@article {10561, title = {Preoperative Serum Human Epididymis Protein 4 Levels in Early Stage Endometrial Cancer: A Prospective Study.}, journal = {Int J Gynecol Cancer}, volume = {27}, year = {2017}, month = {2017 07}, pages = {1200-1205}, abstract = {

OBJECTIVE: The aim of the study was to evaluate the prognostic value of human epididymis protein 4 (HE4) and cancer antigen 125 markers with pathological prognostic factor to complete the preoperative clinical panel and help the treatment planning.

METHODS: This prospective multicenter study was conducted in 2 gynecologic oncology centers between 2012 and 2014 (Institute for Maternal and Child Health IRCCS Burlo Garofolo in Trieste and Catholic University of the Sacred Heart in Rome, Italy). We enrolled 153 patients diagnosed with clinical early (International Federation of Gynecology and Obstetrics stages I-II) type I endometrial cancer.

RESULTS: Human epididymis protein 4 levels seemed to be strictly related to age (P < 0.001) and menopausal status (P < 0.002). Compared with myometrial invasion (MI), the HE4 values were significantly higher in case of invasion of greater than 50\% of the thickness: MI of greater than 50\%, median of 94.85 pmol/L (38.3-820.8 pmol/L), versus MI of less than 50\%, median of 65.65 pmol/L (25.1-360.2 pmol/L), (P < 0.001). The HE4 levels increase significantly with increasing tumor size: diameter of larger than 2 cm, median of 86.9 pmol/L (35.8-820.8 pmol/L), versus diameter of smaller than 2 cm, median of 52.2 pmol/L (33.3-146.8 pmol/L), (P < 0.001). In our population, HE4 did not correlate with the histological grade, endometrial cancer type I versus type II (P = 0.86), the lymphovascular infiltration (P = 0.12), and the cervical invasion (P = 0.6). We established a new variable, considering 3 high-risk tumor features: MI of greater than 50\% and/or histological G3 and/or type II. Human epididymis protein 4 levels significantly increase in high-risk tumors (high risk HE4, 93.6 pmol/L vs low-medium risk, 65.5 pmol/L; P < 0.001).

CONCLUSIONS: A preoperative HE4 evaluation could help stratify patients with deep invasion and/or metastatic disease and is correlated with other relevant prognostic factors to be considered to tailor an adequate surgical strategy.

}, keywords = {Adult, Aged, Aged, 80 and over, Biomarkers, Tumor, Endometrial Neoplasms, Female, Humans, Middle Aged, Neoplasm Staging, Preoperative Care, Prognosis, Prospective Studies, Proteins}, issn = {1525-1438}, doi = {10.1097/IGC.0000000000001015}, author = {Fanfani, Francesco and Restaino, Stefano and Cicogna, Stefania and Petrillo, Marco and Montico, Marcella and Perrone, Emanuele and Radillo, Oriano and De Leo, Rossella and Ceccarello, Matteo and Scambia, Giovanni and Ricci, Giuseppe} } @article {3595, title = {Promoting effective child development practices in the first year of life: does timing make a difference?}, journal = {BMC Pediatr}, volume = {14}, year = {2014}, month = {2014}, pages = {222}, abstract = {

BACKGROUND: There is an increasing need for parenting programs aimed at promoting parent-child interaction. A variety of interventions have been proposed. The use of audiovisual materials for parents has been shown to be effective but limited information is available on the optimal timing for its use, particularly for new parents during the first year of life of their children. The aim of this study is to compare the effectiveness of a video administered at two different times to first-time parents in modifying parental knowledge, attitudes and intentions with regards to effective care practices.

METHODS: Open randomized controlled trial carried out in a referral mother and child hospital. Eligible parents were randomly assigned to receive a video at one month (early intervention) or at seven months (late intervention) of age of their child. The video addressed four specific activities related to early child development: reading aloud to the baby, early exposure to music, promotion of early socialization for parents and for children. The primary outcome was the proportion of parents who declared that their knowledge, attitudes and intentions changed after having seen the video at one or seven months of age of the child.

RESULTS: One hundred and five families were randomly allocated either to the early (53) or to the late (52) intervention group. For 99 families (52 in the early and 47 in the late group) a complete outcome evaluation was available. Parents included in the early administration group more frequently reported modifications in their knowledge of the suggested practices while parents in the late group more frequently reported a change in their attitudes. This finding was consistent across all four practices. The video was found to influence parental intentions in the great majority of interviewed parents with no significant difference between groups (82.7\% and 87.2\% in the early and late intervention group, respectively).

CONCLUSIONS: Audiovisual materials can be an effective complementary tool in programs aimed at supporting parents, particularly those dealing with their first baby. The results provide some useful insights into the differential benefits of using audiovisual aids at different times during the first year of life of the baby.

TRIAL REGISTRATION: ClinicalTrials.gov NCT02120430.

}, issn = {1471-2431}, doi = {10.1186/1471-2431-14-222}, author = {Roia, Anna and Paviotti, Elena and Ferluga, Valentina and Montico, Marcella and Monasta, Lorenzo and Ronfani, Luca and Tamburlini, Giorgio} }