Embryonic mammary gland development.

Embryonic mammary gland development involves the formation of mammary placodes, invagination of flask-shaped mammary buds and development of miniature bi-layered ductal trees. Currently there is a good understanding of the factors that contribute to ectodermal cell movements to create these appendages and of pathways that lead to mammary specification and commitment. Gene expression profiles of early bipotent mammary stem cells populations as well as cell surface proteins and transcription factors that promote the emergence of unipotent progenitors have been identified. Analyses of these populations has illuminated not only embryonic mammary development, but highlighted parallel processes in breast cancer. Here we provide an overview of the highly conserved pathways that shape the embryonic mammary gland. Understanding the dynamic signaling events that occur during normal mammary development holds considerable promise to advance attempts to eliminate cancer by restoring differentiative signals.

[Inequalities in oral health in Italy: what role for dentists?] / Diseguaglianze di salute orale in Italia: quale ruolo per gli odontoiatri?

Due to the lack of both available data and political attention, the oral health of the popula-tion seems to be neglected at a scientific level. Actually, however, the dental sector shows strong ine-qualities in access, especially because of the economic crisis that hit most European countries, particu-larly Italy. In order to understand the impact of the organizational variables related to the supply of dental services on the inequalities, an empirical research was carried out in 2013, involving representatives of the dental profession within the 105 Italian provincial orders of physicians and dentists. Both qualitative and quantitative methodological tools have been used. The main results seem to give us back the image of a profession that is going through a very difficult period; problems, which occur on multiple levels, cannot be attributed solely to the economic crisis that started in 2008. Problems appear structural and require a process of change that has to involve, on the one hand, citizens and government institutions and, on the other, the latter and the dental profession.

Users' involvement in the Italian NHS: the role of associations and self-help groups.

PURPOSE: The purpose of the paper is to show the importance of considering patients' and citizens' associations for understanding users' involvement in health care systems. DESIGN/METHODOLOGY/APPROACH: The paper is based on both qualitative and quantitative data on Italy drawn from various sources (national statistics, own survey data, qualitative interviews). FINDINGS: Although the paper avoids an excessively positive view of the success and frequency of collective patients' participation, it nevertheless shows that the Italian National Health Care System (NHS) is undergoing important changes in this regard. Voice and co-production among patients, health care services and professionals have become more common and important also because of forms of collective action. Professionals themselves often belong to or promote such associations and groups. The Italian case also shows that voice and co-production tend frequently to merge into a single complex strategy where patients' requests go along with their direct involvement in health care provision. SOCIAL IMPLICATIONS: The study provides useful information for policy makers considering the implementation of policies that promote collective action in order to increase an active users' participation in health care. ORIGINALITY/VALUE: This is one of the limited number of Italian studies which investigates users' involvement in the NHS and collective action, thus adding knowledge to the limited research in this field.

The several faces of the medicalization of birth. Italy and its peculiarities.

Background: Medical-scientific advances in maternal care gradually improved the health of mothers and new-borns. However, this has contributed to increasing levels of medicalization, defined as the overuse of medical interventions even in low-risk pregnancies and childbirths. In Italy pregnancy and birth still appear to be rather medicalized than in the rest of Europe. Moreover, the uneven distribution of these practice over the territory appears to be evident. The purpose of this article is to both highlight and explain the Italian peculiarity in terms of high medicalization of childbirth and its territorial variability. Theoretical framework: The extensive literature on medicalization of childbirth was systematized by some scholars who use childbirth as a case study to distinguish four meanings of medicalization, by classifying them into two generations of theories. Alongside this literature several studies attempted to interpret differences in maternity model of care showing the important role played by path dependence. Results: In the European scenario, Italy stands out for its high percentage of cesarean sections, but also for its excessive recourse to antenatal visits during pregnancy and the application of interventions during labor and vaginal births. Going into regional detail, however, Italian situation appears rather uneven: relevant differences emerge in relation to medicalization of both pregnancy and birth. Discussion: The article explores the possibility that areas whit different sociocultural, economic, political and institutional background may have introjected different meanings of medicalization, thus reproducing different maternity models of care. In fact, the simultaneous presence, in Italy, of four different meanings of medicalization seems to be rooted. Even with some similar traits, different conditions and situations emerge in different geographical areas, leading to the prevalence of one meaning rather than another and resulting on different outcomes in terms of medicalization. Conclusion: The data presented in this article seem to deny the existence of a national maternity model of care and. On the contrary, they confirm the idea that medicalization is not necessarily linked to the different health conditions of mothers in different geographical areas and that a path dependent variable is able to explain it.

Gpr125 is a unifying hallmark of multiple mammary progenitors coupled to tumor latency.

Gpr125 is an orphan G-protein coupled receptor, with homology to cell adhesion and axonal guidance factors, that is implicated in planar polarity and control of cell movements. By lineage tracing we demonstrate that Gpr125 is a highly specific marker of bipotent mammary stem cells in the embryo and of multiple long-lived unipotent basal mammary progenitors in perinatal and postnatal glands. Nipple-proximal Gpr125+ cells express a transcriptomic profile indicative of chemo-repulsion and cell movement, whereas Gpr125+ cells concentrated at invasive ductal tips display a hybrid epithelial-mesenchymal phenotype and are equipped to bind chemokine and growth factors and secrete a promigratory matrix. Gpr125 progenitors acquire bipotency in the context of transplantation and cancer and are greatly expanded and massed at the pushing margins of short latency MMTV-Wnt1 tumors. High Gpr125 expression identifies patients with particularly poor outcome within the basal breast cancer subtype highlighting its potential utility as a factor to stratify risk.

Identification of Breast Cancer Inhibitors Specific for G†Protein-Coupled Estrogen Receptor (GPER)-Expressing Cells.

Together with estrogen receptors ERα and ERß, the G protein-coupled estrogen receptor (GPER) mediates important pathophysiological signaling pathways induced by estrogens and is currently regarded as a promising target for ER-negative (ER-) and triple-negative (TN) breast cancer. Only a few selective GPER modulators have been reported to date, and their use in cancer cell lines has often led to contradictory results. Herein we report the application of virtual screening and cell-based studies for the identification of new chemical scaffolds with a specific antiproliferative effect against GPER-expressing breast cancer cell lines. Out of the four different scaffolds identified, 8-chloro-4-(4-chlorophenyl)pyrrolo[1,2-a]quinoxaline 14 c was found to be the most promising compound able to induce: 1) antiproliferative activity in GPER-expressing cell lines (MCF7 and SKBR3), similarly to G15; 2) no effect on cells that do not express GPER (HEK293); 3) a decrease in cyclin D1 expression; and 4) a sustained induction of cell-cycle negative regulators p53 and p21.

Different molecular signaling sustaining adiponectin action in breast cancer.

Obesity is defined as a chronic and excessive growth of adipose tissue. It is increasingly recognized as an oncogenic factor. Adipose tissue, originally thought as a passive depot for fat metabolism, is now identified as an endocrine organ, secreting a wide array of bioactive molecules known as adipocytokines, which act as key mediators in several obesity-associated diseases. Among these adipocytokines, adiponectin has been proposed as having a key role in the pathogenesis of cardiovascular disease and type 2 diabetes along with other diseases such as obesity-associated malignancies, including breast cancer. New insights into the molecular mechanisms linking adiponectin and mammary tumorigenesis could be useful to identify novel therapeutic approaches to be exploited, particularly in obese women.

Objeção de consciência na interrupção voluntária da gravidez. Entre a marginalização de profissionais e o retorno do aborto ilegal / Conscientious objection in voluntary interruption of pregnancy. Between the marginalization of professionals and the return of illegal abortion / Objection de conscience en cas d'interruption volontaire de grossesse. Entre la marginalisation des professionnelles et le retour de l'avortement illegal

A lei n.194 / 1978, ao legalizar a interrupção voluntária da gravidez (VIP) na Itália, introduziu a cláusula da objeção de consciência e, desde então, muitos ginecologistas têm invocado esse direito (os chamados pró-vida que se opõem ao pró-direito-escolha). A hipótese deste artigo é dupla e diz respeito às conseqüências da objeção de consciência: por um lado, os ginecologistas pró-escolha experimentam uma forma de marginalidade, em termos de carga de trabalho, status social e poder, resultando em seu isolamento e estigmatização; por outro, a dificuldade de acessar serviços VIP pode levar ao retorno do aborto ilegal. O objetivo é imaginar quais as conseqüências que isso pode trazer para os usuários e profissionais e entender como será possível garantir um equilíbrio entre o direito à interrupção voluntária da gravidez e a objeção de consciência. Em termos de metodologia, realizou-se uma revisão de literatura, seguida de uma pesquisa por material documental (jornais e sites italianos e estrangeiros discutindo VIP e objeção de consciência); Além disso, uma longa entrevista foi realizada com um ginecologista pró-escolha, que representa um caso simbólico no contexto italiano. Algumas considerações sobre os cenários futuros fecham o artigo. (AU)

Law n.194/1978, while legalizing voluntary interruption of pregnancy (VIP) in Italy, introduced the clause of conscientious objection and, since then, many gynaecologists have invoked this right (the so-called pro-life who are opposed to the pro-choice). The hypothesis of this article is twofold and concerns the consequences of conscientious objection: on the one hand, pro-choice gynaecologists experience a form of marginality, in terms of workload, social status and power, resulting in their isolation and stigmatization; on the other, the difficulty of accessing VIP services can lead to the return of illegal abortion. The aim is to imagine what consequences this can bring to both users and professionals and to understand how it will be possible to guarantee a balance between the right to voluntary interruption of pregnancy and that to conscientious objection. In terms of methodology, a literature review, followed by a search for documentary material (Italian and foreign newspapers and websites discussing VIP and conscientious objection) was carried out; moreover, a long interview was conducted with a pro-choice gynaecologist, who represents a symbolic case in the Italian context. Some consideration about the future scenarios close the article. (AU)

En légalisant l'interruption volontaire de grossesse en Italie, la loi n° 194 de 1978 a introduit la clause d'objection de conscience et, depuis lors, de nombreux gynécologues ont invoqué ce droit (les soi-disant pro-vies opposées aux pro-choix). L'hypothèse de cet article est double et concerne les conséquences de l'objection de conscience : d'un côté, les gynécologues pro-choix subissent une forme de marginalité, en termes de charge de travail, de statut social et de pouvoir, ce qui entraîne leur isolement et leur stigmatisation ; d'autre côté , la difficulté d'accéder aux services liés à l'interruption volontaire de grossesse peut entraîner le retour d'un avortement illégal. L'objectif est d'imaginer les conséquences que cela peut avoir pour les utilisatrices et les professionnels et de comprendre comment il sera possible de garantir un équilibre entre le droit à une interruption volontaire de grossesse et celui à l'objection de conscience. Sur le plan méthodologique, une revue de la littérature, suivie d'une recherche de documents (journaux italiens et étrangers et sites Web traitant de l'interruption volontaire de grossesse et de l'objection de conscience) a été réalisée; de plus, un long entretien a été mené avec un gynécologue pro-choix, qui représente un cas symbolique dans le contexte italien. Quelques considérations sur les scénarios futurs ferment l'article. (AU)

Self-help/mutual aid as active citizenship associations: a case-study of the chronically ill in Italy.

Contrary to the most widespread conception that considers self-help/mutual aid as a component of the 'third sector', an approach is proposed which assumes, on the basis of the specific nature of the social bond and of the social action that characterizes it, it can be more properly considered as part of the 'new civil society' as it has been configured during the time in Western societies. This implies its location in the public non-state and non-systemic space that it has been created in the specific form of associations of citizenship. An interuniversity research project is then presented which, using this approach, studied the case of self-help/mutual aid associations for the chronically ill in Italy, offering some of the findings regarding the origin, structural characteristics, geographical distribution and activities of these associations in order to at least partially verify the heuristic value of this approach and its implications for the processes of reform of the health systems.