•Frequency of sexual behavior lessens during pregnancy, dips in third trimester.•Sexual activity begins 6-8 weeks post childbirth, fully resumes only after 6 months.•Perinatal couples experience less ...desire, orgasm, satisfaction; more dyspareunia.•Perinatal couples must be alerted to possibility of fluctuations in their sex life.
In the time of transition to parenthood, many physical, psychological and social changes may affect the multidimensional theme of sexuality. This area plays a significant role in the overall well-being of the individual, the couple and the family. The aim of this systematic review is to consider current and emerging trends in the study of sexual function during pregnancy and after childbirth, evaluating the available evidence in the literature reported in specific reviews, and pulling together the suggestions that various authors have brought forward as being useful for daily clinical practice. A total of 4 databases were searched on EBSCOhost: MEDLINE, Cochrane reviews, CINAHAL, and PsychInfo. A systematic search strategy was formulated using the key terms Sexuality, Sexual, Pregnancy, Postpartum, Puerperium, Perinatal, and Review. Eleven articles were included. The results revealed a gradual decline in the frequency of sexual behaviour throughout pregnancy, sharper in the third trimester. Sexual activity started to be resumed around 6–8 weeks after childbirth, to fully recover only after 6 months. A simultaneous change in sexual function was also found, such as less orgasm, sexual desire and satisfaction, more dyspareunia. Many aspects are related to these changes: physical, psychological and social factors, fears about negative consequences of sexual intercourse, inadequate or absent professional counselling about sexuality, method of delivery and breastfeeding. Healthcare professionals need to adequately inform couples about the common fluctuations in sexual activity, interest, desire, and responsiveness over the course of the pregnancy and following childbirth. Joint counselling, if possible, is preferred.
Display omitted
•The cytokine storm present in COVID-19 patients induces, together with the imbalance of endothelial functions, a massive cell activation with production of tissue factor, mainly by ...platelets, granulocytes, and MVs.•Plasma MV-associated thrombin generation is present in patients despite prophylactic anticoagulation.•COVID-19 plasma, added to the blood of healthy subjects, induces platelet activation similar to what is observed in vivo. This effect is blunted by pre-incubation with tocilizumab, giving insights into the IL-6–mediated platelet activation that triggers the hypercoagulable state in COVID-19, suggesting the potential effectiveness of anti–IL-6 antibodies and antiplatelet drugs.•Our data provide the bench-to-clinic rationale behind the ongoing clinical trial assessing the potential effectiveness of antiplatelet drugs and IL-6R antagonists in the treatment of COVID-19 patients.
The authors hypothesized that the cytokine storm described in COVID-19 patients may lead to consistent cell-based tissue factor (TF)-mediated activation of coagulation, procoagulant microvesicles (MVs) release, and massive platelet activation. COVID-19 patients have higher levels of TF+ platelets, TF+ granulocytes, and TF+ MVs than healthy subjects and coronary artery disease patients. Plasma MV-associated thrombin generation is present in prophylactic anticoagulated patients. A sustained platelet activation in terms of P-selectin expression and platelet–leukocyte aggregate formation, and altered nitric oxide/prostacyclin synthesis are also observed. COVID-19 plasma, added to the blood of healthy subjects, induces platelet activation similar to that observed in vivo. This effect was blunted by pre-incubation with tocilizumab, aspirin, or a P2Y12 inhibitor.
Choroidal localization from non-small cell lung cancer is rare and when it occurs may cause visual alterations. Targeted therapy against actionable gene mutations represents the standard of care in ...advanced non-small cell lung cancer. We report the case of a 53-year-old woman affected by metastatic anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer who received ALK tyrosine kinase inhibitors, from January 2017. The patient had a complete response of choroidal metastasis after therapy with ALK tyrosine kinase inhibitors. She recovered a complete visus and actually she still continue therapy with alectinib. The patient had a complete recovery of visus in addiction to a long response on treatment.
Laryngopharyngeal reflux (LPR) is a frequent condition in Obstructive Sleep Apnoea (OSA) patients and different studies have been published in the last years about this topic. A review of the ...published literature regarding LPR in OSA patients has been reported. A meta-analysis to evaluate the incidence of LPR in OSA patients and correlate LPR positivity with OSA patients' characteristics has been performed.
A comprehensive review of the English language literature about LPR in OSA patients was performed using the most important electronic databases (PubMed, EMBASE, the Cochrane Library etc.). A total of 10 papers studying LPR in OSA were assessed and considered eligible for the meta-analysis.
The data analysis regarding 870 identified OSA patients showed that 394 patients were LPR +, while 476 were LPR-. The meta-analysis showed no statistical difference regarding the AHI value between LPR + patients and LPR- patients (p = 0,3). Mean BMI was more higher in LPR + patients than in the patients without LPR, showing a significant statistical difference (p = 0.001).
Current international literature demonstrates a high incidence of LPR (45.2%) in OSA patients. The severity of AHI in OSA patients would not seem to correlate with the presence of laryngopharyngeal reflux. The OSA patients with LPR showed a higher BMI compared with LPR- patients.
PDF
