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Del Chierico F.,Parasitology Unit | Vernocchi P.,Parasitology Unit | Vernocchi P.,University of Bologna | Bonizzi L.,University of Milan | And 13 more authors.
Journal of Proteomics | Year: 2012

The establishment of gut microbiota immediately after birth is modulated by different mechanisms that can be considered specific determinants of temporal and spatial variability. Over the last few years, molecular methods have been offering a complementary support to the classical microbiology, often underpowered by its inability to provide unbiased representation of gut microbiota. The advent of high-throughput-omics-based methods has opened new avenues in the knowledge of the gut ecosystem by shedding light on its shape and modulation. Such methods may unveil taxa distribution, role and density of microbial habitants, hence highlighting individual phenotyping (physiological traits) and their relationship with gut dysbiosis, inflammation processes, metabolic disorders (pathological conditions). Synergic meta-omics or "systems biology"-based approaches may concur in providing advanced information on microbiota establishment and pathogen control. During early-life stages this massive amount of data may provide gut microbiota descriptive and functional charts which can be exploited to perform a good practice in childcare and pediatrics, thus providing nutraceutical benefits and endorsing healthy development and aging. This article is part of a Special Issue entitled: Translational Proteomics. © 2012 Elsevier B.V.

Hernandez-Martinez A.,Obstetrics Unit | Pascual-Pedreno A.I.,Gynecology and Obstetrics Unit | Bano-Garnes A.B.,Obstetrics Unit | del Rocio Melero-Jimenez M.,Obstetrics Unit | Molina-Alarcon M.,University of Castilla - La Mancha
Archives of Gynecology and Obstetrics | Year: 2014

Purpose: To assess the main neonatal morbidity results in relation to induced labour indications.Methods: Historical groups from a total of 3,817 deliveries over a three year period (2009, 2010 and 2011) in “Mancha-Centro” Hospital (Alcázar de San Juan) formed the study group. All programmed and non-avoidable caesarean sections and pregnancies under 35 weeks were excluded. The main variable result was a neonatal morbidity variable made up of the Apgar score after 5 min, pH of umbilical artery <7.10 and the neonatal need for resuscitation type III–V. Multivariate analysis was used to control confounding variables.Results: The incidence of induced labour was 22.6 % (862). The highest indication was premature rupture of membranes for more than 12 h 22.8 % (190), poorly controlled diabetes 22.6 % (189) and oligoamnios 16.2 % (135). The rate of pH lower than 7.10 was 2.8 % (22), the rate of the Apgar score lower than 7 after 5 min was 0.2 % (2) and the neonatal need for resuscitation type III–IV was 5.7 % (48) for induced labour. The relation between induced labour and neonatal morbidity indicators were not statistically significant. 10.1 % (4) of induced labour for suspected intrauterine growth restriction and 8.6 % (10) of postterm pregnancies required neonatal resuscitation type III–IV.Discussion: No relation was found between induced labour and the neonatal morbidity indicators. The highest neonatal risk indicator is when a intrauterine growth restriction, hypertensión/preeclampsia or a postterm pregnancy is suspected. © 2014, Springer-Verlag Berlin Heidelberg.

Barletta F.,Gynecology and Obstetrics Unit | Corrado G.,Regina Elena Cancer Institute | Vizza E.,Regina Elena Cancer Institute
Italian Journal of Gynaecology and Obstetrics | Year: 2015

Objective: To evaluate safety and efficacy of the SNAIL Tenaculum™ uterine manipulator (Simple Nebs Arising Incision Landmark) for total laparoscopic radical hysterectomy in early cervical cancer. Material and Methods: SNAIL Tenaculum™ uterine manipulator origin by a surgical reusable instrument named Uterine Tenaculum Forceps, model Schroder (code 32-622-25 of Martin catalogue). It is modified adding two or four nebs 1-2 cm of distance from the tips of the instrument. We grasped the cervix with SNAIL Tenaculum™ and n order to preserve an adequate pneumoperitoneum during colpotomy surgical gloves are placed in vagina. Results: Twenty patients with early cervical cancer underwent total laparoscopic radical hysterectomy used SNAIL Tenaculum™ uterine manipulator. During surgery the nebs were always under vision and the median length of vagina removed was 21 mm. (range 10-40mm). None intra-operative complications were registered. Conclusion: We found SNAIL Tenaculum™ to be a safe and efficient tool with lowest cost so far recorded. It eliminated risks of perforation and LVS involvement, maintaining good uterine mobility. Also the nebs allow surgeon to choose the length of vaginal wall to be removed. © 2014 Partner-Graf srl, Prato.

Ansaloni L.,General Surgery Unit | Coccolini F.,General Surgery Unit | Morosi L.,Istituto di Ricerche Farmacologiche Mario Negri | Ballerini A.,Istituto di Ricerche Farmacologiche Mario Negri | And 12 more authors.
British Journal of Cancer | Year: 2015

Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) is advised as a treatment option for epithelial ovarian cancer (EOC) with peritoneal carcinomatosis. This study was designed to define the pharmacokinetics of cisplatin (CDDP) and paclitaxel (PTX) administered together during HIPEC. Methods: Thirteen women with EOC underwent cytoreductive surgery (CRS) and HIPEC, with CDDP and PTX. Blood, peritoneal perfusate and tissue samples were harvested to determine drug exposure by high-performance liquid chromatography and matrix-assisted laser desorption ionization imaging mass spectrometry (IMS). Results: The mean maximum concentrations of CDDP and PTX in perfusate were, respectively, 24.8 ± 10.4 μg ml-1 and 69.8 ± 14.3 μg ml-1; in plasma were 1.87 ± 0.4 μg ml-1 and 0.055 ± 0.009 μg ml-1. The mean concentrations of CDDP and PTX in peritoneum at the end of HIPEC were 23.3 ± 8.0 μg g-1 and 30.1 ± 18.3 μg-1 g-1, respectively. The penetration of PTX into the peritoneal wall, determined by IMS, was about 0.5 mm. Grade 3-4 surgical complications were recorded in four patients, five patients presented grade 3 and two patients presented grade 4 hematological complications. Conclusions: HIPEC with CDDP and PTX after CRS is feasible with acceptable morbidity and has a favorable pharmacokinetic profile: high drug concentrations are achieved in peritoneal tissue with low systemic exposure. Larger studies are needed to demonstrate its efficacy in patients with microscopic postsurgical residual tumours in the peritoneal cavity. © 2015 Cancer Research UK. All rights reserved.

Maiorana A.,Gynecology and Obstetrics Unit | Incandela D.,Gynecology and Obstetrics Unit | Giambanco L.,Gynecology and Obstetrics Unit | Alio W.,Gynecology and Obstetrics Unit | Alio L.,Gynecology and Obstetrics Unit
Pan African Medical Journal | Year: 2014

Ectopic pregnancy, the implantation of a fertilized ovum outside theendometrial cavity, occurs in 1.5%-2% of pregnancies. It is one of the major causes (about 6%) of maternal death during the first trimester of pregnancy. The remaining 5% implant in the ovary, peritoneal cavity, within the cervix, and the omental pregnancy is the least common form of abdominal pregnancies. A review of the literature on Medline for the period 1958-2012 reported only 16 cases of omental pregnancy. Here we report a case of primary omental pregnancy in a nulliparous woman. A 24 year-old woman gravid 1, para 0, with lower abdominal pain. Her last menstrual period occurred 8 weeks before the visit. The physical examination revealed abdominal tenderness in the lower quadrants, she was not bleeding. Transvaginal ultrasound showed: a free anechoic/hypoechoic area of 30 x 57 mm in the pouch of Douglas and the endometrium was homogeneus with a thickness of 12 mm and no evidence of gestational sac in the uterine cavity. Laboratory data revealed a normal cell blood count and beta hcg levels of 8047 IU/L. Because of continuing abdominal pain and a diagnosis of ectopic pregnancy a diagnostic laparoscopy was performed, which showed hemoperitoneum. Further inspection of abdominal cavity revealed a bloody lesion that was tenaciously adherent to the omentum, using non traumatic laparoscopic forceps and bipolar scissors we carefully removed a friable mass of about 30 mm from the omental attachments. Histological examination showed the presence of blood clot material mixed with trophoblastic tissue. Ultrasound evaluation and andhCG assessment are important to determine the extrauterine location of the ectopic pregnancy but the early diagnosis of abdominal pregnancy requires also a laparoscopic evaluation and, as our case has highlighted, thorough abdominal exploration especially in the absence of adnexal findings when ectopic pregnancy is highly suspected. Early diagnosis of omental pregnancy is difficult but essential to reduce the high mortality risk for the mother. © Antonio Maiorana et al.

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