, melanoma and leukemia. Docking experiments on the biologically active compounds showed a good compatibility with the colchicine binding site of tubulin

Post-communist land use changes related to urban sprawl in the Romanian metropolitan areas

The landscape pattern of the Romanian urban system has experienced significant transformations as a result of the rapid and irreversible changes undertaken after the fall of the communism. In Romania almost 34% of its total population are living in metropolitan areas. The paper is aiming to analyse the landscape-related challenges land-use/land-cover changes in the Romanian metropolitan areas in relation with the main factors involved in the patterns of change: demographic, political and natural. Based on the investigation of relevant cartographic supports of the last 20 years, the authors are making use of different GIS methods in order to conduct a series of complex analysis of the spatial-temporal landscape challenges. The paper will mainly focus on four metropolitan areas considered as case-studies: the capital-city (Bucharest) and the three functional metropolitan areas (Oradea, Iaşi and Constanţa), each metropolitan area is facing different patterns and causes of change

Modified natural cycle in vitro fertilization an alternative in vitro fertilization treatment with lower costs per achieved pregnancy but longer treatment time

OBJECTIVE To analyze the cost and time requirement per achieved pregnancy in optimized modified natural cycle in vitro fertilization (mNC-IVF) based on a treatment protocol with very few consultations and to compare those with conventional gonadotropin-stimulated aVF (clVF) cycles. STUDY DESIGN Mono centric prospective trial. Eighty infertile patients each received 1 modified mNC-IVF cycle using low doses of the clomiphene citrate. Based on the number of consultations and the clinical pregnancy rate per cycle, the total costs and required time to achieve a pregnancy were analyzed and compared with cIVF. Calculations for cIVF were based on standard therapy protocols and outcomes of European registries. RESULTS Patients (21-42 years old, 35.4 +/- 4.7 years) undergoing mNC-IVF required on average 1.2 consultations before follicle aspiration. Pregnancy rate per transfer and per initiated cycle were 25% and 13.6%, respectively. Multiple pregnancies did not occur. According to the calculations, total costs per pregnancy rate were around 15% lower with mNC-IVF as compared to cIVF. In contrast, time to achieve an equal pregnancy rate was calculated to take around 30% longer with mNC-IVF as compared to cIVF. CONCLUSION mNC-IVF using very low dosages of clomiphene citrate avoids multiple pregnancies and is less expensive but more time consuming per achieved pregnancy when compared to clVF

Black Tea Waste as Green Adsorbent for Nitrate Removal from Aqueous Solutions

The aim of the study was to prepare effective low-cost green adsorbents based on spent black tea leaves for the removal of nitrate ions from aqueous solutions. These adsorbents were obtained either by thermally treating spent tea to produce biochar (UBT-TT), or by employing the untreated tea waste (UBT) to obtain convenient bio-sorbents. The adsorbents were characterized before and after adsorption by Scanning Electron Microscopy (SEM), Energy Dispersed X-ray analysis (EDX), Infrared Spectroscopy (FTIR), and Thermal Gravimetric Analysis (TGA). The experimental conditions, such as pH, temperature, and nitrate ions concentration were studied to evaluate the interaction of nitrates with adsorbents and the potential of the adsorbents for the nitrate removal from synthetic solutions. The Langmuir, Freundlich and Temkin isotherms were applied to derive the adsorption parameters based on the obtained data. The maximum adsorption intakes for UBT and UBT-TT were 59.44 mg/g and 61.425 mg/g, respectively. The data obtained from this study were best fitted to the Freundlich adsorption isotherm applied to equilibrium (the values R2 = 0.9431 for UBT and R2 = 0.9414 for UBT-TT), this assuming the multi-layer adsorption onto a surface with a finite number of sites. The Freundlich isotherm model could explain the adsorption mechanism. These results indicated that UBT and UBT-TT could serve as novel biowaste and low-cost materials for the removal of nitrate ions from aqueous solutions

Reduced frequency of perforin-positive CD8+ T cells in menstrual effluent of endometriosis patients

Endometriosis is a widespread disease and commonly reduces the life quality of those affected. Scientific literature indicates different underlying immunological changes. Frequently examined tissues are peripheral blood, endometrial tissue and peritoneal fluid. Yet, knowledge on immunological differences in menstrual effluent (ME) is scarce. In this study, between January 2018 and August 2019, 12 women with endometriosis (rASRM classification: stages I-IV) and 11 healthy controls were included. ME was collected using menstrual cups and venous blood samples (PB) were taken. Mononuclear cells were obtained from ME (MMC) and PB (PBMC) and analyzed using flow cytometry. Concentrations of cell adhesion molecules (ICAM-I and VCAM-I) and cytokines (IL-6, IL-8 and TNF-α) were measured using ELISA. CD8 + T cells obtained from ME were significantly less often perforin-positive in women with endometriosis compared to healthy controls. A comparison between MMC and PBMC revealed that MMC contained significantly less T cells and more B cells. The CD4/CD8 ratio was significantly higher in MMC, and Tregs were significantly less frequently in MMC. In ME, T cells and NK cells expressed significantly more CD69. NK cells obtained from ME were predominantly CD56bright/CD16dim and had a lower frequency of perforin + cells compared to PBMC NK cells. Moreover, ICAM-1 plasma levels were significantly reduced in women with endometriosis compared to healthy controls. In conclusion, CD8 + T cells obtained from the ME were significantly less perforin-positive in endometriosis patients indicating a reduced cytotoxic potential. MMC are distinctively different from PBMC and, thus, seem to be of endometrial origin

The Rare Case of a COVID-19 Pregnant Patient with Quadruplets and Postpartum Severe Pneumonia. Case Report and Review of the Literature

Background and Objectives: The multiple pregnancies associated with COVID-19 is a new and difficult condition to manage. The prognosis for rapid deterioration after the cesarean delivery is difficult to assess and needs close interdisciplinary follow-up due to pregnancy and postpartum-related changes. Materials and Methods: We report the case of a 37-year-old primigesta primipara patient who was admitted to “Elena Doamna” Clinical Hospital of Obstetrics and Gynecology at 33 weeks and 3 days of gestation with high-grade multiple pregnancies (triplets) for threatened premature birth associated with COVID-19. The patient had a history of surgically corrected atrial septal defect during childhood and currently is known to have paroxysmal supraventricular tachycardia. Tocolysis was ineffective and the decision to perform a cesarean operation was made. The diagnosis was established: primigesta, primipara, at 34 weeks of gestation, high-grade multiple pregnancy with triplets, intact membranes, threatened premature birth, surgically corrected atrial septal defect, paroxysmal supraventricular tachycardia, infection with COVID-19. The patient underwent a cesarean intervention and treatment for COVID-19 pneumonia. The intervention took place at 33 weeks and 4 days of gestation resulting in four newborns with weights between 1400 g and 1820 g and Apgar scores between 6–8. All newborns were transferred to a third-degree Neonatology ICU service due to their prematurity. The fourth newborn was not identified in any of the ultrasounds performed during pregnancy. During the postpartum period, the patient had a fulminant evolution of COVID-19 pneumonia, with rapid deterioration, needing respiratory support and antiviral treatment. Discussions: Managing high-risk obstetrical pregnancies associated with COVID-19 requires a multidisciplinary team consisting of obstetricians, anesthesiologists, neonatologists, and infectious disease doctors. Conclusion: Our case is the first to our knowledge in Romania to present an association of high-grade multiple pregancy with COVID19 moderate form, rapidly evolving postpartum, needing rapid intensive care admission, and specific treatment with Remdesivir, with good post-treatment evolution