Biomedical subjects

Francesco De Seta

Publications and source records attributed to Francesco De Seta.

10 recordsLinked to original sources

PubMed2005

VE-cadherin is a critical molecule for trophoblast-endothelial cell interaction in decidual spiral arteries.

Fetal cytotrophoblasts colonize the decidual spiral arteries during pregnancy and partially replace the endothelium by an as yet unknown mechanism. To clarify this issue, we cocultured trophoblast cells (TCs) and decidual endothelial cells (DECs) isolated from first trimester placentae and found by electron microscopic analysis that TCs adhered to DECs and migrated through the interendothelial junctions within 24 h. Since extravillous TCs were shown by FACS analysis to express vascular-endothelial (VE)-cadherin and platelet endothelial cell adhesion molecule-1 (PECAM)-1, we investigated the role of these junctional molecules in TC adhesion to DECs and transendothelial migration of cytotrophoblasts. Both VE-cadherin and PECAM-1 were present at the contact sites between TCs and DECs in decidual sections. TC adhesion and migration were markedly inhibited by mAbs to VE-cadherin and marginally by mAb to PECAM-1. Increased expression of VE-cadherin was observed at the contact areas between TCs and DECs, whereas PECAM-1 was found to be redistributed from intercellular junctions. The induction of apoptosis of DECs by TCs, as the mechanism responsible for their replacement, was ruled out by the negative staining with TUNEL of DECs cocultured with TCs and the absence of DNA fragmentation. In conclusion, VE-cadherin is involved in transendothelial migration of TCs, and replacement of DECs by TCs is not the result of apoptosis.

Antigens, CD↗

PubMed2005

First-trimester intrauterine hematoma and outcome of pregnancy.

OBJECTIVE: To evaluate the outcome of pregnancies complicated by first-trimester intrauterine hematoma. METHODS: An analysis was performed on 248 cases. The pregnancy outcome was correlated with hematoma volume, gestational age (weeks), and maternal age (years). RESULTS: One hundred eighty-two cases were eligible for the study. Clinical complications occurred in 38.5% of the cases (adverse outcome group). Spontaneous abortion (14.3%), fetal growth restriction (7.7%), and preterm delivery (6.6%) were the most frequent clinical conditions observed. Considering the hematoma variables in adverse and favorable outcome groups, we found a significant difference only for gestational age at diagnosis. The median gestational age was significantly lower (P < .02) in the adverse outcome group (7.27, I and III quartiles 6.22-8.78) than in the favorable outcome cases (8.62, I and III quartiles 6.70-9.98). Among clinical conditions, the median gestational age was significantly lower (P = .02) in pregnancies complicated by spontaneous abortion (6.60, I and III quartiles 5.95-8.36) than in cases not ending in a miscarriage (8.50, I and III quartiles 6.70-9.91). The overall risk of adverse outcome was 2.4 times higher when the hematoma was diagnosed before 9 weeks (odds ratio 2.37, 95% confidence interval 1.20-4.70). In particular, intrauterine hematoma observed before 9 weeks significantly increases the risk of spontaneous abortion (odds ratio 14.79, 95% confidence interval 1.95-112.09) CONCLUSION: Intrauterine hematoma can affect the outcome of pregnancy. The risk of spontaneous abortion is related to gestational age and is significantly increased if diagnosed before 9 weeks. LEVEL OF EVIDENCE: III.

Abortion, Spontaneous↗

PubMed2005

The complement system at the fetomaternal interface.

The placenta has a unique structural organization that allows fetal cells expressing paternal alloantigens to establish a peaceful cohabitation with the maternal immune system. The fetal cells are continuously exposed to the humoral and cellular components of the maternal immune system present in the maternal blood that circulates in the intervillous space and in the decidual vessels. This review deals with the role played by the complement system at the placental level both in physiological and pathological conditions of pregnancies. Complement components found in the placental tissue derive to a large extent from blood circulating in placental vessels. However, some complement components may also be produced locally by macrophages and other cell types. Deposition of complement components at tissue level is usually found in association with inflammatory diseases. This is not the case in placentae in which deposits of complement components can also be documented in physiological conditions not resulting in fetal damage. Protection of the semiallogenic human conceptus against maternal complement activation products is achieved by surface expression of complement regulators that act at different steps of the complement sequence. These complement regulators are localized in a strategic position on the surface of villous trophoblast protecting the fetus from the damage that may derive from uncontrolled complement activation. However, pathological conditions of pregnancies may lead to deposition of a higher amount of complement activation products that may exceed the protection of local complement regulators.

Animals↗

PubMed2005

Parametric evaluation of heart rate variability during the menstrual cycle in young women.

Evaluation of heart rate variability (HRV) is based on analysis of consecutive R-R intervals and may provide quantitative information on the modulation of cardiac vagal and sympathetic efferent activities. In particular, power spectral analysis as well as the fractal dimension of HRV represent non-invasive measures that reflect brain-heart interaction in different physiopathological conditions. This study was performed to investigate the relationship between autonomic nervous cardiac influence and three phases (menses, follicular phase and luteal phase) of the menstrual cycle. Heart rate (HR) was recorded in 6 eumenorrheic young females, continuously for 20 min, at rest. From the tachograms, fractal dimension, FFT spectra and beta coefficient were evaluated. The components of two spectral bands were calculated: 0.040 Hz - 0.150 Hz (low frequency, LF), and 0.150 Hz - 0.80 Hz (high frequency, HF). The results indicate no correlation between HR and follicular as well as luteal phase of the menstrual cycle. Total power and HF spectral component increase, whereas LF spectral component decreases in the luteal phase compared to the follicular one. The fractal dimension does not show significant differences among the three phases. Beta coefficient decreases during luteal phase in respect of follicular one and menses. In conclusion, these results indicate in healthy young women a correlation between female sex hormones (17 beta-oestradiol, progesterone and pituitary gonadotrophins) concentrations and some HRV parameters with higher HR variability during the luteal phase.

Adult↗

PubMed2005

Bacterial vaginosis and preterm delivery: an open question.

OBJECTIVE: To evaluate the prevalence of bacterial vaginosis in a population of Italian pregnant women and to study its association with adverse pregnancy outcomes, particularly preterm delivery. STUDY DESIGN: After giving informed consent, 598 women were consecutively enrolled at their first prenatal visit (13-18 weeks of gestation). The presence of bacterial vaginosis was assessed by Gram's method at 13-18 weeks of gestation (early bacterial vaginosis) and at 28-32 weeks of gestation (late bacterial vaginosis). Univariate and multiple logistic regression models of analysis were used to assess the statistical significance of the data. RESULTS: Preterm delivery occurred in 14.7% of pregnant women positivefor bacterial vaginosis at theirfirst prenatal visit and in 6.9% of healthy women (OR 1.6, CI 1.07-2.51). In patients with bacterial vaginosis, preterm delivery occurred more often in the 36th week of gestation (78.6%). CONCLUSION: The presence of bacterial vaginosis at an early gestational age is associated with preterm delivery, although in the study population the condition did not seem to be related to great prematurity.

Adult↗

PubMed2004

Gestational diabetes: universal or selective screening?

OBJECTIVE: To evaluate the incidence of gestational diabetes in our population and verify costs of universal screening. To assess neonatal and obstetrical outcomes with respect to maternal epidemiological characteristics. METHODS: Eight hundred and fifty-six pregnant women between 24th and 28th weeks of gestation were examined in this observational study. Universal screening with glucose challenge test was used to screen the group for gestational diabetes. History, obstetrical and neonatal outcomes were collected and then analyzed. RESULTS: Gestational diabetes was diagnosed in 6.6% of cases. Patients with at least one risk factor had a cesarean section in 50% of cases and a spontaneous vaginal delivery in 23.59% of cases (p < 0.001). The absence of any risk factor was found in 73.7% of positive glucose tolerance test and in 62.5% of affected patients. The cost of universal screening in our study, was 57,60 Euros per case identified. CONCLUSIONS: Given the high prevalence of diabetes, the high proportion of patients potentially not identified with a selective screening in this study and the relatively low cost, universal screening for gestational diabetes seems the best way to identify patients and prevent adverse obstetrical and neonatal outcomes.

Adult↗

PubMed2004

The effects of mediolateral episiotomy on pelvic floor function after vaginal delivery.

OBJECTIVE: To evaluate the effect of mediolateral episiotomy on puerperal pelvic floor strength and dysfunction (urinary and anal incontinence, genital prolapse). METHODS: Five hundred nineteen primiparous women were enrolled 3 months after vaginal delivery. Puerperae were divided in 2 groups: group A (254 women) comprised the women who received mediolateral episiotomy and group B (265 women) the women with intact perineum and first- and second-degree spontaneous perineal lacerations. Each woman was questioned about urogynecological symptoms and examined by digital test, vaginal perineometry, and uroflowmetric stop test score. Data were subjected to Student t test and Fisher exact test to assess, respectively, the difference between the mean values and the proportions within the subpopulations. Using a simple logistic regression model to test an estimate of relative risk, we expressed the odds ratios of the variables considered with respect to the control population (group B). RESULTS: No significant difference was found with regard to the incidence of urinary and anal incontinence and genital prolapse, whereas dyspareunia and perineal pain were significantly higher in the episiotomy group (7.9% versus 3.4%, P =.026; 6.7% versus 2.3%, P =.014, respectively). Episiotomy was associated with significantly lower values, both in digital test (2.2 versus 2.6; P <.001) and in vaginal manometry (12.2 versus 13.8 cm water; P <.001), but not in uroflowmetric stop test. CONCLUSION: Mediolateral episiotomy does not protect against urinary and anal incontinence and genital prolapse and is associated with a lower pelvic floor muscle strength compared with spontaneous perineal lacerations and with more dyspareunia and perineal pain. LEVEL OF EVIDENCE: II-2

Adult↗

PubMed2004

Condylomata acuminata of the neovagina in a HIV-seropositive male-to-female transsexual.

We present an unusual case of condylomata acuminata arising in the transplanted skin of a neovagina in a male-to-female transsexual. The neovagina had been constructed using a penile and a scrotal skin flap. Resection of the larger condylomata was performed; then all visible lesions were ablated by electrovaporization. Microsocpic examination and DNA hybridization revealed condylomata acuminata due to human papillomavirus type 16, 31, and 33 infection.

Adult↗

PubMed2003

Treatment of asymptomatic bacterial vaginosis to prevent pre-term delivery: a randomised trial.

OBJECTIVES: To evaluate the efficacy of clindamycin vaginal cream 2% once daily for 7 days in prolonging pregnancy. STUDY DESIGN: Randomised clinical trial of 112 women between 14 and 25 weeks of gestation with diagnosis of asymptomatic bacterial vaginosis were enrolled in a multicenter randomised trial and assigned to active or no treatment. A total of 55 women were assigned to clindamycin and 57 to no treatment. MAIN OUTCOME MEASURE: frequency of pre-term delivery. RESULTS: The rates of pre-term delivery was 12.2% in the clindamycin group and 15.7% in the no treatment group (P=0.78). Birth weight was <2500 g in three and seven babies, respectively, in the two groups (P=0.32). Mean gestational ages at birth were 38.9 and 39.2 (P=0.52), respectively, in the clindamycin and no treatment groups. CONCLUSIONS: The results of this study suggest that treating asymptomatic bacterial vaginosis does neither markedly prolong pregnancy nor increase birthweight.

Anti-Bacterial Agents↗

PubMed2002

Prevalence of bacterial vaginosis and vaginal flora changes in peri- and postmenopausal women.

Our aim was to evaluate the prevalence of bacterial vaginosis and decrease in lactobacillus colonization in women 40 years old or older in relation to menopausal status by evaluation of Gram-stained smears. A total of 1,486 smears from Italian Caucasian women aged 40 to 79 years were examined. Women were classified as follows: fertile (regular cycles) (n = 328), perimenopausal (irregular cycles) (n = 237), and postmenopausal (n = 921), including 331 women on estroprogestinic hormone replacement therapy (HRT). The prevalences of bacterial vaginosis (assessed as a Nugent score of >or=7) in fertile (9.8%) and perimenopausal (11.0%) women were not statistically different, whereas the prevalence was significantly lower overall in postmenopausal women (6.0%) (P = 0.02). Specifically, 6.3% of postmenopausal women without HRT and 5.4% of postmenopausal women with HRT were positive for bacterial vaginosis. The Nugent score system was not adequate for evaluating the normal and intermediate vaginal flora in women over the age of 40 years. High numbers of peri- and postmenopausal women had no lactobacilli and no bacterial-vaginosis-associated microorganisms. This nonpathological absence of lactobacilli in women with a Nugent score of 4 was scored as 4*, and this group was considered separately from the intermediate flora group. A score of 4* was obtained for 2.1% of fertile women, 11.4% of perimenopausal women, 44.1% of postmenopausal women without HRT, and 6.9% of postmenopausal women with HRT. The physiological reduction in lactobacillus colonization of the vagina in postmenopausal women does not cause an increase in bacterial-vaginosis prevalence. Reversion of lactobacillus flora to premenopausal levels due to HRT does not increase the prevalence of bacterial vaginosis in postmenopausal women.

Adult↗