Vaginal natural oxygenation device (VNOD) for concomitant administration of hyaluronic acid and topical hyperbaric oxygen to treat vulvo-vaginal atrophy: a pilot study.

OBJECTIVE: This is a pilot study to evaluate the effectiveness of concomitant administration of hyaluronic acid and topical hyperbaric oxygen therapy (THOT) by a specifically designed medical device (vaginal natural oxygenation device, VNOD) in improving the symptomatology of postmenopausal patients with vulvo-vaginal atrophy (VVA). PATIENTS AND METHODS: Women with diagnosis of severe VVA from September 2017 to May 2018 were included. Five biweekly administration of THOT and concomitant of hyaluronic acid were performed with a specifically designed medical device. In each occasion, the intensity of patient's symptoms (well-being such as absence of dyspareunia, vaginal dryness, vulvar and/or vaginal itching; vaginal burning; presence of fluid) was determined with a graduated scale from 1 to 6 and the vaginal elasticity and the vaginal wall epithelium appearance were also determined with a graduated scale from 1 to 5. The change in all parameters from baseline to end of therapy was evaluated. RESULTS: Twenty-five patients were considered for the final analysis. A significant improvement in well-being (0.3 vs. 5.1, p < 0.001), vaginal burning (0.2 vs. 5.1, p < 0.001), presence of fluid (0.6 vs. 4.9, p < 0.001), vaginal epithelium appearance (1.8 vs. 4.7, p < 0.001), and vaginal elasticity (1.1 vs. 3.8, p < 0.001) was observed between the first and the last therapy session. All the patients reported a recovery of their sexuality at the end of the five treatment sessions. CONCLUSIONS: In this pilot study, the use of VNOD seems to be a valid treatment of VVA, resulting in a completely natural type of therapy well accepted by patients with immediate therapeutic effects and without side effects; these findings must be confirmed in a well-designed randomized controlled trial.

Prostate-specific antigen synthesis and secretion by human placenta: a physiological kallikrein source during pregnancy.

Prostate-specific antigen (PSA), a kallikrein-like serine protease until recently thought to be prostate specific, has been demonstrated in various nonprostatic tissues and body fluids. PSA has been also found in human endometrium and amniotic fluids, even if the significance of this novel expression is unclear. In this study, we have demonstrated by multiple techniques that human placental tissue, obtained at delivery from normal full-term pregnancies, synthesizes and secretes PSA. RT-PCR showed the presence of PSA messenger ribonucleic acid; biochemical, chromatographic, and immunological studies revealed the expression of both free and complexed PSA forms; immunoelectron microscopy indicated the syncytiotrophoblast as the site of PSA synthesis and secretion. Moreover, in vitro experiments demonstrated that PSA production and secretion are up-regulated by 17beta-estradiol, a pregnancy-related steroid hormone. These results suggest that human placenta is a source of the PSA present in amniotic fluid and maternal serum during pregnancy.

CA-125 spontaneous modifications through the menstrual cycle: preliminary report.

This paper represents a preliminary effort to correlate the variability of CA-125 with the hormonal environment of the menstrual cycle. Despite the reduced number of cases the results seem to show a nearly significative variability of CA-125 through the cycle encouraging us to furtherly search in this direction.

Adenylate cyclase and cyclic AMP-phosphodiesterase activities of fetal membranes: effect of insulin.

Basal activity and response to insulin of adenylate cyclase and cyclic AMP-phosphodiesterase were measured in the fetal membranes before and after labor. Basal activity of adenylate cyclase showed only slight variations after delivery when compared to that observed before labor. Enzyme activity was significantly although weakly decreased by insulin both in the amnion and in chorion before labor, while after delivery a weaker non-significant inhibition was observed. Basal activity of cyclic AMP-phosphodiesterase was lower after delivery with respect to that observed before labor. Insulin inhibited enzyme activity in all conditions. Cyclic AMP levels in intact tissue were not substantially modified by insulin.

Studies on amniotic prolactin: chromatographic pattern and correlation with the lecithin content.

We have measured the concentrations of prolactin and lecithin in the amniotic fluid from 20 normal pregnant women in the 2nd and 3rd trimester. Prolactin is present totally as a low-molecular-weight form, 'little' prolactin, and appears to correlate negatively with lecithin during the 2nd and positively during the 3rd trimester. On the basis of these results and of the information that prolactin is present as high-molecular-weight isohormones in maternal blood, it is argued that amniotic prolactin is synthesized 'in situ' and that different mechanisms are involved in the regulation of prolactin production.