Effect of ejaculatory abstinence period on fertilization and clinical outcomes in ICSI cycles: a retrospective analysis.

RESEARCH QUESTION: Does ejaculatory abstinence impact fertilization outcomes in intracytoplasmic sperm injection (ICSI) cycles in infertile couples? DESIGN: This single-centre retrospective observational study included 6919 ICSI cycles from 2013 to 2022. The primary outcome was the assessment of oocyte fertilization, measured in terms of the rate of formation of two-pronuclear (2PN), 3PN and 1PN zygotes. Secondary outcomes were blastulation, cumulative positive ß-human chorionic gonadotrophin test and clinical pregnancy rates. Relationships between ejaculatory abstinence and fertilization outcomes, and ejaculatory abstinence and clinical outcomes were evaluated with multivariable analysis, including possible confounders. RESULTS: A positive association was observed between ejaculatory abstinence and semen sample volume (P < 0.001), sperm concentration (P < 0.001) and total motile sperm count (P < 0.001). No association was found between the 1PN zygote rate and ejaculatory abstinence (P = 0.97). Conversely, for each additional day of ejaculatory abstinence, the likelihood of obtaining 2PN zygotes from all inseminated oocytes decreased by 3% [adjusted odds ratio (aOR) 0.97, 95% CI 0.94-0.99], whilst the likelihood of obtaining 3PN zygotes from all inseminated oocytes increased significantly by 14% (aOR 1.14, 95% CI 1.07-1.22). No significant associations were found between ejaculatory abstinence and blastulation, cumulative pregnancy or miscarriage rates. CONCLUSIONS: A longer ejaculatory abstinence period significantly decreases the rate of 2PN zygotes, and increases the rate of 3PN zygotes without directly affect blastulation and pregnancy rates.

Investigating mortality trends in Italy during the COVID-19 pandemic: life expectancy changes within provinces and vaccination campaign impact up to December 2022.

OBJECTIVES: We used publicly available population data from 1 January 2019 up to 31 December 2022, to investigate mortality trends in Italy during the COVID-19 pandemic, evaluating changes in life expectancy (LE) at birth within provinces and the impact of COVID-19 vaccinations. STUDY DESIGN: Aggregate data analysis. METHODS: Annual period life tables were used to estimate sex-specific LEs within provinces from 2019 to 2022. We used Arriaga decomposition to analyze the contribution of age groups (<60 years and ≥60 years) to annual LE changes. We implemented a Quasi-Poisson regression model to estimate the number of averted deaths by the achieved COVID-19 vaccination rates from January 2021 up to December 2022, simulating a counterfactual scenario where vaccine doses were not administered. RESULTS: The results revealed geographical heterogeneity in annual LE changes across Italian provinces during the pandemic. By the end of 2022, LE was below the prepandemic levels in 88% of provinces for females and in 76% for males. In addition, we estimated that the achieved vaccination rates averted 460,831 deaths (95% confidence interval: 250,976-707,920), corresponding to a 25% reduction in expected all-cause mortality. CONCLUSIONS: Overall, the study highlighted the significant role of COVID-19 vaccinations in averting a considerable number of deaths and improving LE. However, by the end of 2022, LE had not fully recovered to prepandemic levels in many provinces. This could be attributed to concurrent factors, including enduring COVID-19 pandemic effects, intense summer heat waves and early onset of seasonal flu. Further research and continuous monitoring are essential to fully comprehend long-term mortality trends and optimize public health strategies.

[Formation of lateralization of manipulatory food-procuring behavior in the white rat early ontogenesis].

Study of peculiarities of formation of preference in use of one of forelegs at learning of the manipulatory food-procuring skill has been carried out at different stages of early ontogenesis of white rats. It was established that as early as at the 3-week age the rat pups were already able to learn getting food from a narrow test-tube; however, no expressed preference in using one of the extremities was revealed. After repeated testing of adult rats at the age of 4 months the number of ambidexters was significantly higher than in the control animal group. At learning of the 30-day old rat pups of this manipulatory skill, in the majority of the rat pups, no significant lateralization also was found in using the foreleg. At repeated testing of adult rats the amount of ambidexters did not differ from that in the control group of animals. The obtained results indicate the existence of critical periods in formation of lateral preference in performance of the manipulatory food-procuring skill. There also was shown effect of learning in early ontogenesis on the capability for lateralization of this skill in the adult state in rats.

Defining the role of pharmacists in medication-related genetic counseling.

There is little question that precision medicine will eventually be the standard of care in treatment with algorithms designed for therapy selection and is already being used in some specialties such as cystic fibrosis and multiple cancer treatments. Genetic counselors are the heart of the treatment team in relation to counseling regarding genetic risk factors and disease states. A framework for treatment within the interdisciplinary team with more defined roles and areas of specialty will need to be in place as this practice approach expands with new data and treatments. Pharmacists are poised to be of great assistance in this matrix as many of these roles are merely an extension of current tasks and responsibilities of pharmacy practice.

Conservative multimodal management of osteosynthesis material in surgical wounds with polymicrobial superinfection, including methicillin-resistant Staphylococcus aureus. Clinical case. / Manejo multimodal conservador de material de osteosíntesis ante herida quirúrgica con sobreinfección polimicrobiana, incluyendo Staphylococcus aureus resistente a meticilina. Caso clínico.

Retentive treatment of prosthetic material superinfected by resistant microorganisms is a challenge, especially when the causative agent is a methicillin-resistant Staphylococcus aureus. We present the successful conservative management of osteosynthesis material implanted due to ankle fracture in an elderly patient who suffered superinfection by the aforementioned microorganism, in which the antimicrobial treatment consisted of the combination of antibiotic-guided systemic antibiotics (after a first ineffective empirical cycle), together with topical irrigations of sevoflurane, applications of silver sulfadiazine cream, and subsequently coverage of the skin defect with negative pressure therapy. We highlight the novel role of sevoflurane as an analgesic and as a topical antimicrobial agent (in addition to silver sulfadiazine) in the favourable evolution of the wound, especially in the period in which the empirical antibiotic therapy was ineffective and negative pressure therapy had not yet been applied.

Effects of intranasal administration of epitalon on neuron activity in the rat neocortex.

This report discusses the properties of the synthetic tetrapeptide epitalon (Ala-Glu-Asp-Gly), synthesized on the basis of an epiphyseal peptide extract. Intranasal administration of epitalon was selected as a noninvasive means of applying the agent to the CNS by bypassing the blood-brain barrier. The aim of the present work was to assess the characteristics of the action of epitalon on the frequency of spontaneous neuron activity in the cerebral cortex of white rats. Studies were performed using male Wistar rats anesthetized with urethane (1 g/kg). Extracellular activity of cortical neurons was recorded with a glass microelectrode of resistance 1-2 MOmega. Recording of spontaneous neuron discharges for 10-15 min was followed by intranasal administration of epitalon solution and recording of neuron activity to 30 min after doses of 30 ng per animal. Significant activation of neuron activity was seen several minutes after dosage, with an increase (by factors of 2-2.5) in discharge frequency. In some experiments, the effect of epitalon was multiphasic. The first peak of increased neuron discharge frequency at 5-7 min was followed by peaks at 11-12 and 17-18 min. The increase in discharge frequency occurred because of an increase in the discharge frequency of neurons which were already active and the recruitment of previously silent neurons. At least the first peak of increased neuron activity following exposure to epitalon was found to be associated with the direct action of the peptide on cortical cells.

Preeclampsia and related disorders. Clinical aspects and relevance of endothelin and nitric oxide.

Preeclampsia is a pregnancy-specific disorder believed to result from widespread endothelial dysfunction. Endothelin and NO are two potent vasoactive agents of endothelial origin and, as such, are postulated to play an important role in the pathogenesis of preeclampsia. If these agents are found to be important in preeclampsia, they will most likely exert their effects locally, rather than systemically. Future research on the autocrine and paracrine effects of endothelin and NO may yield important insights into the cause and pathogenesis of this enigmatic disease.

[A large symptomatic gastric leiomyoma. A case report and considerations of the treatment possibilities]. / Grosso leiomioma gastrico sintomatico. Descrizione di un caso e considerazioni sulle possibilità di trattamento.

The authors describe the case of a female patient affected with large symptomatic gastric leiomyoma, six centimeters in diameter, who presented to clinical observation referring gastric pain and melena. The first gastroscopy showed massive bleeding from a submucosal gastric lesion. The lesion was not endoscopically resectable and the injective endoscopic treatment of bleeding failed. The patient was surgically treated with laparotomic excision of the leiomyoma. She was back home in ten days. The authors describe this case to discuss the possibility to resect large gastric leiomyomas using endoscopic resection indeed surgical approach. They also enhance the validity of surgical treatment for its safety and radical approach to large lesions.

[Organization of motor representation in the neocortex of white rats: results of macro- and microstimulation]. / Organizatsiia motornogo predstavitel'stva v neokortekse beloi krysy: dannye makro- i mikrostimuliatsii.

Motor and EMG responses were studied in thirty rats craniotomized under thiopental, in conditions of intracortical microstimulation and surface anode macrostimulation of the parietal and frontal neocortical areas. Strict contralaterality and distinct separation was found in motor representation (MRs) of the fore and hind limbs, of vibrissae fields and even of some joints and functional muscle groups. On the territory of the hind leg MR which was studied in greater details, centrally lies the compact MR zone of toes, mediocaudally from it - a vast MR of the foot, and further still more caudally and with some overlapping, the MRs of the shin, thigh and pelvic-abdominal musculature, respectively.

[Restructuring of the topical organization of the rat motor cortex after damage to the opposite hemisphere]. / Perestroika topicheskoi organizatsii motornoi kory krysy posle povrezhdeniia v protivopolozhnom polusharii.

Topical organization of the motor cortex was compared in outbred rats by the method of intracortical microstimulation in the norm and in different periods after unilateral partial decortication of the motor projection (MP) of the hind-leg. Stable state of the MPs of the fore- and hind-limbs was in the norm, and within their bounds there was an individual variability of MP zones of separate joints. After the operation, the reconstruction of the motor cortex organization in the opposite hemisphered appeared in later periods, in 5-7 months. Expansion was observed of the boundaries of the excitable area in caudal direction and reduction of the part of responses of the limbs distal muscles as compared to proximal ones and of the body muscles. 8-16 months after the operation, the reactions of axial muscles, including the ipsi- and bilateral ones, became more expressed.

[Study of the biological value of rice groats proteins]. / Issledovanie biologicheskoi tsennosti belkov risovoi krupy.

The content of essential amino acids in the total rice protein and its fractions was determined; the degree to which the in vitro protein and starch are liable to be charged by enzymes was studied and also the biological value of the total protein and its fractions underwent appraisal by using the Tetrahymena pyriformis W. as a test organism. As to the amino acids content the protein fractions differ from one another, with lysine level in albumin amounting to 4.07, globulin--2.46, prolamine--0.88 and gluteline--3.15 per cent. Because of a low prolamine content of 1.9 per cent, the biological value of rice is greater than that of other cereals. Following heat treatment the lysine and methionine levels go down by 7 and 6 per cent, respectively, while the degree of the proteins and starch hydrolysis---increases. The hydrolysis of starch forming part of the milled rice results in a greater accessibility of proteins to the action of proteolytic enzymes. The relative nutritional value correlates with the lysine content.

[Plantar pressure platform as clinical assesment tool in the analysis of foot posture with the foot posture index]. / Die Druckmessplattform als klinisch-diagnostisches Instrument zur Analyse der Fußstatik nach dem Foot Posture Index.

BACKGROUND: The foot posture index is a static measurement that splits up the foot posture into neutral, pronatus and supinatus. However, the relation between the foot posture and the plantar pressure standards is not well known. For this, the objective of this research is to check the relationship between the foot posture and plantar pressure standard. SUBJECTS AND MATERIAL: 144 participants (101 women and 43 men), mean age 25.4 ± 6.3 years, were measured for the FPI. The pedobarometric measurement was made with the plantar pressure platform, we measured total surface (cm2), mean pressure (kPa) and maximum pressure (kPa), these measurements were correlated with the FPI measurements. RESULTS: 288 feet were analysed with regard to the correlation between point 5 of FPI (medial arch height) and the plantar surface total area (p = 0.038): lower arch height and supinated foot are related to the maximum pressure points with p = 0.029. The total contact surface can be determined with the final score of the FPI, the scores of FPI 3, 5 and 6 FPI (r2 = 0.059, p < 0.001) with a 5.9 % prediction. CONCLUSION: The supinatus foot is correlated statistically significantly through the maximum pressure and the plantar surface with the pronatus foot.

The use of immunohistochemistry in the evaluation of the nail matrix in biopsies of ingrown toenails.

The success of surgical approaches to ingrown toenails depends on the extraction (either partial or total) of the nail matrix. The identification of the nail matrix in specimens taken from ingrown toenails is not always easy because of the fragmentation of the biopsies, difficulties in matrix orientations and the heavy inflammatory infiltrate. In biopsies taken from polydactyly surgeries, the matrix shows a peculiar pattern of expression of the CD10 and CD34 markers that differs from the one shown by the lateral nail fold. We investigated whether such a pattern was also found in biopsies from ingrown toenails, which can be greatly distorted through inflammation and fibrosis. We examined 15 biopsies from cases of ingrown toenails at different clinical stages. We performed routine Hematoxylin-Eosin studies, as well as immunohistochemical studies with CD10, CD34, HMB-45 and Melan-A. The morphologic changes in all cases were typical of those found in ingrown toenails and their intensities correlated with the clinical stages. Matrical keratinization was identified in all of the biopsies. Morphologic features that are compatible with the lateral nail fold were also seen in seven of the 15 biopsies. In five cases, an intermediate area of transition between matrix and lateral nail folds was heavily distorted by inflammatory changes. Melanocytic markers showed scattered intra-epidermal cells in all but one case. HMB-45 and Melan-A were equally good in demonstrating the melanocytic population. We concluded that the expression of CD10 and CD34 in cases of ingrown toenails is preserved and it follows the pattern described in nails from polydactyly. Therefore, both markers can be useful in fragmented specimens taken from surgeries for ingrown toenails, in order to confirm the removal of the nail matrix.