ABSTRACT

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ABSTRACT

Placenta accreta is a rare and potentially life-threatening complication of pregnancy characterized by abnormal adherence of the placenta to the uterine wall. A previously scarred uterus or an abnormal site of placentation in the lower segment is a major risk factor. The aim of this study was to investigate the change in the incidence of placenta accreta and associated risk factors along four decades, from the 1970s to 2000s, in a tertiary south Italian center. We analyzed all cases of placenta accreta in a sample triennium for each decade. The incidence increased from 0.12% during the 1970s, to 0.31% during the 2000s. During the same period, cesarean section rates increased from 17 to 64%. Prior cesarean section was the only risk factor showing a significant concomitant rise. Our results reinforce cesarean section as the most significant predisposing condition for placenta accreta.

Endometrial cancer (EC) is the most common cancer of the female reproductive tract in developed countries. At the moment, no effective screening system is available. Here, we evaluate the diagnostic performance of a serum metabolomic signature. Two enrollments were carried out, one consisting of 168 subjects: 88 with EC and 80 healthy women, was used for building the classification models. The second (used to establish the performance of the classification algorithm) was consisted of 120 subjects: 30 with EC, 30 with ovarian cancer, 10 with benign endometrial disease, and 50 healthy controls. Two ensemble models were built, one with all EC versus controls (Model I) and one in which EC patients were aggregated according to their histotype (Model II). Serum metabolomic analysis was conducted via gas chromatography-mass spectrometry, while classification was done by an ensemble learning machine. Accuracy ranged from 62% to 99% for the Model I and from 67% to 100% for the Model II. Ensemble model showed an accuracy of 100% both for Model I and II. The most important metabolites in class separation were lactic acid, progesterone, homocysteine, 3-hydroxybutyrate, linoleic acid, stearic acid, myristic acid, threonine, and valine. The serum metabolomics signature of endometrial cancer patients is peculiar because it differs from that of healthy controls and from that of benign endometrial disease and from other gynecological cancers (such as ovarian cancer).

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Objectification theory was tested as a suitable framework for explaining sexual orientation differences in disordered eating behaviors in college-aged Italian men. The theory's applicability to 125 homosexual and 130 heterosexual men was investigated using self-report questionnaires. Gay men scored significantly higher on exposure to sexually objectifying media, body surveillance, body shame, disordered eating behaviors, and depression than heterosexual men. Although path analyses support the theory's applicability to both groups, for gay men the path model demonstrated a better fit to the objectification theory for disordered eating and depression. Practical implications are discussed.

Objective: Previous studies have shown that taking care of elderly, demented patients carries a high cost to caregivers' health, and is associated with negative consequences on physical and mental health. The aim of this study is to investigate which socio-demographic and clinical variables are significantly associated with higher levels of distress in caregivers, and the relationship between caregivers' levels of distress and the coping strategies they adopt. Patients and participants: The study samples 112 caregivers of demented patients, consecutively admitted to the Department of Neurology of San Raffaele-Turro Hospital (Milan, Italy). Measurements and results:Caregivers were asked to complete the CBI and the Italian version of the COPE.The main result is that caregivers with the highest levels of distress are characterised by an impaired physical health status. It was also found that avoidance coping may represent a risk factor associated with higher levels of distress; conversely, an active and problem-focused approach to stressful situations may act as a protective factor.Keywords: Dementia, Caregiver, Burden of Illness, Coping Behavior 3 Riassunto Obiettivo: In letteratura è documentato che prendersi cura di un anziano affetto da demenza comporta per il caregiver un prezzo molto elevato da pagare, e si associa a conseguenze negative sul piano della salute fisica e psichica. Obiettivo della presente ricerca è stato quello di valutare quali variabili socio-demografiche e cliniche possano essere significativamente associate ad elevati livelli di stress nel caregiver stesso, e la relazione esistente tra i livelli di stress del caregiver e il ricorso alle strategie di coping. Pazienti e partecipanti: Lo studio ha coinvolto 112 caregiver di altrettanti pazienti dementi consecutivamente ammessi presso il Reparto di Neurologia dell'Ospedale San Raffaele Turro di Milano. Risultati: I caregiver hanno compilato il CBI e la versione italiana del COPE. I risultati indicano che i caregiver soggetti ad elevati livelli di stress si caratterizzano per uno stato compromesso di salute fisica. Uno stile di coping centrato sull'evitamento delle situazioni problematiche può costituire un fattore di rischio per elevati livelli di stress nel caregiver; il ricorso a strategie attive focalizzate sulla risoluzione del problema può configurarsi come fattore protettivo. 4 IntroductionThere is ample evidence that taking care of dependent elderly people comes at a very high cost to caregivers' health; more specifically, caregiving affects their physical and psychological health both directly and indirectly [1,2].In Italy, family members are the principal caregivers to elderly, non self-sufficient people. Caregivers are mostly spouses or daughters who decided to take care of the patients in a direct way, that is by living with them [3]. On average, three quarters of their daytime is spent responding to the patients' needs; the amount of time devoted to the patient is inexorably destined to increase as the illness worsens [1].Pr...