Ultrasonographic soft markers for detection of rectosigmoid deep endometriosis.

OBJECTIVES: The aim of this study was to evaluate the use of ultrasound (US) soft markers as a first-line imaging tool to raise suspicion of rectosigmoid (RS) involvement in women suspected of having deep endometriosis. METHODS: We included in this prospective observational study all patients with clinical suspicion of deep endometriosis who underwent diagnostic transvaginal US evaluation at our unit from January 2016 to February 2017. Several US soft markers were evaluated for prediction of RS involvement (presence of US signs of uterine adenomyosis, presence of an endometrioma, adhesion of the ovary to the uterus (reduced ovarian mobility), presence of 'kissing ovaries' (KO) and absence of the 'sliding sign'), using as the gold standard expert US examination for the presence of RS endometriosis. RESULTS: Included were 333 patients with clinical suspicion of deep endometriosis. Of these, 106 had an US diagnosis of RS endometriosis by an expert. The only significant variables found in the prediction model were absence of the sliding sign (odds ratio (OR), 13.95; 95% CI, 7.7-25.3), presence of KO (OR, 22.5; 95% CI, 4.1-124.0) and the interaction between these two variables (OR, 0.03; 95% CI, 0.004-0.28). Regarding their interaction, RS endometriosis was present when KO was absent and the sliding sign was present in 10% (19/190) of cases, when both KO and the sliding sign were present in 71.4% (5/7) of cases, when both KO and the sliding sign were absent in 60.8% (76/125) of cases and when KO was present and the sliding sign was absent in 54.5% (6/11) of cases. Thus, when the sliding sign was absent and/or KO was present, transvaginal US showed a specificity of 75% (95% CI, 69-80%) and a sensitivity of 82% (95% CI, 73-88%). CONCLUSIONS: US findings of absence of the sliding sign and/or presence of KO in patients with clinical suspicion of endometriosis should raise suspicion of RS involvement and indicate referral for expert US examination, with a low rate of false-negative diagnosis. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Contraception during Coronavirus-Covid 19 pandemia. Recommendations of the Board of the Italian Society of Contraception.

Purpose: The Italian Society of Contraception identified as one of its priorities the need to give recommendations on management of contraception during Coronavirus-Covid 19 pandemiaMaterials and methods: A concise communication was produced which summarises in an easy-to-read format suitable for clinicians the management of the different contraceptives mostly used. Information how to manage contraception in different conditions is presented.Results: Women may, in general, continue to use either intrauterine and or hormonal contraceptives. The use of condom should be added to any hormonal contraceptive, when the contraceptive efficacy is reduced or when women stop the contraceptive method.Conclusion: At the present time, during the Coronavirus-Covid 19 pandemia, no data contraindicate the use of intrauterine or hormonal contraceptives. Conversely the use of an appropriate contraception is advocate to prevent unintended pregnancies.

New insights into sex chromosome evolution in anole lizards (Reptilia, Dactyloidae).

Anoles are a clade of iguanian lizards that underwent an extensive radiation between 125 and 65 million years ago. Their karyotypes show wide variation in diploid number spanning from 26 (Anolis evermanni) to 44 (A. insolitus). This chromosomal variation involves their sex chromosomes, ranging from simple systems (XX/XY), with heterochromosomes represented by either micro- or macrochromosomes, to multiple systems (X1X1X2X2/X1X2Y). Here, for the first time, the homology relationships of sex chromosomes have been investigated in nine anole lizards at the whole chromosome level. Cross-species chromosome painting using sex chromosome paints from A. carolinensis, Ctenonotus pogus and Norops sagrei and gene mapping of X-linked genes demonstrated that the anole ancestral sex chromosome system constituted by microchromosomes is retained in all the species with the ancestral karyotype (2n = 36, 12 macro- and 24 microchromosomes). On the contrary, species with a derived karyotype, namely those belonging to genera Ctenonotus and Norops, show a series of rearrangements (fusions/fissions) involving autosomes/microchromosomes that led to the formation of their current sex chromosome systems. These results demonstrate that different autosomes were involved in translocations with sex chromosomes in closely related lineages of anole lizards and that several sequential microautosome/sex chromosome fusions lead to a remarkable increase in size of Norops sagrei sex chromosomes.

Monurelle Biogel® vaginal gel in the treatment of vaginal dryness in postmenopausal women.

OBJECTIVES: To evaluate efficacy, tolerability and safety of Monurelle Biogel® vaginal gel for treatment of vaginal dryness. METHODS: Multicenter, national, randomized, controlled vs. no-treatment, open-label study. Ninety-five postmenopausal women were randomized (48 to Monurelle Biogel® and 47 to no treatment). Primary endpoint was the change of Verbal Rating Scale (VRS) total score of vaginal atrophy (VA) symptoms after 8-week treatment. The main secondary endpoints were VRS single-item score, Vaginal Health Index (VHI) score, Maturation Index (MI), Female Sexual Function Index (FSFI), and Female Sexual Distress Scale-Revised (FSDS-R). RESULTS: The VRS total score was statistically significant in favor of the treatment group on day 28 (p = 0.001) but not on day 56 (p = 0.064). By excluding women who were not sexually active, the total VRS scores reached the criteria for clinical success in 27/43 subjects (62.8%) in the control arm and in 38/46 subjects (82.6%) in the treatment arm (p = 0.035) on day 56. The VHI score significantly changed in the active arm (4.71 ± 4.85 vs. 0.28 ± 1.71) (p < 0.001) on day 56. Even the MI significantly improved, with an increase in the percentage of superficial cells (p = 0.01). The improvements in both VHI and MI were still present at the follow-up visit after the discontinuation of the treatment (day 84). Sexual function and distress showed a statistical significant difference on day 56. CONCLUSIONS: Monurelle Biogel® vaginal gel applied twice daily for 8 weeks is effective in relieving vaginal dryness and other VA symptoms. Such a clinical meaningful effect persists at least 4 weeks and is supported by an improvement in the vaginal environment. Trial Registration clinicaltrials.gov Identifier: NCT02994342.

Soy isoflavones, inulin, calcium, and vitamin D3 in post-menopausal hot flushes: an observational study.

PURPOSE OF INVESTIGATION: To evaluate the effect of soy isoflavones and inulin (SII) on hot flushes (HF) and quality of life in a clinical setting, the authors conducted an observational study. MATERIALS AND METHODS: The authors performed an observational, prospective, multicentric study on women in peri-/post-menopause treated or untreated with a product present on the Italian market, consisting in a mixture of calcium (500 mg), vitamin D3 (300 IU), inulin (3 g) and soy isoflavones (40 mg). RESULTS: A total of 135 patients, 75 (55.6%) in the SII group and 60 (44.4%) in the untreated group entered the study. After three months, the mean number of HF declined of 2.8 (SD 3.7) in the SII group and 0.0 in the untreated one. The corresponding values after six months were -3.7 (SD 2.7) in the SII group and -0.9 (SD 5.3) in the control group (p = 0.02). CONCLUSION: This observational trial suggests a possible beneficial effect of a dietary soy supplement containing 40 mg of isoflavone/day plus inulin in the management of menopausal symptoms such as hot flashes.

[Risk assessment of work related stress: examination and operative difficulties in sanitary field]. / Valutazione ex-lege dello stress lavoro-correlato. Esperienze e difficoltà operative nel settore sanitario.

Work related stress can highly negatively affect not only company's productivity but also other aspects causing increased costs for absenteeism, increased number of work accident and near miss, higher turnover, reduced quality of products and services, reduced capability of renewal, and so on. In agreement with the Italian legislative decree 81/08 we evaluated stress level of workers of three different sanitary structures located in the middle of Italy. 305 workers (physicians, nurses, technicians, auxiliary nurse, white collars) were submitted to a questionnaire designed by our team of work. The sector reporting higher stress level was represented by nurses, the sector with lower stress level was made of technicians. We proposed a set of measures aiming to reduce the load of stress based on the assumption that in this sector is fundamental to develop strategies of intervention both at organizational and individual level.

[Comparison of shift work and night shifts: impacts on health and wellbeing among sanitary workers]. / Lavoro a turni e notturno: studio conoscitivo e valutazione clinico-anamnestica in una popolazione di lavoratori della sanità.

The generally agreed view is that there is no ideal shift system, and that most systems will have both advantages and disadvantages. As such, attention has been placed on trying to identify good and bad features of shift systems, with a view to minimising the possible ill health as a consequence of shiftwork. The present study focuses on the quality of the shift and looks at the implications for individual health and wellbeing, during the wellbeing, during the shift. Three groups of sanitary workers, one working in the morning, one working two shifts, and the other working three, took part. All completed a version of the standard shiftwork index (SSI), a set of self reported questionnaires related to health and wellbeing. The three groups differed on many outcome measures, although the differences that did exist didn't suggested advantages for one shift system over the others.

Effects of palladium nanoparticles on the cytokine release from peripheral blood mononuclear cells of non-atopic women.

The object of this study is to determine the cytokine release from PBMCs exposed to Pd model nanoparticles emitted from catalytic converters. PBMCs of 8 healthy non-atopic women were incubated in the presence of Pd nanoparticles (5-10 nm) or salt (potassium hexa-chloropalladate) 10-5 and 10-6 M. Release of cytokines in supernatant of PBMCs was then determined. In cultures without LPS, IL-10 and IL-17 release from PBMCs was inhibited by Pd salt, while Pd nanoparticles inhibited TNF-alpha and IL-17 release. In LPS-stimulated cultures, release of IFN-gamma, TNF-alpha, IL-10 and IL-17 was inhibited by Pd salt, whereas IFN-gamma release was enhanced and TNF-alpha and IL-17 release was inhibited by Pd nanoparticles. In conclusion, Pd salt inhibits cytokine release, whereas Pd nanoparticles exert modulatory effects enhancing the release of IFN-gamma, a Th1 cytokine typical of delayed allergic reactions. This result is interesting considering the increase of allergic contact dermatitis to Pd in people exposed to Pd nanoparticles in urban environments.

[Short-term effect of an estroprogestin containing ethinylestradiol 20 mcg + drospirenone 3 mg in 24+4 regimen at hormonal and cutaneous level in ovarian hyperandrogenism]. / Effecto a breve termine di un estroprogestinico contenente etinilestradiolo 20 mcg+drospirenone 3mg in schema 24 + 4 a livello ormonale e cutaneo nell'iperandrogenismo ovarico.

AIM: evaluate the efficacy of an estroprogestin EP containing 20 mcg ethinilestradiol (EE) and 3 mg drospirenone (DRSP) in the treatment of hyperandrogenism. METHODS: In this study, twenty hyperandrogenic patients were treated with an EP containing EE 20 mcg and DRSP 3 mg in 24+4 regimen for three months. Skin evaluation was performed both quantitatively and qualitatively. RESULTS AND CONCLUSION: This EP combination showed, after a short-term treatment (three months) to decrease significantly seborrhea, acne, and circulating androgens (testosterone, deidroepiandrosterone sulphate, and androstenedione), while increased sex hormone binding globulin levels. Moreover, this EE 20 mcg/DRSP 3mg EP combination changed some parameters of skin quality, increasing corneometry (a parameter related to skin hydration), and reduced trans epidermal water loss (TEWL, a parameter related to skin evaporation), and erythema (a parameter related to skin inflammation). These results could be taken into account in individualizing the treatment of hyperandrogenic patients.

Actin-based movement of Listeria monocytogenes: actin assembly results from the local maintenance of uncapped filament barbed ends at the bacterium surface.

The thermodynamic basis for actin-based motility of Listeria monocytogenes has been investigated using cytoplasmic extracts of Xenopus eggs, initially developed by Theriot et al. (Theriot, J. A., J. Rosenblatt, D. A. Portnoy, P. J. Goldschmidt-Clermont, and T. J. Mitchison. 1994. Cell. 76:505-517) as an in vitro cell-free system. A large proportion (75%) of actin was found unpolymerized in the extracts. The amount of unassembled actin (12 microM) is accounted for by the sequestering functions of T beta 4Xen (20 microM) and profilin (5 microM), the barbed ends being capped. Movement of Listeria was not abolished by depletion of over 99% of the endogenous profilin. The proline-rich sequences of ActA are unlikely to be the target of profilin. All data support the view that actin assembly at the rear of Listeria results from a local shift in steady state due to a factor, keeping filaments uncapped, bound to the surface of the bacterium, while barbed ends are capped in the bulk cytoplasm. Movement is controlled by the energetic difference (i.e., the difference in critical concentration) between the two ends of the filaments, hence a constant ATP supply and the presence of barbed end capped F-actin in the medium are required to buffer free G-actin at a high concentration. The role of membrane components is demonstrated by the facts that: (a) Listeria movement can be reconstituted in the resuspended pellets of high speed-centrifuged extracts that are enriched in membranes; (b) Actin-based motility of endogenous vesicles, exhibiting the same rocketing movement as Listeria, can be observed in the extracts.

A role for centrin 3 in centrosome reproduction.

Centrosome reproduction by duplication is essential for the bipolarity of cell division, but the molecular basis of this process is still unknown. Mutations in Saccharomyces cerevisiae CDC31 gene prevent the duplication of the spindle pole body (SPB). The product of this gene belongs to the calmodulin super-family and is concentrated at the half bridge of the SPB. We present a functional analysis of HsCEN3, a human centrin gene closely related to the CDC31 gene. Transient overexpression of wild-type or mutant forms of HsCen3p in human cells demonstrates that centriole localization depends on a functional fourth EF-hand, but does not produce mitotic phenotype. However, injection of recombinant HsCen3p or of RNA encoding HsCen3p in one blastomere of two-cell stage Xenopus laevis embryos resulted in undercleavage and inhibition of centrosome duplication. Furthermore, HsCEN3 does not complement mutations or deletion of CDC31 in S. cerevisiae, but specifically blocks SPB duplication, indicating that the human protein acts as a dominant negative mutant of CDC31. Several lines of evidence indicate that HsCen3p acts by titrating Cdc31p-binding protein(s). Our results demonstrate that, in spite of the large differences in centrosome structure among widely divergent species, the centrosome pathway of reproduction is conserved.

Reply to the 'Comment on "Metal-organic green dye: chemical and physical insight into a modified Zn-benzoporphyrin for dye-sensitized solar cells"' by R. Steer, RSC Advances, 2018, DOI: 10.1039/c8ra00213d.

The authors reply to the comment by R. P. Steer discussing the reasons for their incorrect assignment of the luminescence decay of the novel compound 5,10,15-(triphenyl),20-[ethynyl-(4-carboxy)phenyl]tetrabenzoporphyrinate Zn(ii) (PETBP). Further DFT and TDDFT calculations have been performed on the compound to investigate the possibility of a direct S2-S0 decay instead of a S2-S1 conversion with a subsequent emission to the ground state. In addition, the presence of traces of very luminescent contaminants of the ring-opened type has been considered on the grounds of calculated absorption and fluorescence spectra. The results of these investigations confirm that the S2-S0 emission reported in the commented paper is not attributable to the target molecule but rather to a neglected luminescent impurity.

Analysis of mid1p, a protein required for placement of the cell division site, reveals a link between the nucleus and the cell surface in fission yeast.

mid1 is required for the proper placement of the contractile actin ring for cytokinesis at a medial site overlying the nucleus. Here we find that mid1 protein (mid1p) shuttles between the nucleus and a cortical medial broad band during interphase and early mitosis. The position of this broad band, which overlies the nucleus, is linked to nuclear position even in cells with displaced or multiple nuclei. We identified and created mutations in an NLS and in two crm1-dependent NES sequences in mid1p. NES mutations caused mid1p accumulation in the nucleus and loss of function. An NLS mutations greatly reduced nuclear localization but did not perturb cytoplasmic localization or function. mid1p localization to the medial broad band was also not dependent on mid1p PH domain or microtubule and actin cytoskeletons. Overexpression of mid1p produced ectopic cell growth at this band during interphase and abnormal karmellae-like nuclear membrane structures. In plo1-1, mid1p formed a medial broad band but did not incorporate into a tight ring, suggesting that polo kinase plo1p is required for activation of mid1p function. Thus, the mid1p broad band defines a compartment at the medial cell surface, whose localization is linked to the position of the nucleus, and whose function may be to position the plane of cell division.

[Cervical, thoracic and upper limb load assessment in dental professionals]. / Studio del carico posturale cervico-dorsale e dell'arto superiore nell'attività dell'odontoiatra.

In order to analyze the effect of working posture on the level of neck, back and shoulder muscular activity, a clinico-anamnestic, electromyographic and postural study of 34 dentistry was undertaken. Using surface electrodes, the level of muscular activity was recorded. The results showed that neck flexed working posture is prevalent: using stereomicroscope gave lower levels than with or without enlarging systems, such as glasses.

[Risk assessment in upper limb overload]. / Studio del sovraccarico biomeccanico dell'arto superiore attraverso l'applicazione di quattro diversi metodi di valutazione del rischio.

One of the most important factors of the work-related musculoskeletal disorders of the upper extremities (WMSDs) is the biomechanical overload. The purpose of this study is to evaluate the possibility to predict the upper limb repetitive stress, according to risk assessment procedures. In order to this aim, we gathered clinical-anamnestic data and risk assessment considerations of a cohort of workers in a car industry.

[Occupational risk stress in shift workers]. / Valutazione del rischio da stress occupazionale in una popolazione di lavoratori a turni.

Aim of our study was to assess the stress risk at work in a group of nurses. 197 workers (nurses, auxiliary, physiotherapists, midwives and technicians of laboratory) were enrolled divided in two sets respectively of 100 people (subset A) with daily and nightly shifts and 97 (subset B) only daily workers. The mean age was 43.29 years (DS +/- 8.13) in subset A and 46.85 years (DS +/- 7.48) in subset B. For the survey S-90, a questionnaire composed by 90 items faces to frame some of the possible factors of risk has been used and the relative effects on health's state induced by the occupational stress were analyzed. The results show a possible greater risk of daily sleepiness in workers with nightly job. The majority of hypertension workers in subgroup B could depend more on the elevated mean age of this sample. Although a greater perception of the psychological load has been found, statistically meaningful association between the insurgence of gastrointestinal symptoms and shift was not showed.

[Professional exposure to natural ultraviolet radiation: risk assessment and management and preventing strategies]. / Esposizione professionale a radiazione ultravioletta (UV) naturale: valutazione, controllo del rischio e strategie di prevenzione.

The aim of our study was to verify the impact of work risk factor in causing cutaneous neoplasia on a group of patients and to assess the risk of exposure to UV on outdoor workers. The survey was divided in three phases: a) Questionnaire, b) Dermatological clinical examination. c) Exposure measurement by spectral radiance method (mW/cm2). 248 subjects were enrolled, 100 of which affected by basal cellular carcinoma (BCC) (68% M and 32% F: mean age 70 +/- 11.93 y) 130 by melanoma (42% M and 58% F; mean age 53 +/- 17.35 y) and 18 by squamous cellular carcinoma (33% F and 67% M: mean age 78 +/- 11.41 y). In addiction 22 healthy male subjects exposed to UV were examined (mean age 38.59 +/- 13.65 y; specific working age 11.88 +/- 10.92 y). The assessment of UV exposure was performed over a 24 days timeframe during summer 2007, all over the working day. Furthermore, maximum allowed exposure time (t(max)) without protection was calculated according to ACGIH guidelines in order to prevent cutaneous alterations. It turned out that the UV exposure, both in working and spare time, is the root cause for squamous cellular cancer developing. Furthermore our results proved that also BCC is related to the overall UV exposure. No clear link to the UV exposure was found for cutaneous melanoma. No precancerous lesions were observed on shortly exposed subjects. The measurements performed revealed, as expected, lower exposure during first and last hours of the day without any particular constrain on t(max), and maximum exposure in the timeframe between 10:00 AM and 4:00 PM. Therefore, it is necessary to pay higher attention to the UV exposure and related consequences on employees health in order to provide with the most suitable preventing measures such the usage of protections depending from the requested exposure time.

Performance indicators for the efficiency analysis of urban drainage systems.

Performance indicators implemented in a decision support system (DSS) for the technical, managerial and economic evaluation of urban drainage systems (UDS), called MOMA FD, are presented. Several kinds of information are collected and processed by MOMA FD to evaluate both present situation and future scenarios of development and enhancement. Particular interest is focused on the evaluation of the environmental impact, which is considered a very relevant factor in the decision making process to identify the priorities for UDS improvements.

[The diagnosis of occupational diseases: a specific task of occupational doctors]. / Diagnosi e denuncia di malattia professionale: un'attività sempre più specialistica.

The Authors examine the problem dealing with Occupational disease diagnosis focusing five main points: diseases of probable/possible occupational origin; chronic and acute diseases; diseases due to biological agents; presumptive causation in legal compensation; public health statistics and medical reports. They conclude that new rules are needed and more advice from Occupational Medicine is required.