Abstract Background and aims Gestational diabetes mellitus (GDM), is characterized by chronic, low-grade subclinical inflammation with altered production of cytokines and mediators. Recently, a new ...protein acting as a “danger signal”, high mobility group box 1 (HMGB1), that migrates quickly during electrophoresis, has been identified. The aim of our study was to analyse serum levels of HMGB1 in pregnant women, with or without GDM, in the third trimester of pregnancy to evaluate correlation with insulin resistance and other risk factors for GDM. Methods and results Seventy five pregnant women positive to the 75 g oral glucose tolerance test (OGTT) were included in the study group and 48 pregnant women who were negative to the screening test, were randomly selected using a computer-generated randomisation table. A significant positive univariate correlation was observed between serum HMGB1 levels, HOMA-IR index, glycaemia values at OGTT and pre-pregnancy BMI. Moreover, logistic regression analysis showed that serum HMGB1 was independent linked to GDM. Conclusion Our study demonstrated that HMGB1, a marker of chronic inflammation, is associated to GDM and insulin resistance level, in the third trimester of pregnancy.
Ovarian cancer is one of the most frequent solid tumor that shows clearly biphasic behaviour in response to chemotherapy, with the majority of patients who achieved complete remission after the first ...cycle of chemotherapy, and subsequently present a relapse which, in most cases, leads to death. Epithelial ovarian cancer (EOC) arises as a consequence of genetic alterations that affect the cells of the ovarian surface, which leads to changes that occur through the activation of oncogenes and inactivation of tumor suppressor genes. The progression of EOC is characterized by a series of combined epigenetic aberrations, including the most important of those determined by the loss of methylation of certain regions of DNA encoding genes such as Ras-association domain-containing family 1 (RASSF1A) tumor suppressor, death-associated protein kinase (DAPK) protein kinase associated with the regulation of apoptosis, human sulfa- tase-I (hSulf-1) sulfatase, which plays a key role in the regulation of apoptosis, breast cancer 1 gene (BRCA1) tumor suppressor gene, involved in the processes of DNA repair, and HOXAI0 (gene required to promote many transcription factors). To date, accumulating evidence suggests that the initial clinical response is due primarily to the therapeutic efficacy of chemotherapy against differentiated can- cer cells that constitute the bulk of the tumor, whereas the high rate of recurrence is thought to be due to remaining drug-resistant cells, biologically distinct, identified as cancer stem cells (CSC). Current efforts are focusing on genetic and cytological definition of CSC, to guide the development of new diagnostic, and therapeutic perspectives.
Abstract
Obesity is associated with an increased risk of an adverse pregnancy outcome. The aim of this study was to analyze the serum levels of high mobility group protein B1 (HMGB1) in obese ...pregnant women, to assess the role of this protein in the pathogenesis of this disease and to evaluate its possible function as a diagnostic marker for obesity-related complications in obese women.
Study participants were randomly selected, from a cohort of pregnant women afferent to our department. A total of 120 women were enrolled in this study: 60 pregnant women had normal body mass index (BMI) and 60 women resulted obese. Pre-pregnancy BMI, weight increase and HMGB1 levels were evaluated for each pregnant woman enrolled. Matching serum HMGB1 levels in two groups, our data evidenced higher levels in the obese women, with a statistically significant difference (p = 0.0023). A significant positive univariate correlation was observed between serum HMGB1 levels and BMI in obese women. HMGB1 serum levels may therefore represent a predictive marker of disease in pregnant women (r = 20.9 and p = 0.0001). Further studies are needed in order to validate the role of this cytokine, with the aim of making it possible to use in clinical practice not only for diagnostic purposes, but especially for the early recognition of complications related to it.
Chinese abstract
肥胖与不良妊娠结局风险的升高相关。本研究的目的在于分析妊娠女性血清中高速泳动族蛋白族蛋白B1（HMGB1）水平，评估此蛋白与肥胖发病机制的相关性，判断其作为肥胖女性的肥胖相关并发症诊断标志物的可能性。
本研究受试者从我科室就诊的妊娠女性中随机抽取。研究共纳入120名女性：60名身体质量指数（BMI）正常的妊娠女性，60名肥胖妊娠女性。研究评估了每名受试者妊娠前BMI、体重增加情况及HMGB1水平。研究将血清HMGB1水平匹配为2组，数据表明肥胖组HMGB1水平更高，差异有统计学意义（p = 0.0023）。肥胖组血清HMGB1水平与BMI之间存在显著单变量相关性。因此，血清HMGB1水平也许可以作为预测妊娠女性相关疾病的指标（r = 20.9, p = 0.0001）。关于该细胞因子的作用还需进一步研究证实，进而使其在临床上不仅用于诊断肥胖这一疾病，还可用于识别早期相关并发症。
To report the incidence and the major risk factors (RFs) associated with preterm birth (PTB), combining both maternal RFs and cervical length (CL), and to understand if cervical length measurement is ...really useful in all the patients.
The study population consisted of 2048 women admitted to the Department of Obstetrics and Gynecology, University Hospital of Messina, over a 2-year period. Preterm cases represented approximately 8.64% of our total population and, exactly, 65% were late preterm, 32% were preterm, and 3% were extremely preterm.
An analysis of PTB sub-categories based on gestational age showed a stronger correlation between gestational age and CL among preterm and extremely preterm, while no correlation was found among late preterm. Between preterm cases and controls, there was a significant difference in pre-pregnancy weight and Body Mass Index (BMI). Moreover, a significant association between PTB and uterine anomalies, poli-oligodramnios and hypertension was found.
We strongly suggest adding a transvaginal ultrasound CL universal screening to all pregnant women at the time of the second trimester ultrasound. We encourage further studies to identify new RFs of PTB and to define the mechanisms by which risk factors are related to PTB.
Voluntary interruption of pregnancy (VIP) is one of the most frequent healthcare procedures in the world and a Public Health concern in many countries, especially after liberalization of the abortion ...laws. The study has been carried out to identify the factors that still influence a fraction of female population towards abortion in the absence of fetal malformations.
We conducted a cross-sectional study in the period 2012-2016. The survey was carried out on all VIPs performed at the Gynecology and Obstetrics Unit of the University Hospital "G. Martino" in Messina, Italy.
The analyzed sample consisted of 1131 women, aged between 16 and 50 years. Only 4% of VIPs was due to a diagnosis of fetal malformation. In relation to the presence or absence of fetal malformations as the possible reason for VIP, the sample was split up into two groups and the socio-demographic characteristics were considered. VIPs in the absence of malformations were significantly more frequent in younger women with a lower educational level, in unmarried and unemployed women and in women who already had children. These results were confirmed to Pearson test that indicated that all these variables were related to VIP in the absence of malformations.
Based on our results, it is crucial to further prevent requests for VIPs through information and sex education programs for adolescents in schools and consultants, and responsible procreation promotion programs.
Struma ovarii is an uncommon type of ovarian tumor derived by germinal cells, characterized by the predominance of thyroid tissue (> 50%); 90-95% of these formations are benign and mainly affect the ...left ovary, while in 6% of the cases struma ovarii is bilateral. The malignant transformation is a rare condition that often occurs after 50 years. In most instances, diagnosis of malignant struma ovarii is made postoperatively during histological analysis. This tumor appears to derive by one germinal cell through loss of heterozygosity of the androgen receptor gene and of the X chromosome. Clinical symptoms comprise abdominopelvic mass, lower abdominal pain, abnormal vaginal bleeding, and ascites (the occurrence of this condition has been observed in one-third of the cases). The patients with struma ovarii generally do not manifest symptoms related to thyroid hyperfunction, reported only in 8% of the cases, and due to hyperstimulation of the thyroid by auto-antibodies. Thyroid tissue of the struma ovarii, often embedded in a teratoma, may be papillary, follicular or with mixed pattern and it can include elements of mucinous cystoadenomas, Brenner's tumor or carcinoid or melanomas cells. Here the authors report their experience with an unusual case of Hashimoto thyroiditis onset after laparoscopic removal of struma ovarii.
Purpose
Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic pain syndrome and a chronic inflammatory condition prevalent in women that leads to urgency, sleep disruption, nocturia ...and pain in the pelvic area, to the detriment of the sufferer’s quality of life. The aim of this review is to highlight the newest diagnostic strategies and potential therapeutic techniques.
Methods
A comprehensive literature review was performed on MEDLINE, PubMed, and Cochrane databases gathering all literature about “Interstitial cystitis” and “Painful Bladder Syndrome”. Visual analogue scales, epidemiological strategies, pain questionnaires and similar techniques were not included in this literature survey.
Results
The etiology, exact diagnosis and epidemiology of IC/PBS are still not clearly understood. To date, its prevalence is estimated to be in the range of 45 per 100,000 women and 8 per 100,000 men, whereas joint prevalence in both sexes is 10.6 cases per 100,000. There are no “gold standards” in the diagnosis or detection of IC/PBS, therefore, several etiological theories were investigated, such as permeability, glycosaminoglycans, mast cell, infection and neuroendocrine theory to find new diagnostic strategies and potential biomarkers.
Conclusion
Due to the fact that this disease is of an intricate nature, and that many of its symptoms overlap with other concomitant diseases, it could be suggested to classify the patients with emphasis on the phenotype, as well as their symptom clusters, to tailor the diagnostic and management choices according to the observed biomarkers.
