ABSTRACT
BACKGROUND: In case of suspicious CTG in labor a conservative attitude is recommended, when possible, through intrauterine resuscitation maneuvers. AIMS: This study aims to evaluate the use of intrauterine resuscitation maneuvers (IRM) at two Italian hospitals; the secondary outcome is the assessment of the agreement in their application. MATERIALS AND METHODS: Retrospective analysis was performed on the data of 80 deliveries (40 vs 40) from two different Italian hospitals, located in Novara (group 1) and in Borgomanero (group 2). In order to evaluate a varied series of CTG traces (normal and pathological), we randomly extracted 13 cases of neonatal asphyxia (2015-2020). The normal CTG traces were identified among the deliveries of the same day of these cases, in a ratio of 1: 4. One gynecologist and one midwife for the group 1 and one other gynecologist and one midwife for the group 2 were given a file with anonymous patient's clinical data, and the CTG registered during labor. Then, they classified the CTG trace, and they stated what they would have done if they had been present. RESULTS: Maternal position was changed for 58 patients, especially in group 2 (25/40 vs 33/40) (p = 0.046). Intravenous fluid administration was performed for 35 patients, more in group 2 (8/40 vs 27/40) (p < 0.001). Oxytocin was used for 21/80 patients: in 7/21 cases were discontinued (p = 0.241). Clark's test was used only in 2 cases, in group 2. No one used tocolysis, oxygen, or amnioinfusion. The concordance rate among operators showed poor agreement regarding the use of IRM, group 2 showed increased general concordance rates. CONCLUSIONS: The use of IRM in labor is recommended but underused and with poor concordance rate in the application, based on our results.
Subject(s)
Asphyxia Neonatorum , Cardiotocography , Asphyxia Neonatorum/complications , Asphyxia Neonatorum/therapy , Cardiotocography/methods , Delivery Rooms , Female , Heart Rate, Fetal , Humans , Infant, Newborn , Pregnancy , Retrospective StudiesABSTRACT
Lipofilling is becoming part of the breast reshaping after quadrantectomy or mastectomy in breast cancer patients, but there are open questions of its safety.
Subject(s)
Adipose Tissue, White/transplantation , Breast Neoplasms/surgery , Mammaplasty/adverse effects , Neoplasm Recurrence, Local/etiology , Breast Neoplasms/pathology , Female , Humans , Mammaplasty/methods , Mastectomy/methods , Treatment OutcomeABSTRACT
Endometriosis, defined as the presence of endometrial tissue outside the uterus, is a common gynecological disease with poorly understood pathogenesis. MicroRNAs are members of a class of small noncoding RNA molecules that have a critical role in posttranscriptional regulation of gene expression by repression of target mRNAs translation. We assessed differentially expressed microRNAs in ectopic endometrium compared with eutopic endometrium in 3 patients through microarray analysis. We identified 50 microRNAs differentially expressed and the differential expression of five microRNAs was validated by real-time RT-PCR in other 13 patients. We identified in silico their predicted targets, several of which match the genes that have been identified to be differentially expressed in ectopic versus eutopic endometrium in studies of gene expression. A functional analysis of the predicted targets indicates that several of these are involved in molecular pathways implicated in endometriosis, thus strengthening the hypothesis of the role of microRNAs in this pathology.
