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Ragusa A, Svelato A, Fogolari M, Ficarola F, Plotti F, De Luca C, D'Avino S, Davini F, De Cesaris M, Messina G, Bertolini A, Marci R, Angeletti S, Angioli R, Terranova C. The endogenous oxytocin after manipulative osteopathic treatment in full-term pregnant women. Eur Rev Med Pharmacol Sci 2024; 28:1155-1162. [PMID: 38375728 DOI: 10.26355/eurrev_202402_35354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
OBJECTIVE The aim of this study is to assess whether the touch of osteopathic manipulative treatment (OMT) can affect the endogenous production of oxytocin in full-term pregnant women and the assessment of well-being following the treatment. PATIENTS AND METHODS In this study have been enrolled 57 pregnant women at full-term pregnancy (37th-41st week) for evaluation of the concentration of salivary oxytocin 2 minutes before and 2 minutes after a single session of OMT by an osteopath lasting for 30 minutes. Pre-OMT and post-OMT saliva samples were collected with the use of Salivette® salivary swabs. 7 salivary swabs were excluded from the analysis. 50 samples were analyzed with an appropriate ELISA kit. RESULTS The mean OT salivary concentration pre-OMT was 89.98±16.39, and post-OMT was 100.60±19.13 tends to increase with p=0.0000051. In multivariate analysis, two subgroups show interesting data in the mean difference in OT salivary concentration post-OMT: women with painful contractions (p=0.06) and women under 35 years (p=0.09). CONCLUSIONS The results of this study demonstrate that the effectiveness of OMT-increasing endogenous oxytocin is statistically significant in full-term pregnant women. The sensation of well-being found in most women indicates that there has been a predominantly central rather than peripheral oxytocin release after OMT.
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Affiliation(s)
- A Ragusa
- Department of Gynecology and Obstetrics, Campus Bio-Medico University Hospital Foundation Rome, Italy.
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Prata F, Ragusa A, Civitella A, Tuzzolo P, Tedesco F, Cacciatore L, Iannuzzi A, Callè P, Raso G, Fantozzi M, Pira M, Ricci M, Pino M, Minore A, Basile S, Testa A, Crimi VG, Deanesi N, Travino A, D'Addurno G, Scarpa RM, Papalia R. Robot-assisted partial nephrectomy using the novel Hugo™ RAS system: Feasibility, setting and perioperative outcomes of the first off-clamp series. Urologia 2024:3915603231220109. [PMID: 38174713 DOI: 10.1177/03915603231220109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Hugo Robot-Assisted Surgery (RAS) System has been conceived with enhanced modularity but its role for nephron-sparing surgery setting still remains poorly explored. We aimed to describe our experience in robot-assisted partial nephrectomy (RAPN) with a three-arms setting for the first off-clamp series using the new Hugo RAS System. METHODS Patients were placed on an extended flank position at the margin of the surgical bed with a slightly flexion (45°). The first 11 mm robotic trocar (camera port) was placed along the pararectal line 14 ± 2 cm far from the umbilicus. The pneumoperitoneum was then induced through the AirSeal system (SurgiQuest, Milford, Connecticut, USA©). Two more 8 mm operative robotic ports were placed under direct vision, either 8 ± 1 cm far from optic's port. Two 12 mm laparoscopic ports for bed-assistant were placed between robotic ports. Monopolar curved shears, fenestrated grasper, and large needle driver were used in a three-instruments configuration. RESULTS Off-clamp RAPN was successfully performed in seven patients with cT1 renal masses using a trans-peritoneal route. Median port placement and docking time was 6 min (IQR, 4-8 min). Hemostasis was achieved through renorraphy using a single transfix stitch with sliding clips technique. There was no need for additional ports placement. No intraoperative complications occurred, no clashing of robotic instruments or between the robotic arms was observed. No technical failures of the system occurred. Median console time was 83 min (IQR, 68-115 min). Median estimated blood loss were 200 ml (IQR, 50-400 ml). All patients were discharged between post-operative day 2 and 3, without the need of hospital readmission. No complications were recorded within the first 30 post-operative days. CONCLUSIONS We performed the first series of off-clamp RAPN using the novel HUGO RAS System. This novel robotic platform showed an easy-friendly docking system, providing excellent perioperative outcomes with a simple three-arms configuration.
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Affiliation(s)
- F Prata
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - A Ragusa
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - A Civitella
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - P Tuzzolo
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - F Tedesco
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - L Cacciatore
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - A Iannuzzi
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - P Callè
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - G Raso
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - M Fantozzi
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - M Pira
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - M Ricci
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - M Pino
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - A Minore
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - S Basile
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - A Testa
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - V G Crimi
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - N Deanesi
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - A Travino
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - G D'Addurno
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - R M Scarpa
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
| | - R Papalia
- Fondazione Policlinico Universitario Campus Bio-Medico, Department of Urology, Rome, Italy
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Ragusa A, Ficarola F, Svelato A, De Luca C, D'Avino S, Carabaneanu A, Ferrari A, Cundari GB, Angioli R, Manella P. Is an episiotomy always necessary during an operative vaginal delivery with vacuum? A longitudinal study. J Matern Fetal Neonatal Med 2023; 36:2244627. [PMID: 37553125 DOI: 10.1080/14767058.2023.2244627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 08/10/2023]
Abstract
Objective: The use of episiotomy during operative vaginal birth (OVB) is rather debated among operators and in literature. It is also important to evaluate the indications for which episiotomy is performed. In fact, the consequences of an episiotomy can be invalidating for patients with long-lasting results. The aim of this study is the evaluation of the role of episiotomy during OVB with the vacuum extractor and its correlation with Obstetric Anal Sphincter Injuries (OASIs).Methods: On of 9165 vaginal births, a total of 498 OVB (5.4%) were enrolled in a longitudinal prospective observational study. The incidence of OASIs was evaluated in our population after OVB performed with the vacuum extractor, during which the execution of episiotomy was performed indicated by clinician in charge.Results: OASIs occurred in 4% of the patients (n = 20). Episiotomy was performed in 39% of them (n = 181). OASIs incidence was 6% (n = 17) in the No Episiotomy and 1.8% (n = 3) in Episiotomy group (p<.001). Performance of episiotomy during OVB determined a protective effect against OASIs (p = 0.025 in full cohort and p = 0.013 in the primiparous group). An expulsive phase under one hour was an almost significant protective factor (p = 0.052).Conclusions: The use of episiotomy during OVB was associated with much lower OASIs rates in nulliparous women with a vacuum extraction; OR 0.23 (CI 95% 0.07-0.81) p = 0.037 in nulliparous women and the number necessary to treat was 18 among nulliparous women to prevent 1 OASIs. A further risk factor that emerged from the analysis is a prolonged expulsive period, whereas fundal pressure does not seem to have a statistically significant influence.
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Affiliation(s)
- Antonio Ragusa
- Department of Obstetrics and Gynecology, Campus Bio-Medico University Hospital Foundation Rome, Rome, Italy
| | - Fernando Ficarola
- Department of Obstetrics and Gynecology, Campus Bio-Medico University Hospital Foundation Rome, Rome, Italy
| | - Alessandro Svelato
- Department of Obstetrics and Gynecology, Fatebenefratelli Hospital Isola Tiberina, Gemelli Isola, Rome, Italy
| | - Caterina De Luca
- Department of Obstetrics and Gynecology, Fatebenefratelli Hospital Isola Tiberina, Gemelli Isola, Rome, Italy
| | - Sara D'Avino
- Department of Obstetrics and Gynecology, Fatebenefratelli Hospital Isola Tiberina, Gemelli Isola, Rome, Italy
| | - Alis Carabaneanu
- Department of Obstetrics and Gynecology, Prato General Hospital, Prato, Italy
| | - Amerigo Ferrari
- Sant'Anna School of Advanced Studies, Institute of Management, MeS (Management and Health) Laboratory, Pisa, Italy
| | - Gianna Barbara Cundari
- Department of Obstetrics and Gynecology, Campus Bio-Medico University Hospital Foundation Rome, Rome, Italy
| | - Roberto Angioli
- Department of Obstetrics and Gynecology, Campus Bio-Medico University Hospital Foundation Rome, Rome, Italy
| | - Paolo Manella
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Ragusa A, Obregón-Cuesta AI, Di Petrillo E, Moscato EM, Fernández-Solana J, Caggiano V, González-Bernal JJ. Intercultural Differences between Spain and Italy Regarding School Bullying, Gender, and Age. Children (Basel) 2023; 10:1762. [PMID: 38002853 PMCID: PMC10670147 DOI: 10.3390/children10111762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/25/2023] [Accepted: 10/28/2023] [Indexed: 11/26/2023]
Abstract
The objectives of this research were to establish the differences between Spain and Italy regarding the presence of bullying in primary and secondary schools, as well as to determine whether there are differences between experiencing or perpetrating bullying and gender and age in the practice of school bullying. To assess the EBIPQ scores in terms of country and gender, the chi-squared test was used, and ANOVA was applied for age. A total of 1536 students from primary and secondary schools in Spain and Italy participated in the study. Their ages ranged from 10 to 19 years (mean = 13.01, standard deviation = 2.19). The results revealed statistically significant differences in terms of bullying categories concerning the country of origin and gender, with a higher number of Italian participants in the role of "no victim aggress" and Spanish participants in the roles of "victim" and "victim and aggress". Additionally, there were more boys in the role of "victim and aggress" and girls in the role of "no victim aggress". Regarding age, statistically significant differences were found, with older students taking on the role of "aggress" on average, while younger students assumed the role of "victim".
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Affiliation(s)
- Antonio Ragusa
- Rome Business School, Department of Education, 00196 Rome, Italy; (A.R.); (E.D.P.)
| | | | - Emma Di Petrillo
- Rome Business School, Department of Education, 00196 Rome, Italy; (A.R.); (E.D.P.)
| | - Eduardo Maria Moscato
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain; (E.M.M.); (J.J.G.-B.)
| | | | - Valeria Caggiano
- Department of Education, University Roma TRE, 00154 Rome, Italy;
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Ragusa A, De Luca C, Zucchelli E, Rinaldo D, Svelato A. Plastic, microplastic, and the inconsistency of human thought. Front Public Health 2023; 11:1145240. [PMID: 37342277 PMCID: PMC10277741 DOI: 10.3389/fpubh.2023.1145240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/11/2023] [Indexed: 06/22/2023] Open
Affiliation(s)
- Antonio Ragusa
- Department of Obstetrics and Gynecology, Campus Bio-Medico University Hospital Foundation Rome, Rome, Italy
| | - Caterina De Luca
- Department of Obstetrics and Gynecology, Fatebenefratelli Gemelli Hospital, Isola Tiberina, Rome, Italy
| | - Emma Zucchelli
- Instituto de Salud Global, Universitat de Barcelona, Barcelona, Spain
| | - Denise Rinaldo
- Department of Obstetrics and Gynecology, Azienda Socio Sanitaria Territoriale (ASST) Bergamo Est, Bolognini Hospital, Seriate, Italy
| | - Alessandro Svelato
- Department of Obstetrics and Gynecology, Fatebenefratelli Gemelli Hospital, Isola Tiberina, Rome, Italy
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Ragusa A, Caggiano V, Obregón-Cuesta AI, González-Bernal JJ, Fernández-Solana J, Mínguez-Mínguez LA, León-Del-Barco B, Mendo-Lázaro S, Di Petrillo E, González-Santos J. The Influence of Bullying on Positive Emotions and Their Effect as Mediators between Controllable Attributions of Success and Academic Performance. Children (Basel) 2023; 10:929. [PMID: 37371161 DOI: 10.3390/children10060929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023]
Abstract
Academic performance (AP) is a topic of particular interest in the academic context. Attributions for academic success (AAS) have been shown to have a significant impact on AP, and more specifically internal controllable attributions (ICA) are closely linked to academic success. Similarly, positive emotions (PE) have a significant influence on AP and may in turn be influenced by bullying. This study examines the connections between ICA of academic success and AP mediated through PE in late primary and early secondary school students and analyzes the relationships between PE and bullying categories. Students (N = 562, 49.46% female, Mage = 11.6 SD = 1.2) reported on their perceptions of ICA and PE in relation to exams and their relationship with bullying through validated questionnaires. The AP was obtained as the average mark of all subjects in the immediately preceding assessment. First, a multiple linear regression analysis considering ICA and PE as predictor variables was carried out, which showed a significantly positive link between ICA and PE, between ICA and AP, and between PE and AP. Subsequently, using the SPSS macro PROCESS, a simple mediation model was implemented to quantify the effect of ICA on AP through PE in exams, and finally an ANOVA between the categories of bullying and PE was performed. The results showed a significant indirect relationship with a positive predictive relationship for AP. The model shows that PE proves to be a significant mediator between ICA and AP, and it is shown that students disengaged from bullying score higher in PE.
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Affiliation(s)
- Antonio Ragusa
- Rome Business School, Department of Education, 00196 Rome, Italy
| | | | | | | | | | | | - Benito León-Del-Barco
- Department of Psychology and Anthropology, University of Extremadura, 10071 Caceres, Spain
| | - Santiago Mendo-Lázaro
- Department of Psychology and Anthropology, University of Extremadura, 10071 Caceres, Spain
| | - Ema Di Petrillo
- Rome Business School, Department of Education, 00196 Rome, Italy
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Mauri PA, Pilloni E, Stillavato S, Ragusa A, Masturzo B, Trojano G, Piteri G, Pegurri G, Ricci ED, Teodoro MC, Guardalà F, Messina A, Svelato A, Parazzini F, Iurlaro E, Viora E. Role of mode of induction and delivery and women's satisfaction after induction of labour at term: An observational study. Eur J Obstet Gynecol Reprod Biol 2023; 286:47-51. [PMID: 37201318 DOI: 10.1016/j.ejogrb.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/03/2023] [Accepted: 05/11/2023] [Indexed: 05/20/2023]
Abstract
This cross-sectional study aimed at evaluating the impact of different modalities of induction of labour (IOL) and delivery on levels of woman' satisfaction. All women aged 18 years or older, who underwent IOL for at-term pregnancy (≥41 weeks of gestation) in randomly selected days during the study period in 6 participating centres were eligible for the study. The questionnaire investigated women's opinion regarding information about induction, pain control, length of induction, their experience about induction, labour and delivery and their attitude towards induction in a subsequent pregnancy. Women were also asked to fill in the Italian version of the Birth Satisfaction Scale-Revised (BSS-R). A total of 300 women entered the study. The answer to the question about a "positive attitude towards induction in a subsequent pregnancy was "absolutely yes" or "yes" respectively in the 77.8%, 52.8% and 48.6% of women who were induced with oral drugs, vaginal drugs and Cook balloon (heterogeneity chi-square p = 0.05). The corresponding values for women who delivered vaginally or by caesarean section (CS) were 63.3% and 36.4% (chi-square p = 0.0009). The mean BSS-R total score was higher among women who underwent IOL with oral drugs than with vaginal drugs (p < 0.0001) or Cook Balloon (p < 0.0001), and among women who delivered vaginally than in those who delivered by CS (p < 0.0001). Women were asked "What do you think is important for a method of induction?": 47.3% (95% CI 41.7%-53.0%) of women answered that "should make the induction as painless as possible", 47.0% (95% CI 41.4%-52.7%) "should induce labour quickly", 44.3% (95% CI 38.8%-50.0%) "should be safe for baby". This study showed that vaginal delivery was associated with a higher rate of satisfaction among induced women. Considering mode of induction, oral drugs were associated with a higher level of satisfaction. Control of pain and quick induction were the most appreciated characteristics.
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Affiliation(s)
- Paola Agnese Mauri
- Midwifery school, Department of Clinical Sciences and Community Health, University of Milan, via Manfredo Fanti 6, 20122 Milan, Italy; SITRA Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122 Milan, Italy.
| | - Eleonora Pilloni
- Obstetrics and Gynecology Department 3, Sant' Anna Hospital, Corso Spezia 60, 10126 Turin, Italy.
| | - Silvia Stillavato
- Obstetrics and Gynecology Department 3, Sant' Anna Hospital, Corso Spezia 60, 10126 Turin, Italy.
| | - Antonio Ragusa
- Department of Obstetrics and Gynecology, Università Campus Bio Medico di Roma, Via Álvaro del Portillo, 21, 00128 Rome, Italy.
| | - Bianca Masturzo
- Obstetrics and Gynecology Department, General Hospital, Via dei Ponderanesi 2, 13875 Ponderano, Biella- University of Turin, Italy.
| | - Giuseppe Trojano
- Department of Maternal and Child Health "Madonna delle Grazie" Hospital ASM, Contrada Cattedra Ambulante, 75100 Matera, Italy.
| | - Giulia Piteri
- Midwifery school, Department of Clinical Sciences and Community Health, University of Milan, via Manfredo Fanti 6, 20122 Milan, Italy.
| | - Giorgia Pegurri
- Midwifery school, Department of Clinical Sciences and Community Health, University of Milan, via Manfredo Fanti 6, 20122 Milan, Italy.
| | - Elena Delfina Ricci
- Midwifery school, Department of Clinical Sciences and Community Health, University of Milan, via Manfredo Fanti 6, 20122 Milan, Italy.
| | - Maria Cristina Teodoro
- Department Maternal and Child Health, Obstetrics and Gynecology Unit, Hospital AO for Emergency Cannizzaro, via Messina 829, 95126 Catania, Italy.
| | - Fabio Guardalà
- Department Maternal and Child Health, Obstetrics and Gynecology Unit, Hospital AO for Emergency Cannizzaro, via Messina 829, 95126 Catania, Italy.
| | - Alessandro Messina
- Obstetrics and Gynecology Department, General Hospital, Via dei Ponderanesi 2, 13875 Ponderano, Biella- University of Turin, Italy.
| | - Alessandro Svelato
- Obstetric Pathology Unit Ospedale Fatebenefratelli Hospital, Gemelli-Isola Tiberina, via di Ponte Quattro capi 39, 00186 Rome, Italy.
| | - Fabio Parazzini
- Midwifery school, Department of Clinical Sciences and Community Health, University of Milan, via Manfredo Fanti 6, 20122 Milan, Italy.
| | - Enrico Iurlaro
- Obstetric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via della Commenda 12, 20122 Milan, Italy.
| | - Elsa Viora
- Associazione Ostetrici e Ginecologi Italiani, via Abamonti 1, 20129 Milan, Italy.
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Ragusa A, González-Bernal J, Trigueros R, Caggiano V, Navarro N, Minguez-Minguez LA, Obregón AI, Fernandez-Ortega C. Effects of academic self-regulation on procrastination, academic stress and anxiety, resilience and academic performance in a sample of Spanish secondary school students. Front Psychol 2023; 14:1073529. [PMID: 36818079 PMCID: PMC9936312 DOI: 10.3389/fpsyg.2023.1073529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/17/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction One of the biggest challenges facing students today is procrastination, which is closely related to stress, anxiety and, in the most severe cases, depression. The aim of the present study is to analyze the influence of academic self-regulation on procrastination, academic anxiety and stress, academic resilience and academic performance. Method The sample consisted of 991 high school students aged between 16 and 19 years (M = 17.25; SD = 3.45). A structural equation model was used to analyze the relationship between the study variables. Results Analyzes showed that academic self-regulation negatively predicted procrastination. In turn, procrastination positively predicted academic stress and anxiety. However, resilience exerted a protective influence by being positively related to academic stress and anxiety. Finally, resilience positively predicted academic performance, whereas stress and anxiety negatively predicted academic performance. Conclusion Thus, the importance of generating strategies for students to learn to self-regulate in academic contexts, manage emotions, foster motivation and develop strategies to help them overcome the vicissitudes they face is emphasized.
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Affiliation(s)
- Antonio Ragusa
- Department of Psychology, University of Burgos, Burgos, Spain
| | | | - Ruben Trigueros
- Department of Psychology, University of Almeria, Almería, Spain,*Correspondence: Ruben Trigueros, ✉
| | - Valeria Caggiano
- Department of Psychology, University of Rome Tor Vergata, Roma, Lazio, Italy
| | - Noelia Navarro
- Department of Psychology, University of Almeria, Almería, Spain
| | | | - Ana I. Obregón
- Department of Psychology, University of Burgos, Burgos, Spain
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Bove A, Brassetti A, Anceschi U, D’Annunzio S, Ferriero M, Mastroianni R, Tuderti G, Misuraca L, Iannuzzi A, Prata F, Ragusa A, Gallucci M, Simone G. Identifying candidates for one-night stay robot assisted simple prostatectomy: Single center analysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01179-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Prata F, Iannuzzi A, Ragusa A, Anceschi U, Flammia R, Tufano A, Bravi C, Brassetti A, Tuderti G, Minervini A, Mari A, Capitanio U, Montorsi F, Autorino R, Veccia A, Fiori C, Porpiglia F, Eun D, Lee J, Deerwesh I, Sundaram C, Steward J, Mottrie A, Leonardo C, Simone G. Analysis of CKD progression for purely Off-Clamp and On-Clamp robotic partial nephrectomy for high nephrometry renal masses: Results of a multicentric series. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00906-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Anceschi U, Amparore D, Prata F, Checcucci E, Bove A, De Cillis S, Iannuzzi A, Quarà A, Ragusa A, Ortenzi M, Misuraca L, Zampa A, Cartolano S, Spadaro G, Tuderti G, Brassetti A, Ferriero M, Mastroianni R, D’Annunzio S, Guaglianone S, Fiori C, Porpiglia F, Simone G. Predictors of BPH6 achievement for urethral-sparing robot-assisted simple prostatectomy: Results of a multicentric series. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00065-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Bove A, Brassetti A, Anceschi U, Amparore D, De Cillis S, Quarà A, Ortenzi M, Checcucci E, Fiori C, D’Annunzio S, Ferriero M, Mastroianni R, Tuderti G, Iannuzzi A, Prata F, Ragusa A, Gallucci M, Porpiglia F, Simone G. Novel composite BPH3 trifecta performance for Robotic Assisted Simple Prostatectomy (RASP) vs. BPH6: A multicenter outcomes comparison. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01177-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Lombó M, Giommi C, Paolucci M, Notarstefano V, Montik N, Delli Carpini G, Ciavattini A, Ragusa A, Maradonna F, Giorgini E, Carnevali O. Preeclampsia Correlates with an Increase in Cannabinoid Receptor 1 Levels Leading to Macromolecular Alterations in Chorionic Villi of Term Placenta. Int J Mol Sci 2022; 23:12931. [PMID: 36361721 PMCID: PMC9656520 DOI: 10.3390/ijms232112931] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 09/06/2023] Open
Abstract
Preeclampsia is a human pregnancy-specific disease characterized by abnormal placentation that usually presents with maternal hypertension and proteinuria. The main hallmark of preeclampsia, impaired trophoblast migration, and the subsequent disruption of uterine arteries remodeling lead to several molecular alterations in the placental compartments with those occurring in the chorionic villi being of the utmost importance. Given the essential role of the endocannabinoid system during preimplantation and trophoblast migration, we have combined the histological and hyperspectral imaging analyses to shed light on the involvement of two cannabinoid receptors in the macromolecular alterations related to preeclampsia. The results obtained by immunohistochemistry showed a significant increase in the protein levels of cannabinoid receptor 1 (CB1) in the preeclamptic chorionic villi. However, no changes were reported regarding transient receptor potential vanilloid 1 (TRPV-1) levels either in the bulk placental samples or chorionic villi when comparing control and preeclamptic patients. Histological analysis and Fourier-transform infrared spectroscopy (FTIRI) showed an increase in collagen deposition together with higher levels of lipid peroxidation and phosphorylated compounds in the pathological villi. Since CB1 enhancement has been described as promoting fibrosis and oxidative stress in several tissues, we proposed that the higher receptor abundance in preeclampsia could be triggering similar molecular effects in preeclamptic term placentas.
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Affiliation(s)
- Marta Lombó
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, 60131 Ancona, Italy
- Department of Molecular Biology, Faculty of Biology and Environmental Sciences, Universidad de León, 24071 León, Spain
| | - Christian Giommi
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Michela Paolucci
- Department of Odontostomatological and Specialized Clinical Sciences, Università Politecnica delle Marche, 60020 Ancona, Italy
| | - Valentina Notarstefano
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Nina Montik
- Department of Odontostomatological and Specialized Clinical Sciences, Università Politecnica delle Marche, 60020 Ancona, Italy
| | - Giovanni Delli Carpini
- Department of Odontostomatological and Specialized Clinical Sciences, Università Politecnica delle Marche, 60020 Ancona, Italy
| | - Andrea Ciavattini
- Department of Odontostomatological and Specialized Clinical Sciences, Università Politecnica delle Marche, 60020 Ancona, Italy
| | - Antonio Ragusa
- Department of Obstetrics and Gynecology, Università Campus Bio Medico di Roma, 00128 Roma, Italy
| | - Francesca Maradonna
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, 60131 Ancona, Italy
- INBB—Consorzio Interuniversitario di Biosistemi e Biostrutture, 00136 Roma, Italy
| | - Elisabetta Giorgini
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Oliana Carnevali
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, 60131 Ancona, Italy
- INBB—Consorzio Interuniversitario di Biosistemi e Biostrutture, 00136 Roma, Italy
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14
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Alorda A, Ragusa A, Cesarz T, Diers N, Ganti L. 236 Delta National Institutes of Health Stroke Scale After Alteplase for Acute Ischemic Stroke. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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15
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Esperto F, Prata F, Civitella A, Tuzzolo P, Crimi V, Deanesi N, Minore A, Ragusa A, Tedesco F, Testa A, Alcini A, Flammia G, Salerno A, Papalia R, Scarpa R. Radical cystectomy video consensus: a simple and effective way to improve awareness of patients undergoing radical cystectomy. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01122-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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16
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Calcagnile T, Sighinolfi M, Puliatti S, Kaleci S, Ticonosco M, Benedetti M, Assumma S, Di Bari S, Ragusa A, Piro A, Ciarlariello S, Fidanza F, Di Pietro C, Rocco B, Micali S. External validation of a nomogram for outcome prediction in management of medium-sized (1–2 CM) kidney stones. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01042-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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17
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Pell R, Walker A, Ganti L, Quinones A, Vera A, Rosario J, Ragusa A. 196 An Infographic Utilized as a Just-In-Time Tool for Paramedic EKG Interpretation. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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18
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Ragusa A, Principi G, Matta M. Pregnancy in the Era of the Environmental Crisis: Plastic and Pollution. CLIN EXP OBSTET GYN 2022. [DOI: 10.31083/j.ceog4910216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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19
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Ragusa A, Matta M, Cristiano L, Matassa R, Battaglione E, Svelato A, De Luca C, D’Avino S, Gulotta A, Rongioletti MCA, Catalano P, Santacroce C, Notarstefano V, Carnevali O, Giorgini E, Vizza E, Familiari G, Nottola SA. Deeply in Plasticenta: Presence of Microplastics in the Intracellular Compartment of Human Placentas. Int J Environ Res Public Health 2022; 19:ijerph191811593. [PMID: 36141864 PMCID: PMC9517680 DOI: 10.3390/ijerph191811593] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 05/04/2023]
Abstract
Microplastics (MPs) are defined as plastic particles smaller than 5 mm. They have been found almost everywhere they have been searched for and recent discoveries have also demonstrated their presence in human placenta, blood, meconium, and breastmilk, but their location and toxicity to humans have not been reported to date. The aim of this study was twofold: 1. To locate MPs within the intra/extracellular compartment in human placenta. 2. To understand whether their presence and location are associated with possible structural changes of cell organelles. Using variable pressure scanning electron microscopy and transmission electron microscopy, MPs have been localized in ten human placentas. In this study, we demonstrated for the first time the presence and localization in the cellular compartment of fragments compatible with MPs in the human placenta and we hypothesized a possible correlation between their presence and important ultrastructural alterations of some intracytoplasmic organelles (mitochondria and endoplasmic reticulum). These alterations have never been reported in normal healthy term pregnancies until today. They could be the result of a prolonged attempt to remove and destroy the plastic particles inside the placental tissue. The presence of virtually indestructible particles in term human placenta could contribute to the activation of pathological traits, such as oxidative stress, apoptosis, and inflammation, characteristic of metabolic disorders underlying obesity, diabetes, and metabolic syndrome and partially accounting for the recent epidemic of non-communicable diseases.
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Affiliation(s)
- Antonio Ragusa
- Department of Obstetrics and Gynecology, Università Campus Bio Medico di Roma, Via Álvaro del Portillo, 21, 00128 Rome, Italy
| | - Maria Matta
- Department of Clinico-Surgical, Diagnostic and Pediatric Sciences, Faculty of Medicine and Surgery, University of Pavia, Via Alessandro Brambilla, 74, 27100 Pavia, Italy
| | - Loredana Cristiano
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Via Vetoio, Loc. Coppito, 67010 Coppito, Italy
- Correspondence:
| | - Roberto Matassa
- Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University, Via A. Borelli, 50, 00161 Rome, Italy
| | - Ezio Battaglione
- Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University, Via A. Borelli, 50, 00161 Rome, Italy
| | - Alessandro Svelato
- Department of Gynecology and Obstetrics of “San Giovanni Calibita” Fatebenefratelli Hospital, Isola Tiberina of Rome, Via di Ponte Quattro Capi, 39, 00186 Rome, Italy
| | - Caterina De Luca
- Department of Gynecology and Obstetrics of “San Giovanni Calibita” Fatebenefratelli Hospital, Isola Tiberina of Rome, Via di Ponte Quattro Capi, 39, 00186 Rome, Italy
| | - Sara D’Avino
- Department of Gynecology and Obstetrics of “San Giovanni Calibita” Fatebenefratelli Hospital, Isola Tiberina of Rome, Via di Ponte Quattro Capi, 39, 00186 Rome, Italy
| | - Alessandra Gulotta
- Department of Gynecology and Obstetrics of “San Giovanni Calibita” Fatebenefratelli Hospital, Isola Tiberina of Rome, Via di Ponte Quattro Capi, 39, 00186 Rome, Italy
| | - Mauro Ciro Antonio Rongioletti
- Department of Pathological Anatomy of “San Giovanni Calibita” Fatebenefratelli Hospital, Isola Tiberina of Rome, Via di Ponte Quattro Capi, 39, 00186 Rome, Italy
| | - Piera Catalano
- Department of Pathological Anatomy of “San Giovanni Calibita” Fatebenefratelli Hospital, Isola Tiberina of Rome, Via di Ponte Quattro Capi, 39, 00186 Rome, Italy
| | - Criselda Santacroce
- Department of Pathological Anatomy of “San Giovanni Calibita” Fatebenefratelli Hospital, Isola Tiberina of Rome, Via di Ponte Quattro Capi, 39, 00186 Rome, Italy
| | - Valentina Notarstefano
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, Polo Montedago Via Brecce Bianche, 60131 Ancona, Italy
| | - Oliana Carnevali
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, Polo Montedago Via Brecce Bianche, 60131 Ancona, Italy
| | - Elisabetta Giorgini
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, Polo Montedago Via Brecce Bianche, 60131 Ancona, Italy
| | - Enrico Vizza
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144 Rome, Italy
| | - Giuseppe Familiari
- Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University, Via A. Borelli, 50, 00161 Rome, Italy
| | - Stefania Annarita Nottola
- Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University, Via A. Borelli, 50, 00161 Rome, Italy
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Ragusa A, Caggiano V, Trigueros Ramos R, González-Bernal JJ, Gentil-Gutiérrez A, Bastos SAMC, González-Santos J, Santamaría-Peláez M. High Education and University Teaching and Learning Processes: Soft Skills. Int J Environ Res Public Health 2022; 19:10699. [PMID: 36078415 PMCID: PMC9518473 DOI: 10.3390/ijerph191710699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/17/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
In the era of globalization and technology, society demands young generations of citizens able to work in a kind of environment characterized by complexity and diversity. Therefore, the education system faces a new kind of challenge, as graduates are reported to need transversal skills, which are unlikely to be learned through traditional classroom teaching. The overall aim of this article is to examine the needs for these skills and their acquisition by higher education teachers to cope with the evolving European labour market of the 2020s. The article envisions the importance of soft skills in the teaching profession. The empirical part consists of a comparative study with Italian and Portuguese teachers, highlighting the status of a set of crucial soft skills (assertiveness, networking skills, teamwork, sensitivity, socialization, action-orientation, ability to work under pressure and social desirability).
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Affiliation(s)
- Antonio Ragusa
- Rome Business School, Department of Education, 00196 Rome, Italy
| | | | - Rubén Trigueros Ramos
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
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21
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Chen K, Cheng X, Zhang R, Cillo G, Ragusa A. Unveiling the Role of Cross-Cultural and Cognitive Differences in Organizational Learning Mechanism of Technology-Acquiring Cross-Border Mergers and Acquisitions: Evidence From Emerging Market Enterprises. Front Psychol 2022; 13:863442. [PMID: 35602689 PMCID: PMC9121060 DOI: 10.3389/fpsyg.2022.863442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/21/2022] [Indexed: 12/05/2022] Open
Abstract
In recent years, cross-border mergers and acquisitions (M&As) of emerging market enterprises (EMEs) have increased rapidly, and many cross-border M&A have been conducted in the United States, Western Europe, and other developed countries. This new type of technology-acquiring cross-border M&A has several unique features. In particular, the cross-cultural differences between the home country and the host country and the cognitive differences between emerging markets and developed markets pose a huge challenge to the organizational learning of technology-acquiring cross-border M&A of enterprises from emerging markets. Based on this, the present study innovatively constructs an integrated theoretical model to explore the role of cross-cultural and cognitive differences in the organizational learning mechanism of technology-acquiring cross-border M&A in emerging markets. In this study, the partial least squares structural equation model (PLS-SEM) was used in an empirical study of 240 Chinese technology-acquiring cross-border M&A enterprises, and it was found that cultural and cognitive differences play an important role in technical ability and learning performance. The study also found that the interaction of cross-cultural differences between the home and host countries and the cognitive differences between the emerging and developed markets promoted the learning performance of cross-border M&A in the emerging markets. Based on the integration theory of cultural differences, cognitive differences, and technical ability, this paper unveils the role of cross-cultural and cognitive differences in organizational learning mechanisms of technology-acquiring cross-border M&A.
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Affiliation(s)
- Kanxiang Chen
- School of Economics, Zhejiang University of Technology, Hangzhou, China
| | - Xuanmei Cheng
- School of Management, Zhijiang College, Zhejiang University of Technology, Hangzhou, China
| | - Run Zhang
- School of Management, Zhejiang University of Technology, Hangzhou, China
| | - Giuseppe Cillo
- Department of Agronomy, Animals, Food, Natural Resources and Environment, University of Padova, Padua, Italy
| | - Antonio Ragusa
- Rome Business School, Rome Business School Nigeria and Space Economy Institute, Rome, Italy
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22
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Ragusa A. Environment and Pregnancy. CLIN EXP OBSTET GYN 2022. [DOI: 10.31083/j.ceog4904083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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23
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Svelato A, Carabaneanu A, Sergiampietri C, Mannella P, D'Avino S, De Luca C, Bartolone M, Angioli R, Ragusa A. "To get the baby out off the hook": a prospective, longitudinal, multicenter, observational study about decision making in vacuum-assisted operative vaginal delivery. BMC Pregnancy Childbirth 2022; 22:128. [PMID: 35172781 PMCID: PMC8848824 DOI: 10.1186/s12884-022-04440-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 01/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Since operative vaginal delivery may be risky for women and might cause neonatal complications, the aim of this study is to assess appropriateness of the procedure. This is a prospective, longitudinal, multicenter, observational study and it was conducted in three Italian Obstetric Units (Pisa, Massa Carrara and Prato). All term pregnant women, either nulliparous and multiparous, with singleton pregnancy and a cephalic fetus, with spontaneous or induced labour, requiring vacuum-assisted delivery were enrolled. Indications to operative vaginal delivery were grouped as alterations of fetal cardiotocography (CTG) patterns, delay/arrest of second stage of labour or elective shortening of second stage of labour. A board consisting of five among authors evaluated appropriateness of the procedure. Results Overall, 466 women undergoing operative vaginal deliveries were included. Cardiotocography, classified as ACOG category 2 or 3 was the indication for vacuum assisted delivery in 253 patients (54.29%). Among these, 66 women (26.1%) had an operative vaginal delivery which was then considered to be inappropriate, while in 114 cases (45.1%) CTG traces resulted to be unreadable. Conclusion Decision making process, which leads clinicians to go for operative vaginal delivery, is often influenced by shortness of time and complexity of the situation. Therefore, clinicians tend to intervene performing vacuum delivery without adopting critical analysis and without adequately considering the clinical situation. Tweetable abstract Operative vaginal delivery might be a risky procedure and should be performed only when clinically indicated and after adequate critical analysis.
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Affiliation(s)
- Alessandro Svelato
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Via di Ponte Quattro capi, 39, 00186, Rome, Italy.
| | - Alis Carabaneanu
- Department of Obstetrics and Gynecology, Prato General Hospital, Prato, Italy
| | | | - Paolo Mannella
- Department of Reproductive Medicine and Child Development, University of Pisa, Pisa, Italy
| | - Sara D'Avino
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Via di Ponte Quattro capi, 39, 00186, Rome, Italy
| | - Caterina De Luca
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Via di Ponte Quattro capi, 39, 00186, Rome, Italy
| | - Martina Bartolone
- Department of Maternal and Child Health and Urological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Roberto Angioli
- Department of Gynecology, University Campus Biomedico, Rome, Italy
| | - Antonio Ragusa
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Via di Ponte Quattro capi, 39, 00186, Rome, Italy
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24
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Civitella A, Prata F, Tuzzolo P, Romei L, Crimi V, Tedesco F, Ragusa A, Cacciatore L, Deanesi N, Testa A, Flammia G, Alcini A, Salerno A, Prata S, Esperto F, Scarpa R, Papalia R. Laparoscopic versus ultrasound guided Transversus Abdominis Plane (TAP) block for postoperative analgesia after radical prostatectomy: A randomized controlled trial. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00109-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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Ragusa A, Svelato A. Search for a predictive relationship between ultrasound thickness of the lower uterine segment and rupture of the uterus in women with a prior cesarean delivery does not make biological sense. Am J Obstet Gynecol 2022; 226:283-284. [PMID: 34582798 DOI: 10.1016/j.ajog.2021.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/22/2021] [Indexed: 11/01/2022]
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26
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Ragusa A, De Luca C, Zucchelli E, Svelato A. What will be the future of Dinoprostone in labor induction? Int J Gynaecol Obstet 2022; 157:751-752. [PMID: 34995359 DOI: 10.1002/ijgo.14086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/23/2021] [Accepted: 01/05/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Antonio Ragusa
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy.,Foundation "Confalonieri Ragonese", Milan, Italy
| | - Caterina De Luca
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Emma Zucchelli
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Alessandro Svelato
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
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27
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Ficarola F, Svelato A, Angioli R, Rossi R, D'Avino S, DE Luca C, Rinaldo D, Ragusa A. Reduced fetal movements: the case of Fetomaternal Hemorrhage. Case series and proposal of a management protocol. Minerva Obstet Gynecol 2021; 74:386-392. [PMID: 34904586 DOI: 10.23736/s2724-606x.21.04972-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Fetomaternal hemorrhage (FMH) was reported more than 60 years ago for the first time defined by the transfer or transfusion of fetal blood into the maternal circulation before or during delivery. The transfused volume is usually very small but when this value exceeds, it may be clinically significant. Antenatal diagnosis of severe FMH is difficult and it can be suspected in case of reduction of fetal movements, abnormal cardiotocography and ultrasound. FMH is associated to different adverse outcomes and admission to neonatal intensive care. The low incidence of FMH limits the studies, thus being able to rely only on diagnosis and retrospective studies. We present case series of FMH and analyze the steps with the purpose of defining a flow-chart for early diagnosis and management of FMH.
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Affiliation(s)
- Fernando Ficarola
- Department of Obstetrics and Gynecology, Policlinico Campus Bio-Medico, Rome, Italy
| | - Alessandro Svelato
- Department of Obstetrics and Gynecology, San Giovanni Calibita, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy -
| | - Roberto Angioli
- Department of Obstetrics and Gynecology, Policlinico Campus Bio-Medico, Rome, Italy
| | - Rita Rossi
- Department of Obstetrics and Gynecology, Massa Carrara General Hospital, Massa Carrara, Italy
| | - Sara D'Avino
- Department of Obstetrics and Gynecology, San Giovanni Calibita, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Caterina DE Luca
- Department of Obstetrics and Gynecology, San Giovanni Calibita, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Denise Rinaldo
- Department of Obstetrics and Gynecology, Bolognini General Hospital, Seriate, Bergamo, Italy
| | - Antonio Ragusa
- Department of Obstetrics and Gynecology, San Giovanni Calibita, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
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Micali S, Calcagnile T, Sighinolfi M, Iseppi A, Morini E, Benedetti M, Oltolina P, Ragusa A, Kaleci S, Bevilacqua L, Puliatti S, De Nunzio C, Arada R, Chiancone F, Campobasso D, Eissa A, Bonfante G, Simonetti E, Cotugno M, Galli R, Curti P, Schips L, Ditonno P, Villa L, Ferretti S, Bergamaschi F, Bozzini G, Zoeir A, El Sherbiny A, Frattini A, Fedelini P, Okhunov Z, Tubaro A, Landman J, Bianchi G, Rocco B. Urinary tract infections in candidates to active treatment of renal stone: results from an international multicentric study on more than 2600 patients. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00867-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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29
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Svelato A, Vergatti MC, Rinaldo D, Sergiampietri C, De Luca C, Ragusa A. Cord entanglement in a monochorionic-monoamniotic twin pregnancy: A case report. Int J Gynaecol Obstet 2021; 154:570-571. [PMID: 34101825 DOI: 10.1002/ijgo.13780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/11/2021] [Accepted: 06/07/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Alessandro Svelato
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | | | - Denise Rinaldo
- Department of Obstetrics and Gynecology, "Bolognini" General Hospital, Seriate, Italy
| | - Claudia Sergiampietri
- Department of Obstetrics and Gynecology, Massa Carrara General Hospital, Massa Carrara, Italy
| | - Caterina De Luca
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Antonio Ragusa
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
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Frigo MG, Agostini V, Brizzi A, Ragusa A, Svelato A. Practical approach to transfusion management of post-partum haemorrhage. Transfus Med 2021; 31:11-15. [PMID: 33400316 DOI: 10.1111/tme.12755] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To describe transfusion management during post-partum haemorrhage (PPH) and the usefulness of standard or point-of-care (POC) laboratory tests for guiding haemostatic management. BACKGROUND PPH is the leading cause of maternal mortality and severe maternal morbidity worldwide. Despite the efforts made in recent years, PPH is often burdened by preventable death. Recent data from the active Italian Obstetric Surveillance System (ItOSS) highlighted the following main critical issues: inadequate communication between healthcare professionals, inability to correctly and promptly assess the severity of haemorrhage, delays in diagnosis and treatment, failure to request blood promptly and inappropriate monitoring post-partum. MATERIALS AND METHODS Data in the literature have been compared with the rotational thromboelastometry (ROTEM)- and the thromboelastography (TEG)-guided algorithms applied in the authors' departments. RESULTS PPH transfusion therapy may have an empirical approach based on the standard use of blood products or a targeted approach based on coagulation monitoring by laboratory or POC tests. Here, the authors describe how they manage PPH in their departments, according to the Italian guidelines, along with the addition of a ROTEM- and a TEG-guided algorithms developed by themselves. CONCLUSION Although the proposed algorithms have not been validated by trials or observational studies conducted in our departments, we believe that these indications could be useful for supporting clinical practice. Furthermore, we deem it appropriate to emphasise the importance of a multidisciplinary approach and the need for standardised and shared protocols to support the decisions of healthcare professionals.
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Affiliation(s)
- Maria Grazia Frigo
- Department of Anesthesia and Resuscitation in Obstetrics, San Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | - Vanessa Agostini
- Transfusion Medicine Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Agostino Brizzi
- General and Locoregional Anesthesia Department, Santa Maria Clinic, Bari, Italy
| | - Antonio Ragusa
- Obstetric and Gynaecology Department, San Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | - Alessandro Svelato
- Obstetric and Gynaecology Department, San Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
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Ragusa A, Svelato A, Santacroce C, Catalano P, Notarstefano V, Carnevali O, Papa F, Rongioletti MCA, Baiocco F, Draghi S, D'Amore E, Rinaldo D, Matta M, Giorgini E. Plasticenta: First evidence of microplastics in human placenta. Environ Int 2021; 146:106274. [PMID: 33395930 DOI: 10.1016/j.envint.2020.106274] [Citation(s) in RCA: 806] [Impact Index Per Article: 268.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/29/2020] [Accepted: 11/09/2020] [Indexed: 05/18/2023]
Abstract
Microplastics are particles smaller than five millimeters deriving from the degradation of plastic objects present in the environment. Microplastics can move from the environment to living organisms, including mammals. In this study, six human placentas, collected from consenting women with physiological pregnancies, were analyzed by Raman Microspectroscopy to evaluate the presence of microplastics. In total, 12 microplastic fragments (ranging from 5 to 10 μm in size), with spheric or irregular shape were found in 4 placentas (5 in the fetal side, 4 in the maternal side and 3 in the chorioamniotic membranes); all microplastics particles were characterized in terms of morphology and chemical composition. All of them were pigmented; three were identified as stained polypropylene a thermoplastic polymer, while for the other nine it was possible to identify only the pigments, which were all used for man-made coatings, paints, adhesives, plasters, finger paints, polymers and cosmetics and personal care products.
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Affiliation(s)
- Antonio Ragusa
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Via di Ponte Quattro Capi, 39, 00186 Rome, Italy
| | - Alessandro Svelato
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Via di Ponte Quattro Capi, 39, 00186 Rome, Italy.
| | - Criselda Santacroce
- Department of Pathological Anatomy, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Via di Ponte Quattro Capi, 39, 00186 Roma, Italy
| | - Piera Catalano
- Department of Pathological Anatomy, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Via di Ponte Quattro Capi, 39, 00186 Roma, Italy
| | - Valentina Notarstefano
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, via Brecce Bianche, 60131 Ancona, Italy
| | - Oliana Carnevali
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, via Brecce Bianche, 60131 Ancona, Italy
| | - Fabrizio Papa
- Department of Pathological Anatomy, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Via di Ponte Quattro Capi, 39, 00186 Roma, Italy
| | - Mauro Ciro Antonio Rongioletti
- Department of Pathological Anatomy, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Via di Ponte Quattro Capi, 39, 00186 Roma, Italy
| | - Federico Baiocco
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Via di Ponte Quattro Capi, 39, 00186 Rome, Italy
| | - Simonetta Draghi
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Via di Ponte Quattro Capi, 39, 00186 Rome, Italy
| | - Elisabetta D'Amore
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Via di Ponte Quattro Capi, 39, 00186 Rome, Italy
| | - Denise Rinaldo
- Department of Obstetrics and Gynecology, ASST Bergamo Est, Bolognini Hospital, Seriate, Via Paderno, 21, 24068 Bergamo, Italy
| | - Maria Matta
- Harvey Medical and Surgery Course, University of Pavia, Corso Strada Nuova 65, 27100 Pavia, Italy
| | - Elisabetta Giorgini
- Department of Life and Environmental Sciences, Università Politecnica delle Marche, via Brecce Bianche, 60131 Ancona, Italy
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Gevi F, Meloni A, Mereu R, Lelli V, Chiodo A, Ragusa A, Timperio AM. Urine Metabolome during Parturition. Metabolites 2020; 10:metabo10070290. [PMID: 32708819 PMCID: PMC7407522 DOI: 10.3390/metabo10070290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/30/2020] [Accepted: 07/14/2020] [Indexed: 12/19/2022] Open
Abstract
In recent years, some studies have described metabolic changes during human childbirth labor. Metabolomics today is recognized as a powerful approach in a prenatal research context, since it can provide detailed information during pregnancy and it may enable the identification of biomarkers with potential diagnostic or predictive. This is an observational, longitudinal, prospective cohort study of a total of 51 serial urine samples from 15 healthy pregnant women, aged 29–40 years, which were collected before the onset of labor (out of labor, OL). In the same women, during labor (in labor or dilating phase, IL-DP). Samples were analyzed by hydrophilic interaction ultra-performance liquid chromatography coupled with mass spectrometry (HILIC-UPLC-MS), a highly sensitive, accurate, and unbiased approach. Metabolites were then subjected to multivariate statistical analysis and grouped by metabolic pathway. This method was used to identify the potential biomarkers. The top 20 most discriminative metabolites contributing to the complete separation of OL and IL-DP were identified. Urinary metabolites displaying the largest differences between OL and IL-DP belonged to steroid hormone, particularly conjugated estrogens and amino acids much of this difference is determined by the fetal contribution. In addition, our results highlighted the efficacy of using urine samples instead of more invasive techniques to evaluate the difference in metabolic analysis between OL and IL-DP.
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Affiliation(s)
- Federica Gevi
- Department of Biology and Ecology University of Tuscia, 01100 Viterbo, Italy; (F.G.); (V.L.)
| | - Alessandra Meloni
- Neonatal Department, Obstetrics and Gynecology Unit, Azienda Ospedaliera Universitaria (AOU), 09124 Cagliari, Italy; (A.M.); (R.M.); (A.C.)
| | - Rossella Mereu
- Neonatal Department, Obstetrics and Gynecology Unit, Azienda Ospedaliera Universitaria (AOU), 09124 Cagliari, Italy; (A.M.); (R.M.); (A.C.)
| | - Veronica Lelli
- Department of Biology and Ecology University of Tuscia, 01100 Viterbo, Italy; (F.G.); (V.L.)
| | - Antonella Chiodo
- Neonatal Department, Obstetrics and Gynecology Unit, Azienda Ospedaliera Universitaria (AOU), 09124 Cagliari, Italy; (A.M.); (R.M.); (A.C.)
| | - Antonio Ragusa
- Department of Obstetrics and Gynecology, Ospedale San Giovanni Calibita, Fatebenefratelli, Isola Tiberina, Via di Ponte Quattro Capi, 39, 00186 Roma, Italy;
| | - Anna Maria Timperio
- Department of Biology and Ecology University of Tuscia, 01100 Viterbo, Italy; (F.G.); (V.L.)
- Correspondence:
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Svelato A, Ragusa A, Manfredi P. General methods for measuring and comparing medical interventions in childbirth: a framework. BMC Pregnancy Childbirth 2020; 20:279. [PMID: 32380966 PMCID: PMC7203888 DOI: 10.1186/s12884-020-02945-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 04/14/2020] [Indexed: 02/07/2023] Open
Abstract
Background The continue increase of interventions during labour in low risk population is a controversial issue of the current obstetric literature, given the lack of evidence demonstrating the benefits of unnecessary interventions for women or infants’ health. This makes it important to have approaches to assess the burden of all medical interventions performed. Methods Exploiting the nature of childbirth intervention as a staged process, we proposed graphic representations allowing to generate alternative formulas for the simplest measures of the intervention intensity namely, the overall and type-specific treatment ratios. We applied the approach to quantify the change in interventions following a protocol termed Comprehensive Management (CM), using data from Robson classification, collected in a prospective longitudinal cohort study carried out at the Obstetric Unit of the Cà Granda Niguarda Hospital in Milan, Italy. Results Following CM a substantial reduction was observed in the Overall Treatment Ratio, as well as in the ratios for augmentation (amniotomy and synthetic oxytocin use) and for caesarean section ratio, without any increase in neonatal and maternal adverse outcomes. The key component of this reduction was the dramatic decline in the proportion of women progressing to augmentation, which resulted not only the most practiced intervention, but also the main door towards further treatments. Conclusions The proposed framework, once combined with Robson Classification, provides useful tools to make medical interventions performed during childbirth quantitatively measurable and comparable. The framework allowed to identifying the key components of interventions reduction following CM. In its turn, CM proved useful to reduce the number of medical interventions carried out during childbirth, without worsening neonatal and maternal outcomes.
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Affiliation(s)
- Alessandro Svelato
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Antonio Ragusa
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy.
| | - Piero Manfredi
- Department of Economics and Management, University of Pisa, Pisa, Italy
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Fenaroli V, Molgora S, Dodaro S, Svelato A, Gesi L, Molidoro G, Saita E, Ragusa A. The childbirth experience: obstetric and psychological predictors in Italian primiparous women. BMC Pregnancy Childbirth 2019; 19:419. [PMID: 31730468 PMCID: PMC6858642 DOI: 10.1186/s12884-019-2561-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 10/16/2019] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The experience of childbirth crucially impacts a mother's psychological well-being and the mother-infant relationship. It is recognised that negative births can be linked to different forms of discomfort, both for the mother as well as for the infant. This prospective longitudinal study aimed to study the effect of obstetric and psychological variables on women's subjective experience of childbirth. METHODS 111 primiparous Italian women completed a set of questionnaires at 38-40 weeks of pregnancy (Time 1) and 1-5 days after childbirth (Time 2). Sociodemographic and obstetric information were collected. Data about the childbirth were obtained from the mother's ward birth records. Women completed the Wijma Delivery Expectancy/Experience Questionnaire both before and after childbirth. RESULTS The subjective experience of birth was significantly predicted by the duration of the expulsive phase (β = .26; p < .05), the use of epidural analgesia (β = .21; p< .05) and by fear of birth (β = .21; p < .05). The effect of mode of birth and duration of the dilatation phase on women's birth experience was not found. CONCLUSIONS In our study, neither instrumental childbirth nor caesarean section have a significant effect on women's birth experience. Instead, both a longer expulsion phase and epidural analgesia contribute to the negative experience. Moreover, the higher the fear of birth, the worse the women's emotional experience. These findings confirmed the role of obstetric and psychological variables on birth experience. More investigation about this topic could be useful to develop specific interventions to prepare women for birth.
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Affiliation(s)
- Valentina Fenaroli
- Department of Psychology, Università Cattolica del Cacro Cuore, Largo Gemelli 1, 20123 Milan, Italy
| | - Sara Molgora
- Department of Psychology, Università Cattolica del Cacro Cuore, Largo Gemelli 1, 20123 Milan, Italy
| | - Serena Dodaro
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Tiber Island, Rome, Italy
| | - Alessandro Svelato
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Tiber Island, Rome, Italy
| | - Livia Gesi
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Tiber Island, Rome, Italy
| | - Giulia Molidoro
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Tiber Island, Rome, Italy
| | - Emanuela Saita
- Department of Psychology, Università Cattolica del Cacro Cuore, Largo Gemelli 1, 20123 Milan, Italy
| | - Antonio Ragusa
- Department of Obstetrics and Gynecology, San Giovanni Calibita Fatebenefratelli Hospital, Tiber Island, Rome, Italy
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Tommaso MD, Pinzauti S, Bandinelli S, Poli C, Ragusa A. Continuous electronic fetal heart monitoring versus intermittent auscultation during labor: Would the literature outcomes have the same results if they were interpreted following the NICHHD guidelines? ADV CLIN EXP MED 2019; 28:1193-1198. [PMID: 31464110 DOI: 10.17219/acem/103843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND All guidelines regarding electronic fetal heart monitoring (EFM) before 2008 were designed to avoid more hypoxia than acidosis. In addition, the results of the Cochrane meta-analysis of 2013 do not show a significant improvement in neonatal outcomes using EFM or intermittent auscultation (IA). OBJECTIVES We retrospectively evaluated the results on delivery outcomes arising from a comparison between EFM and IA during labor of 2 specific and high-quality trials. We hypothesized that revisiting the delivery outcomes through the adoption of the recent National Institute of Child Health and Human Development (NICHHD) guidelines, the reported delivery outcomes would be different. MATERIAL AND METHODS The study retrospectively evaluated the results on delivery outcomes arising from the comparison between EFM and IA during labor of the "Dublin trial" and "Vintzileos trial" published, respectively, in 1985 and 1993. A translational model was constructed to recalculate these results, applying a correction factor to estimate the number of pathological patterns using the NICHHD guidelines for EFM. RESULTS After the reevaluation of the 2 trials using the proposed correction factor, the comparison of the recalculated cesarean section and operative delivery rates for fetal distress between EFM and IA group were no longer statistically significant, both in the Dublin trial and Vintzileos trial. Even the comparison of the recalculated incidence of the rate of non-reassuring fetal heart rate (FHR) patterns in the EFM and IA groups has not given any indication of significance for the Vintzileos trial. CONCLUSIONS Our results lead to reconsidering the results of the Dublin trial and Vintzileos trial in terms of operational rates of births, hypothesizing that these results would have been significantly lower if FHR traces were interpreted using the current NICHHD guidelines, which aim to identify potential acidotic fetuses rather than hypoxic ones.
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Affiliation(s)
| | - Serena Pinzauti
- Department of Health Sciences, University of Florence, Italy
| | | | - Chiara Poli
- Department of Health Sciences, University of Florence, Italy
| | - Antonio Ragusa
- San Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
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Neri L, Viglino G, Marinangeli G, D'Ostilio A, Matalone M, Ragusa A, Vizzardi V, Russo R, Cabiddu G. [Peritoneal Dialysis in Italy: the 6th GSDP-SIN census 2016]. G Ital Nefrol 2019; 36:36-3-2019-2. [PMID: 31250994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVES We report here the results of the 6th National Census (Cs-16) of Peritoneal Dialysis in Italy, carried out in 2017-18 by the Italian Society of Nephrology's Peritoneal Dialysis Study Group and relating to 2016. METHODS The Census was conducted using an on-line questionnaire administered to the 237 non pediatric centers which did perform Peritoneal Dialysis (PD) in 2016. The results have been compared with the previous Censuses carried out since 2005. RESULTS Incidence: In 2016, 1,595 patients (CAPD=56.1%) started on PD (1st treatment for ESRD) and 4,607 on hemodialysis (HD). PD was started incrementally by 32.5% in 144 Centers. 15.6% were late referrals, and 5.1% began within 48-72 hours of insertion. The catheter was positioned exclusively by a Nephrologist in 24.3% of cases. Prevalence: Patients on PD on 31/12/2016 were 4,607 (CAPD=46.6%), with 22.2% of prevalent patients on assisted PD (family member caregiver: 80.5%). Out: In 2016, PD dropout rate (ep/100 pt-yrs: 12.5 to HD; 11.8 death; 7.0 Tx) has not changed. The main cause of transfer to HD remains peritonitis (23.8%), although it is still decreasing (Cs-05: 37.9%). Peritonitis/EPS: The incidence of peritonitis in 2016 was 0.211 ep/pt-yr (939 episodes). The incidence of new cases of EPS in 2015-16 is diminishing too (16 cases=0.176 ep/100 pt-yrs). Other results: In 2016 the number of Centers using 3.86% for the peritoneal equilibration test (PET) (49.8%) increased, and the Centers carrying out home visits diminished (51.5%). CONCLUSIONS Cs-16 confirms that PD in Italy is having good results.
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Affiliation(s)
- Loris Neri
- Nefrologia e Dialisi, Ospedale San Lazzaro, Via Pierino Belli 26, Alba, Cuneo, Italy
| | - Giusto Viglino
- Nefrologia e Dialisi, Ospedale San Lazzaro, Via Pierino Belli 26, Alba, Cuneo, Italy
| | | | - Annamaria D'Ostilio
- Nefrologia e Dialisi, Ospedale Maria SS dello Splendore, Giulianova, Teramo, Italy
| | - Massimo Matalone
- Nefrologia e Dialisi, Azienda Ospedaliera Cannizzaro, Catania, Italy
| | - Antonio Ragusa
- Nefrologia e Dialisi, Ospedale San Vincenzo, Taormina, Italy
| | - Valerio Vizzardi
- Nefrologia e Dialisi, Policlinico Università A. Moro, Bari, Italy
| | - Roberto Russo
- Nefrologia e Dialisi, Spedali Civili, Brescia, Italy
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Marinangeli G, Neri L, Viglino G, Rocca AR, Laudon A, Ragusa A, Cabiddu G. [PD in Italy: the 5th GSDP-SIN Census 2014]. G Ital Nefrol 2018; 35:35-5-2018-2. [PMID: 30234229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To know PD modalities and results in Italy. METHODS The Census was carried out by means of an on-line questionnaire in ALL the 225 non-pediatric public centers which PERFORMED PD in 2014. The results were compared with those of previous Censuses (2005:Cs-05; 2008:Cs-08; 2010:Cs-10; 2012:Cs-12). RESULTS Incidence. In 2014 PD was begun (first treatment for ESRD) by 1,652 pts (CAPD: 57.2%) and HD by 4,442 pts (%PD-incidence= Cs-14: 27,1%; Cs-12: 23.4%; Cs-10: 23.3%; Cs-08: 22.8%; Cs-05: 24.2%). For the first time Incremental PD does not increase (Cs-14: 27,5%; Cs-12: 28,8%; Cs-10: 22,8%; Cs-08: 18,3%; Cs-05: 11,9%). Prevalence. At 31/12/2014 there were 4,480 patients on PD (CAPD: 46.9%) (%PD-prevalence= Cs-14: Cs-12: 17.1%; Cs-10: 16.6%; Cs-08: 16.7%; Cs-05:16.8%; p=NS), 24.3% of whom were on assisted PD (family members: 83.6%; paid caregivers: 11.5%; nurses: 1.1%; NH: 2.8%). Out. In 2014 there was no change in the PD drop-out rate (32.0 ep/100yrs-pt) (death: 502; transplant: 329; switch to HD: 528 pts). The main reason for transferring to HD remained peritonitis (24.8%). Choice (9.3%) and impossibility to continue PD (15.2%) are increasing. Peritonitis. The peritonitis rate (953 episodes) was 0.224 ep/yrs-pt. The incidence of new cases of EPS in 2013-14 (39 cases=0.444 ep/100yrs-pt) is decreasing (2011-12= 0.505; 2009-10= 0.529; 2004-08= 0.701 ep/100-yrs-pt). Other results. Compared to 2012, in 2014 the number of Centers using 3.86% for PET increased (41.3%) (Cs-12: 30.8%; Cs-10: 15.6%; p <0.001), while the number carrying out home visits (59.6%) remained unchanged (56.3% in 2012, 59.4% in 2010). CONCLUSION Cs-14 confirms the extensive use, stability and good results of PD in Italy. Incremental PD and assisted PD are unchanged, peritonitis are decreased and EPS remains a rare event. PET-3.86% is increasingly used.
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Affiliation(s)
| | - Loris Neri
- Nefrologia e Dialisi, Ospedale San Lazzaro, Alba, Cuneo, Italy
| | - Giusto Viglino
- Nefrologia e Dialisi, Ospedale San Lazzaro, Alba, Cuneo, Italy
| | | | - Alessandro Laudon
- Nefrologia e Dialisi, Azienda Provinciale Servizi Sanitari, Trento, Italy
| | - Antonio Ragusa
- Nefrologia e Dialisi, Ospedale San Vincenzo, Taormina, Italy
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Cesari E, Ghirardello S, Brembilla G, Svelato A, Ragusa A. Clinical features of a fatal shoulder dystocia: The hypovolemic shock hypothesis. Med Hypotheses 2018; 118:139-141. [PMID: 30037602 DOI: 10.1016/j.mehy.2018.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 10/28/2022]
Abstract
Shoulder dystocia is a rare but severe obstetric complication associated with an increased risk of brachial plexus palsies, fractures of the clavicle and humerus, hypoxic-ischemic encephalopathy and, rarely, neonatal death. Here we describe a fatal case of shoulder dystocia in a term newborn, although labor was uneventful, fetal heart rate tracing was normal until the delivery of the head and the head-to-body delivery interval (HBDI) occurred within 5 min. Full resuscitation was performed for 35 min without success. Hemoglobin concentration evaluated on the umbilical cord still attached to the placenta was within normal range, while neonatal venous hemoglobin concentration blood gases at 9 min of life showed severe metabolic acidosis and anemia. As previously described by others, our case supports the hypothesis of a hypovolemic shock as the cause of neonatal death, probably due to acute placental retention of fetal blood. The death of the newborn following shoulder dystocia is an event that still presents numerous gaps in knowledge. Further research should focus on.
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Affiliation(s)
- E Cesari
- Gynecologic and Obstetric Department, Children Hospital V. Buzzi, Via Castelvetro 32, Milan, Italy.
| | - S Ghirardello
- Neonatal Intensive Care Unit Department of Clinical Science and Community Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Brembilla
- Gynecologic and Obstetric Department, Children Hospital V. Buzzi, Via Castelvetro 32, Milan, Italy
| | - A Svelato
- Gynecologic and Obstetric Department, Nuovo Ospedale delle Apuane, Via Enrico Mattei 21, Massa Carrara, Italy
| | - A Ragusa
- Gynecologic and Obstetric Department, Nuovo Ospedale delle Apuane, Via Enrico Mattei 21, Massa Carrara, Italy
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Affronti G, Agostini V, Brizzi A, Bucci L, De Blasio E, Frigo MG, Giorgini C, Messina M, Ragusa A, Sirimarco F, Svelato A. The daily-practiced post-partum hemorrhage management: an Italian multidisciplinary attended protocol. Clin Ter 2017; 168:e307-e316. [PMID: 29044353 DOI: 10.7417/t.2017.2026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Postpartum hemorrhage (PPH) is one of the most frequent causes of mortality and morbidity in the obstetric population globally, causing about a quarter of maternal deaths yearly, and is the leading cause of maternal death worldwide. The management of PPH remains a topic of great debate, even in view of new diagnostic and therapeutic possibilities in recent years, for which, however, the body of evidence available thus far is still scarce, as the standard values are lacking. The protocol hereby presented was developed after a literature review and during several meetings of an Italian multidisciplinary task group of specialists adopting a modified Delphi method, and is the result of the synthesis of therapeutic operational protocols for the treatment of PPH applied by the different specialties within the team. This protocol is intended to represent a practical proposal to support clinicians in the management of a particularly complex event that requires the intervention of a multidisciplinary team and the implementation of dedicated management protocols.
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Affiliation(s)
- G Affronti
- Past direttore SC Ostetricia e Ginecologia, Ospedale S. Maria della Misericordia, AOU, Perugia
| | - V Agostini
- UO Servizio Immunoematologia e Medicina Trasfusionale, Cesena-Forlì, Officina Trasfusionale Pievesestina; Medicina Trasfusionale Ospedale M. Bufalini, Cesena
| | - A Brizzi
- Anestesia generale e locoregionale, Clinica S. Maria, Bari
| | - L Bucci
- Anestesia e Rianimazione 1, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - E De Blasio
- UOC Anestesia e Rianimazione, Azienda Ospedaliera G. Rummo, Benevento
| | - M G Frigo
- UOS Anestesia e Rianimazione in Ostetricia, Ospedale Fatebenefratelli S. Giovanni Calibita, Roma
| | - C Giorgini
- SC Anestesia e Rianimazione, Ospedale S. Maria della Misericordia, Azienda Ospedaliero-Universitaria di Perugia
| | - M Messina
- Immunoematologia e medicina trasfusionale, Azienda Ospedaliera OIRM-Sant'Anna, Torino
| | - A Ragusa
- SC UO Ostetricia e ginecologia, Nuovo Ospedale delle Apuane, Massa e Carrara
| | - F Sirimarco
- UO SC Ostetricia e Ginecologia, Azienda Ospedaliera Cardarelli, Napoli, Italia
| | - A Svelato
- SC UO Ostetricia e ginecologia, Nuovo Ospedale delle Apuane, Massa e Carrara
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Svelato A, Ragusa A, Alimondi P, Di Tommaso M, Marci R, Barbagallo V, Alampi RDF, Calagna G, Perino A. Occiput-spine relationship: shoulders are more important than head. Eur Rev Med Pharmacol Sci 2017; 21:1178-1183. [PMID: 28387916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To understand the role of fetal spine position in determining a fetal head position at the time of birth and modality of delivery. PATIENTS AND METHODS This was a multicenter prospective observational study. Fetal occiput and spine position were evaluated by intrapartum ultrasound. Eighty-six women were eligible for inclusion in the study. Occiput rotational movements and modality of delivery in relation to the fetal spine position were investigated. RESULTS At the beginning of labor, fetal occiput was in a posterior position in 52.3% of cases and, in 81.5% of cases the spine was in an anterior transverse position. At birth, occiput and spine were both in an anterior position in 90.4% of cases. The rate of cesarean sections in the SP group was significantly higher than the rate in the SAT group (50% vs. 8%, p < 0.0007). Instead, the rate of vaginal deliveries without intervention in the SP group was significantly lower than the rate in the SA group (14% vs. 71%, p < 0.0001). CONCLUSIONS Fetal spine position could have an important role in determining fetal occiput position at birth. Spine position might play a crucial role in the outcome of delivery.
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Affiliation(s)
- A Svelato
- Department of Obstetrics and Gynecology, Massa Carrara General Hospital, Massa Carrara, Italy.
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Orlandini C, Torricelli M, Spirito N, Alaimo L, Di Tommaso M, Severi FM, Ragusa A, Petraglia F. Maternal anemia effects during pregnancy on male and female fetuses: are there any differences? J Matern Fetal Neonatal Med 2016; 30:1704-1708. [DOI: 10.1080/14767058.2016.1222607] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Cinzia Orlandini
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy,
| | - Michela Torricelli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy,
| | - Nicoletta Spirito
- Department of Obstetric and Gynecology, Ospedale Apuane, Massa Carrara, Italy, and
| | - Lucia Alaimo
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy,
| | - Mariarosaria Di Tommaso
- Department of Health Sciences, Division of Pediatrics, Obstetrics and Gynecology and Nursing Science, University of Florence, Florence, Italy
| | | | - Antonio Ragusa
- Department of Obstetric and Gynecology, Ospedale Apuane, Massa Carrara, Italy, and
| | - Felice Petraglia
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy,
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Affiliation(s)
- Alessandro Svelato
- Department of Cardiovascular Pediatrics and Neonatology, G. Monasterio Tuscany Foundation, G. Pasquinucci Heart Hospital, Massa, Italy.
| | | | - Roberta Spinoso
- Department of Obstetrics and Gynecology, Villa Serena Private Hospital, Palermo, Italy
| | - Antonio Ragusa
- Department of Obstetrics and Gynecology, Massa Carrara General Hospital, Massa Carrara, Italy
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Ragusa A, Gizzo S, Noventa M, Ferrazzi E, Deiana S, Svelato A. Prevention of primary caesarean delivery: comprehensive management of dystocia in nulliparous patients at term. Arch Gynecol Obstet 2016; 294:753-61. [PMID: 26924640 DOI: 10.1007/s00404-016-4046-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 02/09/2016] [Indexed: 12/18/2022]
Abstract
PURPOSE Dystocia is the leading indication for primary caesarean sections. Our aim is to compare two approaches in the management of dystocia in labor in nulliparous women with a singleton fetus in cephalic presentation at term in spontaneous or induced labor. METHODS Prospective cohort study. Four hundred and nineteen consecutive patients were divided into two groups: the standard management group (SM), in acceleration of labor was commenced at the "action line" in the case of arrested or protracted labor, and the comprehensive management group (CM) in which arrested or protracted labor was considered as a warning sign promoting further diagnostic assessment prior to considering intervention. RESULTS Caesarean sections rate was 22.2 % in the SM group (216 patients) and 10.3 % in the CM group (203 patients) (p = 0.001). The rate of oxytocin use decreased from 33.3 % in SM group to 13.8 % in the CM group (p < 0.0005). The rate of amniotomy decreased from 41.7 % in the SM group to 7.4 % in the CM group (p < 0.0005). The percentage of newborns with 5-min Apgar score <7 and/or umbilical cord arterial pH ≤ 7.00 decreased from 2.3 % in SM cohort to 0.5 % in CM cohort (p = ns). The average length of labor did not differ between the two groups of patients (264 vs 277 min; p = ns). CONCLUSION Comprehensive management of dystocia enabled us to achieve a reduction in iatrogenic interventions in labor while maintaining good neonatal outcomes.
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Affiliation(s)
- Antonio Ragusa
- Dipartimento Materno Infantile, U.O.C. di Ginecologia e Ostetricia, Massa Carrara Hospital, Via Enrico Mattei 21, 54100, Massa Carrara, Italy.
| | - Salvatore Gizzo
- Dipartimento di Salute della Donna e del Bambino, U.O.C. di Ginecologia e Ostetricia, University of Padua, Via Giustiniani 3, 35128, Padua, Italy
| | - Marco Noventa
- Dipartimento di Salute della Donna e del Bambino, U.O.C. di Ginecologia e Ostetricia, University of Padua, Via Giustiniani 3, 35128, Padua, Italy
| | - Enrico Ferrazzi
- Department of Woman, Mother and Newborn, School of Medicine, Ospedale "V. Buzzi", Milan, Italy
| | - Sara Deiana
- Department of Obstetrics and Gynaecology, San Giovanni di Dio General Hospital, University of Cagliari, Cagliari, Italy
| | - Alessandro Svelato
- Department of Obstetrics and Gynaecology, Carlo Poma General Hospital, Mantua, Italy
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Caboni P, Meloni A, Lussu M, Carta E, Barberini L, Noto A, Deiana SF, Mereu R, Ragusa A, Paoletti AM, Melis GB, Fanos V, Atzori L. Urinary metabolomics of pregnant women at term: a combined GC/MS and NMR approach. J Matern Fetal Neonatal Med 2015; 27 Suppl 2:4-12. [PMID: 25284171 DOI: 10.3109/14767058.2014.956403] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Physiological changes leading to parturition are not completely understood while clinical diagnosis of labour is still retrospective. Gas chromatography mass spectrometry (GC/MS) and nuclear magnetic resonance spectroscopy (NMR) represent two of the main analytical platforms used in clinical metabolomics. Metabolomics might help us to improve our knowledge about the biochemical mechanisms underlying labour. METHODS Urine samples (n = 59), collected from pregnant women at term of gestation before and/or after the onset of labour, were analysed by GC/MS and NMR techniques in order to identify the metabolic profile. Both GC/MS and NMR data matrices containing the identified metabolites were analysed by multivariate statistical techniques in order to characterise the discriminant variables between labour (L) and not labour (NL) status. RESULTS 18 potential metabolites (11 with (1)H-NMR, eight with GC-MS: glycine was relevant in both) were found discriminant in urine of women during labour. Taken together, the identified metabolites produced a composite biomarker pattern, a sort of barcode, capable of differentiating between labour and not labour conditions. Major discriminant metabolites for NMR and GC/MS analysis were: alanine, glycine, acetone, 3-hydroxybutiyric acid, 2,3,4-trihydroxybutyric acid and succinic acid, giving a urine metabolite signature on the late phase of labour. CONCLUSIONS The metabolomics analysis evidenced clusters of metabolites involved in labour condition able to discriminate between urine samples collected before the onset and during labour, potentially offering the promise of a robust screening test.
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Affiliation(s)
- Pierluigi Caboni
- Department of Life and Environmental Sciences, University of Cagliari , Cagliari , Italy
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Youssef A, Salsi G, Ragusa A, Ghi T, Pacella G, Rizzo N, Pilu G. Caregiver's satisfaction with a video tutorial for shoulder dystocia management algorithm. J OBSTET GYNAECOL 2014; 35:461-4. [PMID: 25357086 DOI: 10.3109/01443615.2014.969208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In our questionnaire, a video tutorial illustrating the management of shoulder dystocia was considered by health personnel as a useful complementary training tool. We prepared a 5-min video tutorial on the management of shoulder dystocia, using a simulator that includes maternal pelvic and baby models. We performed a survey among obstetric personnel in order to assess their opinion on the tutorial by inviting them to watch the video tutorial and answer an online questionnaire. Five multiple-choice questions were set, focusing on the video's main objectives: clarity, simplicity and usefulness. Following the collection of answers, global and category-weighted analyses were conducted for each question. Out of 956 invitations sent, 482 (50.4%) answered the survey. More than 90% of all categories found the video tutorial to be clinically relevant and clear. For revising the management of shoulder dystocia most obstetric personnel would use the video tutorial together with traditional textbooks. In conclusion, our video tutorial was considered by health personnel as a useful complementary training tool.
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Affiliation(s)
- A Youssef
- a Department of Obstetrics and Gynecology , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - G Salsi
- a Department of Obstetrics and Gynecology , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - A Ragusa
- b Department of Obstetrics and Gynecology , Niguarda Hospital , Milan , Italy
| | - T Ghi
- a Department of Obstetrics and Gynecology , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - G Pacella
- a Department of Obstetrics and Gynecology , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - N Rizzo
- a Department of Obstetrics and Gynecology , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - G Pilu
- a Department of Obstetrics and Gynecology , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
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Massaro M, Caló R, Rinaldi E, Battista C, Ghezzani F, Miccoli M, Di Maggio D, Ferrara A, Morciano I, Nibio A, Ragusa A, Cucci F. Cardiac involvement in acute thrombotic thrombocytopenic purpura: a case of conduction system defect. Transfus Apher Sci 2014. [DOI: 10.1016/s1473-0502(14)50052-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Catalano D, Trovato GM, Ragusa A, Martines GF, Tonzuso A, Pirri C, Buccheri MA, Trovato FM. Non-alcoholic fatty liver disease (NAFLD) and MTHFR 1298A > C gene polymorphism. Eur Rev Med Pharmacol Sci 2014; 18:151-159. [PMID: 24488901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Non-Alcoholic Fatty Liver Disease (NAFLD) is related to unhealthy habits, mainly to unfavorable dietary profiles. MTHFR gene encodes MethyleneTetraHydroFolate Reductase, a regulatory enzyme whose polymorphisms are associated with hyperhomocysteinemia. Among polymorphisms, C677T, a thermolabile form, but not A1298C, thermostable, was associated with fatty liver and insulin resistance. AIM to investigate if NAFLD, in subjects referred for nutritional assessment and counselling, has any difference of prevalence and severity when associated with isolated MTHFR A1298C polymorphism and hyperhomocysteinemia. PATIENTS AND METHODS 94 subjects, age 55.65 ± 15.43 years, BMI 27.88 ± 5.17 kg/m2, 26 with MTHFR Wild type genotype (1298AA) and 68 with MTHFRA1298C single polymorphism were studied: of them, 35 were homozygous (MTHFR1298CC), 33 were heterozygous (MHTFR 1298AC). Insulin resistance was assessed by HOMA-IR, NAFLD by UltraSound Brigh-Liver-Score (BLS). RESULTS MTHFR subgroups (wild and A1298C single polymorphism) were not different for age, gender, dietary profile and BMI. In NAFLD, MTHFR 1298AC (heterozygous) vs. homozygous wild genotype (MTHFR 1298AA) patients had more severe NAFLD (BLS: 1.12 ± 1.14 vs. 0.54 ± 0.76, p < 0.029), greater insulin resistance (HOMA 3.20±2.35 vs. 2.12 ± 1.12; p < 0.036), higher AST and gammaGT. CONCLUSIONS MTHFR1298AC gene heterozygous polymorphisms can be weakly predictive for NAFLD severity. This mutation occurs frequently in populations with low prevalence of overall mortality and of atherosclerosis-associated disease: it could have maintained and maintain its persistence by an heterozygosis advantage mechanism, within significant adherence to healthy nutritional profiles. Interactions of nutrition, genetics and health are a part of the aging process throughout the life span and a greater consideration to the genetic characteristics of populations and individuals is warranted.
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Affiliation(s)
- D Catalano
- Department of Medical and Pediatric Sciences, University of Catania, Catania, Italy.
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Svelato A, Ragusa A, Perino A, Meroni MG. Is x-ray compulsory in pubic symphysis diastasis diagnosis? Acta Obstet Gynecol Scand 2013; 93:219. [PMID: 24576154 DOI: 10.1111/aogs.12275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 10/01/2013] [Indexed: 12/16/2022]
Affiliation(s)
- Alessandro Svelato
- Department of Obstetrics and Gynecology, University Hospital Paolo Giaccone, Palermo, Italy
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Puntoni M, Ragusa A, Sbrana F, Bigazzi F, Sampietro T. Tangier skin fibroblasts show early senescence also in heterozygous state. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Youssef A, Maroni E, Ragusa A, De Musso F, Salsi G, Iammarino MT, Paccapelo A, Rizzo N, Pilu G, Ghi T. Fetal head-symphysis distance: a simple and reliable ultrasound index of fetal head station in labor. Ultrasound Obstet Gynecol 2013; 41:419-424. [PMID: 23124698 DOI: 10.1002/uog.12335] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/22/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To assess the reproducibility of measurement of a new sonographic index of fetal head station in labor, the fetal head-symphysis distance (HSD), using three-dimensional ultrasound, and its correlation with digital assessment of fetal head descent and with the angle of progression (AoP). METHODS Three-dimensional (3D) ultrasound volumes were acquired from 47 nulliparous women in active labor following assessment of fetal head station with digital examination. The HSD (the distance between the lower edge of the pubic symphysis and the nearest point of the fetal skull) was measured independently by two operators in order to evaluate intra- and interobserver reproducibility. The correlation between HSD, AoP and fetal head station was evaluated using regression analysis. Using 3D tomographic ultrasound imaging (TUI), measurements of the HSD were obtained in different parasagittal planes to evaluate the influence of inaccurate alignment of the probe with the midline of the pelvis. RESULTS Measurement of HSD showed high intraobserver (intraclass correlation coefficient (ICC) = 0.995; 95% CI, 0.991-0.997) and interobserver (ICC = 0.991; 95% CI, 0.984-0.995) reliability. In addition, a high correlation was demonstrated between mid-sagittal and parasagittal HSD measurements. HSD showed significant negative correlation with both fetal head station and AoP. CONCLUSION Fetal HSD is a simple and reliable method for the assessment of fetal head descent in labor.
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Affiliation(s)
- A Youssef
- Department of Obstetrics and Gynecology, Sant'Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy.
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