Biomedical subjects

G Buffetti

Publications and source records attributed to G Buffetti.

10 recordsLinked to original sources

PubMed1994

[The IUD and uterine perforation].

The intrauterine device (IUD) is an effective and relatively safe contraceptive. Approximately 15% of women of child-bearing age in Italy use the IUD. The major health risks associated with IUD use are perforation of the uterus, pregnancy (both intrauterine and ectopic), and pelvic inflammatory disease. Perforation of the uterus by an IUD is a serious complication and this is possible both during the insertion and later. Perforation of the uterus is rare, but potentially fatal. The incidence is of 0.12-0.68/1000 insertion. Although some patients have signs and symptoms suggestive of perforation (pain or bleeding), many are apparently asymptomatic at the time the diagnosis of perforation is made. Perforation is often suspected or diagnosed when the IUD string is no longer visible at the external os. A patient who has sustained a perforation is not protected against pregnancy. Numerous factors affect perforation: the type of IUD, the uterine size and position, timing of the insertion in relation to the last delivery or abortion and the experience of the clinical. Serious consequences have been described, such as severe damage to the viscera (i.e. bowel, kidney) and/or peritonitis. The diagnosis is clinical, ultrasonic, radiological and coelioscopic. Coelioscopic diagnosis makes it possible to choose the method of treatment. In experienced hands, this method is rapid, the hospitalization required short and the sequelae simple.

Adolescent↗

PubMed1994

[Vulvar vestibulitis].

In 1987 Friedrich defined the vulvar vestibulitis syndrome as "severe pain on vestibular touch or vaginal entry; tenderness to pressure localized within the vulvar vestibule; and physical findings confined to vestibular erythema of varying degrees". The vulvar vestibule extends laterally from the hymenal ring to a line of more keratinized skin on the labia minora (Hart's line). Anteriorly the vestibule reaches upwards to the frenulum of the clitoris and posteriorly downward to the fourchette. Characteristics of vestibulitis are the patient's complaint of entry dyspareunia, discomfort at the opening of the vagina and erythema and point tenderness discovered on palpation of the gland orifice with a cotton-tipped applicator (cotton swab is pressed gently in a circle around the base of the hymenal ring or at the posterior fourchette of the vagina). Women report severe pain at the vaginal introitus during intercourse, localized pain from tampon use. Pain developed in all patients during periods when they were sexually active, although there are a few reports of vulvar vestibulitis in celibate women. Vulvar vestibulitis may be acute or chronic. The cause of vulvar vestibulitis are most likely multifactorial. Vestibulitis may result from any infectious process that causes vulvovaginitis, irritants agents (soaps, sprays), antiseptics, creams, destructive treatments (cryosurgery, podophyllin, laser treatment), HPV, recurrent bacterial vaginosis, chronic candidiasis, altered vaginal acid-base balance. The candidal organism appears to play some role in this syndrome. Human papillomavirus appears to be an associated variable. An allergy-based etiology for vestibulitis has not been defined.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

PubMed1993

[The Papanicolaou classification in the Bethesda system (National Cancer Institute, Bethesda, Maryland)].

In December of 1988, the National Cancer Institute in Bethesda, Maryland (USA), held a workshop that produced published guidelines for reporting the results of cervical and vaginal cytology. A second workshop was held in April 1991 to discuss the initial proposal and suggest modifications. The final recommendations are the following: the Papanicolaou classification for reporting consultation is not acceptable in the modern practice of diagnostic cytopathology (because it does not reflect current understanding of cervical/vaginal neoplasia--has no equivalent in diagnostic histopathologic terminology--does not provide diagnoses for non-cancerous entities and, as a result of numerous modifications, the specific Papanicolaou classes no longer reflect diagnostic interpretations uniformly). The cytologic report is a medical consultation in the same manner as is the histomorphologic report. Clinical information is absolutely essential for making the diagnosis. (A cytopathologic diagnosis should be an interpretation of morphologic findings, but this interpretation is best made in the context of the patient's clinical situation). The cytopathologist should determine whether the specimen is adequate for diagnostic evaluation. If unsatisfactory or satisfactory for evaluation but limited by ..., this should be noted in the report. The use of precise diagnostic terms to facilitate unambiguous communication between cytopathologist and clinician. The terminology for squamous epithelial lesions includes: 1) Atypical squamous cells of undetermined significance. 2) Squamous intraepithelial lesion (SIL), which encompass the spectrum of squamous cell carcinoma precursors, divided into low-grade SL (HPV-associated cellular changes, mild dysplasia and CIN1) and high-grade SIL (moderate dysplasia, severe dysplasia and carcinoma in situ and CIN2 and CIN3).(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Squamous Cell↗

PubMed1993

[George Nicholas Papanicolaou].

G. N. Papanicolaou was born on May the 13, 1883 in the city of Kymi on the Greek island of Euboea. He received his MD degree from the University of Athens in 1904 and a PhD from the University of Munich in 1910. After service as a medical officer in the Balkan War of 1912-1913, he came to New York with Mary (for over 50 years Dr Pap's life companion). George's violin playing at restaurants and coffee-shops supplied them with a few extra cents. Papanicolaou was appointed assistant in the Pathology Laboratory at the New York Hospital. In 1928 he presented his work "New Cancer Diagnosis" to the third race betterment conference (Battle Creek, Michigan). But the work was met with scepticism. The now famous monograph "The Diagnostic Value of Vaginal Smears in Carcinoma of the Uterus" was published in 1941 in the Am J Obst Gyn. During this time, he developed his method of preservation of these cells by wet fixation and precise staining. Papanicolaou persisted with his ideas, and finally cytologic examination of the cervix was accepted. The power of Papanicolaou screening for uterine cancer was remarkable. The first National Cytology Congress, held in 1948, hailed this new diagnostic tool for carcinoma of the cervix as unique because it could detect cancer before it was visible. He described the importance of a distinct cellular pattern corresponding to cervical intraepithelial neoplastic lesions. The value of this pattern, expressing evolutionary steps in the development of cancer at individual cell levels, was not appreciated.(ABSTRACT TRUNCATED AT 250 WORDS)

Cyprus↗

PubMed1993

[Sports and pregnancy].

In the absence of underlying cardiovascular, metabolic endocrine disease or other high-risk problems (threatened premature labour, conditions associated with an increased risk of prematurity, acute fetal distress), pregnancy can be considered a variation in the normal human physiologic condition. Beneficial effects can be realized from submaximal exercise programs, apparently without concomitant deleterious effects on the fetus, which continues to receive an adequate oxygen and nutrition supply during maternal and moderate exercise. The physician should advise women to be careful in their choice of sports and not to begin new activities or increase their intensity during pregnancy. The benefits of regular aerobic exercise are well known. The effect of anaerobic workouts during pregnancy is less clear. Nonetheless, women should be advised to avoid anaerobic training such as sprinting and interval work during pregnancy. Swimming is an excellent cardiovascular conditioner with minimal risk of orthopedic complication. Violent sports should be avoided.

Adult↗

PubMed1992

[Non-sexual transmission of sexually transmissible diseases].

Sexually transmitted diseases can be transmitted through nonsexual transmission. Neonatal contamination has been proven at parturition from mothers with anogenital diseases. Another example is transmission through exchange of underwear, towels, bed sharing, etc. It is possible that contamination may occur with use of the contaminated speculum and forceps. Use of laser may release viruses during treatment for viral diseases. Candidiasis, trichomoniasis and genitalis condilomatosis, which should not be considered an exclusively sexually transmitted diseases are considered.

Candidiasis↗

PubMed1992

[Sampling devices for the Papanicolaou test].

Smear quality is related to the experience of the sample taker and also to the screening instrument used. Most Authors concur that both an endocervical and an ectocervical specimen must be collected to assure adequate sampling of the transitional zone. The cytobrush alone is effective mainly for endocervical sampling while the Ayre spatula alone is effective mainly for ectocervical sampling; the cotton swab is ineffective for both endocervical and ectocervical sampling. Values and failure of the sampling devices are described.

Diagnostic Errors↗

PubMedDate not supplied

The unicum and cytobrush plus spatula for cervical cytologic sampling: a comparison.

OBJECTIVE: To compare the efficacy of the Unicum, a new ectocervical-endocervical nylon brush, with that of the Cytobrush plus wooden spatula in the collection of cervical-endocervical material. STUDY DESIGN: Thirty-eight patients who underwent routine gynecologic examinations agreed to have a smear taken with the wooden spatula plus Cytobrush and the Unicum. RESULTS: The two methods were equally effective in collecting endocervical-ectocervical smears. CONCLUSION: With our method, sampling is done with only one device; the ectocervix and endocervix are sampled simultaneously, and adequate sampling of the transformation zone must be achieved.

Cervix Uteri↗

PubMedDate not supplied

[Screening for ovarian carcinoma].

Approximately 1 in 70 women in the USA will develop ovarian cancer in their lifetime. As the incidence of ovarian cancer is higher than that of cervical cancer, an effective screening program is indicated from a medical point of view. This article examines the reduction in ovarian cancer mortality that might be achieved if we can develop a screening test for the detection of this disease during its preclinical phase. Until recently the only potential screening test for ovarian cancer was vaginal examination. With pelvic examination small ovarian lesions are often missed. Ultrasound examination of the ovaries is a much more reliable method for examining the ovary than gynecologic palpation. The combination of serum CA125 measurement with ultrasound examination offers the most specific and sensitive method for the early detection of ovarian cancer. Question concerning the optimal population to screen remain unanswered. If a screening protocol for ovarian cancer is available, demonstration that it results in a reduction in mortality in the screened population will be required. This will only be obtained by performing a large population based, randomised controlled study. Therefore, a simple and reliable screening test for the early detection of ovarian cancer is still urgently required.

Adult↗

PubMedDate not supplied

[Paget disease of the vulva].

The question of whether vulvar Paget's disease is an intraepidermal disease with potential to invade the underlying dermis or a tumor of adnexal origin with spread to the overlying epidermis remains to be resolved. The most common complaint is pruritus. The lesion is described as red, inflamed or erythematous. The delay in diagnosis is considerable in most cases. The disease can be diagnosed only by biopsy. The lesion frequently extends beyond the clinically apparent borders. The disease without underlying invasive carcinoma appears to remain as an intraepithelial malignancy for a long time. The high incidence of other malignancies (breast, colon, cervix, ovary) warrants careful examination in patients with Paget's disease of the vulva. Close follow-up for a longer period of time will be necessary before excluding recurrence. A major goal of conservative surgery is to preserve sexual function, normal anatomy and body image.

Adult↗