@article {8077, title = {Insights from Cardiac Mechanics after Three Decades from Successfully Repaired Aortic Coarctation.}, journal = {Congenit Heart Dis}, year = {2015}, month = {2015 Nov 11}, abstract = {

BACKGROUND AND AIMS: Patients who underwent a successful repair of the aortic coarctation show chronic hyperdynamic state and normal left ventricular (LV) geometry; however, there are few data regarding the LV systolic function in the long term. Accordingly, we assessed LV systolic mechanics and factors associated with LV systolic dysfunction (LVSD) in patients with repaired CoA.

METHODS: Clinical and echocardiographic data from 19 repaired CoA were analyzed 28 {\textpm} 13 years after surgery. Stress-corrected midwall shortening (sc-MS) and mitral annular peak systolic velocity (S{\textquoteright}) were analyzed as indexes of LV circumferential and longitudinal systolic function, respectively. Echocardiographic data of CoA patients were compared with 19 patients matched for age and hypertension and 38 healthy controls. Sc-MS was considered impaired if <89\%, S{\textquoteright} if <8.5 cm/s (10th percentiles of healthy controls, respectively).

RESULTS: There were no statistical differences between study groups in LV volumes, mass and geometry. LV ejection fraction and Sc-MS were similar in all groups, however, CoA group had a significantly lower peak S{\textquoteright} in comparison with matched and healthy controls (7.1 {\textpm} 1.3, 10.3 {\textpm} 1.9, and 11.1 {\textpm} 1.5, respectively; all P < 0.001). Prevalence of longitudinal LVSD defined as low S{\textquoteright} was 84\% in CoA, 13\% in matched, and 5\% in healthy control group (all P<0.05). Multivariate logistic regression analysis revealed that low peak S{\textquoteright} was independently related to higher E/E{\textquoteright} ratio and the presence of CoA.

CONCLUSIONS: Patients who underwent a successful repair of CoA commonly show asymptomatic longitudinal LVSD associated with worse LV diastolic function in the long-term follow-up.

}, issn = {1747-0803}, doi = {10.1111/chd.12310}, author = {Faganello, Giorgio and Fisicaro, Maurizio and Russo, Giulia and Iorio, Anita and Mazzone, Carmine and Grande, Eliana and Humar, Franco and Cherubini, Antonella and Pandullo, Claudio and Barbati, Giulia and Tarantini, Luigi and Benettoni, Alessandra and Pozzi, Marco and Di Lenarda, Andrea and Cioffi, Giovanni} } @article {3566, title = {Effects of estroprogestins containing natural estrogen on vaginal flora.}, journal = {Gynecol Endocrinol}, volume = {30}, year = {2014}, month = {2014 Nov}, pages = {830-5}, abstract = {

Estroprogestins with "natural oestrogen" has represented a new option in terms of combined hormonal contraception. So, the aim of this study is to investigate how estroprogestins with natural estrogen may modify the vaginal niche. In literature, very few studies focused on the interaction between hormonal contraception and vaginal milieu. This is a prospective comparative study. We enrolled 60 women from January 2013 to September 2013, 30 of them were administered estradiol valerate dienogest (E2V+DNG - Klaira{\textregistered}) in a quadriphasic regimen, while the other 30 women were administered 17-β estradiol with nomestrol acetate (EV+NOMAC - Zoely{\textregistered}) in a monophasic regimen. After a baseline study of vaginal milieu at recruitment of patients (Gram stain with Nugent score, vaginal pH, vaginal wet mount for the quantification of leukocytes, Lactobacilli and/or presence of Candida), we performed the same follow-up after six months of estroprogestin therapy. Our results showed that the women treated with E2V+DNG had a trend of an improvement of vaginal health in terms of increase of lactobacillar flora and reduction of vaginal pH in place of women treated with EV+NOMAC that showed a reduction of cervical mucus. Finally, our data about the effects on vaginal flora exerted by two estroprogestin pills (EPs) containing a natural estrogen suggest slight, but interesting differences in terms of vaginal ecology. These differences could be related to the type of estrogen, type of progestin, regimen of administration and, after all, to the net balance between estrogenic and progestin component of the EPs.

}, keywords = {Adolescent, Adult, Drug Combinations, Estradiol, Female, Humans, Megestrol, Middle Aged, Nandrolone, Norpregnadienes, Prospective Studies, Vagina, Young Adult}, issn = {1473-0766}, doi = {10.3109/09513590.2014.936847}, author = {De Seta, Francesco and Restaino, Stefano and Banco, Rubina and Conversano, Ester and De Leo, Rossella and Tonon, Maddalena and Maso, Gianpaolo and Barbati, Giulia and Lello, Stefano} } @article {1897, title = {Effects of hormonal contraception on vaginal flora.}, journal = {Contraception}, volume = {86}, year = {2012}, month = {2012 Nov}, pages = {526-9}, abstract = {

BACKGROUND: The sector of the market that deals with contraception offers a long list of different contraceptive methods. Within the estroprogestinic choice, the routes of administration are oral, transdermic and vaginal one. Even though efficacy is comparable with these methods, secondary and adverse effects are directly involved in the acceptability of the method.

STUDY DESIGN: This was a prospective comparative study. During 1 year, we enrolled 60 asymptomatic women who voluntarily requested combined oral contraception (COC) or combined contraceptive vaginal ring (CCVR group). After a baseline study of vaginal milieu prior to starting hormonal contraception, we performed a follow-up. For each woman, we examined vaginal pH; quantification of leukocytes, lactobacilli, Candida and cocci on saline microscopy fluid; Gram stain with Nugent score and the presence of vaginal infection [culture for Trichomonas vaginalis, albicans and nonalbicans Candida, Group B Streptococcus (GBS)].

RESULTS: At the end of follow-up, there was a little change of vaginal milieu in both groups. We noted an increase of lactobacilli in the CCVR users and an increase of GBS in COC users.

CONCLUSION: CCVR compared to COC users showed an increase of the number of lactobacilli in vaginal flora. It means that an increase of leukorrhea in that group could be protective in terms of prevention of vaginal imbalance/infection.

}, keywords = {Administration, Intravaginal, Adolescent, Adult, Bacterial Load, Candida, Candida albicans, Contraceptive Devices, Female, Contraceptives, Oral, Combined, Female, Humans, Hydrogen-Ion Concentration, Lactobacillus, Leukocyte Count, Middle Aged, Prospective Studies, Streptococcus agalactiae, Trichomonas vaginalis, Vagina}, issn = {1879-0518}, doi = {10.1016/j.contraception.2012.02.012}, author = {De Seta, Francesco and Restaino, Stefano and De Santo, Davide and Stabile, Guglielmo and Banco, Rubina and Busetti, Marina and Barbati, Giulia and Guaschino, Secondo} }