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Biomedical subjects

L Bocciolone

Publications and source records attributed to L Bocciolone.

45 records · Page 3Linked to original sources
PubMed1990

Maternal and paternal moderate daily alcohol consumption and unexplained miscarriages.

The relation between parental moderate alcohol consumption and the risk of miscarriage was analysed using data from a case-control study in Milan between January 1987 and June 1988. Cases were 94 women who had two or more 'unexplained' miscarriages (after exclusion of genetic, endocrine and Müllerian factors) and without full-term pregnancies, admitted or referred to the First Obstetric and Gynecologic Clinic of the University of Milan. A total of 176 women admitted for normal delivery on selected days to the same university clinic and without previous miscarriages were chosen as controls. Compared with non-drinkers the risk of recurrent miscarriage was 0.9 for regular drinkers. The point estimates were 0.9 for women reporting one drink per day and 0.8 for those reporting two or more. Compared with non-drinkers, the relative risk estimates for drinking by fathers were slightly above unity, being 1.7 for less than three drinks and 1.4 for three or more drinks per day, but the trend in risk was not statistically significant.

Abortion, Habitual↗
PubMed1990

Endometrial patterns during danazol and buserelin therapy for endometriosis: comparative structural and ultrastructural study.

We studied endometrial structure and ultrastructure in serial biopsy specimens from patients with endometriosis treated with danazol (N = 19) or intranasal buserelin (N = 13) for 6 months. Biopsies were performed before and at 3 and 6 months of treatment. The specimens were studied by light, scanning, and transmission electron microscopy. Six morphometric indices were evaluated. Danazol produced a progestational effect on endometrial glands and stroma associated with marked hypotrophy of the mucosa, and buserelin treatment resulted in weakly proliferative or inactive mucosa. Both drugs induced noncyclicity and hypotrophy of endometrium although with different mechanisms of action, and it is suggested that they may have similar effects on ectopic endometrium. Because the atrophic effect of danazol appeared earlier than that of buserelin, the former could be recommended for short-term therapy.

Adult↗
PubMedDate not supplied

Detection of sentinel nodes by lymphoscintigraphy and gamma probe guided surgery in vulvar neoplasia.

BACKGROUND: Pathologic lymph node status is the most important prognostic factor in vulvar cancer; however, complete inguinofemoral node dissection is associated with significant morbidity. Intraoperative lymphoscintigraphy associated with gamma detecting probe-guided surgery has proved to be reliable in the detection of sentinel node (SN) involvement in melanoma and breast cancer patients. The present study evaluates the feasibility of the surgical identification of inguinal sentinel nodes using lymphoscintigraphy and a gamma detecting probe in patients with early vulvar cancer. METHODS: Technetium-99-labeled colloid human albumin was administered perilesionally in 44 patients. Twenty patients had T1 and 23 had T2 invasive epidermoid vulvar cancer; one patient had a lower-third vaginal cancer. An intraoperative gamma detecting probe was used to identify SNs during surgery. Complete inguinofemoral node dissection was subsequently performed. SNs underwent separate pathologic evaluation. RESULTS: A total of 77 groins were dissected in 44 patients. SNs were identified in all the studied groins. Thirteen cases had positive nodes: the SN was positive in all of them; in 10 cases the SN was the only positive node. Thirty-one patients showed negative SNs: all of them were negative for lymph node metastasis. CONCLUSIONS: Lymphoscintigraphy and SN biopsy under gamma detecting probe guidance proved to be an easy and reliable method for detection of SNs in early vulvar cancer. If these preliminary data will be confirmed, the technique would represent a real progress towards less aggressive treatment in patients with vulvar cancer.

Adult↗
PubMedDate not supplied

Medical therapy of advanced malignant epithelial tumours of the ovary.

Despite improvements seen in median and overall survival using a combination of platinum-compounds and paclitaxel (PTX), long-term survival rates for patients with advanced epithelial ovarian carcinoma remain disappointing and ongoing efforts have aimed to develop more effective primary therapy. In the early 1990Os the drug PTX was first tested in ovarian cancer. In the Gynaecological Oncology Group (GOG) trial 111 the cisplatin (CP)+PTX regimen was judged to be superior compared to the platinum-based control arm with an improvement of overall response rate, median progression-free interval and overall median survival. These favourable data were confirmed by a European-Canadian Intergroup trial (OV10). In contrast, in a further GOG trial (GOG132) there was no difference in survival between CP alone and the combination of PTX and CP. The International Collaborative Ovarian Neoplasm Study (ICON)3 is the first and only trial comparing PTX plus carboplatin against carboplatin alone or a (non-taxane) CP-based control arm. The last analysis performed with a total of 1,293 events showed an estimated absolute difference in one-year progression-free survival of 1% and in two-year overall survival of 2% both in favour of PTX plus carboplatin. The results of ICON3, in accordance with GOG132 study, appear to contradict the earlier positive results seen for PTX and CP in the GOG-111 and OV10 trials and suggested that single agent carboplatin, CY-adriamycin-CP are safe and effective first-line treatments for women requiring chemotherapy for ovarian cancer. A meta-analysis with individual patient data is warranted to better clarify the issue of PTX in the front line therapy of advanced ovarian cancer. Salvage chemotherapy is often utilised in patients with advanced ovarian cancer, due to the high frequency of recurrent disease even after a clinical or pathological complete response after primary chemotherapy. Main objectives of salvage chemotherapy include: i. improvement in quality of life and symptoms; ii. tumour load reduction and survival advantage; iii. evaluation of potentially active new drugs to be included in first-line. Since the goal is palliation in most cases, monotherapy is generally indicated. However, the chances of response are directly related to the treatment-free interval, with a response rate nearly equivalent to that of primary chemotherapy when the treatment-free interval exceeds 24 months. Extension of the platinum-free interval before re-treatment with platinum or taxanes may allow partial reversal of resistance to these agents which can therefore still show significant activity in relapsing patients. Unfortunately, durable response to salvage chemotherapy is rare and cure is almost impossible. The sequential use of the agents currently available for salvage treatment in monotherapy may transform ovarian cancer into a chronic disease and confers long survival to the patients. Perhaps, the most interesting role of second-line chemotherapy is to identify new potentially active drugs, which can be moved up-front. Most of the compounds used in second line (gemcitabine, topotecan, liposomal doxorubicin) are in fact under investigation to develop alternative schedules and sequences of drug administration. A new phase III multi-national randomised study for patients with advanced stage epithelial ovarian or primary periperitoneal carcinoma will evaluate the impact of incorporating a new drug within either a platinum-based triplet (new drug + platinum + PTX) or a sequential-doublet (new drug + platinum followed by platinum + PTX) in order to identify one or more experimental regimens able to improve long-term survival with acceptable toxicity.

Antineoplastic Agents, Phytogenic↗
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↗
PubMedDate not supplied

[Determinants of the frequency of cesarean section in Italy, 1980-1983].

The frequency and determinants of cesarean section rates in Italy were analyzed using data collected routinely by the Italian Central Institute of Statistics on more than 2,400,000 deliveries in 1980-83. The rate of cesarean section in Italy rose from 11.2/100 deliveries in 1980 to 14.5 in 1983. This increase was comparable with other European countries, although the rate of abdominal deliveries was still about 30-40% lower than in the United States and Canada. In the southern (and less rich) areas, the rate of cesarean section was about 40% lower than in the North or Centre of Italy. The rate of cesarean birth rose constantly with maternal age; being in comparison with teen-agers, about three times higher in women aged 45 years or more. Compared with women with primary or intermediate degree, those with university education reported about 40% higher rate of cesarean section, but this differences was markedly reduced after taking into account maternal age and birth weight. In southern areas of the country the frequency of cesarean birth was about 40% higher in public hospital than in private ones (11.5 and 8.1/100 deliveries, respectively), while in northern and central areas the frequency of cesarean birth was higher in private hospital than public ones (18.5 vs 14.7/100 deliveries in the North, and 19.6 vs 14.6/100 deliveries in the Centre). There were relationships between cesarean rates and birth weight or gestational weeks. The lowest values were observed in very low birth weight (less than or equal to 999 gr) as in babies weighing 3000-3999 gr and in deliveries occurred between the 25th and 27th gestational weeks and in term deliveries. About 55% of deliveries with breech presentation were delivered by cesarean section.

Adolescent↗
PubMedDate not supplied

[Frequency of multiple pregnancies in various Italian regions: 1955-1983].

The trend in frequency of multiple birth in Italy has been analyzed on the basis of the number of single and multiple births, according to age and regions, published annually by the Central Institute of Statistics. The rates and ratios of twin and triple or more pregnancy were computed for region, children sex and calendar period. Specific and standardized rates by maternal age are presented here too. Between 1955 and 1983 the frequency of multiple births declined from 12.6/1000 to 9.6/1000 deliveries. The downward trend was constant till the late 70's, when multiple pregnancy rates flattened out, being constant till the early 80's. This was largely attributable to decreasing trend in dizygotic multiple pregnancies, the monozygotic rates were generally constant over the considered period. Rates of triple births decreased slightly till the early 70's and increased in relative and absolute terms from late 70's on, thus if in the quinquennium 1955-1959 only 1 out of 99 multiple births was a triplet, this ratio increased to 1 out of 70 in 1980-1983. There was no noticeable variation in the North/South multiple birth frequency ratio, which was constantly about 0.7. Similarly the national trends were generally reproduced in various regions, the regional differences were largely attributable to differences in dizygotic multiple pregnancy rates.

Adult↗
PubMedDate not supplied

[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↗