A comparison of the prevalence of chronic endometritis determined by the use of different diagnostic methods in women with and without reproductive failure

Objective: To compare the prevalence of chronic endometritis (CE) when different diagnostic methods are used. Design: Prospective observational study. Setting: University affiliated hospital. Patient(s): Four groups of women were studied, including women with proven fertility (Fertile, n=40), unexplained recurrent miscarriage (RM, n=93), recurrent implantation failure (RIF, n=39) and infertile subjects undergoing endometrial scratch in a natural cycle preceding frozen-thawed embryo transfer (Infertility, n=48). Intervention(s): Endometrial biopsy was performed precisely seven days following LH surge (LH+7). Plasma cells were identified by traditional H&E staining and immunohistochemistry (IHC) for Syndecan-1(CD138). Main Outcome Measure(s): The prevalence of chronic endometritis. Result(s): The use of CD138 epitope is more sensitive than H&E staining in identifying plasma cells. The use of plasma cell count per unit area had the lowest observer variability than that of cell count per 10 randomly chosen HPF or cell count per section. Using this method, the prevalence of CE in women with RM, RIF and Infertility were 10.8%, 7.7%, and 10.4%, respectively, not significantly higher than that of fertile subjects (5.0%). Conclusion(s): Using what may be a new method of plasma cell assessment, it appears that the prevalence rates of CE reported in many earlier studies may have been over-estimate

The Italian Treasury Econometric Model (ITEM)

In this paper, we provide a description of the Italian Treasury Econometric Model (ITEM). We illustrate its general structure and model properties, especially with regard to the economy's response to changes in policy and in other dimensions of the economic environment. The model has a quarterly frequency and includes 371 variables. Out of these, 124 are exogenous and 247 endogenous. The model structure features 36 behavioral equations and 211 identities. One of the key features of the model is the joint representation of the economic environment on both the demand and the supply side. Since it is designed for the needs of a Treasury Department, its public finance section is developed in great detail, both on the expenditure and revenue side. It also features a complete modeling of financial assets and liabilities of each institutional sector. After documenting the model structure and the estimation results, we turn to the outcomes of model simulation and ascertain the model properties. In ITEM the shocks that generate permanent effects on output are associated with: a) variation of variables that affect the tax wedge in the labor market and the user cost of capital; b) labor supply change; c) variation in the trend component of TFP (technical progress). By contrast, variables that exert their effects on the demand side have only temporary effects on output. We also perform in-sample dynamic simulation of the model. This allows us to derive simulated values of all the endogenous variables which can be compared with the corresponding actual values. This allows us to appraise, for each aggregate, whether the simulated values track the observed data.Macroeconometric models; Economic Policy

Metaplasia ossea diagnosticata su leiomioma uterino

Riportiamo un caso di metaplasia ossea in un leiomioma uterino scoperto casualmente in una donna di 53 anni operata di isterectomia totale per una neoformazione annessial

Chronic endometritis and altered embryo implantation: a unified pathophysiological theory from a literature systematic review

Purpose: Chronic endometritis (CE) is a frequent hysteroscopic and histological finding which affects embryo transfer implantation during IVF-ICSI cycles. In particular, CE impairs proper decidualization and, subsequently, implantation. Although this correlation has been clearly clarified, a pathophysiological explanation assembling all the studies performed has not been elucidated yet. For this reason, we have structured a systematic review considering all the original articles that evaluated a pathological element involved in CE and implantation impairment. Methods: The authors searched electronic databases and, after screening, collected 15 original articles. These were fully scanned and used to create a summary pathway. Results: CE is primarily caused by infections, which lead to a specific cytokine and leukocyte pattern in order to prepare the uterus to fight the noxa. In particular, the immunosuppression requested for a proper semi-allogenic embryo transfer implantation is converted into an immunoreaction, which hampers correct embryo implantation. Moreover, endometrial vascularization is affected and both irregular vessel density and luminal thickening and thrombosis reduce what we have first identified as endometrial flow reserve. Finally, incorrect uterine wave propagation could affect embryo contact with decidua. Conclusion: This is the first summary of evidence on CE pathophysiology and its relationship with infertility. Understanding the CE pathophysiology could improve our knowledge in embryo transfer success

Prevalence and Causes of Vision Loss in High-Income Countries and in Eastern and Central Europe in 2015: Magnitude, Temporal Trends, and Projections

Background: Within a surveillance of the prevalence and causes of vision impairment in high-income regions and Central/Eastern Europe, we update figures through 2015 and forecast expected values in 2020. Methods: Based on a systematic review of medical literature, prevalence of blindness, moderate and severe vision impairment (MSVI), mild vision impairment and presbyopia were estimated for 1990, 2010, 2015, and 2020. Results: Age-standardized prevalence of blindness and MSVI for all ages decreased from 1990 to 2015 from 0.26% (0.10-0.46) to 0.15% (0.06-0.26), and from 1.74% (0.76-2.94) to 1.27% (0.55-2.17), respectively. In 2015, the number of individuals affected by blindness, MSVI and mild vision impairment ranged from 70,000, 630,000 and 610,000, respectively, in Australasia to 980,000, 7.46 million and 7.25 million, respectively, in North America and 1.16 million, 9.61 million and 9.47 million in Western Europe. In 2015, cataract was the most common cause for blindness, followed by age-related macular degeneration (AMD), glaucoma, uncorrected refractive error, diabetic retinopathy, and cornea-related disorders, with declining burden from cataract and AMD over time. Uncorrected refractive error was the leading cause of MSVI. Conclusions: While continuing to advance control of cataract and AMD as the leading causes of blindness remains a high priority, overcoming barriers to uptake of refractive error services would address approximately half of the MSVI burden. New data on burden of presbyopia identify this entity as an important public health problem in this population. Additional research on better treatments, better implementation with existing tools and ongoing surveillance of the problem are needed

Peri-Conceptional Intake of Folic Acid Supplement to Date: A Medical-Legal Issue

Folic Acid (FA) supplementation during pregnancy represents a so widespread and established recommendation all over the world, to be taken for granted sometimes. As a matter of fact, this vitamin supplement is worldwide recommended mostly during peri-conceptional period for its proved preventive effect on Neural Tubal Defects (NTDs), like spina bifida. However, The biological and clinical potential of FA is reassessing and this represents a hot topic in scientific community, mostly in consideration of the possible medical-legal implications. An overview is mandatory in order to keep in mind FA-related possibl

Dynamic crosstalk within the tumor microenvironment of uterine cervical carcinoma: baseline network, iatrogenic alterations, and translational implications.

Uterine cervical cancer is the fourth most frequent gynecological tumor worldwide. The tumor microenvironment of cervical cancer is the result of persistent high-risk human papillomavirus infection together with stromal activation of estrogen receptor alpha and the pro-angiogenic and pro-inflammatory activity of immune cells, mainly T-helper 17 cells and tumor-associated macrophages. Therapeutic management (e.g., immunotherapy, especially in advanced cases) may be influenced by the translational implications of tumoral stroma crosstalk and an abundance of tumor-infiltrating lymphocytes within the tumor microenvironment. The prognosis of cervical cancer is inversely correlated with microvessel density, making anti-angiogenic strategies with agents such as bevacizumab crucial for improving both progression-free survival and overall survival in patients with advanced and recurrent tumors

La verdadera tragedia de la existencia humana según la estética de Thomas Ligotti

This article is dedicated to presenting the Ligotti’s bio-bibliographic trajectory, a highly recognized author in the US, in which the main biographical facts and narrative works that have marked his literary production will be noted. In addition, the labels ("Metaphysical", "Philosophical", "Pessimistic", "Nihilistic", among others) that have been given to Ligotti to define his narrative, whose center of study is the misfortune of the human being, will be studied.Therefore, the objective is to find a common minimum denominator of the aforementioned categories, taking the pessimistic philosophy of Peter Wessel Zapffe as the central point within the Ligottian aesthetic.  El presente artículo está dedicado a presentar brevemente la trayectoria bio-bibliográfica de Thomas Ligotti, un autor sumamente reconocido en Estados Unidos, donde se destacarán los principales acontecimientos biográficos y las obras narrativas y filosóficas que más han marcado su trayectoria. Asimismo, se tendrán en cuenta las etiquetas (“metafísico”, “filosófico”, “pesimista”, “nihilista”, entre otras) que se le han otorgado a Ligotti para definir su narrativa, cuyo centro de estudio es la desdicha del ser humano. Por tanto, el objetivo es el de encontrar un mínimo común denominador de las categorías antes mencionadas, tomando la filosofía pesimista del muy poco conocido Peter Wessel Zapffe como punto central dentro de la estética ligottiana. &nbsp