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Biomedical subjects

F Viazzo

Publications and source records attributed to F Viazzo.

5 recordsLinked to original sources

Uterine myoma in postmenopause: a comparison between two therapeutic schedules of HRT.

OBJECTIVES: It is still controversial whether hormone replacement therapy (HRT) can affect the onset of uterine myomas or their growth in postmenopause. It is likely that some therapeutic schedules can influence the myometrial growth differently, due to a more potent stimulation of the uterine receptors. The aim of the present study is to evaluate the effects of two different hormonal treatment schedules on the risk of uterine myoma onset or progression. METHODS: In a 2 year prospective randomised study we compared an oral cyclic association of oestradiol valerate and cyproterone acetate versus a sequential combination of transdermal E(2) and per oral medrossiprogesterone acetate on 240 postmenopausal women with and without uterine myomas. RESULTS: Among the patients without uterine myomas treated with the transdermal-oral combination we noted the onset of myomas in 5% of cases after 24 months of treatment, while no new uterine formation was observed for the orally treated women (P<0.01). Among the patients with uterine myomas at the beginning of the study, in the group transdermally treated we found a mean increase in myoma volumes of 25.3% in the following 24 months, which was significantly different compared with the initial volume of myomas. On the other hand, women treated with the oral combination showed no significant modification of myoma volumes at the end of the study. CONCLUSIONS: Percutaneous-oral schedule of HRT seems to affect the growth of uterine myomas more than a single oral combination of oestradiol valerate and cyproterone acetate.

Administration, Cutaneous↗

Vertical transmission of hepatitis C virus and follow-up of newborns from infected mothers.

BACKGROUND: Aim of the study is to analyze the rate of vertical transmission of HCV and the time of clearance of maternal antibodies in non-infected babies serum. METHODS: We have studied 36 babies born to HCV-positive and HIV-negative pregnant women at the University of Pavia. All mothers underwent blood tests to evaluate the presence of anti-HCV antibodies and viral RNA during pregnancy and after delivery. All babies underwent several tests at different times to evaluate the presence of viral RNA and the clearance of maternal antibodies. RESULTS: All babies proved HCV-Ab positive at birth, but only one case (2.7%) proved infected at PCR analysis. Different patterns of HCV-Ab clearance were noted in the 35 non-infected babies. Of 24 babies from HCV-RNA-positive mothers, HCV-Ab reached zero in 24 months while in 11 babies from HCV-RNA-negative mothers, the antibodies disappeared at 12 months. A statistical difference was noted between the two groups of babies for the time of clearance of antibodies. CONCLUSIONS: The risk of vertical transmission in babies born to HCV-RNA negative mothers is very low, and the clearance of maternal antibodies is set within 12 months of follow-up. Mothers positive to HCV-RNA have a higher risk of transmitting the virus to their offspring and the time of clearance of antibodies in non-infected babies seems to be longer. A correct follow-up of these children must be no shorter than 24 months.

Female↗

Bone mineral changes during and after lactation.

OBJECTIVE: To investigate variations in bone mineral density during lactation and throughout the 12 months after scheduled cessation of lactation in relation to the resumption of ovarian function. METHODS: Three hundred eight mothers who decided to lactate were scheduled to fully breast-feed for 6 months, followed by a 1-month weaning period, and then suppress lactation with cabergoline. Their bone mineral density variations were compared with those of a control group of nonlactating mothers during the first 18 months postpartum. Half the lactating women were given daily oral calcium supplements of 1 g in an open design. RESULTS: There was a significant progressive decrease in bone mineral density in lactating women over the first 6 months, followed by recovery of bone mass up to levels that at 18 months were higher than baseline. In nonlactating women, bone mineral density increased progressively after delivery, and at 18 months postpartum had increased by 1.1-1.9% compared with baseline. Compared with lactating women who resumed menstruation within 5 months of delivery, breast-feeding mothers with longer amenorrhea initially lost more bone, but they also gained significantly more bone after resumption of menses, so there were no differences at 18 months postpartum. Oral calcium supplementation decreased bone loss, but had only a transient effect. CONCLUSION: A scheduled lactation period of 6 months, followed by a 1-month weaning period, allowed bone mineral density to reach higher values compared with early postpartum, regardless of calcium supplementation and duration of postpartum amenorrhea.

Adult↗

Long-term sequential treatment with combined estradiol valerate and cyproterone acetate in early postmenopause.

BACKGROUND: We sought to evaluate the long-term safety and efficacy of cyclic combined estradiol valerate and cyproterone acetate. METHODS: A six-year, single center, open study was performed of forty-eight recently postmenopausal women. We evaluated biochemical markers of bone turnover, bone mineral content, bone mineral density, serum lipids, climacteric symptoms, and bleeding throughout the six-year period. Ultrasound evaluation of the endometrium was performed yearly for the first two years. RESULTS: Markers of bone turnover were decreased over the study period, while bone mineral content and density remained unchanged. High density lipoprotein cholesterol levels were increased with unchanged blood pressure over the six years. Menopausal symptoms showed significant improvements within 6 months. Endometrial scan results never required hysteroscopic evaluation. CONCLUSION: Sequentially combined estradiol valerate and cyproterone acetate can be used for an indefinite number of years in women with recent natural menopause. Cyproterone acetate provides adequate endometrial protection and cycle control while allowing estradiol valerate to exert its positive effects on lipid profile, bone metabolism, and climacteric symptoms.

Cyproterone Acetate↗