Cytomegalovirus (CMV) is a DNA virus, which affects all ages individuals. During the intrauterine life, CMV can affect the foetus and can produce severe morphological abnormalities, especially in the brain structure, leading to various neurosensorial deficiencies after birth. This study aims to demonstrate the utility of ultrasonography in identifying and establishing the long-term prognosis of the foetuses with CMV congenital infection. After a systematic review of the last 10 years literature, fifteen articles were considered from the databases for this study. The most frequently detected abnormalities are represented by periventricular cerebral calcifications, ventricular dilatations, cerebellar hypoplasia, leukomalacia, microcephaly, foetal ascites, ventricular septal defects, intrauterine growth restriction, oligoamnios or anamnios. These pathological aspects could influence the evolution of the foetuses, their long-term development and could also produce intrauterine death of the foetus. Also, the addition of MRI increases the power of ultrasound for the diagnosis of cerebral damages. These techniques could be complementary, but they should not exclude each other in exposed foetuses.
Background: In 1989, Botulinum toxin (BoNT) was accepted by the FDA for the management of some ophthalmic disorders. Although it was initially considered a lethal toxin, in recent times, Botulinum toxin A (BoNT-A), which is the more used serotype, has expanded to cover different clinical conditions, primarily characterized by neuropathic pain, including migraines and headaches. Evidence suggests that migraines are influenced by hormonal factors, particularly by estrogen levels, but very few studies have investigated the prevalence and management strategies for migraines according to the hormonal status. The effects of several therapeutic regimens on migraines have been investigated, but the medications used varied widely in proven efficacies and mechanisms of action. BoNT-A is increasingly used in the management of migraine and several placebo-controlled trials of episodic and chronic migraine are currently underway. This paper is a review of the recently published data concerning the administration of BoNT-A in the prevention of chronic migraines. Considering the lack of population-based studies about the effectiveness of BoNT-A in the alleviation of premenstrual and perimenopausal migraines, this study proposes a new perspective of the therapeutic approach of migraine syndrome associated with menopausal transition and the premenstrual period. Methods: We selected the reviewed papers from CrossRef, PubMed, Medline, and GoogleScholar, and a total of 21 studies met our inclusion criteria. Results: To date, no specific preventive measures have been recommended for menopausal women with migraines. BoNT-A often reduces the frequency and intensity of migraine attacks per month; the treatment is well tolerated and does not exhibit a significantly higher rate of treatment-related side effects. No population-based studies were conducted in order to highlight the role of BoNT-A in menopause-related migraines, neither in menstrual migraines. Conclusion: There is a need for further research in order to quantify the real burden of menstrual and perimenopausal migraines and to clarify if BoNT-A could be used in the treatment of refractory postmenopausal and premenstrual migraines.
Menopause is a physiological period, considered to be installed after at least 12 months without menstruation. The mean age at menopause is 51 years. This condition is the consequence of hormonal imbalance that produces a series of general manifestations, which have become increasingly important and in most of the cases require treatment to improve. This paper aims to analyze all the therapeutical strategies applied for the improvement of the menopausal symptomatology. After a review of the last five years literature, we identified epidemiological studies, clinical cases, guidelines, and meta-analysis regarding the proper management strategies for the symptoms and pathologies associated with menopause. Fifty-three studies have been included in this paper that provides an overview of the impact of various menopause therapies. Vasomotor symptoms (VMS), hormonal replacement therapy (HRT), consisting of the administration of estrogen, alone or combined with progesterone, have been demonstrated to reduce their frequency and severity. Also, systemic estrogen therapy has shown its efficiency in depression, genito-urinary syndrome, cognitive disorders, and postmenopausal migraine syndrome. Non-hormonal treatments, including alimentary supplements, proved their efficacy with low rates of adverse effects. Among nonhormonal therapeutical alternatives, antidepressants such as venlafaxine, paroxetine, or fluoxetine (selective serotonin reuptake inhibitors-SSRI), and the anticonvulsant gabapentin have shown their utility for treating depressive disorders and vasomotor symptoms.
The cell distribution and function of alveolar macrophages and T lymphocytes were investigated in the bronchoalveolar lavage (BAL) of 15 patients with systemic sclerosis (SSc). In alveolar macrophages, both spontaneous and PMA-stimulated TNF-alpha production were increased in SSc. PMA-induced IL-6 production was also elevated. Spontaneous IL-6 excretion of scleroderma alveolar macrophages was similar to the controls. Yeast and C3b-coated yeast (opsonised yeast) phagocytosis, chemotaxis and Fc receptor activity of alveolar macrophages were normal. The proportion of CD3, CD4 and CD8 T-lymphocyte subsets in the BAL was similar to the control values. The lymphocyte blast transformation index of the non-adherent cells deriving from the BAL fluid was markedly decreased.
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