In recent years, a growing interest has arisen regarding the possible relationship between adverse pregnancy outcomes (APOs) and inadequate maternal hemodynamic adaptations to the pregnancy. A ...possible association between “placental syndromes,” such as preeclampsia (PE) and fetal growth restriction (FGR), and subsequent maternal cardiovascular diseases (CVD) later in life has been reported. The two subtypes of FGR show different pathogenetic and clinical features. Defective placentation, due to a poor trophoblastic invasion of the maternal spiral arteries, is believed to play a central role in the pathogenesis of early-onset PE and FGR. Since placental functioning is dependent on the maternal cardiovascular system, a pre-existent or subsequent cardiovascular impairment may play a key role in the pathogenesis of early-onset FGR. Late FGR does not seem to be determined by a primary abnormal placentation in the first trimester. The pathological pathway of late-onset FGR may be due to a primary maternal cardiovascular maladaptation: CV system shows a flat profile and remains similar to those of non-pregnant women. Since the second trimester, when the placenta is already developed and increases its functional request, a hypovolemic state could lead to placental hypoperfusion and to an altered maturation of the placental villous tree and therefore to an altered fetal growth. Thus, this review focalizes on the possible relationship between maternal cardiac function and placentation in the development of both early and late-onset FGR. A better understanding of maternal hemodynamics in pregnancies complicated by FGR could bring various benefits in clinical practice, improving screening and therapeutic tools.
A cylindrical hydrogel tube, completely submerged in water, hydrates by swelling and filling its internal cavity. When it comes back into contact with air, it dehydrates: the tube thus expels the ...solvent through the walls, shrinking. This dehydration process causes a depression in the tube cavity, which can lead to circumferential buckling. Here we study the occurrence of such buckling using a continuous model that combines nonlinear elasticity with Flory–Rehner theory, to take into account both the large deformations and the active behaviour of the hydrogel. In quasi-static approximation, we use the incremental deformation formalism, extended to the chemo-mechanical equations, to determine the threshold value of the enclosed volume at which buckling is triggered. This critical value is found to depend on the shell thickness, chemical potential and constitutive features. The results obtained are in good agreement with the results of the finite element simulations of the complete dynamic problem.
Background and purpose
Recognizing stroke symptoms and acting quickly can reduce death and disability, but public awareness of stroke risk factors, symptoms and what to do about them is still ...limited. Stroke educational campaigns are used worldwide but there are few published evaluations of such campaigns.
Methods
The literature from 1999 to 2012 on the effectiveness of stroke educational campaigns was reviewed and summarized with narrative synthesis. Web‐based campaigns were also described. Three databases and one search engine were explored with two keywords (stroke campaign and stroke promotion). The reference lists of all included articles were also examined.
Results
Twenty‐two intervention studies and five web‐based campaigns were included in the review. Most interventions proved partially effective, in terms of gender preference (women) or type of information retained or media preferred. Only one intervention proved ineffective. Mass media campaigns can be effective but require sustained funding, and their ability to target high‐risk subgroups, whether aging, linguistic or socioeconomic, is unclear. Three community‐based participatory stroke promotion interventions proved partially effective, but the small sample sizes might have underpowered the results. Web‐based campaigns are efficient in reaching a large number of people but tend to attract a selected and self‐selected population.
Conclusions
Stroke educational campaigns have the potential to improve knowledge and awareness and change the behavior of a large number of people. Health promoters and investigators must adopt flexibility and participatory mentality to develop cost‐effective interventions. Both community‐based campaigns and E‐tools should be integrated within a comprehensive multifaceted stroke promotion strategy to expand their reach.
A case series of young stroke in Rome Rasura, M.; Spalloni, A.; Ferrari, M. ...
European journal of neurology,
02/2006, Volume:
13, Issue:
2
Journal Article
Peer reviewed
In this hospital case series study we enrolled 394 consecutive ischemic stroke patients aged 14–47 years, all of whom were submitted to a diagnostic protocol. We evaluated the incidence of cerebral ...ischemia in young adults, as well as the risk factors and the etiopathogenesis of this pathology. Modified diagnostic criteria adopted from the TOAST and Baltimore–Washington Cooperative Young Stroke Study were used for the etiologic classification. The crude annual incidence rate was 8.8/100 000 (95% CI 7.7–9.9), which is in keeping with the rates reported in comparable registries. Risk factors were distributed as follows: smoking in 56% of patients, hypertension in 23%, dyslipidemia in 15%, migraine in 26%, and diabetes mellitus in 2%. Oral contraceptives were being taken by 38% of the women enrolled. The etiology of stroke in the patients was as follows: cardioembolism in 34%, atherothrombosis in 12%, non‐atherosclerotic vasculopathies in 14% (including arterial dissection in 12%), other determined causes in 13%, lacunar stroke in 2.5%, migraine in 1%, and undetermined causes in 24%. Despite its biased sampling frame, this large hospital case series, in which risk factor distribution and etiopathogenesis were investigated, stresses the need for an adequate diagnostic approach in young ischemic patients.
To counteract the arising problem of couple infertility, having good quality gametes is increasingly important. A molecule that seems to be useful to favor this condition is myo-inositol (MI), the ...most common stereoisomer of the inositol family, involved as second messenger in several cell pathways (osmoregulation, chromatin remodeling, gene expression, etc.). To evaluate this possibility, a treatment with myo-inositol in idiopathic infertile couples was performed in this randomized, placebo-controlled study.
86 couples were enrolled and randomly assigned to two groups, treated either with MI (Xyminal®, Lo.Li. Pharma Srl, Rome, Italy) or placebo suppositories, to evaluate the effects on sperm motility, cervical mucus quality and pregnancy rate. Moreover, in pregnancy cases, all routine controls on gestation progress and foetal health were performed to confirm the safety of this treatment.
As showed in this study, MI treatment allows an increase of total sperm motility (54.42 ± 8.72) in comparison to placebo group (46.21 ± 5.33). Moreover, MI mildly improves cervical mucus quality and increases the number of pregnancies (18.60%) in comparison to the placebo group (6.97%).
MI improves sperm motility and cervical mucus quality, increasing the probability of conception. The absence of adverse events both for the mother and the foetus confirmed the safety of this molecule in pregnancy, supporting even more its use for couples seeking pregnancy.
The aim of the study is to investigate the efficacy of a treatment with myoinositol plus L-tyrosine, selenium, and chromium in women with polycystic ovarian syndrome (PCOS).
One hundred and ...eighty-six women, with diagnosis of PCOS, were divided in four groups according to their clinical features. Phenotype A: androgen excess + ovulatory dysfunction + polycystic ovarian morphology. Phenotype B: androgen excess + ovulatory dysfunction. Phenotype C: androgen excess + polycystic ovarian morphology. Phenotype D: ovulatory dysfunction + polycystic ovarian morphology. All patients were given daily for six months a compound with 2 g myo-inositol, 0.5 mg L-Tyrosine, 0.2 mg folic acid, 55 mcg selenium, 40 mcg chromium. Hormonal assessment, BMI, Ferriman-Gallway Gallway score, HOMA index, and follicular monitoring were reported before starting the therapy, three months and six months after.
Phenotype A showed an improvement, consistent with restored ovulation: more regular length of the menstrual cycle, detection of periovulatory follicle at ultrasound, and rising of progesterone in the luteal phase. A total of 45 patients (65.2%) ovulated after six months. In the same period glucose and HOMA index decreased. In the phenotype B, 80% of patients ovulated after six months. An improvement of the clinical and biochemical sign of hyperandrogenism was also reported. In the phenotype C, after BMI had followed the treatment for six months, it decreased in a statistically significant manner. In the phenotype D, 49 out of 82 women (59.7%) restored their regular menstrual period and ovulated.
Our study reported how the synergistic action of myoinositol, L-tyrosine, selenium, and chromium could restore normal menstrual cycle, ovulation, and decrease weight in these patients.
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