Birth control knowledge among freshmen of four Italian universities.

Since sexual health education (SHE) is not mandatory in Italian schools, we conducted a survey on freshmen of four Italian university campuses in 2012 to investigate the respective level of sexual health knowledge (SHK) in relation to birth control, with the aim to inform public health policy makers. A convenience strategy was employed to sample 4,552 freshmen registered with various undergraduate courses at four Italian universities: Padua university (Veneto Region); university of Milan (Lombardy Region); university of Bergamo (Lombardy Region); university of Palermo (Sicily Region). We investigated the level of SHK on birth control using 6 proxy indicators: (1) the average length of a woman's period [outcome with 3 levels: wrong (base) vs. acceptable vs. correct]; (2) the most fertile interval within a woman's period (binary outcome: correct vs. wrong answer); (3) the event between the end of a period and the beginning of the next cycle (binary outcome: correct vs. wrong answer); (4) the average survival of spermatozoa in the womb (binary outcome: correct vs. wrong answer); (5) the concept of contraception (binary outcome: correct vs. wrong answer); (6) the efficacy of various contraceptives to prevent unintended pregnancies (linear score: 0-17). We fitted 6 separate models of multiple regression: multinomial for outcome 1; logistic for outcomes 2, 3, 4, 6; linear for outcome 6. Statistical estimates were adjusted for a number of socio-demographic factors. Results were expressed as odds ratios (OR) for the 4 multiple logistic regression models, linear coefficients (RC) for the linear regression model and relative risk ratio (RRR) for the multinomial logistic regression model. The level of significance of each risk estimate was set at 0.05. The level of SHK of freshmen sampled was rather low, as 60% interviewees did not know the average length of a woman's period, the average survival of spermatozoa in the womb and the concept of contraception, whilst the most fertile interval within a woman's period was known only to 55% of interviewees. The mean score of SHK on the efficacy of various contraceptive methods was only 5 (scale 0-17). Some categories of students were consistently and significantly less knowledgeable on birth control at multivariable analysis: males; students from the university of Palermo; those with vocational secondary school education and those not in a romantic relationship at the time the survey was conducted. The results of this survey clearly call for the introduction of SHE programs in Italian schools, as already done in several European countries. School SHE should start as early as possible, ideally even before secondary school. SHE should be holistic and delivered with a multiple agency coordinated approach involving the Ministry of Health, the Ministry of Education, University and Scientific Research (MIUR), families, schools, public health departments, primary health care providers, pharmacists, media, other.

Determinants of Length of Stay After Vaginal Deliveries in the Friuli Venezia Giulia Region (North-Eastern Italy), 2005-2015.

Although length of stay (LoS) after childbirth has been diminishing in several high-income countries in recent decades, the evidence on the impact of early discharge (ED) on healthy mothers and term newborns after vaginal deliveries (VD) is still inconclusive and little is known on the characteristics of those discharged early. We conducted a population-based study in Friuli Venezia Giulia (FVG) during 2005-2015, to investigate the mean LoS and the percentage of LoS longer than our proposed ED benchmarks following VD: 2 days after spontaneous vaginal deliveries (SVD) and 3 days post instrumental vaginal deliveries (IVD). We employed a multivariable logistic as well as a linear regression model, adjusting for a considerable number of factors pertaining to health-care setting and timeframe, maternal health factors, newborn clinical factors, obstetric history factors, socio-demographic background and present obstetric conditions. Results were expressed as odds ratios (OR) and regression coefficients (RC) with 95% confidence interval (95%CI). The adjusted mean LoS was calculated by level of pregnancy risk (high vs. low). Due to a very high number of multiple tests performed we employed the procedure proposed by Benjamini-Hochberg (BH) as a further selection criterion to calculate the BH p-value for the respective estimates. During 2005-2015, the average LoS in FVG was 2.9 and 3.3 days after SVD and IVD respectively, and the pooled regional proportion of LoS > ED was 64.4% for SVD and 32.0% for IVD. The variation of LoS across calendar years was marginal for both vaginal delivery modes (VDM). The adjusted mean LoS was higher in IVD than SVD, and although a decline of LoS > ED and mean LoS over time was observed for both VDM, there was little variation of the adjusted mean LoS by nationality of the woman and by level of pregnancy risk (high vs. low). By contrast, the adjusted figures for hospitals with shortest (centres A and G) and longest (centre B) mean LoS  were 2.3 and 3.4 days respectively, among "low risk" pregnancies. The corresponding figures for "high risk" pregnancies were 2.5 days for centre A/G and 3.6 days for centre B. Therefore, the shift from "low" to "high" risk pregnancies in all three latter centres (A, B and G) increased the mean adjusted LoS just by 0.2 days. By contrast, the discrepancy between maternity centres with highest and lowest adjusted mean LoS post SVD (hospital B vs. A/G) was 1.1 days both among "low risk" (1.1 = 3.4-2.3 days) and "high risk" (1.1 = 3.6-2.5) pregnanices. Similar patterns were obseved also for IVD. Our adjusted regression models confirmed that maternity centres were the main explanatory factor for LoS after childbirth in both VDM. Therefore, health and clinical factors were less influential than practice patterns in determining LoS after VD. Hospitalization and discharge policies following childbirth in FVG should follow standardized guidelines, to be enforced at hospital level. Any prolonged LoS post VD (LoS > ED) should be reviewed and audited if need be. Primary care services within the catchment areas of the maternity centres of FVG should be improved to implement the follow up of puerperae undergoing ED after VD.

[Heart valve surgery during pregnancy. Experience with eight cases]. / Cirurgia valvar em gestantes. Experiência em oito casos.

PURPOSE: To analyze the results of the valve cardiac surgery in pregnant women and cardiopulmonary bypass consequences to the patients and their fetuses. METHODS: Study of 8 pregnant women who underwent cardiac surgery between January of 1986 and December of 1996. Patients' average age was 31.4 +/- 8.9 years and the gestation age ranged from 12 to 31 (average of 26.6 +/- 7.1) weeks. Fetus monitorization was performed in all patients. The temperature was always higher than 34 degrees C, as well as high flow rates during the cardiopulmonary bypass. Four surgeries of aortic valve and four of mitral valve were performed, in which two were reoperations. RESULTS: There was no mortality. There were two premature births and in one child there was neurological damage. The other children did not have growth problems. CONCLUSION: Valve cardiac surgery in pregnant women may have good results as long as care in the cardiopulmonary bypass and fetus monitorization are undertaken.

Telomere shortening, ageing, and chromosome damage.

A relationship between telomere shortening and ageing has been established. A series of young and elderly healthy donors. Alzheimer disease patients, young and old Down's syndrome individuals were cytogenetically analyzed. No preferential damage in distal bands was seen in age-related chromosome instability.

Alterations in replication timing of X-chromosome bands in Rett syndrome.

A cytogenetic study has been carried out on 30 girls affected with Rett syndrome, 35 of their family members and 25 unrelated healthy control females. Karyotyping at the 850 band level revealed no detectable chromosome abnormalities in either the affected girls or their families. Observations on the sequence of the appearance of early replicating bands on both the active and the inactive X-chromosome demonstrated the same replication patterns in all of the groups investigated with the exception that band Xp21 appeared with greater frequency in the Rett syndrome cells. A degree of variation was detected both between and within the subjects when the timing of the latest bands to replicate was investigated for the active X, but the same consensus order was obtained for all groups. A comparable number of elongated X-chromosomes was found in the girls with Rett syndrome (8%) when compared to their mothers (12%) when synchronized cells were treated with a short pulse of BrdU. If a disturbance in X-inactivation does contribute to the aetiology of Rett syndrome, it is at a level which is not detected by observations on the relative timing of replication of chromosome bands.

Investigation of the nucleolar organizer regions in Alzheimer's disease.

The Ag-stained nucleolus organizer regions and the satellite association (SA) were studied in peripheral lymphocyte cultures derived from 10 patients with Alzheimer's disease (AD), 10 elderly controls and 10 young controls. Our results showed a significant lower frequency of Ag staining and SA in relation to the chromosome pair 21 in the AD patient group when compared with the elderly and young control groups. These results point to a reduction in the activity of ribosomal genes in the AD patient group.

Alzheimer's disease and ageing: a chromosomal approach.

Alzheimer's disease (AD) is the most common type of dementia in elderly people. Interrelations between AD and senescence have been the subject of many studies. Some researchers have suggested that chromosomal alterations may be involved in the etiology or pathogenesis of AD. We present cytogenetic findings in patients with Alzheimer's disease, normal elderly controls and young controls. Aneuploidy, premature centromere division, polyploidy and C-anaphase, were analysed and the results suggest that the cytogenetic alterations observed are inherent to the cellular ageing process and not specifically related to Alzheimer's disease.

X-inactivation in girls with Rett syndrome.

Cytogenetic studies have been carried out on a series of nine girls with Rett syndrome, six of their mothers and nine normal female controls. No abnormality of the X-chromosome has been observed in any subject. X-inactivation studies using various methods of detecting the timing of individual band replication were performed. The overall pattern seen was essentially the same in all subjects, but in the patients with Rett syndrome there may be an alteration in the timing of the X-inactivation process in the region Xp11.3 or 4-->Xp21.

Fragile sites, Alzheimer's disease, and aging.

The fragile site expression under conditions of folate deprivation was compared in the chromosomes from 5 Alzheimer's disease (AD) female patients, 5 healthy elderly females and 5 healthy young females. Although different fragile sites were observed in the three groups, nevertheless, more similarities were found between the AD patients and elderly normal donors. The only fragile site common to all groups was 3p14. This site was the most frequent in the young donors group. In both AD and elderly control groups we observed a higher frequency of fragility in 6p21, but not in the young controls. Other interesting fragility points observed in these two groups were: 6q21 and 14q24 (in the AD patients) and 9q13, 14q24 and 17q21 (in the healthy aged). 6p21 and 17q21 have been proposed as 'new' fragile sites. We confirm the existence of these fragile sites and comment that in these bands the genes MTBT2 and MTBT1, which are microtubule (beta) associated protein tau-like and tau 1, respectively, are mapped. The tau protein is a component of paired helical filaments which accumulate in degenerating neurons in the brain of patients with AD and with less intensity of normal elderly individuals.

Lymphocyte proliferation and sister chromatid exchange in Alzheimer's disease.

Sister chromatid exchange (SCE) and lymphocyte proliferation were studied in peripheral lymphocyte cultures derived from 5 patients with Alzheimer disease (AD), 5 control elderly subjects and 5 young donors. These parameters did not differ significantly between the AD group and the elderly control group, but higher SCE frequency and less intensive proliferation were observed in the AD group and in the elderly control group when compared to the young donors.

Terminal deletion 6p23: a case report.

We report on a girl with cleft lip and cleft palate, antimongoloid slant of the palpebral fissures, umbilical hernia, skeletal anomalies, partial syndactyly, hypertonia with increased deep tendon reflexes, psychomotor and growth retardation, and other congenital anomalies. Cytogenetic studies demonstrated a 46,XX,del(6)(qter----p23:) chromosome constitution.

Investigation of the effect of hydrogen peroxide on the chromosomes of young and elderly individuals.

Active oxygen species have been considered to be responsible for the aging process and for the induction and initiation of neoplastic processes. The effect of hydrogen peroxide, an active oxygen species, was investigated in the chromosomes of three young women (20-21 years of age) and of three elderly women (73-79 years of age) in a culture medium favorable to the appearance of folate-sensitive fragile sites. Hydrogen peroxide at a final concentration of 5 X 10(-6) during the final hours of culture caused a significant increase in hypodiploidy and structural aberrations, chromatid gaps in particular, only in the cultures from the three elderly women, suggesting that the chromosomes of older women are more sensitive to this agent than those of younger women. The preferential chromosome loss in both treated and untreated cultures from the elderly women involved chromosome X. The preferential sites for structural aberrations were 9p12, a constitutive heterochromatin site and 6q21, where the gene of mitochondrial superoxide dismutase, an enzyme involved in antioxidant processes in the cell, is located. Hydrogen peroxide significantly intensified the effect naturally occurring in the cells of elderly persons, such as hypodiploidy and increased structural aberrations, thus acting at the chromosome level in a manner similar to that of the natural aging process of the organism.

Chemical studies of marine invertebrates. XXIII. A novel polyhydroxylated sterol from the soft coral Litophyton viridis (Coelenterata, Octocorallia, Alcyonacea).

The structure of 24-methylenecholest-5-en-3beta,7beta,19-triol (II) isolated from the soft coral Litophyton viridis, has been established by X-ray diffraction analysis. The compound is accompanied by its 7-monoacetate derivative.