@article {1876, title = {First trimester maternal serum PIGF, free β-hCG, PAPP-A, PP-13, uterine artery Doppler and maternal history for the prediction of preeclampsia.}, journal = {Placenta}, volume = {33}, year = {2012}, month = {2012 Jun}, pages = {495-501}, abstract = {

OBJECTIVE: To evaluate the detection of pregnancy hypertensive disorders by integrating maternal history, serum biomarkers and uterine artery Doppler in the first trimester.

METHODS: We prospectively recruited 2118 women that underwent an 11-13 weeks aneuploidy screening. We gathered information on maternal history, uterine artery Doppler and serum biomarkers (PAPP-A, PlGF, PP-13 and free β-hCG). Models were developed for the prediction of overall preeclampsia (PE), early-onset PE, late-onset PE and gestational hypertension (GH). For each outcome, we performed a multivariate logistic regression starting from the saturated model: adopting a step-down procedure we excluded all factors not statistically significant (p > 0.05). Sensitivity models only for statistically significant parameters were calculated from the ROC curves for fixed false-positive rates (FPR).

RESULTS: Among 2118 women, 46 (2.17\%) developed GH and 25 (1.18\%) were diagnosed with PE, including 12 (0.57\%) early-onset PE and 13 (0.61\%) late-onset PE. For a fixed FPR of 10 and 5\%, serum PlGF, free β-hCG and chronic hypertension identified respectively 67 and 75\% of women who developed early-onset PE. In the model for the prediction of overall PE the combination of the uterine artery Doppler pulsatility index (UtA PI) with PlGF and chronic hypertension reached a sensitivity of 60\% for a 20\% of FPR.

CONCLUSION: An integration of maternal characteristics and first trimester maternal serum biomarkers (free β-hCG and PlGF) provided a possible screening for early-onset PE. In the overall PE model, UtA PI turned out to be statistically significant but did not improve the detection rate.

}, keywords = {Adult, Biological Markers, Chorionic Gonadotropin, beta Subunit, Human, Cohort Studies, Female, Galectins, Humans, Hypertension, Pregnancy-Induced, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Pregnancy Proteins, Pregnancy Trimester, First, Pregnancy-Associated Plasma Protein-A, Prospective Studies, Ultrasonography, Prenatal, Uterine Artery, Uterus}, issn = {1532-3102}, doi = {10.1016/j.placenta.2012.03.003}, author = {Di Lorenzo, G and Ceccarello, M and Cecotti, V and Ronfani, L and Monasta, L and Vecchi Brumatti, L and Montico, M and D{\textquoteright}Ottavio, G} } @article {1938, title = {Role of high molecular weight hyaluronic acid in postmenopausal vaginal discomfort.}, journal = {Minerva Ginecol}, volume = {64}, year = {2012}, month = {2012 Aug}, pages = {321-9}, abstract = {

AIM: Aim of the present study was to quantify the intensity of vulvovaginal symptoms before and after treatment with high molecular weight hyaluronic acid (HA), to test the tolerability and safety of the product, to evaluate the effect on the quality of life and the compliance to the treatment.

METHODS: This was a double-blind randomized placebo-controlled study. In seven months we enrolled 36 post-menopausal women, equally distributed in placebo and active group. The evaluation was based on at least three atrophy-related signs and on the patient reported symptoms. After the written informed consent, the participants were instructed to apply the gel (drug or placebo) daily. Three days after the end of the treatment the patients received a final examination to evaluate the progress of symptoms, the presence of any adverse events and their correlation with the treatment.

RESULTS: Self-evaluation scales and investigator evaluation showed that the vaginal dryness was significantly reduced both in placebo and in the active group; however, high molecular weight HA was the only active treatment in reducing significantly itching and burning (P<0.02 and <0.04 respectively). Both treatments significantly reduced vaginal atrophy (P<0.001), erythema (P<0.01 placebo and P<0.001 HA) and vaginal dryness (P<0.001), but HA treatment was significantly more effective on the first two symptoms. Both treatments were very well tolerated and compliance of the treatment was very high.

CONCLUSION: High molecular weight HA could be effective in subjective and objective improvement of postmenopausal vaginal atrophy providing a good compliance. No adverse events occurred during the entire period of the study.

}, keywords = {Atrophy, Double-Blind Method, Female, Humans, Hyaluronic Acid, Middle Aged, Molecular Weight, Postmenopause, Vagina, Vaginal Diseases}, issn = {0026-4784}, author = {Grimaldi, E F and Restaino, S and Inglese, S and Foltran, L and Sorz, A and Di Lorenzo, G and Guaschino, S} }