209 research outputs found
STRATEGIE NARRATIVE DANTESCHE IN SALVATORE SATTA
No full textThe essay analyses Dantean references in Salvatore Satta's “Il giorno del giudizio”, investigating in particular the meanings of the “catabasis” in the memorial spaces and the ways of representing any single character's story. In a synchronic perspective – that of doomsday – it's up to the author to select what is meaningful and gives sense to an entire life. Something must be left out, but what is distilled, the synthesis, can become writing only after life – which is nothing but an ephemeral prefiguration – have found in death its reality and its fulfilment: Satta's writing becomes the where and when of the judgment. In the novel, however, there is no distinction between the damned and the blessed, there is no salvation nor redemption: in “Il giorno del giudizio” the protagonists will be “absolved or condemned” all together, and their “ridiculous god” with them. Salvatore Satta retains the Christian sense of the original sin, but denies the possibility of salvation. The souls in Nuoro recognize in the judgment the moment when their convulsive motion ceases. The “ridiculous god” is the author precisely for immortalizing them through the force of writing, embodying them in his writing and so putting an end to the circle in which their lives were imprisoned. Writing delivers them from sin and from the law: the judgment at last takes place
Placenta previa associated with severe bleeding leading to hospitalization and delivery: a retrospective population-based cohort study
No full textIntroduction: The aim of our study was to compare maternal and neonatal outcomes in women with placenta previa complicated with severe bleeding leading to hospitalization until delivery versus those without severe bleeding episodes.
Methods: This is a population-based retrospective cohort study including all pregnant women with placenta previa who delivered at our medical center in the study period, divided into the following groups: 1) women with severe bleeding leading to hospitalization resulting with delivery (n = 32); 2) patients with placenta previa without severe bleeding episodes (n = 1217).
Results: Out of all women with placenta previa who delivered at our medical center, 2.6% (32/1249) had an episode of severe bleeding leading to hospitalization and resulting with delivery. The rate of anemia was lower (43.8% versus 63.7%, p = 0.02) while the need for blood transfusion higher (37.5% versus 21.1%, p = 0.03) in the study group. The rate of cesarean sections was significantly different between the groups, and a logistic regression model was constructed in order to find independent risk factors for cesarean section in our patients.
Conclusion: To the best of our knowledge, this is the first study to evaluate the impact of severe bleeding on the outcome of pregnancies complicated with placenta previa. Our study demonstrates that, in women with placenta previa, severe bleeding does not lead to increased adverse maternal or neonatal outcomes
Placental calcifications: a clue for the identification of high-risk fetuses in the low-risk pregnant population?
No full textAbstract
"What does it mean, Doctor?" and "Is it going to affect my baby in some way?". Those are the most typical questions of pregnant women to obstetricians. Answering is sometimes easier but placental calcification is not the case, since placental architecture and disease are two different faces of the same coin and the association between them is not completely clear. Placenta can function properly, even in the presence of architectural alterations, without any fetal consequences. So, remains the question, when does a placental structural anomaly become a sign of increased attention to maternal conditions, fetal development and well-being? The present review will analyze these concepts, with emphasis on placental calcification, its pathogenesis, and the state-of-the-art regarding the influence of this finding on pregnancy outcomes among low-risk pregnant patients
Divagazioni intorno a un capolavoro della letteratura sarda: Il giorno del giudizio di Salvatore Satta
No full textA rereading of Salvatore Satta's masterpiece that highlights the narratologically discriminating strategies and turning points: the plane of intertextual relations, which humorously relates the great European History and the small stories of the Nuoro village in the late 19th and early 20th centuries; the path in which the author engages autobiographically: a catabasis with no possibility of anabasis; the construction of the characters, starting certainly with the contrast between Don Sebastiano and Donna Vincenza: but more generally, conforming in a sense to Dante's lesson, Satta preserves the originality of each individual figure. Of each character he exalts the individual affair, the dramatic and unrepeatable development. Salvatore Satta is their "ridiculous God" because, at the moment he arouses them and even eternalizes them by embodying them in Scripture, he ends their movement, the circle that imprisoned their existence. Scripture frees them from sin and the law; it is the judgment that is finally fulfilled.Una rilettura del capolavoro di Salvatore Satta che mette in luce le strategie e gli snodi narratologicamente discriminanti: il piano delle 'interferenze' intertestuali, il quale pone in relazione umoristicamente la grande Storia europea e le piccole storie del borgo nuorese tra fine Ottocento e inizio Novecento; il percorso in cui è autobiograficamente impegnato l’autore: una catabasi senza possibilità d’anabasi; la costruzione dei personaggi, a partire certo dalla contrapposizione fra Don Sebastiano e Donna Vincenza: ma più in generale, conformandosi in un certo senso alla lezione dantesca, Satta preserva l'originalità di ogni singola figura che, emergendo dalla comunità cui appartiene indissolubilmente, si affaccia ora sulla pagina. Di ciascun personaggio esalta la vicenda individuale, lo sviluppo drammatico e irripetibile. Salvatore Satta è il loro «Dio ridicolo» perché, mentre li suscita e perfino li eterna, incarnandoli nella scrittura, pone fine al loro movimento, al circolo che imprigionava la loro esistenza. La scrittura li libera dal peccato e dalla legge, è il giudizio che finalmente si compie
The physiologic anticoagulant and anti-inflammatory role of heparins and their utility in the prevention of pregnancy complications
No full textAbstract
Accumulating evidence supports the concept of increased thrombin generation, placental vascular lesions, and inflammation as crucial points in the development of the great obstetrical syndromes [preeclampsia, intrauterine growth restriction (IUGR), preterm labor (PTL), preterm prelabor rupture of membranes (PROM), fetal demise and recurrent abortions]. In light of this, the role of heparins for primary or secondary prevention of these syndromes is becoming more and more apparent, mainly due to the antithrombotic and anti-inflammatory effects of heparins. There is agreement regarding the use of heparin in the prevention of gestational complications in patients with antiphospholipid syndrome, while its use for other obstetrical complications is under debate. In the present review we will describe the physiologic role of heparins on coagulation and inflammation and we will discuss current evidence regarding the use of heparins for the prevention/treatment of obstetrical syndromes
Experiences of maternity care among women at increased risk of preterm birth receiving midwifery continuity of care compared to women receiving standard care : results from the POPPIE pilot trial
No full textBackground: Midwifery continuity of care models for women at low and mixed risk of complications have been shown to improve women’s experiences of care. However, there is limited research on care experiences among women at increased risk of preterm birth. We aimed to explore the experiences of care among women with risk factors for preterm birth participating in a pilot trial (POPPIE) of a midwifery continuity of care model which included a specialist obstetric clinic. Methods: A total of 334 pregnant women identified at increased risk of preterm birth were randomly allocated to either midwifery continuity of care (POPPIE group) or standard maternity care. Women in both groups were followed up at six-to-eight weeks postpartum and were invited to complete a postnatal survey either online or by post. An equal status exploratory sequential mixed method design was chosen to collect and analyse the quantitative postnatal survey data and qualitative interviews data. The postnatal survey included measures of social support, trust, perceptions of safety, quality of care, control during childbirth, bonding and quality of life. Categorical data were analysed with chi-squared tests and continuous data were analysed with t-tests and/or Mann-Whitney U test to measure differences in measures scores among groups. The qualitative interview data were subjected to a thematic framework analysis. Data triangulation brought quantitative and qualitative data together at the interpretation stage. Findings: A total of 166 women completed the survey and 30 women were interviewed (90 and 16 in POPPIE group; 76 and 14 in standard group). We found survey respondents in the POPPIE group, compared to respondents in the standard group, were significantly more likely to report greater trust in midwives (Mann-Whitney U, p<0.0001), greater perceptions of safety during the antenatal care (t-test, p = 0.0138), have a particular midwife to contact when they needed during their pregnancy (t-test, p<0.0001) and the postnatal period (chi-squared, p<0.0001). They reported increased involvement in decisions regarding antenatal, intrapartum and postnatal care (t-test, p = 0.002; p = 0.008; p = 0.006 respectively); and greater postnatal support and advice about: feeding the baby (chi-squared, p<0.0001), handling, settling and looking after the baby (chi-squared, p<0.0001), baby’s health and progress (chi-squared, p = 0.039), their own health and recovery (chi-squared, p = 0.006) and who to contact about any emotional changes (chi-squared, p = 0.005). There were no significant differences between groups in the reporting of perceptions of safety during birth and the postnatal period, concerns raised during labour and birth taken seriously, being left alone during childbirth at a time of worries, control during labour, bonding, social support, and physical and mental health related quality of life after birth. Results from qualitative interviews provided insight and depth into many of these findings, with women in the POPPIE group reporting more positive experiences of bonding towards their babies and more positive physical health postnatally. Conclusions: Compared with standard maternity care, women at increased risk of PTB who received midwifery continuity of care were more likely to report increased perceptions of trust, safety and quality of care. Trial registration: ISRCTN (Number: 37733900); UK CRN (ID: 31951)
Uterine and ovarian changes during testosterone administration in young female-to-male transsexuals
No full textObjective Female-to-male transition remains a specific clinical indication for long-term testosterone administration. There is a limited number of studies dealing with the effect of androgen treatment on their female receptive targets (mainly breast and uterus) and the knowledge in this field is scarce and, sometimes, contradictory. Materials and Methods We performed a prospective study including 12 patients aged between 20 years and 32 years, with a diagnosis of gender dysphoria, treated with parenteral testosterone administration before sexual reassignment surgery. Results Endometrial histology revealed the presence of active endometrium in 10 cases and secretive endometrium in two cases. Multifollicular ovaries were observed in all cases of active endometrium, while corpus luteum was present in the two cases of secretory endometrium. Fibroids or hypertrophic myometrium were observed in 58% of the patients. Estrogen receptor was very high (59%) in the endometrial epithelial cells and low (17%) in the myometrium. Androgen receptor expression was modest in endometrial epithelial cells (24%) and sustained in myometrium (69%). Ki67 expression is steadily present in all uterine compartments, varying from 8% in epithelial endometrium to 2% in the myometrium. Conclusion Our data suggest that long-term testosterone administration to female-to-male patients during reproductive age induces a low proliferative active endometrium, associated with some hypertrophic myometrial changes
Uterine Fibroid Torsion during Pregnancy: A Case of Laparotomic Myomectomy at 18 Weeks’ Gestation with Systematic Review of the Literature
No full textUterine myomas are the most common benign growths affecting female reproductive system, occurring in 20–40% of women, whereas the incidence rate in pregnancy is estimated from 0.1 to 3.9%. The lower incidence in pregnancy is due to the association with infertility and low pregnancy rates and implantation rates after in vitro fertilization treatment. Uterine myomas, usually, are asymptomatic during pregnancy. However, occasionally, pedunculated fibroids torsion or other superimposed complications may cause acute abdominal pain. There are many controversies in performing myomectomy during cesarean section because of the risk of hemorrhage. Nevertheless, the majority of indication arises before labor and delivery due to acute symptoms leading to a discussion regarding the need for intervention during pregnancy. Therefore, we present a case of successful multiple laparotomic myomectomy at 17 + 2 weeks of gestational age and a systematic review of the literature in order to clarify the approach to this pathologic condition and its effect on pregnancy outcome
Ultrasonographic approach to diagnosis of fetal inflammatory response syndrome: a tool for at-risk fetuses?
No full textPreterm parturition is a syndrome that may result from many underlying mechanisms. Infection and inflammation are the prominent ones. Intrauterine infection and inflammation have an effect akin to sepsis, and that is similar to systemic inflammatory response in adults. Indeed, there is evidence to support the association of a fetal inflammatory response syndrome (FIRS) to systemic infection and inflammation. The utilization of invasive procedures for the prenatal diagnosis of FIRS is associated with a risk for complications resulting from the invasive method. The progress in the imaging quality of obstetrical ultrasound and the development of novel methods for functional anatomical assessment of the fetal organs may help to identify, noninvasively, fetuses at risk for FIRS in patients presenting with preterm labor. We review the studies describing advanced sonographic modalities and the imaging findings in the heart, thymus, kidney, adrenal glands, and spleen of these fetuses
LMWH in the prevention of preeclampsia and fetal growth restriction in women without thrombophilia. A systematic review and meta-analysis.
No full text- …
