1,721,170 research outputs found
Complex pelvic organ prolapse: decision-making algorithm
No full textPurpose: The pelvic floor is considered as a single anatomical and functional unit, consisting of several structures that suspend the pelvic organs maintaining their function. For this reason, a multi-compartmental prolapse is a common disease that needs a multidisciplinary pelvic floor team in order to be treated. The aim of the authors is to suggest a treatment algorithm to better approach complex pelvic organ prolapse. Methods: A multidisciplinary pelvic floor team was set up 7 years ago. Starting from the literature review integrated with a team experience, a decision-making algorithm was drawn up. It was used to guide all the shared treatment for the complex pelvic floor disorders. Results: An accurate preoperative assessment with a shared diagnosis among the specialist is the base to follow the proposed algorithm. It leads to combine different surgical procedures considering advantages and disadvantages which may have an influence on the final outcome. Conclusions: The proposed algorithm provides an integrated surgical view of complex pelvic floor disorders. It shows how is it feasible to associate surgical treatments of different compartments to obtain good pelvic floor anatomical and functional results and leading to an improvement of the patients’ quality of life
Towards a molecular understanding of the atheropotective effects of estrogens: a review of estrogen effects on endothelial activation
No full textEarly phases of atherosclerosis are characterized by an increased adhesion of leukocytes to vascular endothelium, leading to a recruitment of white blood cells into the intima. Leukocyte adhesion is mediated by the expression of specific adhesion molecules on endothelial cells, dependent on a dysfunctional status of vascular endothelium (endothelial activation), potentially caused by the exposure to diverse atherogenic stimuli. Female sex steroid hormones regulate vascular function acting directly on vascular cells, and producing a net anti-inflammatory effect. Among the various mechanisms mediating the anti-atherogenic effects of estrogens, the inhibition of endothelial activation process and of leukocyte adhesion molecule expression are particularly important, for the strategic pathophysiological role played by these processes during atherogenesis. This brief review discusses recent discoveries on the molecular mechanisms of estrogens on endothelial activation, as well as pathophysiological and clinical implications of these effects
Selective estrogen receptor modulators: different actions on vascular cell adhesion molecule-1 (VCAM-1) expression in human endothelial cells
No full textNitric oxide and the biology of pregnancy
No full textNitric oxide (NO) is a key regulator of both maternal and fetal homeostasis during pregnancy, facilitating the maternal cardio-vascular changes, fetal development and growth and adaptation to extrauterine life. Dysfunction of the NO system during pregnancy is associated to placental and vascular-related diseases such as hypertensive disorders of pregnancy (HDP) and intrauterine growth restriction (IUGR). Emerging therapeutic strategies involving NO precursors, NO donors, natural derivatives or pharmacological modulators of the NO system seem hold promise for the treatment of such conditions of pregnancy
Can a traumatic childbirth experience affect maternal psychopathology and postnatal attachment bond?
No full textThe aim of the present study was to explore the relationship between the experience of childbirth as a traumatic event and the quality of postnatal attachment to child, analyzing the role of depressive symptomatology on this relationship. A sample of 103 women, aged from 26 to 46 years (M = 35.05, SD = 4.51) filled in questionnaires to assess postpartum stress symptoms related to the childbirth experience, postnatal attachment toward their newborns, and level of depressive symptomatology. A mediation analysis was carried out. The level of postpartum stress symptoms positively affects maternal depressive symptomatology and negatively affects the quality of postnatal attachment. Moreover, the relationship between a traumatic childbirth experience and postnatal attachment is both direct and indirect. In fact, a traumatic childbirth experience also affects the level of postnatal depression that, in turn, negatively affects the quality of postnatal attachment bond. The presence of postpartum distress symptoms affects the well-being of mothers, and these conditions interfere with the ability of women to develop good attachment bonds with their children. These results showed the relevance of paying attention to pregnant women, to help them to live childbirth in a positive and non-stressful way
PSU14 Assessing Unwarranted Variation in Minimally-Invasive Surgery for Pelvic Organ Prolapse in Tuscany, Italy: A Case Study
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