How Photogenerated I2 Induces I-Rich Phase Formation in Lead Mixed Halide Perovskites.

Bandgap tunability of lead mixed halide perovskites (LMHPs) is a crucial characteristic for versatile optoelectronic applications. Nevertheless, LMHPs show the formation of iodide-rich (I-rich) phase under illumination, which destabilizes the semiconductor bandgap and impedes their exploitation. Here, it is shown that how I2 , photogenerated upon charge carrier trapping at iodine interstitials in LMHPs, can promote the formation of I-rich phase. I2 can react with bromide (Br- ) in the perovskite to form a trihalide ion I2 Br- (Iδ- -Iδ+ -Brδ- ), whose negatively charged iodide (Iδ- ) can further exchange with another lattice Br- to form the I-rich phase. Importantly, it is observed that the effectiveness of the process is dependent on the overall stability of the crystalline perovskite structure. Therefore, the bandgap instability in LMHPs is governed by two factors, i.e., the density of native defects leading to I2 production and the Br- binding strength within the crystalline unit. Eventually, this study provides rules for the design of chemical composition in LMHPs to reach their full potential for optoelectronic devices.

Defect Engineering to Achieve Photostable Wide Bandgap Metal Halide Perovskites.

Bandgap tuning is a crucial characteristic of metal-halide perovskites, with benchmark lead-iodide compounds having a bandgap of 1.6 eV. To increase the bandgap up to 2.0 eV, a straightforward strategy is to partially substitute iodide with bromide in so-called mixed-halide lead perovskites. Such compounds are prone, however, to light-induced halide segregation resulting in bandgap instability, which limits their application in tandem solar cells and a variety of optoelectronic devices. Crystallinity improvement and surface passivation strategies can effectively slow down, but not completely stop, such light-induced instability. Here we identify the defects and the intragap electronic states that trigger the material transformation and bandgap shift. Based on such knowledge, we engineer the perovskite band edge energetics by replacing lead with tin and radically deactivate the photoactivity of such defects. This leads to metal halide perovskites with a photostable bandgap over a wide spectral range and associated solar cells with photostable open circuit voltages.

Incidence and Risk Factors for Infectious Complications of EBUS-TBNA: Prospective Multicenter Study

The aim of our study was to describe the incidence of infectious complications of endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) and to analyze the potential risk factors in a prospective cohort of patients. Methods: We conducted a prospective multicenter study, with all consecutive patients referred for an EBUS-TBNA with patients at risk of developing an infectious complication (considering>10 nodal samplings, known immunosuppression, bronchial colonization and cavitated or necrotic lesions) and a second group without any risk factor. Results: Three hundred seventy patients were included: 245 with risk factors and 125 without risk factors (as the control group). Overall, 15 patients (4.05%) presented an acute infectious complication: fourteen in cases (5.7%) and 1 in controls (0.8%). Of these, 4 patients presented pneumonia, 1 mediastinitis, 4 obstructive pneumonitis and 6 mild complications (respiratory tract infection that resolved with antibiotic). Also 7 (1.9%) patients had self-limited fever. One-month follow-up showed 1 mediastinitis at sixteenth day post-EBUS, which required surgical treatment, and 3 pneumonias and 3 respiratory tract infections at nineteenth day (1.9%). All patients had a good evolution and there were no deaths related with infectious complication. We observed an increased risk of complication in patients with risk factors and in patients with necrosis (p=0.018). Conclusions: The incidence of infectious complications in a subgroup of patients with risk factors was higher than in patients without risk factors. Nevertheless, it remains low, and no fatal complication occurred, which reinforces the idea that EBUS-TBNA is a safe technique for the assessment of the mediastinum. Necrotic lesions are a risk factor of post-EBUS infection, and their puncture should be avoided. (AU)

Incidence and Risk Factors for Infectious Complications of EBUS-TBNA: Prospective Multicenter Study.

The aim of our study was to describe the incidence of infectious complications of endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) and to analyze the potential risk factors in a prospective cohort of patients. METHODS: We conducted a prospective multicenter study, with all consecutive patients referred for an EBUS-TBNA with patients at risk of developing an infectious complication (considering>10 nodal samplings, known immunosuppression, bronchial colonization and cavitated or necrotic lesions) and a second group without any risk factor. RESULTS: Three hundred seventy patients were included: 245 with risk factors and 125 without risk factors (as the control group). Overall, 15 patients (4.05%) presented an acute infectious complication: fourteen in cases (5.7%) and 1 in controls (0.8%). Of these, 4 patients presented pneumonia, 1 mediastinitis, 4 obstructive pneumonitis and 6 mild complications (respiratory tract infection that resolved with antibiotic). Also 7 (1.9%) patients had self-limited fever. One-month follow-up showed 1 mediastinitis at sixteenth day post-EBUS, which required surgical treatment, and 3 pneumonias and 3 respiratory tract infections at nineteenth day (1.9%). All patients had a good evolution and there were no deaths related with infectious complication. We observed an increased risk of complication in patients with risk factors and in patients with necrosis (p=0.018). CONCLUSIONS: The incidence of infectious complications in a subgroup of patients with risk factors was higher than in patients without risk factors. Nevertheless, it remains low, and no fatal complication occurred, which reinforces the idea that EBUS-TBNA is a safe technique for the assessment of the mediastinum. Necrotic lesions are a risk factor of post-EBUS infection, and their puncture should be avoided.

Neurodevelopment Outcome in Children with Fetal Growth Restriction at Six Years of Age: A Retrospective Cohort Study.

OBJECTIVE: This study aimed to describe neurodevelopment in fetal growth restriction children at the age of six. Secondly, we tried to demonstrate influencing factors that can improve or exacerbate this development, as well as predictive factors that might select a population at risk to assist with early childhood support. METHOD: It was a study of 70 children affected with FGR. FGR was based on these definitions: birth weight below the 3rd percentile or birth weight below the 10th percentile with an abnormal hemodynamic Doppler study. Neurodevelopment was assessed at 6 years old by means of Batelle Development Inventory. A global development quotient under a 100 score was considered a neurodevelopment delay. All variables regarding pregnancy care, delivery episode, postpartum, neonatal care, sociodemographic issues, and the need for support in the first years were studied. RESULTS: The mean gestational age at diagnosis was 33.14 weeks (standard deviation (SD = 4.31), with 32.9% of early-onset diagnoses. The mean gestational age at delivery was 35.61 (SD = 3.21), and the cesarean rate was 64.3%. The average age of the children at the moment of the evaluation was 76.20-month-old (SD = 3.70). The mean global development quotient was 97.28 (SD = 13.97). We were able to record a 57.1% of global development delay. In the cases of cognition, only 17.1% of the children registered a delay. Motor and communication skills were the most frequently affected. We discovered that socioeconomic status was positively related to the global development quotient, as well as both gestational age at delivery and middle cerebral artery pulsatility index was positively related to the global development quotient. CONCLUSIONS: We found a higher neurodevelopment delay rate (57.1%). We could relate a higher gestational age at delivery and a higher MCA percentile with better global neurodevelopment quotients.

[Bifidobacterium longum subsp. infantis CECT 7210 (B. infantis IM-1®) shows activity against intestinal pathogens]. / Bifidobacterium longum subsp. infantis CECT 7210 (B. infantis IM-1®) muestra actividad frente a patógenos intestinales.

Introduction: Diarrhea caused by severe acute gastroenteritis is one of the main causes of infant mortality in children under 5 years of age. Therefore, it is interesting to perform a preclinical and clinical validation of the efficacy of B. longum subsp. infantis IM-1® against various gastrointestinal pathogens. B. infantis IM-1® was evaluated against different gastrointestinal pathogens that cause diarrhea in infants, using in vitro models, animal models, and clinical studies. B. infantis IM-1® is able in an in vitro model of MA-104 and HT-29 cells to inhibit rotavirus replication (up to 36.05%) as well as to protect cells from infection due to rotavirus (up to 48.50 %). An 11-amino acid peptide (MHQPHQPLPPT) with a molecular mass of 1,282 KDa produced by this probiotic with antirotaviral capacity has been identified. In a murine model, the IM-1® strain has been shown to provide in vivo protection against rotavirus infection. In adhesion experiments with HT29, IM-1® was able to displace some pathogens from the enterocyte, especially Cronobacter sakazakii and Salmonella enterica, and prevent the adhesion of C. sakazakii and Shigella sonnei. In a clinical study with 190 babies under 3 months of age, IM-1® reduced episodes of diarrhea, being safe, well tolerated and associated with a lower prevalence of constipation. B. infantis IM-1® is a safe, well tolerated and effective probiotic in reducing episodes of diarrhea caused by the main gastrointestinal pathogens in infants.

Introducción: La diarrea causada por gastroenteritis agudas graves es una de las principales causas de mortalidad infantil en niños menores de 5 años. Por ello es interesante realizar una validación preclínica y clínica de la eficacia de B. longum subsp. infantis IM-1® frente a diversos patógenos gastrointestinales. El B. infantis IM-1® fue evaluado frente a diferentes patógenos gastrointestinales causantes de diarrea en bebés utilizando modelos in vitro, modelos animales y estudios clínicos. B. infantis IM-1® es capaz en un modelo in vitro de células MA-104 y HT-29 de inhibir la replicación de rotavirus (hasta un 36,05 %), así como de proteger las células de la infección por rotavirus (hasta un 48,50 %). Se ha identificado un péptido de 11 aminoácidos (MHQPHQPLPPT) con una masa molecular de 1282 KDa producido por este probiótico con capacidad antirotaviral. En un modelo murino, la cepa IM-1® ha demostrado proporcionar protección in vivo contra la infección por rotavirus. En experimentos de adhesión con HT29, IM-1® fue capaz de desplazar algunos patógenos del enterocito, especialmente C. sakazakii y Salmonella entérica, e impedir la adhesión de C. sakazakii y Shigella sonnei. En un estudio clínico con 190 bebés de menos de 3 meses de edad IM-1® redujo los episodios de diarrea. Fue seguro, se toleró bien y se asoció con una menor prevalencia de estreñimiento. B. infantis IM-1® es un probiótico seguro, que se tolera bien y es eficaz en la reducción de los episodios de diarrea causados por los principales patógenos gastrointestinales en bebés.

Fournier's Gangrene under Sodium-Glucose Cotransporter-2 Inhibitors Therapy in Gynecological Patients.

Fournier's gangrene (FG) is a serious pathology of the soft tissues and fascia of the perineum and genital region with a high morbidity and mortality rate. In recent years, the SGLT-2 inhibitor oral antidiabetic has been related to this entity. According to the new warnings from the main drug agencies, a compilation of cases has been initiated to establish or deny a possible causal relationship. Most of these cases have been reported in men. However, it is important not to underestimate this entity in the gynecological field, since it is extremely serious and requires intense and rapid aggressive treatment based on surgery and empiric antibiotherapy. Later, some cares are needed to involve surgical reconstruction of the defects introduced by debridement. As a result of the low incidence of FG, clinical trials' data may be insufficient to robustly assess this issue because of the limited numbers of participants. Real-world evidence may help to clarify the association between SGLT2i and FG. The aim of this review is to describe and compare the reported cases of GF in diabetic women who received SGLT2 inhibitors as antiglycemic agents.

Construction of a Prognostic Score for Ultrasound Evaluation of the Transobturator Sling for Stress Urinary Incontinence.

Currently, pelvic floor ultrasound allows us to correctly visualize the synthetic material used in stress urinary incontinence surgery. The objective of this study is the construction of a score and its correlation with the SUU clinic. During the study period, 81 patients with transobturator slings were studied using ultrasound. Through multivariate analysis, the statistically significant variables were the distance from the sling to the urethral wall (p = 0.004), the shape of the sling at rest (p = 0.003), and the symmetry of the mesh (p = 0.016). Through these variables, the construction of a score was carried out. Once the model was constructed, its internal validation was carried out to determine the discrimination capacity of patients who present clinical stress and those who do not, with an area under the curve of 0.848 (95% CI (0.72−0.97), p < 0.001). This simple score using three ultrasound variables serves to adequately and objectively discriminate patients who have successful surgery and absence of clinical effort.

A Three-Step Procedure for Emergency Cerclage: Gestational and Neonatal Outcomes.

(1) Background: The objective of our prospective observational study was to evaluate a new technique for emergency cerclage, which was performed on a cohort of patients with cervical incompetence in the second trimester. (2) Methods: 26 pregnant women presented at 15 to 24 weeks of gestation with cervical dilatation and bursa prolapse. A new emergency cerclage was performed using a technique consisting of the first cerclage in a tobacco bag and a second occlusive cerclage located inferiorly to the first. The technique is concluded with the performance of a cervical cleisis when vaginal bag prolapse is present, and this overall procedure is called the three-step procedure for emergency cerclage (TSEC). (3) Results: To assess its effectiveness, we measured the latency from procedure to delivery, pregnancy duration, infant birth weight, and rate of premature amniorrhexis. The mean latency from procedure to delivery was 14 weeks + 6 days, the mean weight of newborns was 2550 g and the mean gestational age at delivery was 35 weeks. The neonatal survival rate was 95.8%. The rate of premature amniorrhexis (<34 weeks gestational age) was 8.3% (two cases) with successful perinatal outcomes. There were significant differences (p < 0.05) between groups. A multivariate regression model showed that the best variables for predicting the latency to delivery were the cervical dilatation at diagnosis, use of the three-step cerclage, cervical length after the procedure, and gestational age at diagnosis. (4) Conclusions: The excellent results obtained with the TSEC procedure in terms of the latency from the procedure to delivery, gestational age at delivery, birth weight, and having few reported complications highlight the importance of collecting new data on this promising novel procedure.

Transmitted Fetal Immune Response in Cases of SARS-CoV-2 Infections during Pregnancy.

(1) Background: Little is known about the effects of SARS-CoV-2 on the placenta, and whether the maternal inflammatory response is transmitted vertically. This research aims to provide information about the effects of SARS-CoV-2 infection on maternal and fetal immunity. (2) Methods: We have studied placental changes and humoral and cellular immunity in maternal and umbilical cord blood (UCB) samples from a group of pregnant women delivering after the diagnosis of SARS-CoV-2 infection during pregnancy. IgG and IgM SARS-CoV-2 antibodies, Interleukin 1b (IL1b), Interleukin 6 (IL6), and gamma-Interferon (IFN-γ), have been studied in the UCB samples. Lymphocyte subsets were studied according to CD3, CD8, CD4, CD34, and invariant natural Killer T cells (iNKT) markers. We used in situ hybridization techniques for the detection of viral RNA in placentas. (3) Results: During the study period, 79 pregnant women and their corresponding newborns were recruited. The main gestational age at the time of delivery was 39.1 weeks (SD 1.3). We did not find traces of the SARS-CoV-2 virus RNA in any of the analyzed placental samples. Detectable concentrations of IgG anti-SARS-CoV-2 antibodies, IL1b, IL6, and IFN-γ, in UCB were found in all cases, but IgM antibodies anti-ARS-CoV-2 were systematically undetectable. We found significant correlations between fetal CD3+ mononuclear cells and UCB IgG concentrations. We also found significant correlations between UCB IgG concentrations and fetal CD3+/CD4+, as well as CD3+/CD8+ T cells subsets. We also discovered that fetal CD3+/CD8+ cell counts were significantly higher in those cases with placental infarctions. (4) Conclusion: we have not verified the placental transfer of SARS-CoV-2. However, we have discovered that a significant immune response is being transmitted to the fetus in cases of SARS-CoV-2 maternal infection.

Genital Prolapse in Pregnant Woman as a Presentation of Aggressive Angiomyxoma: Case Report and Literature Review.

Background: Aggressive angiomyxoma is a rare entity within mesenchymal cell neoplasms, especially in pregnant women. Its main characteristic is the ability to infiltrate neighboring structures and to recur. Case Presentation: We present the case of a pregnant woman who debuted with a genital prolapse in the second trimester of pregnancy. She was diagnosed with bilateral ovarian teratomas and a pelvic mass of which the diagnosis could not be established until delivery. The route of delivery used was cesarean section since the genital prolapse behaved as a previous tumor. After the puerperium, the patient was referred for consultation to complete the study of the mass. The extension study was carried out with a negative result. The patient underwent surgery for tumor exeresis. Hormonal treatment was not administered according to the patient's preferences. Conclusions: Aggressive angiomyxoma is a benign neoplasm that should be considered in the differential diagnosis of pelvic tumors in women. In pregnant women, the vaginal route of delivery is not contraindicated as long as the tumor does not obstruct the birth canal. The definitive treatment is surgery, preferably performed in a second stage after delivery.

Merged two-way mapping technique: an alternative 3D electroanatomical mapping approach to guide challenging ablation procedures of accessory pathways with bidirectional conduction properties.

BACKGROUND: Catheter ablation of accessory pathways (AP) with bidirectional conduction may be challenging due to issues related to anatomical course or location. OBJECTIVE: We describe an alternative electro-anatomical mapping technique which aims at depicting the entire anatomic course of the AP from the atrial toward the ventricular insertion in order to guide catheter ablation. METHODS: Twenty consecutive patients with confirmed bidirectional AP conduction and at least one previous ablation procedure or para-Hisian location were included. 3-D electro-anatomical mapping was used to depict the merged 10-ms isochrone area of maximum early activation of both the ventricular and atrial signals during sinus rhythm and ventricular pacing/orthodromic tachycardia, respectively. Catheter ablation was performed within the depicted earliest isochrone area. RESULTS: Acute bidirectional AP conduction block was achieved in all patients 4.2 ± 1.7 s after the first radiofrequency energy pulse was delivered, without reconnection during a 30 ± 10 min post-ablation observation time. No procedural complications were seen. After a mean follow-up period of 9 ± 7 months (range 3 to 16), no recurrences were documented. CONCLUSION: This merged two-way mapping technique is a safe, efficient, and effective technique for ablation of APs with bidirectional conduction.

Bifidobacterium longum subsp. infantis CECT 7210 (B. infantis IM-1®) muestra actividad frente a patógenos intestinales / Bifidobacterium longum subsp. infantis CECT 7210 (B. infantis IM-1®) shows activity against intestinal pathogens

La diarrea causada por gastroenteritis agudas graves es una de las principales causas de mortalidad infantil en niños menores de 5 años. Por ello es interesante realizar una validación preclínica y clínica de la eficacia de B. longum subsp. infantis IM-1® frente a diversos patógenos gastrointestinales. El B. infantis IM-1® fue evaluado frente a diferentes patógenos gastrointestinales causantes de diarrea en bebés utilizando modelos in vitro, modelos animales y estudios clínicos.B. infantis IM-1® es capaz en un modelo in vitro de células MA-104 y HT-29 de inhibir la replicación de rotavirus (hasta un 36,05 %), así como de proteger las células de la infección por rotavirus (hasta un 48,50 %). Se ha identificado un péptido de 11 aminoácidos (MHQPHQPLPPT) con una masa molecular de 1282 KDa producido por este probiótico con capacidad antirotaviral. En un modelo murino, la cepa IM-1® ha demostrado proporcionar protección in vivo contra la infección por rotavirus. En experimentos de adhesión con HT29, IM-1® fue capaz de desplazar algunos patógenos del enterocito, especialmente C. sakazakii y Salmonella entérica, e impedir la adhesión de C. sakazakii y Shigella sonnei. En un estudio clínico con 190 bebés de menos de 3 meses de edad IM-1® redujo los episodios de diarrea. Fue seguro, se toleró bien y se asoció con una menor prevalencia de estreñimiento.B. infantis IM-1® es un probiótico seguro, que se tolera bien y es eficaz en la reducción de los episodios de diarrea causados por los principales patógenos gastrointestinales en bebés. (AU)

Diarrhea caused by severe acute gastroenteritis is one of the main causes of infant mortality in children under 5 years of age. Therefore, it is interesting to perform a preclinical and clinical validation of the efficacy of B. longum subsp. infantis IM-1R against various gastrointestinal pathogens. B. infantis IM-1R was evaluated against different gastrointestinal pathogens that cause diarrhea in infants, using in vitro models, animal models, and clinical studies.B. infantis IM-1R is able in an in vitro model of MA-104 and HT-29 cells to inhibit rotavirus replication (up to 36.05%) as well as to protect cells from infection due to rotavirus (up to 48.50 %). An 11-amino acid peptide (MHQPHQPLPPT) with a molecular mass of 1,282 KDa produced by this probiotic with antirotaviral capacity has been identified. In a murine model, the IM-1R strain has been shown to provide in vivo protection against rotavirus infection. In adhesion experiments with HT29, IM-1R was able to displace some pathogens from the enterocyte, especially Cronobacter sakazakii and Salmonella enterica, and prevent the adhesion of C. sakazakii and Shigella sonnei. In a clinical study with 190 babies under 3 months of age, IM-1R reduced episodes of diarrhea, being safe, well tolerated and associated with a lower prevalence of constipation.B. infantis IM-1R is a safe, well tolerated and effective probiotic in reducing episodes of diarrhea caused by the main gastrointestinal pathogens in infants. (AU)

New surgical realities: implementation of an enhanced recovery after surgery protocol for gynecological laparoscopy-a prospective study.

BACKGROUND: Multimodal rehabilitation allows optimization of functional recovery in surgery patients by reducing the postoperative stress and hospital stay duration, without increasing the morbidity and mortality. It is reportedly successful in other surgical disciplines, and guidelines for its application to gynecological surgery are available; however, most evidence for these guidelines is derived from observational and/or retrospective studies. Therefore, this study aimed to investigate the applicability of an enhanced recovery after surgery (ERAS) protocol in laparoscopic gynecological surgery and its influence on the postoperative stay, morbidity, mortality, and readmission, through a prospective approach. METHODS: This prospective cohort study was performed on 90 patients who underwent laparoscopic hysterectomy for benign causes from October 2017 to October 2019. Patients in whom the ERAS (ERAS group, n = 30) and traditional (control group, n = 60) protocols were implemented were compared. All patients were followed for 6 months. RESULTS: The groups were homogeneous and did not differ significantly with respect to the demographic characteristics (age, ASA score, body mass index), surgical indications, and surgery types. Adherence to the ERAS protocol was over 99%. The postoperative hospital-stay durations were 1.73 days (r = 1-3) and 2.97 days (r = 2-6) in the ERAS and control groups, respectively (p = 0.000). No significant intergroup differences were observed in the rates of complications and readmissions. CONCLUSIONS: The ERAS protocol is applicable in laparoscopic gynecological surgery and can be implemented with good adherence. This can allow optimization of patient recovery by reducing the hospital stay duration, without increasing the rates of morbidity, mortality, or readmission.

Effects of SARS-CoV-2 Pandemic on the Mental Health of Spanish Ob-Gyn Specialists-A Nationwide Study.

It has been reported that frontline health professionals have suffered from an increased rate of mental disorders as a consequence of the SARS-CoV-2 pandemic. OBJECTIVE: This study aims to evaluate the impact of the pandemic on the mental health of Spanish specialists in the obstetrics and gynecology fields after the fifth Spanish COVID-19 wave. METHODS: Psychometric screening of the professionals was performed using a nationwide online survey designed by the Psychosocial Obstetrics and Gynecology taskforce. Post-traumatic stress disorder (PTSD), depression, and general anxiety disorder were screened. RESULTS: We found high scores for PTSD, depression, and generalized anxiety disorder. Up to 12.4% of specialists met the PTSD criteria, 12.8% showed complex PTSD, 37% showed depression, and up to 37% had a positive screening for generalized anxiety disorder. Our results showed that the pandemic has particularly affected the group of female Ob-Gyn specialists, with significant higher scores in depression and anxiety scales. CONCLUSIONS: As a lesson learned for the future in case of new health emergencies, it would be very important to provide professionals with adequate psychological support, ensuring enough human and material resources, flexible work shifts, and facilities to reconcile work and family-life, especially in the case of female specialists.

Measuring Resilience in Women with Endometriosis.

Endometriosis is a multifactorial disease with pathophysiological factors not yet well known; it also presents a wide symptomatic range that makes us think about the need for multidisciplinary management. It is a chronic disease in which there is no definitive treatment, and is associated in a large majority of cases with psychological pathology. Connecting comorbidities and multimorbidities on a neurobiological, neuropsychological, and pathophysiological level could significantly contribute to their more successful prevention and treatment. In our study, resilience is analyzed as an adjunctive measure in the management of endometriosis. Methods: A multi-centre, cross-sectional study was performed to analyse resilience levels in a sample of Spanish women suffering from endometriosis. CDRIS-25, CDRIS-10, BDI, the STAI, and the SF-36 Health Questionnaire were used for assessments. A representative group of 202 women with endometriosis was recruited by consecutive sampling. Exploratory and confirmatory factor analyses were performed for both resilience scales. Results: Mean CDRIS-25 and CDRIS-10 scores were 69.58 (SD 15.1) and 29.37 (SD 7.2), respectively. Women with adenomyosis and without signs of deep endometriosis showed the lowest scores. The best predictive model included women's age, years of endometriosis evolution, number of pregnancies, and history of fertility problems as the best predictive factors. Conclusions: Women build resilience as the number of years of evolution of the disease increases. Symptoms such as dyspareunia and continued abdominal pain were more prevalent among less resilient women.

Correlates of Sexual Function in a Sample of Spanish Women with Endometriosis.

BACKGROUND: In the present study, we aim to report on the sexual function of women experiencing symptoms of endometriosis, analysing the clinical and psychosocial factors that may be associated. METHODS: A multicentre cross-sectional study was performed to analyse the sexual function in a sample of 196 Spanish women with endometriosis, using the Female Sexual Function Inventory. RESULTS: The Female Sexual Function Inventory (FSFI) was validated in our endometriosis study group. The mean FSFI score for the sample was 22.5 (SD 6.6), with 20.9 and 26.9 being in the 25th and 75th percentiles, respectively. Although physical sexual pain and dyspareunia were factors that influenced the sexual function of women with endometriosis, our results show that the impairment was multifactorial. CONCLUSIONS: We found impaired sexual function in women diagnosed with endometriosis. The final model included deep endometriosis, depression, age, and unemployment as strongest predictive factors for poor (deteriorated) sexual function.

Obstetricians' Attitude towards Childbirth.

(1) Background: In Spain, as in other countries, there is an increase in policies and practices focused on the humanization of perinatal care. In this regard, the quality of interpersonal interactions between women and health professionals is one of the main factors, and, apart from other factors, it is influenced by health professionals´ attitudes towards childbirth. The main objective of this study was to determine the attitudes of obstetricians towards the humanization of childbirth and the promotion of a positive childbirth experience. (2) Methods: The psychosocial task force of the Spanish Society of Obstetrics and Gynecology designed a nationwide online survey. The questionnaire on attitudes towards childbirth (CAVE, acronym for "cuestionario de actitudes sobre vivencias y experiencias en el parto") was used for the assessment. Exploratory and confirmatory factor analyses of the scale were also performed. (3) Results: A total of 384 participants completed the survey. Obstetricians showed a high-quality clinical obstetric performance, but some difficulties in identifying birth-related psychological-trauma risk factors. Some differences according to practice and gender were found in the final score and in areas regarding psychosocial risk, pain, accompaniment, and women´s expectations. (4) Conclusions: In light of the results, it is advisable to launch education initiatives aimed to improve interaction with pregnant women.

Brain Sparing Effect on Neurodevelopment in Children with Intrauterine Growth Restriction: A Systematic Review.

BACKGROUND: Fetal growth restriction (FGR) is a pregnancy complication. Multiple studies have connected FGR to poor cognitive development, behavior disorders, and academic difficulties during childhood. Brain sparing has traditionally been defined as an adaptive phenomenon in which the brain obtains the blood flow that it needs. However, this adaptive phenomenon might not have a complete protective effect. This publication aims to systematically review the consequences of brain redistribution on neurodevelopment in children who presented with placental intrauterine growth restriction. METHODS: We performed a systematic review according to PRISMA guidelines. It included studies on intrauterine growth restriction or small-for-gestational-age (SGA) fetuses, which middle cerebral artery was measured, and neurodevelopment assessed during childhood. PUBMED and EMBASE databases were searched for relevant published studies. RESULTS: Of the 526 studies reviewed, only 12 were included. Brain sparing was associated with poor cognitive function and lower scores in IQ. Cerebral redistribution was related to better executive function and better behavior at 4 years old but not at 12 years old. CONCLUSIONS: We can assume that fetal brain sparing could not be a fully protective phenomenon. We could not find clinical differences in behavioral and executive functions because the results were heterogeneous. Some cognitive abilities could be affected in FGR brain sparing fetuses.