'Guess who'? An Italian multicentric study on pigmentation traits prevalence in endometriosis localizations.

OBJECTIVES: Previous evidence seems to support the more common presence of certain pigmentation types in women with endometriosis. The aim of this study was to assess the association of certain somatic phenotypes with specific localizations of the disease. The genetic makeup of those somatic traits may will help in better define the disease pathogenesis. STUDY DESIGN: Multicentric, retrospective study of women aged 18 to 45 with histologically confirmed endometriosis. 575 patients were recruited at eleven different Italian endometriosis clinics from March 2015 to January 2021. Data regarding clinical and surgical features were recorded following the self-administered endometriosis patient questionnaire and the surgical standard of reports approved by the World Endometriosis Research Foundation (WERF). Pigmentation types/somatic phenotypes frequencies among endometriosis localizations were reported. A logistic regression analysis was performed to determine somatic types independently associated with disease' localizations. RESULTS: Having green eyes increased by ∼4 folds (OR 3.7; 95% CI: 1.42-9.61; p = 0.007) the risk of having a ureteral nodule, whereas brown/black eyes decreased this risk (OR 0.34; 95% CI: 0.13-0.87; p = 0.025). Consistently, the combination of green eyes and blonde/light brown hairs increased the odds of ureteral endometriosis by more than 5 folds (OR 5.40; 95%CI: 2.02-14.49; p = 0.001), even after correction for anthropometric confounders (aOR 5.85; 95% CI: 2.13-16.09; p < 0.001). CONCLUSIONS: The association between endometriosis and pigmentary traits has been herein confirmed, with the novel finding of the possible predisposition of ureteral endometriosis in patients with green eyes and blonde/light brown hairs. Further investigation on the genetic makeup of somatic traits may provide new inroads also into the molecular aspects of endometriosis leading to a better understanding of this complex disease.

Neurological development and iron supplementation in healthy late-preterm neonates: a randomized double-blind controlled trial.

Late-preterm infants (LPT) are at increased risk for long-term neurodevelopmental sequelae and iron deficiency. The aim of the study is to assess the positive effect of iron supplementation on psychomotor development in healthy LPT. We designed a randomized placebo-controlled double-blind trial dividing the newborns into two groups. Every patient was assessed using the Griffiths Mental Development Scales (GMDS)-II edition at 12-month post-conceptional age. The study was performed at the Neonatology Unit of our Hospital, in Italy. Sixty-six healthy LPT infants born between 340/7 and 366/7 weeks of gestational age were enrolled in the study. One group received martial prophylaxis from the third week of life to 6 months of post-conceptional age (2 mg/kg/day of iron pidolate), the other received placebo. Fifty-two of the enrolled infants were assessed using the GMDS at 12-month of post-conceptional age. Statistical analysis of the mean scores of the Griffiths subscales was performed. There was a difference in the mean developmental quotient (DQ) (p < 0.01) between the two groups: iron group mean DQ 121.45 ± 10.53 vs placebo group mean DQ 113.25 ± 9.70. Moreover, mean scores of the Griffiths subscales A, B, and D showed significant differences between the two groups (scale A p < 0.05, scale B p < 0.02, scale D p < 0.01, respectively).Conclusions: We recommend that all LPT neonates receive iron supplementation during the first 6 months of life in order to improve their 1-year neurodevelopmental quotient. What is Known: • Late-preterm infants (LPT) are at increased risk for long-term neurodevelopmental sequelae and also for iron deficiency. • Iron deficiency is an independent risk factor for adverse neurological outcomes. What is New: • Healthy late-preterm who received iron supplementation during the first 6 months of life achieved better neurological outcomes at 12-month post-conceptional age than LPT who received placebo. • Our study strongly supports the need for the implementation of martial prophylaxis in LPT neonates.

Three-dimensional assessment of restored smiling mobility after reanimation of unilateral facial palsy by triple innervation technique.

The aim of this study was to assess surgically restored facial mobility using an optical 3D instrument. Eleven patients (age range 42-76 years) with unilateral facial palsy, treated by triple innervation procedure (masseteric and partial hypoglossal reinnervation, plus double cross-face facial grafting), performed five facial animations: rest position, smiling by contracting the healthy side, clenching the teeth, and pushing the tongue against the lower incisors and Mona Lisa smiling. These were recorded by stereophotogrammetry. Sixty healthy subjects were also recorded. The 3D reconstruction of each facial expression was registered onto the rest position scan, and the root mean square (RMS) point-to-point distance between the two 3D surfaces was calculated automatically for the facial thirds. RMS values on the rehabilitated hemiface were 74.8% (upper third), 46.6% (middle third), and 54.1% (lower third) of those recorded in healthy subjects. RMS values were higher in the middle and lower thirds than in the upper third, and during smile provided by masseteric stimulus (P<0.05). The rehabilitated hemiface differed more from healthy subject values than the healthy hemiface did (P<0.05). On average, patients were more asymmetric than healthy subjects (P=0.004). The proposed method is non-invasive and non-contact, and it can quantify localized facial movements after surgical procedures.

Reliability of optical devices for three-dimensional facial anatomy description: a systematic review and meta-analysis.

The use of three-dimensional (3D) optical instruments to measure soft tissue facial characteristics is increasing, but systematic assessments of their reliability, practical use in research and clinics, outcome measurements, and advantages and limitations are not fully established. Therefore, a review of the current literature was performed on the reliability of facial anthropometric measurements obtained by 3D optical facial reproductions as compared to conventional anthropometry or other optical devices. The systematic literature search was conducted in electronic databases following the PRISMA guidelines (PROSPERO registration: CRD42018085473). Overall, 815 studies were identified, with 27 final papers included. Two meta-analyses were conducted. Tested devices included conventional cameras, laser scanning, stereophotogrammetry, and structured light. Studies measured living people or inanimate objects. Overall, the optical devices were considered reliable for the measurement of linear distances. Some caution is needed for surface assessments. All instruments are suitable for the analysis of inanimate objects, but fast scan devices should be preferred for living subjects to avoid motion artefacts in the orbital and nasolabial areas. Prior facial landmarking is suggested to improve measurement accuracy. Practical needs and economic means should direct the choice of the most appropriate instrument. Considering the increasing interest in surface-to-surface measurements, fast scan devices should be preferred, and dedicated protocols devised.

Three-dimensional superimposition for patients with facial palsy: an innovative method for assessing the success of facial reanimation procedures.

Facial palsy is a severe condition that may be ameliorated by facial reanimation, but there is no consensus about how to judge its success. In this study we aimed to test a new method for assessing facial movements based on 3-dimensional analysis of the facial surfaces. Eleven patients aged between 42 and 77 years who had recently been affected by facial palsy (onset between 6 and 18 months) were treated by an operation based on triple innervation: the masseteric to temporofacial nerve branch, 30% of the hypoglossal fibres to the cervicofacial nerve branch, and the contralateral facial nerve through two cross-face sural nerve grafts. Each patient had five stereophotogrammetric scans: at rest, smiling on the healthy side (facial stimulus), biting (masseteric stimulus), moving the tongue (hypoglossal stimulus), and corner-of-the-mouth smile (Mona Lisa). Each scan was superimposed onto the facial model of the "rest" position, and the point-to-point root mean square (RMS) value was automatically calculated on both the paralysed and the healthy side, together with an index of asymmetry. One-way and two-way ANOVA tests, respectively, were applied to verify the significance of possible differences in the RMS and asymmetry index according to the type of stimulus (p=0.0329) and side (p<0.0001). RMS differed significantly according to side between the facial stimulus and the masseteric one on the paralysed side (p=0.0316). Facial stimulus evoked the most asymmetrical movement, whereas the masseteric produced the most symmetrical expression. The method can be used for assessing facial movements after facial reanimation.

Circulating nerve growth factor level changes during oxaliplatin treatment-induced neurotoxicity in the rat.

BACKGROUND: Oxaliplatin neurotoxicity represents a clinically-relevant problem and its etio-pathogenesis is still unknown. We explored the possible role of some neuronal growth factors ("neurotrophins") during the course of oxaliplatin sensory neuronopathy. MATERIALS AND METHODS: In our rat model two different doses of oxaliplatin were used (2 and 3 mg/kg i.v. twice weekly for 9 times). The neurotoxicity of the treatment was assessed with neurophysiological and pathological methods and serum neurotrophin levels were measured by ELISA. RESULTS: Both oxaliplatin-treated groups showed the neurophysiological and neuropathological changes which mimic the chronic effects of oxaliplatin administration in humans, e.g. reversible sensory impairment due to dorsal root ganglia neuron damage. These changes were associated with a significant and dose-dependent reduction only in the circulating level of nerve growth factor (NGF), which returned to normal values after neurophysiological and pathological recovery. CONCLUSION: This specific association between neurological impairment and NGF modulation indicates that NGF impairment has a role in the neurotoxicity of oxaliplatin.

Resynchronization of blood pressure circadian rhythm after westward trans-7-meridian flight with and without melatonin treatment.

Blood pressure (BP) of a healthy 37-yr-old male traveling from Milan to Houston was monitored for 36 h before the flight and continued for 5 d after the arrival. The rhythmometric analysis of BP data was made to investigate the rate of adaptation to a rapid rest-activity cycle shift. Since two trips were evaluated, during the second one the subject took melatonin (3 mg) before the nocturnal rest. In the first trip the BP circadian rhythm synchronization occurred on the 5th day. In the second trip melatonin promoted an immediate but unstable adaptation to the new rest-activity cycle.

[An atypical case of Horton's arteritis and associated polymyalgia rheumatica]. / Un caso atipico di arterite di Horton e polimialgia reumatica associata.

The authors report a case of Horton's arteritis and associated rheumatic polymyalgia, which was complicated from a diagnostic point of view by the atypical clinical and biohumoral conditions. Both the subjective and objective symptoms were relatively unclear compared to laboratory and instrumental findings which pointed strongly to an autoimmune disorder. The coexistence of biohumoral data of a cholestatic hepatitic type, not common to other pathologies, although reported in the literature, led to further diagnostic difficulties. Diagnosis was finally confirmed by temporal artery biopsy.

[A case of deep venous thrombosis and primary amyloidosis]. / Un caso di trombosi venosa profonda e amiloidosi primaria.

On the basis of a complicated case of primary amyloidosis observed at our medical division, the clinical criteria and the biochemical and physiological supports correlated to this disease are discussed. In particular, it has been tried to make a distinction between primary and secondary amyloidosis. In this study, the clinical case of a 67-year-old man with a history of monoclonal gammopathy of uncertain significance, dizziness and syncopal episodes personally observed for a deep venous thrombosis of the inferior right limb is described. Of particular interest is the discovery of unusual resistance to anticoagulant treatment.

Blood pressure patterns in normal pregnancy and in pregnancy-induced hypertension, preeclampsia, and chronic hypertension.

OBJECTIVE: To compare the 24-hour blood pressure (BP) pattern in physiologic pregnancy, pregnancy-induced hypertension, preeclampsia, and chronic hypertension. METHODS: We investigated four groups of women with singleton pregnancy: 73 controls, 48 patients with pregnancy-induced hypertension, 38 with preeclampsia, and 53 with mild to moderate chronic hypertension. The 24-hour BP monitoring was performed longitudinally in controls and in patients with chronic hypertension, and at the time of diagnosis in those with pregnancy-induced hypertension or preeclampsia. RESULTS: Nineteen thousand eight hundred seventy-two BP measurements were analyzed. In controls, the mean values of BP indices were lower than those first reported in nonpregnant women, and the acrophase was always localized in the first part of the afternoon. In pregnancy-induced hypertension and especially in preeclampsia, besides the obvious quantitative increase in BP, circadian BP oscillations were less pronounced than in controls, and the severity of hypertension seemed to favor the loss of diurnal rhythm. Conversely, in chronic hypertension, circadian oscillations were the same as in controls. CONCLUSION: Standardized 24-hour BP monitoring during pregnancy allows quantitative and qualitative evaluations of the hypertensive status. However, if such a technique is used routinely in every clinical setting, we should establish specific thresholds of normality for pregnancy.

Morphometric evaluation of rat liver after castration: effects of testosterone.

In men and animals subject to orchiectomy, varying degrees of hypotrophy have often been observed, even involving non-reproductive organs. Liver hypotrophy appears particularly interesting in view of the metabolic alterations that could possibly ensue. We have applied the morphometric approach to the study of this kind of hypotrophy in castrated rats and in animals receiving a substitutive, testosterone-based treatment after castration. The morphometric model adopted was built on the basis of an interactive approach, using an image analyser (IBAS) with specially-designed software, and consists of number and size, as well as surface and volume fractions, of hepatocytes, their nuclei, cytoplasm, and the relevant relation to the sinusoidal bed. The effects of castration were revealed by a reduction of the mean volume of hepatocytes, associated with a reduction of the sinusoidal bed. Such reduction is correspondingly associated with an increase of the extraparenchymal components (endothelia, Glisson capsule). In the testosterone-treated group, while no appreciable symptoms of retrieval were yet observable in the volume of hepatocytes, the sinusoidal bed was instead superimposable onto the control group data as far as both volume and blood/hepatocyte interface were concerned. In the castrated animals the number of hepatocytes per mm3 was found to be increased. The group of testosterone-administered rats also showed a high level for this parameter which, associated with the spread of the capillary bed, could be compatible with a picture of precocious hyperplastic response to the therapy. The correlation between the available morphometric data and the biochemical results which are being currently sought will further clarify the meaning of this phenomenon.

The early maturation of the circadian system in newborns.

The time of maturation of the circadian periodicity in humans has been differently considered. The present study aimed to investigate the existence of rhythmic variations in the body temperature of healthy full-term infants just after birth. We studied 19 healthy term newborns, nursed in their cribs at environment temperature of 25 degrees C and moderately dimmed artificial lighting during the night. Continuous recording of body temperature was performed with a solid memory recorder (Fiamarker) connected to a disposable rectal probe, during the first three days of life. Data were analyzed by means of single and mean cosinor methods and spectral analysis. All the newborns, except two, demonstrated a statistically significant circadian periodicity of temperature (p < .001). Acrophases were distributed along the 24h since the synchronization to environment was not yet completed. A clear ultradian fluctuation of body temperature was observed in all 19 newborns with an unexpected fall of temperature every three-four hours. Our data show that the maturation of the circadian system is probably almost complete in newborns, but the adjustment to the new environment can be expected in the subsequent weeks of life.

Circadian rhythmicity in the rat exocrine pancreas: chronomorphological patterns.

Circadian rhythmicity of the structural morphometric model of rat endocrine pancreas has been studied in 24 Wistar female rats, four months old, kept in LD 12:12. The following parameters were evaluated: the volume fractions of nucleus and cytoplasm of exocrine cells, the size distribution and number in unit tissue volume of acinar cell nuclei, the mean nuclear diameter, the shape coefficient of glandular acini (that is the ratio acinar area/perimeter2 which indicates the shifting of structures from circularity). A statistically significant circadian rhythm was demonstrated for the shape coefficient of glandular acini. Results obtained in the present experiment are compared with data recorded in a previous study.

A chronomorphological structural model of rat thyroid gland.

Circadian rhythmicity of the structural morphometric model of thyroid has been studied in 36 Wistar rats kept in LD 12:12. The parameters evaluated are: a. the volume fraction occupied by: 1. follicle epithelium, 2. colloid, 3. interstitium at 6 time points in 24h; b. the follicle size distribution; c. the number of follicles per unit tissue volume. The circadian rhythms of mean follicular diameter and of follicular cavity mean diameter have been demonstrated (p less than 0.03 and p less than 0.01 respectively) and show overlapping acrophases of -120 degrees (-64 degrees/-176 degrees) and -108 degrees (-99 degrees/-116 degrees). The synchronization between rhythms, shown for mean follicular diameter and for follicular cavity mean diameter, suggests a rhythmical pulsation of the whole follicle, while the thickness of the follicular epithelium does not undergo a statistically significant periodic variation.

Yeast-derived hepatitis B vaccine in thalassaemic patients: a preliminary report.

Preliminary results of a trial involving a yeast-derived hepatitis B vaccine administered to 41 transfusion-dependent thalassaemic patients and 2 patients with spherocytosis are reported. Twenty-microgram doses of HBsAg were administered according to either a 0, 1, and 6 month or 0, 1, and 2 month schedule. Serum specimens collected prior to vaccination, one month after each vaccine dose, and again at 5 and 15 months, were tested for HBV markers and ALT. To date, seroconversion (anti-HBs titres greater than 10 IU/l) was observed in 15%, 67%, and 86% of patients one month following the three vaccine doses, respectively. Although the study is still in progress, a comparison of these results with those previously obtained using plasma-derived vaccine indicates that seroconversion to the recombinant yeast-derived vaccine is at least as high as that obtained by plasma-derived vaccines in patients affected by thalassaemia major.

Polyclonal lymphadenopathy presenting as plasma cell leukemia with reversible renal insufficiency.

A case is reported of an elderly patient with generalized lymphadenopathy who, at presentation, showed a blood and bone marrow picture suggestive of plasma cell leukemia, polyclonal hypergammaglobulinemia restricted almost exclusively to IgA, and severe renal insufficiency. Treatment with melphalan and prednisone produced a complete remission that lasted only 1 month. A second partial remission was obtained, but the patient eventually died of heart failure. The pathological picture of the lymph nodes and spleen was intermediate between that of angioimmunoblastic lymphadenopathy (AIL) and of the plasma cell type of giant lymph node hyperplasia (Castleman's disease). The hypothesis is presented that AIL, Castleman's disease and many other polyclonal lymphadenopathies recently described in immunodeficient or elderly patients, including the present case, represent a continuous spectrum of lymphoproliferative disorders due to abnormal responses to various stimuli.

[Therapy of bronchospasmic crisis of childhood with aminophylline]. / Terapia delle crisi broncospastiche dell'infanzia con aminofillina.

We tested a new product containing aminophylline with 1,56% alcohol as therapy of bronchospasm in childhood to evaluate therapeutic activity, tolerance and adverse reactions. Authors confirm the usefulness of this product in childhood but dosage must be individualized with monitoring of theophylline blood levels.