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G Festa

Publications and source records attributed to G Festa.

3 recordsLinked to original sources

[Indications for hormone replacement therapy].

BACKGROUND: The purpose of the present study is to evaluate indications and contraindications, advisability and compliance of hormone replacement therapy (HRT) in women in the climacteric who, owing to the cessation of ovarian activity, face loss of the state of present and future wellbeing. METHODS: A series of 602 women who have attended the Menopause Centre of the II Division of the Department of Gynaecology and Obstetrics of the Second University of Naples in the period from 1/12/1998 to 10/4/2001. The diagnostic methodology adopted is outlined and the reasons for the prescription of HRT indicated. Patients who do not present contraindications were assessed in relation to the gravity of the climacteric syndrome and the likelihood of a future pathology bound up with the lack of estrogens. The intensity of the symptomatology was assessed on the basis of Kuppermann's nomogram. RESULTS: The cessation of ovarian activity occurred between the ages of 40 and 45 in 16.9% of cases while the percentage was 5.9% prior to the age of 40. Cases in which a climacteric syndrome was present numbered 147, or 24.2%. Women who present a cardiovascular risk represent a noteworthy percentage (27.1%). A high number of women are at osteoporotic risk: 223, or 37.0%. Although it has a great number of indications, HRT is only prescribed in about half the patients. Stress is laid on the caution exercised by physicians in prescribing HRT and the diffidence of women in accepting it. Of the well-known contraindications to HRT the most common are those relative to the mammary risk. CONCLUSIONS: HRT was only prescribed for about half the women who came to our attention both as a result of the caution of the physicians who consider even relative contraindications peremptory, and because of the diffidence of a percentage of women with regard to such therapy. Alternative therapies to HRT are in fact a second valid choice, especially in the prevention of osteoporosis.

Adult↗

Arginase, a new marker of mammary carcinoma.

Activities of arginase, alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase were determined in sera obtained in a group of healthy women, women with verified carcinoma of the breast, benign mastopathy, a group of patients with carcinoma of various organs and a group of patients with acute viral hepatitis. Preoperative values of serum arginase activity in patients with breast carcinoma were up to 4-fold those found in healthy women. Sensitivity of the test was 86%. After the surgery, the activity decreased abruptly during the first week and normalised within 15-30 days. In benign diseases of the breast, the activity of arginase was normal. Serum arginase activity is raised in both benign and malignant liver diseases, however, the quotients alanine aminotransferase/arginase, aspartate aminotransferase/arginase and alkaline phosphatase/arginase differ significantly. Thus, use of alanine aminotransferase/arginase quotient implies a high degree of confidence in differentiating between increased arginase activity in mammary carcinoma (alanine aminotransferase/arginase = 0.572 +/- 0.278) and high arginase activity in hepatitis (alanine aminotransferase/arginase = 12.226 +/- 1.822).

Adult↗

[Laparoscopic appendectomy and laparotomy appendectomy: comparison of methods].

The study compares the real advantages of laparoscopic appendicectomy using only a transumbilical trocar, with laparotomic appendicectomy in the management of acute and/or chronic pain in the lower right abdominal quadrant. From May 1997 to April 2000, 88 patients were treated: 27 (group I) with the laparoscopic approach, and 61 (group II) with laparotomy. We compared operating times, incidence of complications, hospital stay and cosmetic result. We also reviewed the literature on this subject over the past ten years. Average operating time was 45 minutes in group I and 30 minutes in group II; complications consisted in 2 cases of omphalitis in the laparoscopic group and 3 infections of the wound and 2 cases of lipolysis of the abdominal wall in the laparotomic group. The average hospital stay was 3.2 days in the laparoscopic group against 4.7 days in the laparotomic group. Resumption of work and sport occurred after 10 to 20 days and 15 to 45 days in groups I and II, respectively. The total cost was lower in the laparoscopic group. The laparoscopic approach appears to be an effective technique for the management of acute and chronic appendicitis, as it allows both treatment of the pathology and diagnosis and treatment of other unknown pathologies, with exploration of the abdominal cavity. In addition, it guarantees a good cosmetic result, a short hospital stay with a low incidence of complications and an advantageous cost/benefit ratio.

Adolescent↗