Biomedical subjects
Publications and source records attributed to A M Lomeo.
We report two cases of primary malignant melanoma of the vagina explaining the essential clinical pathological and therapeutic features. They themselves, added those represented in literature, might constitute a further contribution to best definition of the unusual genital pathology, especially as regards prognostic and therapeutic aspects.
Papillary hidradenoma of the vulva is a benign neoplasm arising from apocrine sweat glands of the skin. The treatment of choice is local excision. The prognosis for the patient is excellent. We present one case observed recently.
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The functional integrity of the membrane of sperm from semen samples collected from 10 fertile men (Group A) and from 50 infertile men (Group B) was assessed by studying the swelling reaction of sperm when suspended in a medium of distilled water ('Water-test'). The results were correlated with routine semen-analysis and with the results of Eosin-Y staining. The mean values for the 'Water-test' were significantly different (P less than 0.01) between Groups A and B (84.8 +/- 3.5 versus 70.9 +/- 13.3, respectively). No significant correlations were observed in either Group A or B, between values for the 'Water-test' and values for the sperm count, the percentage of sperm with normal morphology and the percentage of motile sperm. There was a good correlation in both Group A (r = 0.86, P less than 0.01) and Group B (r = 0.92, P less than 0.01) between values for the 'Water-test' and those for the Eosin-Y test. These results indicate that the 'Water-test' is a simple and reliable test for evaluating sperm membrane integrity.
The authors report a case of cardiotoxicity secondary to 5-FU, the 67th in literature in a 46-year-old woman subjected to adjuvant therapy with a CMF protocol after surgical treatment for carcinoma of the breast, and presenting onset of clinical symptoms 16 hours after administration of the first dose. Analysis of previous cases reported in literature revealed no evidence of age or sex as risk factors. Doubts exist as to whether or not pre-existing heart disease and thoraco-mediastinic radiotherapy increase the risk. With regard to the causes of the syndrome, the authors are inclined to attribute its onset to an auto-immune mechanism. 5-FU-induced cardiotoxicity, though rare, should be borne in mind and the use of the drug should be discontinued at the first signs of cardiotoxicity.
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A prospective, randomized, multicenter study was conducted on the efficacy and safety of two prophylactic antibiotic regimens in both abdominal and vaginal hysterectomy. Patients received three intravenous doses of clindamycin (900 mg) plus either aztreonam (1 g) or cefotaxime (1 g); the doses were given at the induction of anesthesia and 8 and 16 hours later. A total of 170 patients undergoing abdominal hysterectomy and 142 patients undergoing vaginal hysterectomy completed the trial and were evaluated. Following abdominal hysterectomy infections occurred at the operative site in 1.2% of patients given a regimen including aztreonam and in 4.7% of those given a regimen including cefotaxime; the difference between the two groups was not significant. Neither were significant differences observed in the incidence of fever, the incidence of bacteriuria, the need for postoperative antibiotics, or the duration of postoperative hospitalization, although results were slightly better for patients receiving clindamycin plus aztreonam. Following vaginal hysterectomy, slightly but not significantly better results for the same parameters were obtained in the group given clindamycin plus cefotaxime. Diarrhea was the only adverse reaction attributable to antibiotic treatment and occurred more frequently in patients given cefotaxime. It was concluded that the two regimens were similarly effective and safe in preventing infections following hysterectomy.
Over recent years cancer of the vulva has occupied an important position among gynecological neoplasia. It is possible that in the future, due to increased life expectation and the consequent aging of the population, there will be a considerable increase in this pathology. Today the survival rate after five years in patients affected by this invasive tumour is just over 50%, notwithstanding the mutilating and complex surgical treatment. Greater attention on behalf of both patient and doctor to a difficult and often neglected symptomatology, the identification of effective risk factors and a greater knowledge of the natural history of this disease may allow early diagnosis in the future and possibly help reduce the incidence of the disease.
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