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Background: Pain plays a central role in endometriosis. The complex relationship among pain characteristics, comorbid pain disorders and daily life represents a challenge for medical support. This multicentre cross‐sectional case–control study analysed the association between endometriosis‐related chronic pain and functions of daily life in 510 women with endometriosis, 265 (52%) who experienced chronic pain, either from endometriosis alone (N = 134, 26.3%) or in association with additional pain disorders (N = 131, 25.7%). Methods: Self‐administered questionnaires from the Brief Pain Inventory and the Pain Disability Index were used to investigate associations between pain characteristics (frequency, duration, intensity) and daily life. Also, associations between different endometriosis characteristics (rASRM stage, presence of adhesions, localisation of lesions) and pain were evaluated. Results: Chronic pain is negatively associated with almost all (12/14) aspects of daily life investigated, including standing, walking, sitting, defaecation, sleep, sports activities, family and domestic responsibilities, sexuality, social functioning, professional life, mood, and joy of life. Altogether, 33.7% of women with chronic pain reported moderate and 27.5% severe limitations. Comorbid pain disorders resulted in significantly more limitations. The length of pain episodes showed a particularly important influence, especially for family/domestic responsibilities (OR 22.94, p < 0.001), professional life (OR 16.56, p < 0.001) and social functioning (OR 41.03, p < 0.001). Conclusions: Our data confirm that despite treatment, about 50% of women experience pain. Pain was associated with at least moderate negative effects on almost all areas of daily life; additional pain comorbidities increased limitations. Improving pain management is essential for improving quality of life in women with endometriosis. Significance: The study provides an accurate overview of the impact of endometriosis‐associated pain on daily life. This is important because pain plays a central role in women living with endometriosis, and despite modern therapies, many women continue to suffer from chronic pain. The detailed analysis of its impact with a comprehensive survey of all aspects of daily life in a very large study population is unique. We expect an improved understanding of consequences of pain to significantly advance medical support in these patients. [ABSTRACT FROM AUTHOR]

Some microbial sexually transmitted infections (STIs) have adverse effects on the reproductive tract, sperm function, and male fertility. Given that STIs are often asymptomatic and cause major complications such as urogenital inflammation, fibrosis, and scarring, optimal treatments should be performed to prevent the noxious effect of STIs on male fertility. Among STIs, Chlamydia trachomatis is the most common asymptomatic preventable bacterial STI. C. trachomatis can affect both sperm and the male reproductive tract. Recently, mesenchymal stem cells (MSCs) derived exosomes have been considered as a new therapeutic medicine due to their immunomodulatory, anti-inflammatory, anti-oxidant, and regenerative effects without consequences through the stem cell transplantation based therapies. Inflammation of the genital tract and sperm dysfunction are the consequences of the microbial infections, especially Chlamydia trachomatis. Exosome therapy as a noninvasive approach has shown promising results on the ability to regenerate the damaged sperm and treating asthenozoospermia. Recent experimental methods may be helpful in the novel treatments of male infertility. Thus, it is demonstrated that exosomes play an important role in preventing the consequences of infection, and thereby preventing inflammation, reducing cell damage, inhibiting fibrogenesis, and reducing scar formation. This review aimed to overview the studies about the potential therapeutic roles of MSCs-derived exosomes on sperm abnormalities and male infertility caused by STIs. [ABSTRACT FROM AUTHOR]

Background: Diagnostic ultrasound has revolutionized obstetric practice. Doppler techniques provided in vivo studies of the fetus-placental and uterus-placental circulations, in an increasingly precise manner. The assessment of fetal well-being is essential in obstetric practice, however, in veterinary medicine, there is a deficit of ultrasound parameters related to fetal distress. The main of this research was to determine the hemodynamic characteristics and behavior, through Doppler ultrasonography, of maternal-fetal vessels during the final third of gestation in bitches with fetuses under stress, as well as correlating them with each other and with fetal distress. Materials, Methods & Results: An observational, prospective study was carried out, in which 30 healthy bitches were examined, during the last third of pregnancy, with fetuses under fetal distress. Fetuses were evaluated in 2 stages: (1st): 50-54 days and (2nd): 55-60 days of gestation. All fetuses were calmly assessed, one by one, and fetal heart rate (FHR) was measured 5 times, for at least 3 min, to identify and confirm fetal distress. At least 3 fetuses were evaluated in each bitch and each measurement was performed in triplicate, setting a hemodynamic mean for each value evaluated. The flow pattern in the middle cerebral artery (MCA), internal carotid artery (ICA) and umbilical artery (UA) was evaluated. The analyzed vessel was initially visualized in B mode, followed by evaluation by color and spectral Doppler. The variables observed were: peak systolic velocity (PSV), end diastolic velocity (EDV) and the resistivity (RI) and pulsatility (PI) index, as well as the systole/diastole ratio (S/D). The analysis of RI and PI of the umbilical artery showed a statistically significant difference between the mean values found for the times studied, increasing from time 1 to time 2. For middle cerebral and internal carotid arteries, PI, RI and the relationship systole/diastole (S/D), showed a statistically significant difference between the mean values found for the times studied, decreasing from time 1 to time 2. Discussion: Fetal heart rate (HR) findings are considered normal above 200 beats per minute (bpm), only if preceded by acceleration and deceleration. This fact confirms the presence of fetal stress, by this parameter, for the fetuses in the present study. Corroborating the picture of fetal distress, another study concluded that HR tends to increase up to 20 days before delivery, a fact that did not occur in the study in question, where animals in the same gestational period were evaluated. Recent research has concluded that an elevated umbilical artery PI at 28 weeks of gestation, in the absence of fetal growth restriction or prematurity, is associated with some adverse cognitive findings in 12-year-olds children. In the present study, a progressive increase in this index was observed throughout the final third of pregnancy. Although the pups were not monitored after birth, this data serves as a warning for veterinarians, and can be useful in the assessment and diagnosis of possible postnatal nervous alterations. Like what was found in the present study, a study reported that from the 4th week to birth, the PSV of the umbilical artery (UA) increased almost linearly, with high significance. For the middle cerebral arteries, the PI showed a statistically significant difference between the mean values found for the times studied, however, decreasing throughout the final third of pregnancy. [ABSTRACT FROM AUTHOR]

More than 30 years have passed since endothelial nitric oxide synthesis was described using the umbilical artery and vein endothelium. That seminal report set the cornerstone for unveiling the molecular aspects of endothelial function. In parallel, the understanding of placental physiology has gained growing interest, due to its crucial role in intrauterine development, with considerable long‐term health consequences. This review discusses the evidence for nitric oxide (NO) as a critical player of placental development and function, with a special focus on endothelial nitric oxide synthase (eNOS) vascular effects. Also, the regulation of eNOS‐dependent vascular responses in normal pregnancy and pregnancy‐related diseases and their impact on prenatal and postnatal vascular health are discussed. Recent and compelling evidence has reinforced that eNOS regulation results from a complex network of processes, with novel data concerning mechanisms such as mechano‐sensing, epigenetic, posttranslational modifications, and the expression of NO‐ and l‐arginine‐related pathways. In this regard, most of these mechanisms are expressed in an arterial‐venous‐specific manner and reflect traits of the fetal systemic circulation. Several studies using umbilical endothelial cells are not aimed to understand placental function but general endothelial function, reinforcing the influence of the placenta on general knowledge in physiology. [ABSTRACT FROM AUTHOR]

Antiphospholipid syndrome is an autoimmune disease characterized by the persistent presence of antiphospholipid antibodies, along with occurrence of vascular thrombosis and pregnancy morbidity. The variety of antiphospholipid antibodies and their related mechanisms, as well as the behavior of disease in wide groups of patients, have led some authors to propose a differentiation of this syndrome into two independent entities: vascular and obstetric antiphospholipid syndrome. Thus, previous studies have discussed whether specific autoantibodies may be responsible for this differentiation or, in contrast, how the same antibodies are able to generate two different clinical presentations. This discussion is yet to be settled. The capability of serum IgG from patients with vascular thrombosis to trigger the biogenesis of endothelial cell-derived microparticles in vitro is one of the previously discussed differences between the clinical entities of antiphospholipid syndrome. These vesicles constitute a prothrombotic mechanism as they can directly lead to clot activation in murine models and recalcified human plasma. Nevertheless, other indirect mechanisms by which microparticles can spread a procoagulant phenotype could be critical to understanding their role in antiphospholipid syndrome. For this reason, questions regarding the cargo of microparticles, and the signaling pathways involved in their biogenesis, are of interest in attempting to explain the behavior of this autoimmune disease. [ABSTRACT FROM AUTHOR]

More than 30 years have passed since endothelial nitric oxide synthesis was described using the umbilical artery and vein endothelium. That seminal report set the cornerstone for unveiling the molecular aspects of endothelial function. In parallel, the understanding of placental physiology has gained growing interest, due to its crucial role in intrauterine development, with considerable long-term health consequences. This review discusses the evidence for nitric oxide (NO) as a critical player of placental development and function, with a special focus on endothelial nitric oxide synthase (eNOS) vascular effects. Also, the regulation of eNOS-dependent vascular responses in normal pregnancy and pregnancy-related diseases and their impact on prenatal and postnatal vascular health are discussed. Recent and compelling evidence has reinforced that eNOS regulation results from a complex network of processes, with novel data concerning mechanisms such as mechano-sensing, epigenetic, posttranslational modifications, and the expression of NO- and l-arginine-related pathways. In this regard, most of these mechanisms are expressed in an arterial-venous-specific manner and reflect traits of the fetal systemic circulation. Several studies using umbilical endothelial cells are not aimed to understand placental function but general endothelial function, reinforcing the influence of the placenta on general knowledge in physiology., (© 2021 Wiley Periodicals LLC.)