SARS-CoV-2 IgG "heritage" in newborn: A credit of maternal natural infection.

Description of transplacental passage of specific SARS-CoV-2 IgG from mothers who contracted natural infection to their newborns. Retrospective cohort analysis including pregnant women diagnosed with SARS-CoV-2 and their newborns both tested for SARS-CoV-2 specific IgG and IgM with antibody titration at delivery. Nasopharyngeal swab were taken from both mothers and neonates, and tested for SARS-CoV-2 using polymerase chain reaction (PCR). IgM and IgG were analyzed in maternal and neonatal serum of 143 mother-infant dyads. 86% of women with a positive SARS-CoV-2 PCR >14 days before delivery developed specific IgG and 84% of their infants showed transplacental passage of IgG. Pregnant women infected with SARS-CoV-2 achieve antibody seroconversion following the kinetics described in the general population, and transplacental transfer of IgG specific antibodies occurs. No conclusion can be drawn on passive immunity efficacy or duration.

Distribution of the Clinical Manifestations of Alpha 1 Antitrypsin Deficiency in Respiratory Outpatients from an Area of Northern Italy.

BACKGROUND: Alpha 1 antitrypsin deficiency (AATD) is an autosomal codominant genetic condition that affects Caucasians of the European population due to the presence of a deficient allele of the SERPINA1 gene. A frequency of about 1/5,000 individuals has been estimated in Italy. OBJECTIVES: The aim of the study was to evaluate the distribution of the clinical manifestations of severe and intermediate genetic AATD in the geographic area around Parma in Northern Italy. METHOD: 238 subjects were submitted to molecular analysis of the SERPINA1 gene, and data on anthropometric variables, smoking habits, number of packs per year, AAT serum concentration, and clinical manifestations were recorded and presented as mean ± SD or median values (1st quartile; 3rd quartile). RESULTS: The results show a distribution of genetic AATD of 4.1% of the screened population in the area encompassing the city of Parma. PI*MS and PI*MZ were the most common genotypes at 40.9% and 28.2% of the population with genetic AATD, and asthma and emphysema were the most represented clinical manifestations. CONCLUSION: Our study allowed to increase the knowledge of the distribution of genetic AATD in Northern Italy providing information regarding frequencies of genotypes and clinical manifestations of the disorder.

Coronavirus Disease 2019: COSeSco - A Risk Assessment Score to Predict the Risk of Pulmonary Sequelae in COVID-19 Patients.

BACKGROUND: The presence of interstitial pneumonia in coronavirus disease 2019 (COVID-19) patients, as diagnosed through laboratory, functional, and radiological data, provides potential predicting factors of pulmonary sequelae. OBJECTIVES: The objectives were the creation of a risk assessment score for pulmonary sequelae at high-resolution computed tomography (HRCT) through the assessment of laboratory data, lung function, and radiological changes in patients after the onset of COVID-19 interstitial pneumonia and the identification of predictive factors. METHODS: We enrolled 121 subjects hospitalized due to COVID-19 pneumonia in our study. Clinical features, Charlson Comorbidity Index (CCI) score, HRCT score, and blood chemistry data at hospital admission, as well as HRCT score, pulmonary function testing values, exercise capacity by means of a 6-Minute Walk Test (6MWT), and dyspnea perception by the modified Medical Research Council (mMRC) at 4-month follow-up, were all recorded. The variables were elaborated in order to create a predictive model to identify patients at high risk of pulmonary sequelae at HRCT. RESULTS: At the time of follow-up visit, 63% of patients had functional abnormality (diffusion lung capacity and/or total lung capacity <80% of predicted). Age, BMI, CCI, D-dimer, 6MWT, and mMRC were included in the COVID-19 Sequelae Score (COSeSco, ranging 0-15), which was able to individuate COVID-19 patients with radiologic sequelae (HRCT score >10%) at follow-up. The most revelatory COSeSco value that was found to intercept the highest sensitivity (100%) and specificity (77%) was 2. CONCLUSION: The COSeSco - comprising age, BMI, comorbidities, D-dimer, walking distance, and dyspnea perception - makes it possible to identify particularly at-risk COVID-19 patients who are likely to develop pulmonary sequelae assessed by HRCT.

Passive immunity in newborn from SARS-CoV-2-infected mother.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vertical transmission is an open issue. Recent reports call into question in utero or peripartum viral transmission to the offspring. Few data are available on immunoglobulin G (IgG) and/or IgM in newborns. Insufficient evidence is available regarding passive immunity in neonates born from SARS-CoV-2 infected women. We report a case of a neonate showing the presence of blood specific IgG and the absence of IgM and negative nasopharyngeal swab. He was born from an asymptomatic SARS-CoV-2-infected mother with positive IgG and IgM. The transplacental passage of specific IgG antibodies from the affected mother to the unaffected fetus highlights neonatal passive immunity.

Catastrophisation, chronic pain and sexuality: a cross-sectional investigation in fibromyalgia and rheumatoid arthritis.

OBJECTIVES: In the present study we investigate the putative differences in pain catastrophising (PC), pain perception (PP), sexual functioning (SF), satisfaction (SS), and overall quality of life between fibromyalgia (FM) and rheumatoid arthritis (RA) patients as compared to healthy controls (HC). METHODS: Fifty-seven native Italian-speaking female individuals suffering either from FM or RA and thirty-eight healthy female controls (FM = 40; RA = 17; HC = 38) were submitted to a semi-structured interview aimed at assessing PP intensity (Visual Analog Scale; VAS), general health conditions (36-items Short-Form Health Survey; SF-36), PC (Pain Catastrophising Scale; PCS), SF and SS (Index of Sexual Satisfaction; ISS/ Female Sexual Function Index; FSFI). RESULTS: FM patients had a significantly higher PP both as compared to RA and HC (p<0.002 for both), and higher PC as compared to HC but not as compared to RA patients (p<0.03 and p<0.64). When compared to RA patients and HC, they showed a lower quality of life (p<0.002 for both comparisons), a compromised SF (p<0.003 and p<0.002, respectively) and a lower index of SS with respect to HC (p<0.002). RA patients had higher PP (VAS; p<0.002), lower quality of life and SF as compared to HC (p<0.002 and p<0.003, respectively). CONCLUSIONS: FM and RA patients showed a significantly lower quality of life, SF and SS as compared to HC. PC was significantly related to PP and low quality of life in FM patients while in RA patients it negatively affected quality of life and especially the sexual sphere both when considering SF and SS.

Allergens from Edible Insects: Cross-reactivity and Effects of Processing.

PURPOSE OF REVIEW: The recent introduction of edible insects in Western countries has raised concerns about their safety in terms of allergenic reactions. The characterization of insect allergens, the sensitization and cross-reactivity mechanisms, and the effects of food processing represent crucial information for risk assessment. RECENT FINDINGS: Allergic reactions to different insects and cross-reactivity with crustacean and inhalant allergens have been described, with the identification of new IgE-binding proteins besides well-known pan-allergens. Depending on the route of sensitization, different potential allergens seem to be involved. Food processing may affect the solubility and the immunoreactivity of insect allergens, with results depending on species and type of proteins. Chemical/enzymatic hydrolysis, in some cases, abolishes immunoreactivity. More studies based on subjects with a confirmed insect allergy are necessary to identify major and minor allergens and the role of the route of sensitization. The effects of processing need to be further investigated to assess the risk associated with the ingestion of insect-containing food products.

Air Trapping Is Associated with Heterozygosity for Alpha-1 Antitrypsin Mutations in Patients with Asthma.

BACKGROUND: Alpha-1 antitrypsin deficiency (AATD) is a hereditary disorder involving lungs, characterized by low serum concentration of the protein alpha-1 antitrypsin (AAT) also called proteinase inhibitor (PI). Asthma is common in AATD patients, but there are only few data on respiratory function in asthmatic patients with AATD. OBJECTIVES: The aim of the study was to evaluate lung function in asthmatic outpatients with mutation in the SERPINA1 gene coding for AAT versus asthmatic subjects without mutation. METHODS: We performed the quantitative analysis of the serum concentration of AAT in 600 outpatients affected by mild to moderate asthma from the University Hospital of Parma, Italy. Fifty-seven of them underwent the genetic analysis subsequently; they were subdivided into mutated and non-mutated subjects. All the mutated patients had a heterozygous genotype, except 1 (PI*SS). We assessed the lung function through a flow-sensing spirometer and the small airway parameters through an impulse oscillometry system. RESULTS: The values of forced vital capacity (% predicted) and those of the residual volume to total lung capacity ratio (%) were, respectively, lower and higher in patients mutated versus patients without mutation, showing a significantly greater air trapping (p = 0.014 and p = 0.017, respectively). Moreover, patients with mutation in comparison to patients without mutation showed lower forced expiratory volume in 3 s (% predicted) and forced expiratory volume in 6 s (L) spirometric values, reflecting a smaller airways contribution. CONCLUSIONS: In asthmatic patients, heterozygosity for AAT with PI*MZ and PI*MS genotypes was associated with small airway dysfunction and with lung air trapping.

Performance of the FMF First-Trimester Preeclampsia-Screening Algorithm in a High-Risk Population in The Netherlands.

OBJECTIVE: The aim of the study was to evaluate the performance of the first-trimester Fetal Medicine Foundation (FMF) screening algorithm, including maternal characteristics and medical history, blood pressure, pregnancy-associated plasma protein A and placenta growth factor, crown rump length, and uterine artery pulsatility index, for the prediction of preeclampsia in a high-risk population in the Netherlands. METHODS: This is a prospective cohort including nulliparous women and women with preeclampsia or intrauterine growth restriction in previous pregnancy. We screened patients at 11-14 weeks of gestation to calculate the risk for preeclampsia. The primary outcome was preeclampsia and gestational age at delivery. Performance of the model was evaluated by area under the receiver operating characteristic (ROC) curves (AUCs) and calibration graphs; based on the ROC curves, optimal predicted risk cutoff values for our study population were defined. RESULTS: We analyzed 362 women, of whom 22 (6%) developed preeclampsia. The algorithm showed fair discriminative performance for preeclampsia <34 weeks (AUC 0.81; 95% CI 0.65-0.96) and moderate discriminative performance for both preeclampsia <37 weeks (AUC 0.71; 95% CI 0.51-0.90) and <42 weeks (AUC 0.71; 95% CI 0.61-0.81). Optimal cutoffs based on our study population for preeclampsia <34, <37, and <42 weeks were 1:250, 1:64, and 1:22, respectively. Calibration was poor. CONCLUSIONS: Performance of the FMF preeclampsia algorithm was satisfactory to predict early and preterm preeclampsia and less satisfactory for term preeclampsia in a high-risk population. However, by addressing some of the limitations of the present study, the performance can potentially improve. This is essential before implementation is considered.

The AFLATOX® Project: Approaching the Development of New Generation, Natural-Based Compounds for the Containment of the Mycotoxigenic Phytopathogen Aspergillus flavus and Aflatoxin Contamination.

The control of the fungal contamination on crops is considered a priority by the sanitary authorities of an increasing number of countries, and this is also due to the fact that the geographic areas interested in mycotoxin outbreaks are widening. Among the different pre- and post-harvest strategies that may be applied to prevent fungal and/or aflatoxin contamination, fungicides still play a prominent role; however, despite of countless efforts, to date the problem of food and feed contamination remains unsolved, since the essential factors that affect aflatoxins production are various and hardly to handle as a whole. In this scenario, the exploitation of bioactive natural sources to obtain new agents presenting novel mechanisms of action may represent a successful strategy to minimize, at the same time, aflatoxin contamination and the use of toxic pesticides. The Aflatox® Project was aimed at the development of new-generation inhibitors of aflatoxigenic Aspergillus spp. proliferation and toxin production, through the modification of naturally occurring molecules: a panel of 177 compounds, belonging to the thiosemicarbazones class, have been synthesized and screened for their antifungal and anti-aflatoxigenic potential. The most effective compounds, selected as the best candidates as aflatoxin containment agents, were also evaluated in terms of cytotoxicity, genotoxicity and epi-genotoxicity to exclude potential harmful effect on the human health, the plants on which fungi grow and the whole ecosystem.

Cardiovascular Hemodynamic Changes After Antenatal Corticosteroids in Growth Restricted and Appropriate for Gestational Age Fetuses.

PURPOSE: To investigate hemodynamic effects after antenatal corticosteroids (ACS) administration in appropriate for gestational age (AGA) and early growth restricted (GR) fetuses by measurement of Doppler cardiovascular function parameters. MATERIALS AND METHODS: Prospective cohort study. AGA and GR singleton pregnancies receiving ACS for fetal lung maturation between 24 + 0-33 + 6 weeks were enrolled. Feto-placental vascular hemodynamics were studied by: umbilical artery (UA) pulsatility index (PI), middle cerebral artery (MCA) PI, renal artery (RenA) PI. Cardiac function was evaluated by ductus venosus (DV) PI and by echocardiographic parameters: E to A wave ratios (E/A) and mitral and tricuspid annular plane systolic excursion (MAPSE and TAPSE) for diastolic function, left and right myocardial performance index (MPI) for overall (diastolic and systolic) function. A single operator performed all the measurements at 3 different time points (E): E0 before or within 4 hours of ACS administration (baseline examination), E1 24-48 hours after the first dose and E2 7 days after the second dose of ACS. The values were expressed as z-scores. Pairwise comparisons with paired t-test were performed to compare measurements before and after exposure to ACS. RESULTS: 25 AGA and 20 GR fetuses (mean gestational age: 31 + 1 and 30 + 6, respectively) were included in the analysis. In the AGA group ACS administration was associated with a significant reduction in UA PI. In the GR fetuses ACS temporarily (E0-E1) restored UA-end diastolic flow (EDF) in 6 of 9 fetuses with A/R-EDF ("Return of EDF phenomenon") and produced a significant increase (worsening) in right MPI (both in E1-E2 and in E0-E2). CONCLUSION: ACS administration is associated with UA vasodilation in both AGA and GR fetuses and with an increase in right MPI in the latter group. This suggests a worsening in cardiac function in GR fetuses.

Intra- and Interobserver Reproducibility of Third Trimester Middle Cerebral Artery Pulsatility Index Measurement: A Prospective Cross-Sectional Study.

BACKGROUND: Middle cerebral artery (MCA) pulsatility index (PI) Doppler in the third trimester of pregnancy is increasingly used. OBJECTIVES: The aim of the study was to investigate intra- and interobserver reproducibility of MCA PI in the third trimester. METHOD: Singleton pregnancies between 30+0 and 40+0 weeks were recruited. MCA Doppler velocimetry measurements were performed prospectively, independently, and blindly. Intra- and interobserver reproducibility was assessed by concordance correlation coefficient (CCC) and intraclass correlation coefficient (ICC); Bland-Altman plots were built, and limits of agreement (LoA) were calculated. Results were interpreted according to the cutoff set by the True Reproducibility of Ultrasound Techniques Review. RESULTS: We enrolled 101 patients. ICCs for intraobserver reproducibility were 0.84 and 0.78 for raw values and percentiles, respectively; CCCs were 0.72 and 0.64. For interobserver reproducibility ICCs were 0.84 and 0.78, CCCs 0.72 and 0.63. According to the chosen criteria, these values show a poor-moderate reproducibility of third trimester MCA PI. Cohen's Kappa coefficients were 0.59 and 0.42, indicating a moderate agreement in discriminating normal and abnormal values. CONCLUSIONS: Intra- and interobserver reproducibility of third trimester MCA PI, as assessed by ICC, CCC, and LoA, is far from satisfactory. This should be taken into account before taking clinical decisions.

Potentially traumatic events, post-traumatic stress disorder and post-traumatic stress spectrum in patients with fibromyalgia.

OBJECTIVES: Fibromyalgia (FM) is defined as a severe, chronic, non-articular rheumatic condition characterised by widespread musculoskeletal pain, hyperalgesia and generalised tender points, in the absence of inflammatory or structural musculoskeletal abnormalities. Pain is the predominant symptom, allodynia and hyperalgesia are common signs. Extreme fatigue, impaired cognition and non-restorative sleeping difficulties coexist in addition to other somatic symptoms. Several studies suggest there is a meaningful relationship between FM and the psychological symptoms of depression and post-traumatic stress disorder (PTSD). PTSD is a mental disorder that can develop after a person has been exposed to a traumatic event, characterised by a specific set of symptoms including re-experiencing of the event, avoidance and numbing and arousal. The present study investigates the impact of lifetime potentially traumatic events, including losses, and of post-traumatic stress symptoms on the severity of illness in patients with fibromyalgia (FM). METHODS: Sixty-one patients with FM, diagnosed according to the American College of Rheumatology criteria, were consecutively enrolled at the Unit of Rheumatology, University of Pisa, Italy. Assessments included: the SCID-5 and the Trauma and Loss Spectrum Self-Report (TALS-SR) lifetime version. RESULTS: 21.3% of the subjects (n=13) met the criteria for "partial" PTSD: 57.4% criterion B, 42.6% criterion C, 31.1 criterion D and 44.3% criterion E. Fibromyalgia patients without PTSD reported significantly lower scores in all domains compared to the patients with partial PTSD, the latter ones reporting significantly lower scores in all domains compared to full PTSD with the exception of domain I. In particular, these differences were noticeable in Domain VI and Domain VIII. CONCLUSIONS: The results of the study show that fibromyalgic patients with PTSD report more potentially traumatic events, avoidance symptoms, numbing, arousal, maladaptive coping and personality characteristics compared to patients with partial or without PTSD; these results could indicate that loss and/or trauma events represent a risk factor for the development of symptoms of FM in genetically predisposed individuals.

Screening for Common Fetal Trisomies in Twin Pregnancies: First-Trimester Combined, Cell-Free DNA, or Both?

OBJECTIVE: To examine the distribution of risks for fetal trisomies after first-trimester combined screening in twins and to investigate different strategies for clinical implementation of cell-free DNA (cfDNA) testing. METHODS: We retrospectively analyzed all twin pregnancies undergoing first-trimester combined screening over a 10 years' period. The population was stratified according to various risk cut-offs, and we examined different screening strategies for implementation of cfDNA testing in terms of impact on invasive testing rate, cfDNA test failure rate, and economic costs. RESULTS: We included 572 twin pregnancies: 480 (83.92%) dichorionic and 92 (16.08%) monochorionic. Performing a first-line combined screening and offering cfDNA testing to the group with a risk between 1 in 10 and 1 in 1,000, would lead to an invasive testing rate of 2.45%, and cfDNA testing would be performed in 22.20% of the population. This strategy would be cost-neutral compared to universal combined screening alone. CONCLUSIONS: First-trimester combined screening results can be used to stratify twin pregnancies into different risk categories and select those that could be offered cfDNA testing. A contingent screening strategy would substantially decrease the need for invasive testing in twins and it would be cost-neutral compared to combined testing alone.

Claimed effects, outcome variables and methods of measurement for health claims on foods related to the gastrointestinal tract proposed under regulation (EC) 1924/2006.

Most of the requests of authorisation to the use of health claims pursuant to Regulation EC 1924/2006 related to the gastrointestinal (GI) tract have received a negative opinion by the European Food Safety Authority (EFSA), mainly because of an insufficient substantiation of the claimed effect (CE). The present manuscript refers to the collection, collation and critical analysis of outcome variables (OVs) and methods of measurement (MMs) related to the GI tract compliant with Regulation 1924/2006. The critical evaluation of OVs and MMs was based on the literature review, with the final aim of defining their appropriateness in the context of a specific CE. The results obtained are relevant for the choice of the best OVs and MMs to be used in randomised controlled trials aimed to substantiate the claims on the GI tract. Moreover, the results can be used by EFSA for updating the guidance for the scientific requirements of such health claims.

Personality Traits in Fibromyalgia (FM): Does FM Personality Exists? A Systematic Review.

INTRODUCTION: Fibromyalgia (FM) is the second most common rheumatic disease with many effects on patient's quality of life. It has been described as a chronic condition characterized by widespread musculo-skeletal pain, sleep disorders and prominent fatigue. Regarding the role of personality factors in fibromyalgia, researchers have focused both on personality traits and psychopathological aspects showing inconsistent results. In particular, several studies have examined the role of alexithymia in FM patients, a trait of personality characterized by difficulty in identification, recognition and description of emotions and feelings, while others have focused on a specific type of personality, such as type D personality (distressed personality). Other studies investigated personality in FM patients referring to Cloninger's model, a psychobiological model of personality that includes both temperamental and character dimensions of personality. Analyzing scientific literature on this subject seems well suited to provide a critical review of the latest studies and their results. METHODS: The method used for this review satisfies the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). We identified PsycInfo and PubMed as databases for our research. RESULTS: Personality is studied under many aspects and a reference model is not always present. Many studies underline high levels of alexithymia and type D personality in FM patients but when depression is controlled, these results do not differ from those of healthy controls. CONCLUSION: Studies that use a comprehensive model of personality present a different theoretical approach and use alternatively the Big-Five model, Eysenck's and Cloninger's models. The use of a comprehensive model of personality and the control of psychopathological disorders, such as anxiety and depression, seem to be very relevant for a better understanding of a specific personality profile associated with fibromyalgia.

Intraobserver and interobserver reproducibility of third trimester uterine artery pulsatility index.

OBJECTIVES: The primary aim of the study was to investigate intraobserver and interobserver reproducibility of uterine artery (UtA) pulsatility index (PI) in the third trimester of pregnancy. The secondary aim of the study was to examine whether high maternal body mass index (BMI) or gestational age (GA) influence the reliability of this measurement. METHODS: Singleton pregnancies in women with known BMI were recruited between 30+0 and 40+0  weeks. UtA PI Doppler measurements were performed prospectively, independently, and blindly by 2 Fetal Medicine Foundation-accredited operators. Intraobserver and interobserver reproducibility was assessed by concordance correlation coefficient (CCC) and intraclass correlation coefficient (ICC); Bland-Altman plots were built and limits of agreement (LoA) were calculated. The analysis was performed for both raw numbers and percentiles. To estimate the intraoperator and interoperator agreement in defining normal and pathological measurements, the assessments were divided in 2 categories-UtA PI <95th percentile/ ≥95th percentile-and Cohen's kappa coefficients were calculated. Results were interpreted according to the cutoffs reported by the True Reproducibility of Ultrasound Techniques review. Correlation between maternal BMI and GA and accuracy of UtA measurements was studied with Spearman's correlation coefficient. RESULTS: Measurements were available in 101 women. For intraobserver reproducibility, ICCs and CCCs were calculated for raw values and percentiles and were 0.912 and 0.835, and 0.837 and 0.716, respectively. For interobserver reproducibility, ICCs and CCCs were 0.809 and 0.732, and 0.677 and 0.576, respectively. This indicates a poor-moderate reproducibility of third trimester UtA PI. LoA were also wide (from a minimum of -0.30-0.35 to a maximum of -0.53-0.62). Cohen's kappa coefficients were 0.478 and 0.418, showing a moderate intraoperator and interoperator agreement in distinguishing between normal and pathological values. No correlation was found between maternal BMI and GA and reproducibility of the measurements. CONCLUSIONS: Intraobserver and interobserver reproducibility of third trimester UtA PI as assessed by ICC, CCC, and LoA is only moderate-poor. The agreement between operators in defining pathological and normal measurements is moderate.

Intra- and inter-observer reproducibility and generalizability of first trimester uterine artery pulsatility index by transabdominal and transvaginal ultrasound.

OBJECTIVES: The primary aim of the study was to assess intra-observer and inter-observer reproducibility and generalizability (general reliability) of first trimester Doppler measurements of uterine arteries (UtA) performed both transabdominally (TA) and transvaginally (TV). Secondary aims were to investigate whether maternal BMI and acquisition modality (transabdominal or transvaginal) affect feasibility and reliability of UtA Doppler evaluation. METHODS: Singleton pregnancies between 11+0 and 13+6 weeks underwent TA and TV Doppler measurements of UtA prospectively, blindly and independently by Fetal Medicine Foundation-accredited operators. The more experienced operator performed all the scans to assess intra-observer reproducibility. Inter-observer reproducibility and generalizability was evaluated among different operators and different ultrasound equipment. Intra- and inter-rater reliability was assessed by Concordance Correlation Coefficient and Intraclass Correlation Coefficient; agreement was estimated with Limits of Agreement and reported graphically with Bland-Altman plots. Correlation between BMI and feasibility and accuracy of UtA measurements were studied with Spearman's correlation coefficient. Differences between TA and TV measurements were evaluated by Wilcoxon test. RESULTS: A total of 101 women were enrolled. The intra-observer reproducibility for TA and TV measurements ranged from 0.87 to 0.94, respectively. The inter-observer reproducibility varied from 0.57 (for TA measurements by the less experienced operator) to 0.95 (for TV measurements by the more experienced operator), and it was independent of the ultrasound equipment used. Spearman's correlation coefficient failed to demonstrate a correlation between BMI and time to get the first set of TA-TV measurements, or between BMI and TA-TV reproducibility. In four patients, the operators could not obtain the TA measurements due to high BMI. In our population the UtA pulsatility index (PI) values did not differ significantly between the TA or TV approach. CONCLUSIONS: UtA PI measurements obtained by experienced operators show a moderate intra- and inter-observer reproducibility. The TV approach might be used when TA measurements fail in obese women, especially since specific reference ranges for TV measurements may not be necessary. © 2016 John Wiley & Sons, Ltd.

Resolving the Role of Plant NAD-Glutamate Dehydrogenase: III. Overexpressing Individually or Simultaneously the Two Enzyme Subunits Under Salt Stress Induces Changes in the Leaf Metabolic Profile and Increases Plant Biomass Production.

NAD-dependent glutamate dehydrogenase (NAD-GDH) of higher plants has a central position at the interface between carbon and nitrogen metabolism due to its ability to carry out the deamination of glutamate. In order to obtain a better understanding of the physiological function of NAD-GDH under salt stress conditions, transgenic tobacco (Nicotiana tabacum L.) plants that overexpress two genes from Nicotiana plumbaginifolia individually (GDHA and GDHB) or simultaneously (GDHA/B) were grown in the presence of 50 mM NaCl. In the different GDH overexpressors, the NaCl treatment induced an additional increase in GDH enzyme activity, indicating that a post-transcriptional mechanism regulates the final enzyme activity under salt stress conditions. A greater shoot and root biomass production was observed in the three types of GDH overexpressors following growth in 50 mM NaCl, when compared with the untransformed plants subjected to the same salinity stress. Changes in metabolites representative of the plant carbon and nitrogen status were also observed. They were mainly characterized by an increased amount of starch present in the leaves of the GDH overexpressors as compared with the wild type when plants were grown in 50 mM NaCl. Metabolomic analysis revealed that overexpressing the two genes GDHA and GDHB, individually or simultaneously, induced a differential accumulation of several carbon- and nitrogen-containing molecules involved in a variety of metabolic, developmental and stress-responsive processes. An accumulation of digalactosylglycerol, erythronate and porphyrin was found in the GDHA, GDHB and GDHA/B overexpressors, suggesting that these molecules could contribute to the improved performance of the transgenic plants under salinity stress conditions.

Therapy and differential diagnosis of posterior reversible encephalopathy syndrome (PRES) during pregnancy and postpartum.

PURPOSE: Posterior reversible encephalopathy syndrome (PRES) is an usually reversible neuro-radiological clinical entity characterized by headache, confusion, visual disturbances or blindness and seizures. It rarely occurs without seizures. METHODS: We conducted a literature review in MEDLINE about PRES during post partum and pregnancy, focusing on differential diagnosis and therapy. We reviewed 28 articles (case reports, original articles and reviews) describing PRES as well as a case of a severe, immediate postpartum HELLP syndrome (haemolysis, elevated liver enzyme levels, low platelet count) with PRES without generalized seizure. RESULTS: The development of PRES after delivery is unusual. Magnetic resonance imaging represents the gold standard for the diagnosis of this condition. White matter oedema in the posterior cerebral hemispheres is typical on neuroimaging. PRES is reversible when early diagnosis is established and appropriate treatment is started without delay. The pathogenesis of PRES is discussed and the importance of a prompt diagnosis is emphasized, as the crucial role of rapid blood press reduction. CONCLUSION: MRI is the diagnostic gold standard and it may be useful in the differential diagnosis. The goal of the therapy is to control elevated blood pressure and to prevent seizures or promptly manage it.

Thermal degradation of red cabbage (Brassica oleracea L. var. Capitata f. rubra) anthocyanins in a water model extract under accelerated shelf-life testing.

Red cabbage (RC) represents a source of anthocyanins acylated with hydroxycinnamic acids (HCA) that are described to enhance their stability. Nevertheless, data about their thermal degradation are still controversial. Our aim was to comprehensively analyse the degradation kinetics of individual RC anthocyanins in a model aqueous extract treated at 40 °C × 30 days to simulate severe but realistic storage conditions. Free anthocyanins and radical-scavenging capacity showed different kinetics. The results confirm the high stability of RC anthocyanins (t1/2: 16.4-18.4 days), although HPLC analyses of each molecule displayed distinct kinetics with t1/2 from 12.6 to 35.1 days. In particular, the sinapoyl acylation negatively affected the stability of the anthocyanins, while the forms monoacylated with glycosyl p-coumaric and ferulic acids exhibited higher stability. In conclusion, our results indicate that acylation is not a prerogative of stability, as this is instead more dependent on specific acylation patterns and the glycosylation of HCA.