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Manuela Neri,1–3 Gian Benedetto Melis,1–3 Elena Giancane,1–3 Valerio Vallerino,1–3 Monica Pilloni,1–3 Bruno Piras,1–3 Alessandro Loddo,1–3 Anna Maria Paoletti,1–3 Valerio Mais1–3 1Department of Obstetrics and Gynaecology, University of Cagliari, Italy; 2Department of Surgical Sciences, University of Cagliari, Italy; 3Maternal Child Department, University Hospital of Cagliari, ItalyCorrespondence: Manuela NeriDepartment of Obstetrics and Gynaecology, Department of Surgical Sciences, University of Cagliari, Maternal Child Department, University Hospital of Cagliari, Policlinico Universitario Duilio Casula, SS 554 – bivio Sestu, blocco Q, Monserrato, Cagliari 09042, ItalyTel +39 333 8867567Email manu.neri11@hotmail.itAbstract: Uterine fibroids (UFs) are the most common gynaecological benign disease. Even though often asymptomatic, UFs can worsen women’s health and their quality of life, causing heavy bleeding and anaemia, pelvic discomfort and reduced fertility. Surgical treatment of UFs could be limited by its invasiveness and the desire to preserve fertility. Thus, effective medical therapies for the management of this condition are needed. Common drugs used to control bleeding, such us hormonal contraceptive or levonorgestrel-releasing intrauterine system, have no effect on fibroids volume. Among other more efficient treatments, the gonadotropin-releasing hormone (GnRH) agonist or the selective progesterone-receptor modulators have a non-neutral safety profile; thus, they are used for limited periods or for cyclic treatments. Elagolix is a potent, orally bioavailable, non-peptide GnRH antagonist that acts by a competitive block of the GnRH receptor. The biological effect is a dose-dependent inhibition of gonadal axis, without a total suppression of estradiol concentrations. For this reason, even though comparative studies between elagolix and GnRH agonists have not been performed, elagolix has been associated with a better profile of adverse events. Recently, elagolix received US FDA approval for the treatment of moderate to severe pain caused by endometriosis. Several clinical trials assessed the efficacy of elagolix for the treatment of heavy bleeding caused by UFs and the definitive results of Phase III studies are expected. Available data on elagolix and UFs showed that the drug, with or without low-dose hormone add-back therapy, is able to significantly reduce menstrual blood loss, lead to amenorrhea and improve haemoglobin concentrations in the majority of participants in comparison with placebo. The safety and tolerability profile appeared generally acceptable. The concomitant use of add-back therapy can prevent bone loss due to the hypoestrogenic effect and can improve safety during elagolix treatment.Keywords: uterine fibroids, leiomyomas, elagolix, non-peptide GnRH antagonist, heavy menstrual bleeding

This article describes a case study of a 42-year-old woman who presented with heavy vaginal bleeding. A transvaginal ultrasound scan revealed a normal uterus with an intrauterine system (IUS) in place, but also detected an ectopic pregnancy in the left adnexa. Three-dimensional (3D) ultrasound was then used to confirm the presence of both the IUS and the ectopic pregnancy. The patient underwent emergency surgery to remove the ectopic pregnancy. The article suggests that 3D ultrasound can be a valuable tool in diagnosing complicated cases of ectopic pregnancy and recommends its use in early pregnancy scans. [Extracted from the article]

OBJECTIVE: We aimed to quantitatively evaluate body fat composition in a group of HIV patients treated with Highly Active Anti- retroviral Therapy (HAART) to ascertain both fat loss and fat distribution changes and to identify possible therapeutic and host related associated risk factors. PATIENTS AND METHODS: A total of 180 patients with available total body DEXA scan were assigned to a) Group 1, with clinically evident body fat changes, (BFC) and b) Group 2, without BFC. Clinical and immunovirologic data were collected. We used Student t-test and x2 or Fisher exact test to compare the characteristics of the two groups. Paired t-test was used to compare basal and follow-up data. The relationships between variables were evaluated by calculating Pearson's correlation coefficient and its significance. RESULTS: HAART duration was significantly (p<0.0001) higher for patients in Group 1 than in Group 2, as well as PI (p<0.02) and NRTI (p<0.002) therapy duration. Current CD4 count and CD4 rise from nadir resulted significantly higher in Group 1 than in Group 2 (p<0.02 and 0.006, respectively). Whole Body Fat (WBF), Peripheral Fat (PF) and Leg (L) fat negatively correlated with PI and NRTI therapy duration, while Trunk Fat (TF)/PF positively correlated with PI and NNRTI duration. No significant correlation was found, instead, with NNRTI therapy duration. At 5-year follow-up, we registered a further increase in TF, Arms (A) and L fat, especially in PI-treated patients. CONCLUSIONS: Body fat changes should always be considered when dealing with HIV-affected patients on HAART. The fat loss seemed to involve mainly peripheral regions, while fat accumulation tendency occurred in the trunk. [ABSTRACT FROM AUTHOR]

7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK, Purpose of the study To evaluate the prevalence of respiratory symptoms and COPD in a stable HIV‐infected outpatient population and to further investigate the role of HAART and other possibly [...]

OBJECTIVE: To evaluate the changes in Bone Mineral Density (BMD) and bone remodelling markers in a group of HIV patients treated with HAART and controlled in a long follow up and to identify possible risk factors for accelerated bone mass loss. PATIENTS AND METHODS: In a series of 172 HIV patients treated with HAART a total of 67 patients (44 males and 33 females) underwent repeated bone mineral density measurement by DEXA in lumbar spine and in femur; the patients were classified according to T-score WHO criteria. Serum bone alkaline phosphatase (BAP), by IRMA, and urine pyridinoline/deoxypyridinoline (PYD&DPD), by EIA, were also assayed in all cases. RESULTS: At baseline, 62/67 patients were on HAART, while 5 were naïve; 44.8% were previous intravenous drug users (IVDU), 46.3% heterosexual and 8.9% homosexual, mean age being 40.2 ± 6.5 years, and 23.9% had previous AIDS diagnosis. Fifteen/67 (22.4%) of treated patients had osteoporosis and 25/67 (37.3%) osteopenia in spine and/or femur including 3 naïve, 27/67 (40.3%), including 2 naïve, had normal BMD in both sites. Fifty-one/67 patients were monitored during follow up (56.8 ± 5.3 months); 27 (52.9%) of these (Group 1), received protease inhibitors (PI) and 24 (47.1%), including naïve, (Group 2) received not nucleoside reverse transcriptase inhibitors (NNRTI) for > 50% of follow up period. In Group 1 patients, BMD reduction was observed after follow up in respect of basal condition in both spine and femur, but significantly (p = 0.011) only for the latter. However, mean BMD values remained stable in both sites in Group 2 patients. Basal BAP and PYD&DPD levels were higher in Group 1 than Group 2, but not significantly. Moreover, only PYD&DPD levels at the follow up evaluation were significantly (p = 0.031) higher in Group 1 than Group 2. Of the remaining 16/67 patients with osteoporosis/osteopenia, 10 received PI and 6 NNRTI and were treated with therapies that could increase bone density, in particular, 9 with Alendronate/Vitamin D/Calcium and 7 with only vitamin D/calcium; these patients were excluded from statistical analysis of 51 Group 1/Group 2 cases. In the 16 patients, after these specific treatments, mean spine and femur BMD increased over time, but significantly only in those cases including alendronate in their protocol. CONCLUSIONS: The study showed that in HIV patients on HAART BMD decrease, even osteoporosis, can be present persisting over time, particularly in PI in respect of NNRTI treated patients. The pathogenesis is probably multifactorial, the different antiviral drugs seeming to differently affect bone metabolism. Alendronate/Vitamin D/Calcium therapy can be useful to slow down bone mass loss and also improve osteoporosis/ osteopenia conditions, thus, reducing fracture risk also continuing HAART. [ABSTRACT FROM AUTHOR]

Objective: This study is a proof of concept that aims to measure the impacts of a human/cobot collaboration on the human and his task during a simulated chemistry assembly., Background: The 5th industrial revolution calls for refocusing work on the human operator, placing him or her at the center of the system. Thus, cobotic systems are increasingly implemented to support human work. In this research, we study the impact of a real-life cobot on the performance (e.g. number of errors, time completion), workload, risk exposure and acceptability of participants realizing an industrial-like assembly task., Method: Participants had to reproduce an assembly model with Duplos in collaboration with a cobot in a laboratory setting. The effect of the human expertise on the task (prior to the collaboration) and the level of cobot adaptation to human safety constraints on the performance at the task and on operator were tested., Results: The main results report that expert participants did less mistakes and were less exposed to risks than non-experts. However, both of them succeeded in the task thanks to the cobot adaptation. Also, the cobot was able to adapt to human safety constraints. This adaptation led participants to expose themselves to fewer risks. Also, contrary to previous findings, experts had a similar score of acceptability than non-experts., Conclusion: This laboratory experiment is a proof of concept demonstrating that using a cobotic solution could potentially assist humans in supporting high-risk work operations., Application: Cobotic system designers and work designers could benefit from this research's exploratory results when supporting the design of constraints in workstations for high-risk work operations., Competing Interests: Conflict of interest The authors declare that no conflicts of interest might have influence theresearch., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

Background: Over the past decade, transvaginal ultrasound (TVUS) has revolutionized the diagnosis of deep endometriosis. We can now accurately describe and evaluate lesions in multiple compartments of the pelvis, increasing diagnostic capacity without the need for initial laparoscopy. Recent consensus and publications support the new and growing evidence for this technique. Research into deep endometriosis has increased substantially, and new diagnostic evidence is now available., Objectives: The aim of this article was to review the state of the art in ultrasound diagnosis of deep endometriosis., Methods: We performed a detailed search of the PubMed database to identify eligible primary studies. We included English-language publications with the following terms: "endometriosis" AND "deep" AND "ultrasound" AND "transvaginal." Studies focusing on ultrasound in deep endometriosis were included; we selected them based on title reading, then narrowed the selection by reading the abstract. We excluded publications that did not use TVUS as one of the main techniques to evaluate deep endometriosis., Results: Two hundred forty-three studies were identified and selected as described above, resulting in a total of 73 studies included in this review., Conclusions: Our understanding of deep endometriosis has evolved over the past decade. Efforts have been made to reduce the diagnostic delay in this common disease, particularly with the increased use of imaging, especially TVUS, as a first-line diagnostic modality because of its availability, good test performance, cost-effectiveness, and low environmental impact compared to other imaging modalities. This statement is supported by recent publications and guidelines from some medical societies. Advances in technology, equipment and research have allowed us to identify additional compartments involved, including the parametrium. The progress made in recent years offers hope for earlier detection and improved management of patients with suspected endometriosis who suffer not only from pelvic pain but also from infertility., (© 2025 S. Karger AG, Basel.)

We report the use of a new multiplex Real-Time PCR platform to simultaneously identify 24 pathogens and 3 antimicrobial-resistance genes directly from respiratory samples of COVID-19 patients. Results were compared to culture-based diagnosis. Secondary infections were detected in 60% of COVID-19 patients by molecular analysis and 73% by microbiological assays, with no significant differences in accuracy, indicating Gram-negative bacteria as the predominant species. Among fungal superinfections, Aspergillus spp. were detected by both methods in more than 7% of COVID-19 patients. Oxacillin-resistant S. aureus and carbapenem-resistant K. pneumoniae were highlighted by both methods. Secondary microbial infections in SARS-CoV-2 patients are associated with poor outcomes and an increased risk of death. Since PCR-based tests significantly reduce the turnaround time to 4 hours and 30 minutes (compared to 48 hours for microbial culture), we strongly support the routine use of molecular techniques, in conjunction with microbiological analysis, to identify co/secondary infections., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (Copyright © 2024 Elsevier Inc. All rights reserved.)