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Biomedical subjects

A Gastaldi

Publications and source records attributed to A Gastaldi.

At least 19 recordsLinked to original sources
PubMed1992

Weight loss and menstrual cycle: clinical and endocrinological evaluation.

This study explores the clinical and endocrine implications of weight loss. The frequency of menstrual abnormalities was found to be greatly influenced by reduction in body weight. The occurrence of amenorrhea appeared to be proportional to the rate of weight loss, while regular cycles and luteal phase deficiency were inversely correlated to weight loss. Endocrine variations were noted. Significant decreases in luteinizing hormone and follicle stimulating hormone levels occurred only in amenorrheic patients with a weight loss higher than 20%. The estradiol level decreased in proportion to the reduction in body weight. Cortisolemia increased in all patients, with higher values apparent in amenorrheic women presenting with a weight loss higher than 20%. The prolactin values were normal except in amenorrheic patients who had lower levels. A reduction of insulin levels occurred in all groups, with a significant difference found only in amenorrheic women in Group C (weight loss higher than 20%). The data suggest that weight loss in young women causes alterations in the menstrual cycle mainly through two mechanisms involving both the hypothalamic-pituitary-adrenal axis and ovarian steroidogenesis together with estrogen catabolism.

Adolescent↗
PubMed1992

Leuprorelin acetate depot vs danazol in the treatment of endometriosis: results of an open multicentre trial.

A national multicentre trial was organized in order to compare the efficacy and safety of leuprorelin acetate depot and danazol in the treatment of endometriosis. Sixty-seven patients with pelvic endometriosis of different severity at laparoscopy were included in the study and followed during the 24 weeks of treatment. Leuprorelin acetate depot 3.75 mg was injected every 24 days, while the daily dose of danazol was 600-800 mg. At the end of the study objective improvements induced by the two drugs were observed by a second laparoscopic examination. In addition, at regular intervals during the study semiquantitative evaluation of subjective symptoms were monitored. Scoring the final objective changes in the two patient groups revealed no significant difference, however the women treated with leuprorelin acetate depot registered significantly better control of pelvic pain. Due to its efficacy, tolerability and ease of use, leuprorelin acetate appears to be an excellent drug for the treatment of endometriosis.

Adult↗
PubMed1991

Reproductive and menstrual factors and risk of peritoneal and ovarian endometriosis.

OBJECTIVE: Between 1987 and 1989 data were collected to evaluate risk factors for pelvic endometriosis. DESIGN: A case-control study was conducted on 241 cases with laparoscopically or laparotomically confirmed peritoneal or ovarian endometriosis consecutively admitted to three teaching hospitals in Northern Italy. The control group consisted of 437 women admitted to hospitals for acute conditions covering similar catchment areas. RESULTS: Compared with nulliparous women, the risk of endometriosis decreased with increasing number of births: the point estimates were 0.4 and 0.3, respectively, for those with one and two or more births (X2(1) trend = 50.3, P less than 0.001). No relation emerged with age at first birth and spontaneous miscarriages. Relative to women whose menarche occurred at age 11 or younger, the risk of endometriosis was slightly lower in those who experienced later menarche, but the trend in risk was not significant. Women with irregular menstrual cycles showed a lower frequency of the disease (relative risk, 0.3; 95% confidence interval, 0.2 to 0.5). The role of various factors was largely similar for different disease locations (ovary, peritoneum, and both) and indication for diagnostic surgery (sterility, pelvic pain, and other reasons). CONCLUSIONS: This study found that parity and irregular/long menses lower the risk of endometriosis. These findings were similar in different subgroups of disease location and indication for surgery, giving strong evidence of the consistency of the general results.

Abortion, Spontaneous↗
PubMed1989

Histological features of uteroplacental vessels in normal and hypertensive patients in relation to birthweight.

Placental bed biopsies were obtained during caesarean section from normal, pre-eclamptic and hypertensive pregnancies. Of the 14 biopsies from normal pregnancies 13 showed normal vascular physiological changes in the decidua and in the myometrium. Biopsies from 24 pregnancies complicated by pre-eclampsia showed acute atherosis in 18 and physiological changes limited to the decidua in six; none had normal physiological changes. Biopsies from five hypertensive patients showed all three types of histological changes. The mean birthweight centile was lower in the group with atherosis than in the group with limited and the group with normal physiological changes.

Birth Weight↗
PubMed1989

Ovulation induction with intravenous gonadotropin-releasing hormone.

The efficacy of ovulation induction with the use of pulsatile gonadotropin-releasing hormone (GnRH) therapy was examined in 21 infertile women. Seventeen had hypothalamic amenorrhea (HA) and 4 polycystic ovary syndrome (PCO). All patients were treated as outpatients. GnRH was infused in a pulsatile mode by means of portable auto-infusion pumps connected to an indwelling intravenous catheter inserted into a forearm vein. The doses varied from 1.8 to 5 micrograms/pulse with a frequency of 90 minutes. Ovulation occurred in 52 out of 64 cycles (81.2%). Ten (47.6%) of the 21 patients became pregnant. Seven patients had normal term deliveries and 3 aborted spontaneously. With regard to the 17 patients with HA, ovulation occurred in 93.7% of treatment cycles and 6 women became pregnant. In the case of the PCO patients, ovulation was achieved in 6 out of 15 cycles (40%) and 2 women became pregnant. There was no overstimulation or any other serious complication. In conclusion, therapy with GnRH provides an elevated probability of therapeutic success, especially in HA.

Adult↗
PubMed1989

[Effects of therapy and pregnancy on hyperprolactemia caused by a pituitary adenoma. A clinical case].

A woman who presented with amenorrhea and galactorrhea with a large prolactinoma (8.5 mm) which regressed on bromocriptine therapy is described. When treatment with bromocriptine was instituted (10 mg/daily) mean serum prolactin concentration fell from 490 ng/ml to 108 ng/ml. Despite a progressive reduction in size up to disappearance of the adenoma after the first 5 years of therapy, prolactin levels remained high. Bromocriptine treatment was stopped after 6 years, when pregnancy was diagnosed. Pregnancy proceeded without complications and lactation was initiated and maintained. After 8 months of breast-feeding, menstrual function resumed spontaneously and bromocriptine therapy was no longer required. Bromocriptine can cause not only a decrease in serum prolactin levels but also a regression in the size of prolactinomas in hyperprolactinemic women. No problems associated with pregnancy and/or breast-feeding were noted in these patients.

Adult↗
PubMed1988

Ataxia-telangiectasia and endodermal sinus tumor of the ovary: report of a case.

Ataxia-telangiectasia, an inherited disorder characterized by progressive cerebellar ataxia and telangiectasias, is often associated with primary immunodeficiency and high incidence of malignancies, mostly of the lymphoreticular type. Endodermal sinus tumor is a rare germ cell tumor of the ovary characterized by an extremely rapid growth and poor prognosis. Both these diseases are associated with an abnormal production of alpha-fetoprotein. Primary tumors of the ovary in patients with ataxia-telangiectasia are extremely rare and the association of an endodermal sinus tumor and ataxia-telangiectasia has never been reported in the literature. This case report serves to focus on the particular problems encountered in the diagnosis and management of two diseases both characterized by the same serum marker.

Adolescent↗
PubMed1988

Vasoactive intestinal polypeptide (VIP) selectively stimulates prolactin release in healthy women.

The neuropeptide, vasoactive intestinal polypeptide (VIP), is released from the hypothalamus to the portal circulation, and experiments on animals provide evidence that it might modulate hormone secretion from the pituitary. Here we report the effects of VIP on the release of different pituitary hormones, including prolactin (PRL), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and thyrotropin-releasing hormone (TSH), in normal women. Seven healthy women (aged 27-32; body weight 53-60 kg), with normal menses and receiving no medication, were tested on days 20-23 of their cycle. Porcine VIP was injected i.v. as a bolus dose of 1 mcg/kg body weight. Blood samples were collected 10 minutes prior to VIP administration and 5, 15, 30, 45, 60 and 90 minutes after VIP injection. Blood pressure and heart rate were continuously monitored. Hormone levels were determined by RIA. Stress, which can stimulate PRL release, was assayed by measuring the effect of placebo on hormone release (5 controls). VIP injection induced a significant (p less than 0.01) increase in plasma PRL levels. Basal PRL was 20.25 +/- 9.14 ng/ml; 5 minutes after VIP injection PRL levels rose to 45.0 +/- 14.9 ng/ml (p less than 0.01). At 15 minutes a plateau was reached (46.0 +/- 14.5 ng/ml), then the levels slowly decreased. VIP administration did not modify the plasma concentration of LH, FSH or TSH at any time during the observation period. The present study indicates that VIP might play a physiological role as a RPL-releasing factor in human beings.

Adult↗
PubMed1988

Treatment of primary invasive cervical cancer. Considerations on 997 consecutive cases.

From 1965 to 1979 997 consecutive cervical cancer patients were treated at the University of Brescia. Stage I B and II A low risk patients underwent radical surgery, followed by Co60 external pelvic radiation when positive nodes and/or adverse pathological factors on the specimens were encountered. In stage I B the 5-year survival was 95.9% and 82.7% in the two groups and in stage II A 93.3% and 76.5% respectively. Bulky and large tumors were treated by intracavitary radium followed by radical hysterectomy and, if indicated, by Co60 external beam pelvic radiation. All other patients and all stage II B were treated by radiotherapy. The results of primary radical surgery may reflect the favourable preselection of cases. Postoperative radiation teletherapy in case of adverse pathological factors is of benefit to the patients.

Brachytherapy↗
PubMed1987

Ceftazidime in antibiotic prophylaxis for emergency cesarean section: a randomized prospective study.

The efficacy of two randomized antibiotic prophylactic schedules with ceftazidime (group A: single preoperative 2 g intramuscular dose; group B: 3 perioperative 1 g intramuscular doses every 6 h) was evaluated in 200 pregnant women undergoing cesarean section. Postoperative complications were observed in 9 cases (4 in group A and 5 in group B; p = NS). Analysis of possible risk factors revealed 1) a relationship between postoperative morbidity and overweight (body mass index above 30) in group A only; 2) a possible contributory effect of duration of labor (more than 6 h) in group A; and 3) a possible effect of duration of rupture of the membranes (more than 6 h) in group B only. The results obtained lead to the conclusion that single-dose prophylaxis with ceftazidime is as effective as short-term 3-dose ceftazidime prophylaxis in preventing post-cesarean complications.

Adult↗
PubMedDate not supplied

Systemic lupus erythematosus and pregnancy: a prospective study.

We have prospectively followed 25 pregnancies in 21 patients: 20 were affected by systemic lupus erythematosus (SLE) and 1 by subacute cutaneous lupus erythematosus (SCLE). A flexible treatment schedule was applied to the follow-up of all the pregnancies, and included low dose aspirin, steroids at medium-low dosage and, if needed, azathioprine (AZA) after 20 weeks of gestation. There were 4 spontaneous first trimester abortions and 21 live-born neonates without major problems related to the treatment or to the maternal disease. The relapse rate of the disease recorded during the observation period was 0.07 patient/month, not different from that already reported in SLE patients (pregnant or nonpregnant). Obstetrical complications were relatively frequent, but careful monitoring allowed us to avoid late fetal wastage. We conclude that in SLE patients a successful pregnancy outcome, without worsening of the disease, can be obtained with a careful multidisciplinary follow-up.

Adult↗
PubMedDate not supplied

Conservative surgical treatment in infertile patients with endometriosis.

In the period 1985-1988 23 infertile patients with pelvic endometriosis underwent conservative surgery with microsurgical technique. 8.7% (only 2 women) of the patients were in 2nd stage, 43.5% in 3rd stage and 47.8% in 4th stage of the American Fertility Society classification (1985). Associated pathology was found in 52.2% of the patients. Surgical techniques and results are presented. We obtained 13 (56.5%) full term pregnancies. The postoperative birth rate was 50% in 2nd stage, 80% in 3rd stage and 36.4% in 4th stage. Associated pathology was present in 69.2% of pregnant patients. Ten women (43.5) did not conceive: 10% were at 2nd, 20% at 3rd and 70% at 4th stage. Associated disease was present in 30% of women that did not become pregnant.

Adult↗
PubMedDate not supplied

Ovarian hyperstimulation syndrome (OHS): a case of severe OHS.

A 26 year old patient, who underwent an ovulation stimulation therapy (Clomiphene /UH-FSH), monitored only by ultrasound presented a severe Ovarian Hyperstimulation Syndrome (OHS). beta-HCG values confirmed conception, that outcame in an abortion. During an ovulation stimulation therapy, patient's management with the ultrasound examination, is often inadequate and it's moreover necessary to determine the 17 beta E2 levels.

Abortion, Spontaneous↗
PubMedDate not supplied

Polycystic ovary syndrome: long-term evolution.

A study was made of the long-term evolution of 64 women with PCO in order to identify the clinical and/or endocrine alterations that may modify the prognosis of each case. The patients were divided into two groups: Group A, where at the conclusion of the observation period disorders were present, and Group B, where they were not. A comparison between the clinical and endocrine data obtained from the two groups at the first observation showed only one significant difference, concerning the time of onset of menstrual irregularities; these coincided with the menarche in only 57.6% of the cases in Group A, but in 94.7% of those in Group B.

Adult↗
PubMedDate not supplied

Uterine fibromyoma and sterility: role of myomectomy.

The role of abdominal myomectomy with regard to surgical technique, subsequent conception and term pregnancy was evaluated. Of 30 patients undergoing myomectomy 13 conceived and 10 had a good pregnancy. It should be noted that 10 of 30 patients considered in this study had a leiomyomas associated disease, representing another cause of infertility. Thus, a preoperative evaluation of the reproductive capability of the couple would allow a selection of patients who are to undergo myomectomy resulting in a better pregnancy rate. In the present series, the ages of the patients and the size of the leiomyomas did not significantly influence the pregnancy rate. The most important correlation with subsequent fertility was the duration of infertility prior to myomectomy. The general principles of reproductive microsurgery should be kept in mind when performing myomectomy.

Adult↗