Adenomyosis: What the Patient Needs.

A panel of experts in the field of endometriosis expressed their opinions on management options in a 28-year-old patient, attempting pregnancy for 1 year, with severe cyclic pelvic pain and with clinical examination and imaging techniques suggestive of adenomyosis. Many questions this paradigmatic patient may pose to the clinician are addressed, and all clinical scenarios are discussed. A decision algorithm derived from this discussion is also proposed.

Vaginal Uterine Morcellation Within a Specimen Containment System: A Study of Bag Integrity.

Study Objective: To evaluate the integrity of the endoscopic bag after transvaginal in-bag morcellation of uteri that need to be removed by vaginal morcellation during total laparoscopic hysterectomy (TLH).

Design: Prospective pilot study (Canadian Task Force classification II-2).

Setting: University hospital.

Similar Occurrence of Febrile Episodes Reported in Non-Atopic Children at Three to Five Years of Age after Prebiotics Supplemented Infant Formula.

This is a follow up study of a multicenter randomised placebo-controlled trial in seven centres in five West European countries. The RCT assessed the effect of infant formula supplemented with a mixture of prebiotics (with neutral short-chain and long-chain oligosaccharides and pectin-derived acidic oligosaccharides) during infancy in term-born children (n=1130). In the follow-up study 672 children (60% of the study population) participated: 232 (56%) from the prebiotics group (PG), 243 (58%) from the control group (CG), and 197 (66%) from the non-randomised breast-fed group (BG).

The pleiotropic effects of vitamin D in gynaecological and obstetric diseases: an overview on a hot topic.

The traditionally recognized role of vitamin D consists in the regulation of bone metabolism and calcium-phosphorus homeostasis but recently a lot of in vitro and in vivo studies recognized several "noncalcemic" effects of vitamin D metabolites. Accumulating evidence suggests that the metabolic pathways of this vitamin may play a key role in the developing of gynaecological/obstetric diseases. VDR-mediated signalling pathways and vitamin D levels seem to (deeply) affect the risk of several gynaecological diseases, such as polycystic ovary syndrome (PCOS), endometriosis, and ovarian and even breast cancer.

How to Manage Bowel Endometriosis: The ETIC Approach.

A panel of experts in the field of endometriosis expressed their opinions on management options in a 35-year-old patient desiring pregnancy with a history of previous surgery for endometrioma and bowel obstruction symptoms. Many questions that this paradigmatic patient may pose to the clinician are addressed, and various clinical scenarios are discussed. A decision algorithm derived from this discussion is proposed as well.

Infant feeding and allergy prevention: a review of current knowledge and recommendations. A EuroPrevall state of the art paper.

The relationship between infant feeding patterns and the later development of food allergies has been the focus of much debate and research over the last decade. National recommendations have been made by many countries on how to feed infants to reduce the risk of food allergy but due to the lack of firm evidence the recommendations differ widely. This review has been developed as part of EuroPrevall, a European multicentre research project funded by the European Union, to document the differing feeding recommendations made across Europe, to investigate the current evidence base for any allergy prevention feeding recommendations and to identify areas where further research is needed.

Preterm infants fed fortified human milk receive less protein than they need.

Objective: The aim of this study was to compare the actual nutrient intakes observed in a previously reported study with assumed nutrient intakes based on the customary assumptions about the composition of human milk.

Study Design: Fortified human milk is assumed to provide adequate amounts of nutrients for premature infants. This assumption holds if milk has the composition of milk expressed by mothers of premature infants during weeks 2 to 3 of lactation.

Endometrioma excision and ovarian reserve: a dangerous relation.

Endometrioma is one of the most frequent pathologies in gynecologic surgery. Laparoscopic cyst excision is considered the best treatment in terms of lower recurrence and improved fertility. However, it was recently questioned whether the excision of the endometrioma could decrease the function of the operated ovary and if it could affect the subsequent fertility.

Early dietary intervention with a mixture of prebiotic oligosaccharides reduces the incidence of allergic manifestations and infections during the first two years of life.

A mixture of neutral short-chain galactooligosaccharides (scGOS) and long-chain fructooligosaccharides (lcFOS) has been shown to reduce the incidence of atopic dermatitis (AD) and infectious episodes during the first 6 mo of life. This dual protection occurred through the intervention period. The present study evaluated if these protective effects were lasting beyond the intervention period.

Ursodeoxycholic acid treatment in preterm infants: a pilot study for the prevention of cholestasis associated with total parenteral nutrition.

In a prospective, double-blind, placebo-controlled trial, the efficacy and safety of ursodeoxycholic acid (UDCA) was evaluated in preterm infants, in terms of its potential impact on fat absorption, advancement of enteral feeding, development of cholestasis, growth, nutritional status, and metabolic status. Although fecal fat excretion slightly decreased and achievement of full enteral feeding was earlier in the UDCA group, these differences were not significant. Interestingly, whereas serum gamma-glutamyl transferase activity increased during the parenteral nutrition period in the placebo group, we observed a constant and significant decrease in the UDCA group.

Early supplementation of prebiotic oligosaccharides protects formula-fed infants against infections during the first 6 months of life.

A mixture of neutral short chain galactooligosaccharides and long chain fructo-oligosaccharides (scGOS/lcFOS) has been shown to have prebiotic and immunomodulatory effects comparable to human milk oligosaccharides. This can be translated into clinical practice as a potential to prevent infections and allergy. The hypothesis of this study was that this specific prebiotic mixture could have a preventive effect against infections during the first 6 mo of life.

Adjustable fortification of human milk fed to preterm infants: does it make a difference?

Background: Inadequate nutrition leading to growth failure is common among premature infants. Although fortified breast milk (breast milk plus commercially prepared fortifier) is the preferred feeding, nutrient intakes achieved with fortified breast milk fall short of meeting nutrient needs. This is mainly due to inadequate protein content of fortifiers and variability in composition of expressed breast milk.

Surgical treatment of deep endometriosis and risk of recurrence.

Study Objective: To evaluate the risk of recurrence of deep endometriosis after conservative surgery.

Design: Retrospective analysis (Canadian Task Force classification II-3).

Setting: Tertiary care university hospital.

Ultrasound screening for developmental dysplasia of the hip.

Background: Clinical examination of newborns has been shown to be inadequate for the early detection of developmental dysplasia of the hip (DDH). It is debatable whether US examination is a valid alternative.

Objective: To contribute further knowledge to the natural history of DDH; to examine the distribution of hip morphology as classified by Graf according to sex and risk factors in an unselected Italian population; to propose a temporal pattern of US screening of all newborns to detect DDH.

Influence of microalbuminuria on left ventricular geometry and function in hypertensive patients with type 2 diabetes mellitus.

Background: An increased urinary albumin excretion (UAE) is associated with an augmented risk of cardiovascular disease in diabetic patients and in non-diabetic subjects. Left ventricular hypertrophy has been demonstrated to be a powerful predictor of cardiovascular morbidity and mortality in arterial hypertension and when the ventricular geometry is concentric the relation is even stronger. This echocardiographic and Doppler study was designed to evaluate the influence of microalbuminuria on the left ventricular geometry and function in hypertensive patients with type 2 diabetes melitus.

Acute hepatitis complicating intravenous amiodarone treatment.

We describe a case of acute hepatitis after a loading dose of intravenous amiodarone. An 83-year-old woman was admitted in emergency for recent-onset atrial fibrillation associated with left ventricular failure. Twenty-four hours after having started parenteral amiodarone, she developed biochemical alterations indicative of severe hepatic cytolysis associated with impairment of the synthetic capacity which rapidly reverted after suspension of the drug.