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Biomedical subjects

G B Candiani

Publications and source records attributed to G B Candiani.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

[Pregnancy in "older" women: biologic limit or social prejudice? Bibliographic review].

The number of women undertaking a pregnancy in late reproductive age is increasing. It is unclear if age of 35 to 40 years constitutes a real biologic limit to reproduction or if unfounded social prejudices play a role. Many publications present advanced age as a significant risk factor for the mother and fetus. Only recent data can be considered because of constant advances in perinatal medicine. Furthermore, many studies are limited by the small sample size and by the lack of control groups and correct statistical analysis. Reproductive outcome is influenced by obstetric, maternal, social and psychological factors. The most recent data obtained on large series of women after control for confounding variables have demonstrated that advanced maternal age is a risk factor for fewer complications than generally believed, such as probability of conception, frequency of chromosomal anomalies, occurrence and consequences of hypertension and diabetes, type of delivery, and maternal and fetal mortality. In the absence of preexisting maternal disease and if correct care is provided by health personnel the prognosis for a pregnancy in an older woman is not greatly different from that of a younger one. By adopting an appropriate attitude the physician can reduce the mother's excessive preconceived concerns, thus allowing the delivery of correct prenatal care and a serene pregnancy.

Adult↗
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Rhythms in the ovulatory cycle. 3rd: Cortisol and dehydroepiandrosterone sulphate (DHEA-S).

The circadian profiles of cortisol and dehydroepiandrosterone sulphate (DHEA-S) were analyzed in a homogeneous group of 15 young normally cycling women, at 4 times of the menstrual cycle: early follicular (EF), late follicular (LF), early luteal (EL) and late luteal (LL) stages. The circatrigintan variations of the same hormones were also evaluated. Population-mean cosinor analysis allowed the demonstration of a highly significant circadian periodicity for both variables in any of the 4 stages of the menstrual cycle; on the other hand, the same computation failed to demonstrate a significant circatrigintan periodicity. In each of the stages considered, the circadian acrophase of DHEA-S was delayed in comparison to that of cortisol, being located in the early afternoon hours. The demonstration of a clear-cut circadian oscillation in serum DHEA-S prompts studies on possible chrono-abnormalities of the steroid production in women with hyperandrogenic diseases.

Adult↗
PubMedDate not supplied

Rhythms in the ovulatory cycle. 2nd: LH, FSH, estradiol and progesterone.

The circadian profiles of LH, FSH, estradiol and progesterone were compared in a homogeneous group of 15 young normally cycling women, at 4 well characterized times of the menstrual cycle: early follicular (EF), late follicular (LF), early luteal (EL) and late luteal (LL) stages. The circatrigintan profiles of the same hormones were also evaluated. Population-mean cosinor analysis failed to demonstrate a circadian periodicity of LH in any of the 4 stages of the menstrual cycle; a circadian rhythm for FSH was present only in the 2 luteal phases (EL, LL); the same type of rhythmicity was present for estradiol only in the late luteal stage; on the contrary, a highly significant circadian rhythm of progesterone was present in each of the 4 menstrual stages considered (EF, LF, EL and LL). Population-mean cosinor analysis showed a highly significant circatrigintan periodicity of LH and FSH with the acrophases respectively between -109 degrees and -181 degrees and between -74 degrees and -125 degrees. Circatrigintan rhythmicity was also present for estradiol (acrophases between -161 degrees and -245 degrees) and progesterone (acrophases between -246 degrees and -296 degrees).

Adult↗
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Laparotomy versus laparoscopy in the surgical treatment of endometriosis: the end of an era?

The Authors compare the efficiency of laparoscopic treatment with laparotomic surgical management of endometriosis. When the disease causes mechanical distortions and adnexal adhesions, there is an obvious explanation for infertility; in these cases laparotomic surgery has so far proved the only treatment to produce significantly valid results. No findings have yet been reported to demonstrate that cytoreduction, either pharmacological, laparoscopic or laparotomic, offers concrete advantages compared with simple observation when the disease is in the early stage.

Endometriosis↗
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[Epidemiology of spontaneous abortion: a review of the literature].

Spontaneous abortion is the commonest complication of pregnancy. Its reported incidence appears to be constant in developed countries but the frequency of subclinical fetal loss is largely unknown. There is a well known relationship between fetal loss and advancing maternal age. Trisomic fetuses occur more commonly in older women and most are aborted but old women are also at greater risk of aborting a chromosomally normal fetus. Recent epidemiological data have demonstrated a significant association between maternal cigarette smoking and spontaneous abortion. A role of gravidity, early age at menarche, alcohol and methylxanthine consumption has been recently claimed, but epidemiological evidence is scanty and largely controversial. The present paper reviews the epidemiological data on spontaneous abortion.

Abortion, Spontaneous↗
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Rhythms in the ovulatory cycle. 1st: Prolactin. Chronobiological Research Group on Synthetic Peptides in Medicine.

Circadian and circatrigintan profiles of prolactin (PRL) in young normally cycling women at 4 well characterized times of the ovulatory cycle have been compared. Circadian patterns of PRL (collected at 2-h intervals for 24h at each phase selected) change during the 4 phases, being higher in the luteal phase. In a consistent percentage of individuals, serum PRL rises notably during the night; in one half of the subjects a peak is located also in the afternoon or early evening. The statistically significant circatrigintan rhythm of PRL shows the acrophase approximately in the mid-luteal phase.

Adult↗
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Communicating uteri: description and classification of a new type.

A case of bicornuate-bicervical communicating uterus with atresia of the right hemicervix is reported. This cannot be included in any of the nine groups of Toaff's classification of uterine malformations proposed in 1984, and should be classified as a new, tenth type.

Adult↗
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Second-look laparoscopy in the treatment of endometriosis.

The results of second-look laparoscopy were compared with subjective symptomatology and findings at pelvic exploration in 36 patients who had received conservative treatment for endometriosis. In the 14 patients given pharmacologic treatment, second-look laparoscopy demonstrated active endometriosis in 57.1%, whereas pelvic pain was present in 64.3% and gynecologic examination was positive in 28.6%. In the 22 patients who underwent surgery, active endometriosis was detected by second-look laparoscopy in 31.8%, whereas 40.9% reported pelvic pain and pelvic examination was positive in 31.8%. Thus clinical signs and symptoms were unreliable in the diagnosis of endometriosis recurrence, whereas laparoscopy was indispensable. It should be programmed for 6 months from the end of medical treatment and 12 months after surgery; however, if the pain symptomatology recurs, then laparoscopy is performed immediately.

Adult↗
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GnRH agonists in the treatment of endometriosis.

GnRH agonists, synthetic peptide analogs of GnRH, desensitize pituitary receptors for the native molecule, thus causing reversible hypogonadotropic hypogonadism. Numerous clinical studies have suggested that these compounds are efficacious in the treatment of endometriosis, but it is not clear whether they are superior to the other drugs used in treatment of this disease. The frequency of recurrence of pain symptoms at the end of treatment is high and the data on recovery of fertility are conflicting. Long-term administration of GnRH agonists is a safe and well tolerated treatment but its role in the management of endometriosis is still not well defined.

Animals↗
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Recurrent spontaneous abortion: state of the art and new horizon.

Spontaneous abortion is the commonest complication of pregnancy and its frequency has been estimated to be between 15 and 20% of all clinical pregnancies. A comprehensive classification of etiologic factors that may cause repeated abortions is made and the importance of a precise program of the necessary diagnostic steps is underlined.

Abortion, Habitual↗
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The classification of endometriosis: historical evolution, critical review and present state of the art.

The surprising disagreement in treatment results obtained by the various authors treating endometriosis is in large part due to differences in the severity of the disease. Only the adoption of a satisfactory staging system allows valid comparison between homogeneous groups of patients. This paper reviews and analyzes the various classifications proposed with the aim of showing the original aspects and the defects that led to the development of new systems including the most recent one published by the American Fertility Society. Devising a classification system presents unexpectedly great problems, but it is essential to be able to compare treatment results.

Colonic Neoplasms↗
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Sonographic evaluation of uterine morphology: a new scanning technique.

Through sonographic sections with mid-empty bladder it is possible to evaluate all uterine biometric data. This technique was evaluated in thirty-four cases of uterine malformations and satisfactory results were obtained in thirty-two of them. If further studies on randomized patients confirm the specificity of this technique, it could become a basic non invasive investigation for the screening of uterine malformations.

Diagnosis, Differential↗
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Second-look hysteroscopy after conservative surgery of the uterus.

A hysteroscopic second look has been performed following sixteen intracavitary myomectomies, twenty-nine metroplasties and thirty-four intra-uterine adhesiolyses. This control has been performed three months after laparotomic operation and after forty-five days of sequential estro-progestogen treatment in cases of transcervical operation. The hysteroscopic second-look proved to be an excellent follow-up method after uterine conservative surgery and it avoids the use of X-rays, allows a detailed morphological evaluation of the uterine cavity and offers the possibility of complementary surgery, when necessary.

Endoscopy↗