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Biomedical subjects

G B Candiani

Publications and source records attributed to G B Candiani.

At least 55 records · Page 3Linked to original sources

[Prevention of acute neonatal respiratory insufficiency. A method of conditioning the baboon lung during cesarean section].

Preterm baboons at 140 +/- 3 day gestation (term 182 +/- 7 days) have been subjected to lung conditioning, consisting of a series of prolonged inflations of the lungs at 35 cm H2O, followed by approximately 10 min of application of continuous positive airway pressure (CPAP) equal to 15-20 cm H2O, before umbilical cord interruption. The aim of this study was to evaluate, in a primate experimental model, the safety and efficacy in the prevention of neonatal RDS of a technique so far experimented on only in ovine models. Thoraco-pulmonary compliance exceeded the value of 0.2 ml (cm H2O)-1.kg-1 in only 1 animal out of 5 (20%), which didn't develop illness, versus 69% of positive results achieved with the same technique in lambs at 128-130 day gestation, an experimental model considered in the literature as equivalent to a 140 +/- 3 day gestation baboon as far as it concerns incidence and severity of RDS. The application of lung conditioning was easy and safe (as previously reported), but its effectiveness in a primate model is still to be defined.

Animals↗

Ectopic pregnancy and recurrent spontaneous abortion: two associated reproductive failures.

The association between spontaneous abortion and ectopic pregnancy was evaluated in a case-control study conducted on 161 women (cases) with recurrent spontaneous abortions (two or more consecutive spontaneous abortions) and 170 control subjects who delivered normal infants. The risk of ectopic pregnancy in women with a history of recurrent spontaneous abortion was about fourfold that of controls (relative risk adjusted for age and number of pregnancies = 4.3; 95% confidence interval 1.4-14.7). This association was confirmed by comparing the observed number of extrauterine pregnancies in women with recurrent spontaneous abortions with the expected number computed from regional data on the frequency of ectopic pregnancies; the estimated relative risk was 3.7, with a 95% confidence interval of 2.2-7.0. The present report found an association between spontaneous abortions and ectopic pregnancies, suggesting some common risk/etiologic factors for these two reproductive failures.

Abortion, Habitual↗

Endometrial reconstruction after hysteroscopic incisional metroplasty.

Endometrial reconstruction after hysteroscopic metroplasty of a septate uterus was studied by light microscopy and scanning electron microscopy when the uterus was removed 13 days after metroplasty for a histologic diagnosis of leiomyosarcoma. We observed a retraction of the margins of the incised septum, which could prevent the formation of intrauterine adhesions. Reepithelialization of the cut surface seemed to proceed both centripetally, by proliferation of the surrounding normal endometrium, and centrifugally from the bottom of the glands present at the base of the septum.

Adult↗

CA 125 in serum, peritoneal fluid, active lesions, and endometrium of patients with endometriosis.

Ca 125 levels in serum and peritoneal fluid were measured in 39 patients with endometriosis and 18 patients with normal pelvic anatomy at laparoscopy, and the presence of this antigen in endometriotic tissue and endometrial mucosa was also investigated. Serum CA 125 concentrations were elevated in patients with Stage III or IV endometriosis compared with control subjects (32.9 +/- 11.2 versus 16.4 +/- 8.9 U/ml, means +/- SD; p less than 0.001). CA 125 values were greater than 35 U/ml in 36.8% of women with Stage III or IV endometriosis and in none of the control subjects. No significant differences in CA 125 levels in peritoneal fluid were found between patients with endometriosis and control subjects. The immunohistochemical studies found CA 125 in 10% of the endometriotic lesions and 37.5% of the endometrial samples of patients with endometriosis and in 33.3% of the endometrial samples of control subjects.

Adult↗

Ultrasonography in the differential diagnosis of "double" uteri.

A total of 43 infertile patients with hysterosalpingographic diagnosis of bifid uterus underwent sonography and subsequent laparoscopy/hysteroscopy to evaluate the capacity of ultrasound to demonstrate the peritoneal profile of the malformed uteri correctly. Sonographic visualization was adequate in 39 cases (90.7%) and the following were identified correctly: 1 of 2 didelphic uteri, all of 11 bicornuate uteri, all of 4 complete septate uteri, and all of 22 partial septate uteri. The sensitivity of ultrasound in detecting the presence of a perimetrial fundal notch was 92.3% and its specificity 100%. Thus, a precise differential diagnosis of "double" uteri was possible with this technique, which may in some clinical situations provide an alternative to laparoscopy.

Endoscopy↗

Short-term reproductive prognosis when no cause can be found for recurrent miscarriage.

The short-term reproductive prognosis of recurrent miscarriage for which no cause was found has been evaluated in 95 couples investigated between 1980 and 1986 at the First Obstetric and Gynaecological Clinic of the University of Milan. The actuarial overall 3-year livebirth delivery rate was 64%, increasing constantly with time. The reproductive success rate decreased with the number of previous miscarriages from 80% in women with two, to 60% with three and 46% with four or more miscarriages. No effect of age and socio-economic status emerged. There was a positive association between the number of previous miscarriages and the risk of miscarriage in the next pregnancy. Compared with women with two miscarriages the relative risk of another miscarriage was 2.3 for those with three previous miscarriages and 5.0 for those with four or more (chi 2 1 for trend adjusted for age = 5.2, P = 0.02).

Abortion, Habitual↗

Structural and ultrastructural patterns of the human preovulatory endometrium following clomiphene citrate treatment.

To investigate ultrastructural modifications in the endometrium of women receiving clomiphene citrate (CC) treatment, we performed endometrial biopsies in the preovulatory phase in 17 patients with anovulatory infertility and 16 normo-ovulating women with tubal or male sterility. Histology, scanning and transmission electron microscopy (SEM and TEM) revealed midproliferative phase aspects in 11.7% of the treated group and 6% of the controls, late proliferative aspects in 76.4% and 82%, and postovulation days 1-3 characteristics in 11.7% and 12% respectively. No significant differences were observed between the patients and controls; our data indicate that CC taken in a dose not exceeding 100 mg/day from day 3 of the cycle can induce endometrial maturation that is almost identical with that of a spontaneous preovulatory phase. This type of endometrium should therefore allow implantation of a fertilized egg and maintain unmodified the complex biohumoral relations with the embryo.

Clomiphene↗

Ultrasound in the diagnosis of subclasses of unicornuate uterus.

Fourteen infertile women with hysterographic diagnoses of unicornuate uterus underwent pelvic ultrasonography and, subsequently, laparoscopy to evaluate the ability of ultrasound to diagnose the subclasses of this malformation. Seven women underwent laparotomy to remove a rudimentary horn. Ultrasound demonstrated a sensitivity of 85.7% and a specificity of 100% in diagnosing the presence of a rudimentary horn, and a sensitivity of 80% and a specificity of 100% in diagnosing the presence of a cavity in the rudimentary horn. Urography confirmed the supplementary information on the urinary tract provided by ultrasound. Ultrasound appears to have a role in the clinical management of women with unicornuate uterus.

Female↗

Serum CA 125 measurements in the diagnosis of endometriosis recurrence.

Seventy-one women underwent follow-up laparoscopy for persistent infertility six to 24 months after conservative treatment of endometriosis. The disease was staged according to the revised American Fertility Society classification of 1985. The serum CA 125 concentration was also measured in each patient to evaluate its efficacy in the diagnosis of endometriosis recurrence. The patients with stages I and II endometriosis had serum CA 125 levels not significantly higher than in the patients with negative findings, whereas those with stages III and IV endometriosis presented significantly higher levels (P less than .005 and P less than .001, respectively) than the disease-free women. The sensitivity of serum CA 125 measurements in the diagnosis of endometriosis recurrence was 14.8%, the specificity was 100%, and the predictive values of normal (less than 35 U/mL) and elevated levels were 27 and 100%, respectively. In some cases, serum CA 125 measurements may be used instead of follow-up laparoscopy, or to indicate when laparoscopy should be performed or postponed.

Adult↗

Gestational aspects of uterus didelphys.

The reproductive history was analyzed of 13 women with a laparoscopic or laparotomy diagnosis of uterus didelphys and followed for two to six years. Two patients (15.4%) presented with primary infertility; the other 11 had a total of 27 pregnancies, the outcome of which was spontaneous abortion in 20 cases (74%), premature labor in 6 (22.2%) and term birth in 1 (3.7%), with a live birth rate of 18.5%. Metroplasty was performed in five cases, with live birth in three, spontaneous abortion in 1 and no postoperative conceptions in one. Cervical cerclage was performed in only one case and bilateral ovarian resection in one. The live birth rate, considering all pregnancies before and after treatment, was 35%. The compromised fertility of the uterus didelphys is probably attributable to congenital alterations in vascularization that may have a negative influence on developmental phases following implantation, particularly the structuralization of the fetomaternal relations that precede placentation.

Adult↗

Can ultrasound be used to screen uterine malformations?

Eighty-nine patients were examined by ultrasound during the second phase of the menstrual cycle. The operators were not aware of the patients' history or results of previous ultrasonographic or radiologic investigations. The operators' aim was to diagnose uterine malformations graded as normal, suspected, or abnormal. Ultrasound identified 7 of 9 patients with a didelphic or complete septate uterus and 2 out of 3 with a bicornuate or partial septate uterus. Two other cases were suspected (one with a unicornuate, the other with a didelphic uterus). One false-positive case occurred, and 10 patients were not identified as having a malformed uterus (sensitivity, 42.9%; specificity, 97.8%). False-negatives involved mainly minor malformations.

Adult↗

Reproductive performance of women with unicornuate uterus.

The reproductive history of 19 women with a diagnosis of unicornuate uterus confirmed by laparoscopy or laparotomy is analyzed. The patients were followed for 2 to 10 years. One patient had a cavitary communicating rudimentary horn, four a cavitary noncommunicating rudimentary horn, seven a noncavitary rudimentary horn, and seven no rudimentary horn. Six of the patients presented with primary infertility. The other 13 women had a total of 29 pregnancies, 1 (3.4%) in a rudimentary horn determining rupture; abortions occurred in 17 (58.6%), premature labor in 3 (10.3%), and term births in 8 (27.6%), with a live birth rate of 38%. Of the 11 births, 6 (54.5%) were breech presentations, and 9 (81.8%) were cesarean sections. In five cases the rudimentary horn was removed, with associated salpingooophorectomy in three patients. Cervical cerclage was not performed in any of the patients.

Abortion, Spontaneous↗

A contribution to the therapy of cervicocarcinoma: remarks on 40 patients presenting paraaortic metastases (1970-1979).

The Authors report survival data concerning 40 patients affected by cervicocarcinoma who, between 1970 and 1979, underwent exploratory laparotomy after pelvic radiotherapy, with detection of paraaortic lymphnode metastases. The patients subjected to laparotomy only (21 cases) have a 9-month average survival, which increases to 24 months in those with lymphadenectomy and complete pelvic surgery. While all the patients in the first group have died, in the second 3 survive at 5 years and 3 show no evidence of disease at 52,46 and 35 months from surgery. Hysterectomy with pelvic and lomboaortic lymphadenectomy, whether therapeutical or palliative, seems to be in patients with paraortic metastases provided surgery is feasable.

Adult↗