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Biomedical subjects

L Mencaglia

Publications and source records attributed to L Mencaglia.

16 recordsLinked to original sources
PubMed1991

Early detection of endometrial cancer and hyperplasia: a reappraisal.

It is widely recognized that endometrial carcinoma represents one of the most frequent types of pelvic malignancy in women. Recent improved knowledge about population at risk, the criteria of classification of endometrial hyperplasia, different potential for neoplastic transformation for each type of neoplasia, and asymptomatic latency of the pathology allow some considerations. Endometrial cytology is of basic importance in a mass screening programme due to its low cost, accuracy and feasibility. The combination of hysteroscopy and endometrial biopsy is the diagnostic method of choice for symptomatic patients. It permits the elimination of curettage in the diagnostic management in over 95% of cases, with obvious advantages, better diagnostic accuracy and greater convenience for patients and doctors.

Biopsy↗
PubMed1990

Endometrial carcinoma and its precursors: early detection and treatment.

Endometrial carcinoma is the most frequent genital neoplasia in women. Precursors of this condition include endometrial hyperplasia, particularly when cytologic atypia occurs. Among the frequent early clinical manifestations of endometrial carcinoma is abnormal uterine bleeding that must be differentiated from bleeding associated with benign conditions. Early detection of endometrial carcinoma and its precursors in women at risk is the best prophylactic measure in the final therapeutic outcome. In this review, the accuracy of methods of early diagnosis of endometrial carcinoma and its precursors is assessed, in order to provide early therapy and optimum prognosis. The epidemiology of endometrial carcinoma, as well as the risk factors for the development of this neoplasia, are also reviewed. A histologic classification of endometrial hyperplasia and carcinoma of the endometrium, based on current theories of histopathogenesis, is included.

Biopsy↗
PubMed1988

Hysteroscopic detection of heterotopic intrauterine bone formation.

The diagnosis and management of heterotopic intrauterine bone formation was performed hysteroscopically in nine patients. The presenting symptom was secondary infertility in seven, pelvic pain in one and passage of bone fragments in one. All nine patients had a history of spontaneous and therapeutic abortion. Hysteroscopy was more accurate than hysterosalpingography in detecting the condition. Four pregnancies occurred in the seven infertile patients following removal of the bone. In four of nine cases there was clear evidence of remaining bone fragments after the initial removal.

Adult↗
PubMed1987

Endometrial cytology: six years of experience.

This article deals with a 6-yr mass screening program for the early detection of endometrial cancer, which took place 1978-1983. The diagnostic accuracy of endometrial cytology and the possibility of integrating this technique with the hysteroscopy and endometrial biopsy were studied. The authors analyzed 2,504 outpatients, all over the age of 45. The results of endometrial cytology were compared with those found using hysteroscopy and endometrial biopsy. Endometrial cytology showed high sensitivity in diagnosing endometrial cancer (97.7%) and high specificity in diagnosing true negatives. However, this technique was not adequate in identifying benign endometrial pathology, e.g., endometrial hyperplasia, polyps, or submucous fibromas. Epidemiological and clinical data in our series were fundamental in establishing mass screening for the early detection of endometrial cancer using integrated techniques. These data should be taken into consideration for creating new projects. The significantly high prevalence of endometrial neoplasia even in asymptomatic women over 45 years of age (4 per 1000) and the possibility of improving the accuracy of endometrial diagnosis using hysteroscopy and endometrial biopsy were the cornerstones of this project.

Cytodiagnosis↗
PubMed1987

Hysteroscopy in perimenopausal and postmenopausal women with abnormal uterine bleeding.

From February 1983 to January 1985, we performed outpatient microhysteroscopic examinations on 618 women 45 years of age or older with abnormal uterine bleeding (AUB). Three hundred thirty-four (54%) had normal and functional or hypoatrophic endometrium, 78 (12.6%) had low-risk hyperplasia, 8 (1.3%) had high-risk hyperplasia, and 66 (10.6%) had adenocarcinoma. Correlation with histologic findings revealed the considerable diagnostic accuracy of the technique: its reliability approaches 100% when one deals with endometrial neoplasia, 87.5% with high-risk hyperplasia and 65.2% with low-risk hyperplasia. The diagnosis cannot rely on hysteroscopic examination only. A biopsy can be performed during the examination or immediately thereafter. In 54.1% of AUB patients, no endometrial changes could be detected on hysteroscopy and biopsy. Curettage, therefore, would have resulted in overtreatment of these patients. Moreover, the usefulness of dilatation and curettage in about half of AUB patients over 45 should be questioned seriously.

Adenocarcinoma↗
PubMedDate not supplied

Hysteroscopic metroplasty: the role of ultrasound in the diagnosis and monitoring of patients with uterine septa.

52 patients with septate uterus underwent hysteroscopic metroplasty in the Obstetric and Gynecologic Clinic "R" in Palermo. In this group of patients ultrasound examinations were also performed in order to define their role in diagnosis of type of malformations and in monitoring the endoscopic surgical procedure. Preliminary results seem to indicate that real-time ultrasound is a reliable technique for both purposes.

Adult↗
PubMedDate not supplied

Is hysteroscopy of value in the investigation of female infertility?

A prospective multicentre study was designed to ascertain the value of hysteroscopy in the evaluation of female infertility. The study comprises 619 CO2 hysteroscopies in women complaining of infertility. Four hundred and ninety nine examinations (80%) were performed without anaesthesia or cervical dilatation. Twenty eight cases of malformation were diagnosed. Adhesions were found in 68 patients (11%), polypi in 56 (9.1%) and submucous fibroids in 51 (8.2%). Endometrial hyperplasia was diagnosed by hysteroscopy in 67 patients, but there was only 42% histological correlation. Examination of the tubal ostia by hysteroscopy revealed 26 patients (4%) with unilateral tubocornual polyps and one with bilateral polyps. The correlation with hysterosalpingography (HSG) in 185 patients was poor. In 20% where the HSG was reported as normal there were hysteroscopically demonstrable lesions whereas there were false positive findings at HSG in 35% of cases. Hysteroscopy is the only technique which provides an accurate clinical evaluation of the uterine cavity although it does not provide significant information about the cervical canal or fallopian tubes.

Adult↗
PubMedDate not supplied

HIV infection and pregnancy: diagnostic and follow-up program for the pregnant woman and newborn child.

The authors take as their starting point the cases of 8 pregnancies in HIV serologically positive women, admitted for their observation from July 1986 to March 1988. They emphasize the importance of clinical, anamnestic and serological screening in order to identify those subjects at risk, and thereby prevent the vertical transmission of the virus. To this end, they propose a protocol to be used for all women at risk, both pregnant and not, both seropositive and seronegative. They also advise repeated clinical and immunological checks of the children of asymptomatic carrier mothers.

AIDS Serodiagnosis↗
PubMedDate not supplied

Spermatozoa fertilization capability: multivariate data analysis.

The Hamster egg fertilization rate with human spermatozoa is one of the methods to estimate male fertility capability. The authors describe the statistical-mathematical method, PLS (Partial Least Square) to evaluate a cause-effect relationship between the Hamster egg fertilization level and the number and motile level of the spermatozoa.

Female↗
PubMedDate not supplied

Diagnosis of cervical lesions from human papova virus.

The impact of human papillomavirus (HPV) infection in genital pathology has been clarified relatively recently and its relevance appears to be parallel to the liberalization of sexual customs. Aside from some aspects of the infection grossly evident to the naked eye, an increasing number of sub-clinical lesions, that can be colposcopically identified as "flat condylomata" is commonly revealed by cytologic screenings. The Authors report their experience in the diagnosis of this frequent pathology in gynecologic practice, underlining the importance of more fine laboratory investigations, mostly ultrastructural and immunohistochemical.

Cervix Uteri↗
PubMedDate not supplied

Hysteroscopic treatment of uterine septa.

Patients with septate uterus usually undergo reproductive failures with recurrent abortions and premature deliveries. Up till now surgical therapy for such a defect has relied on different abdominal metroplasty procedures reflecting the need to establish normal anatomy and physiology of the uterus. Nowadays, wide experience accumulated in hysteroscopic management of intrauterine adhesions, has allowed the incision of the uterine septa with the hysteroscopic technique. In this report the Authors describe the surgical technique of the hysteroscopic metroplasty in eleven cases. Initial results are encouraging: surgical outcome is good, with no intra- or postoperative morbidity; if the pregnancy outcome rate confirms these results, then the traditional abdominal surgical approach should become an out-moded therapy, so making hysteroscopic metroplasty the treatment of choice for the uterine septa.

Abortion, Spontaneous↗
PubMedDate not supplied

Hysteroscopic evaluation of intrauterine progesterone contraceptive system as a treatment for abnormal uterine bleeding.

Intrauterine Progesterone Contraceptive System has been used in twenty patients aged 45 to 52, affected by dysfunctional uterine bleeding due to glandular hyperplasia (6 cases), focal glandular hyperplasia (8 cases), cystic hyperplasia (4 cases) and adenomatous hyperplasia (2 cases). Hysteroscopy and endometrial biopsy were performed every two months after insertion of IPCS. Complete regression or clear improvement were observed in all cases. The question if regression may be considered permanent or temporary remains to be answered.

Adult↗