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A Agarossi

Publications and source records attributed to A Agarossi.

8 recordsLinked to original sources

Factors predicting the persistence of genital human papillomavirus infections and PAP smear abnormality in HIV-positive and HIV-negative women during prospective follow-up.

As part of an extensive multi-institutional DIANAIDS study focused on assessing the risk factors, natural history, diagnosis and follow-up of genital human papillomavirus (HPV) infections in HIV-infected women, the present communication reports a sub-cohort of 142 women (89 HIV+ and 48 HIV-), followed-up for a mean of 14.07 (+/-10.84) months to analyse the factors predicting the persistence and clearance of HPV infections (polymerase chain reaction [PCR] and sequencing) and cervical Papanicolaou (PAP) smear abnormalities, using both univariate (Kaplan-Meier) and multivariate (Cox) survival analysis. The appearance of new HPV infections during the follow-up was significantly more frequent in HIV-positive than in HIV-negative women, odds ratio (OR) 8.800 (95% confidence interval [CI]: 1.199-64.611), and also the clearance rate was significantly less frequent in HIV-positive than in HIV-negative women, 69.2% vs 22.8%, respectively (OR 0.330; 95% CI: 0.163-0.670). These two groups were also markedly different with respect to the clinical course of the cervical lesions, in the frequency of progressive disease (determined by PAP smear) was higher in HIV-positive group (12/89) than in HIV-negative women (2/52) (OR 3.506; 95% CI 0.816-15.055) (P = 0.055), in whom the disease regressed more frequently than in HIV-positive women (13.5% vs 7.9%) (OR 0.584; 95% CI 0.217-1.573). Using (1) HPV-positivity, (2) oncogenic HPV-type and (3) significant PAP smear abnormality at the end of follow-up as outcome measures, (1) was significantly (P < 0.001) predicted by the following variables in univariate analysis: age, mode of contraception, CD4 count, and HIV-positivity. The significant predictors of (2) were age and mode of contraception. The outcome measure (3) was significantly predicted by CD4 count, PAP smear abnormality and PCR status at entry. In the multivariate analysis, the significant independent predictive factors for HPV-positivity proved to be only the HIV status (P < 0.001), and PCR status at entry, p53 polymorphism at aa-72, oncogenic HPV type and significant PAP smear at entry remained independent predictors, with the significance level of P < 0.05. None of the significant predictors of oncogenic HPV type in univariate analysis retained their independent value in multivariate analysis. Oncogenic HPV type at entry proved to be an independent predictor of significant PAP smear (P < 0.05). The present results indicate that HIV-infected women, even on highly active antiretroviral therapy, demonstrate a more aggressive clinical course of cervical HPV infections, and fail to eradicate the disease more frequently than HIV-negative women. This persistence of HPV-positivity, oncogenic HPV type and significant PAP smear abnormality can be predicted by the results of PAP test and HPV typing in univariate analyses, and partly retain their independent predictive value also in multivariate analysis. Clearly, in addition to regular monitoring by PAP smear, HPV testing for the oncogenic HPV types seems to provide additional prognostic information in the management of cervical lesions in HIV-infected women.

AIDS-Related Opportunistic Infections↗

Cesarean section using the Misgav Ladach method.

OBJECTIVE: To stress the advantages of the Misgav Ladach method for cesarean section. STUDY DESIGN: In this study operative details and the postoperative course of 139 patients who underwent cesarean section according to the Misgav Ladach method in 1995-96 are presented. RESULTS: The Misgav Ladach method reduces operation time, time of child delivery, and time of recovery. The rates of febrile morbidity, wound infection and wound dehiscence are not affected by the new technique. CONCLUSION: Our study highlights the efficiency and safety of the Misgav Ladach method, and points out the speeded recovery, with early ambulation and resumption of drinking and eating, that makes the cesarean section delivery closer and closer to natural childbirth.

Adult↗

Serum 2'-5'-oligoadenylate synthetase levels and clinical response to interferon-beta therapy in women with genital human papillomavirus infection.

To investigate the activity of parenterally administered interferon-beta (IFN-beta) in women with genital human papillomavirus (HPV) infection, serum 2'-5'-oligoadenylate synthetase (2'-5'OAS), an enzyme induced by IFNs, was measured before, during, and after therapy. Serum levels of 2'-5'OAS significantly increased during therapy (P = .005). The patients classified as not responding to treatment at 3 months of follow-up had baseline levels of 2'-5'OAS significantly higher than those who responded to treatment (P = .0011). Differences between the IFN-beta-treated group and untreated controls appeared at day 6 (P = .0019). 2'-5'OAS is a useful parameter in monitoring parenterally administered IFN-beta. The data suggest that women with genital HPV infection and elevated baseline levels of 2'-5'OAS are unlikely to respond to therapy with IFN-beta.

2',5'-Oligoadenylate Synthetase↗

HPV, HIV infection, and risk of cervical intraepithelial neoplasia in former intravenous drug abusers.

The relation between human immunodeficiency virus (HIV), human papilloma virus (HPV) infection, sexual habits, reproductive history, and risk of cervical intraepithelial neoplasia (CIN) has been analyzed in a cross-sectional study conducted since 1986 among female former intravenous drug abusers attending for the first time to the Colposcopic Unit of the Ospedale Luigi Sacco of Milan and women consecutively admitted to the Community for Past Drug Abusers, S. Patrignano, Rimini. A total of 434 subjects entered the study; of those 128 (30%) had a diagnosis of CIN. Compared with HIV-negative subjects, odds ratio (OR) of CIN was 8.0 (95% confidence interval (CI) 4.6-14.1) for HIV-positive ones and the frequency of CIN 2 and 3 was higher in HIV-positive than that in HIV-negative subjects (chi 2(1), trend, 6.67, P 0.01). Compared with women without current HPV infection the OR estimate was 38.0 (95% CI 20.3-71.2) in those with current diagnosis of HPV infection. Considering HIV-positive subjects only, the frequency of CIN increased with stage of HIV infection and was higher in women with lower CD4+ values. Finally, no relation emerged between CIN risk and age, indicators of sexual habits, oral contraceptive use, parity, and history of spontaneous or induced abortions.

Adult↗

Risk factors for respiratory distress syndrome in the newborn. A multicenter Italian survey. Study Group for Lung Maturity of the Italian Society of Perinatal Medicine.

Risk factors for respiratory distress syndrome (RDS) in the newborn have been evaluated using data from a large survey conducted between 1980 and 1989 in selected periods in eleven perinatal units placed in five Italian regions. A total of 1624 liveborn infants consecutively delivered at the collaborating centers, at delivery 26-37 weeks gestational age and without clinically evident congenital anomalies were included in the survey. All the newborns were followed up to the 28th day of life. A total of 131 newborns (7.8%) developed RDS. Overall 1st-7th and 1st-28th day of life infant mortality rates were 54.8 and 61.6/1,000 livebirths; the corresponding rates in babies who developed RDS were 419.8 and 465.6/1,000 livebirths. The frequency of RDS was higher in males than in females and the corresponding relative risk, RR, was 0.7, with 95% confidence interval, CI, ranging from 0.5 to 0.9. The risk of RDS markedly increased with decreasing birth weight: compared to babies weighing more than 2500 g at birth the RR estimates were respectively 1.4, 4.5, 8.8 and 39.3 in those weighing > 2000-2500 g, > 1500-2000 g, > 1000-1500 g and 1000 g or less. Likewise, compared to babies born between the 35th and the 37th week of gestation, the RR of RDS was 3.3 and 21.5 in those born between the 31st-34th or before the 31st week of gestation. Multiple pregnancy, gestational or chronic diabetes, pregnancy-induced or chronic hypertension and premature rupture of the membranes were not related to the risk of RDS.(ABSTRACT TRUNCATED AT 250 WORDS)

Apgar Score↗

Effect of cigarette smoking on plasmatic regulation of vascular prostacyclin in pregnancy and puerperium.

Prostaglandins, particularly prostacyclin, participate in the control of fetal and maternal circulations. In the present study the effect of cigarette smoking on plasma prostacyclin-stimulating activity during late pregnancy and the puerperium (four to six months) and in the newborns was assessed. Plasma samples from 22 apparently healthy nonsmokers and 17 smokers (more than 15 cigarettes per day) were obtained twice during pregnancy and once after delivery. Plasma samples from nine infants born to smokers and seven infants born to nonsmokers were obtained 72 to 96 hours after birth. Plasma activity was evaluated by incubating the plasma samples with cultured rat aortic smooth muscle cells and measuring the prostacyclin released in the culture medium by specific radioimmunoassay of its stable metabolite, 6-keto-prostaglandin F1 alpha. In all of the women, plasma activity did not change significantly during pregnancy or after delivery. In smokers, plasma activity was always lower than in nonsmokers, but not significantly so. The plasma activity of infants born to smokers was significantly lower than that of infants born to nonsmokers.

Animals↗

[Sex behavior and sexually transmitted diseases in drug-dependent women: study of 465 cases].

465 intravenous drug abuser (IVDA) women were studied to evaluate the prevalence of sexually transmitted diseases, 2207 university students have been considered as control group. A complete gynecological evaluation with Pap smear and cervico-vaginal cultures were performed. Informations on sexual and behavioural patterns were collected using a standard questionnaire. IVDAs show early onset of sexual activity (15 vs. 18 yrs) and many sexual partners; just a small percentage of them use condom, efficacious in the protection against venereal diseases. These peculiar behavioural patterns and the immunodeficiency ascribable to the drug abuse may condition the high frequency of viral and bacterial infections of lower genital tract (53% vs 0.8% and 67% vs 10% respectively). Cervical intraepithelial neoplasia has been found significantly more frequently in IVDA women (16%) than in control group (1%) p less than .01.

Adult↗