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Biomedical subjects

L Scarpellini

Publications and source records attributed to L Scarpellini.

At least 19 recordsLinked to original sources
PubMed1997

Systemic methotrexate treatment in early unruptured ectopic pregnancy.

Ectopic pregnancy is one of the most common and dangerous complications of the early pregnancy period. Until now diagnosis has been late because major symptoms occur after tubal rupture and so only demolitive surgery has been possible. At present, with the appearance of ultrasound in obstetrics an earlier diagnosis of this pathology can be made before tubal rupture so medical treatment has become possible. We treated a series of twelve patients with early ectopic pregnancy (9 tubal and 3 with no localized site of implantation) with intramuscular 0.5 mg/kg methotrexate and oral 0.1 mg/kg of folic acid (Citrovorum Factor) on alternate days, in the attempt to reduce hospitalization and obtain more effective and safer medical management. We observed a fall in serum beta-HCG levels after one cycle of treatment in 11 out of 12 patients and after two cycles of therapy in the remaining case. Minimal side-effects were observed in four cases. Three pregnancies occurred after treatment before the advised interval time and ended in blighted ovum. Methotrexate systemic therapy can be considered an elective treatment and a sufficiently safe management in early unruptured ectopic pregnancy when a good clinical selection of patients is performed.

Administration, Oral↗
PubMed1996

Serum lipoperoxide level variations in normal and luteal phase defect cycles.

A luteal phase defect (LPD) is a clinical problem leading to infertility and is characterized by reduced progesterone levels during the luteal phase. Serum lipoperoxidation is an expression of cellular hypoxic damage occurring under all stress-oxidative conditions. Forty-eight consecutive infertility patients, according to the infertility class II of the WHO classification, underwent clinical observation. Twenty-five patients ovulated constantly with a normal luteal phase, while the other 23 had a LPD, hormonally and histologically assessed. The luteal phase was monitored biochemically by titration of progesterone, oestradiol, and serum lipid peroxides during the ovulatory period and 6-12 days after ovulation. The mean plasmatic concentration of oestradiol was not statistically different between the LPD and the normal-cycle groups, while a statistically significant difference was found for progesterone plasmatic concentrations between the LPD and the normal-cycle groups (p < 0.05); a greater statistical difference was also found in the mean serum lipoperoxide titration (p < 0.001). These findings suggest that serum lipoperoxidation titration may be a useful tool in the study of the interactions between hormonal milieu and sympathetic activity.

Estradiol↗
PubMed1995

Serum CA 125 and first trimester abortion.

OBJECTIVE: The study was carried out to assess the clinical value of serum CA 125 in association with serum beta-human chorionic gonadotropin (hCG) for predicting pregnancy outcome. METHODS: One hundred spontaneous pregnancies, 52 non-threatened pregnancies and 48 with threatened abortions, observed in the Department of Obstetrics and Gynecology at the University 'La Sapienza', Rome, Italy, were evaluated during the first trimester using ultrasound examination, CA 125 and beta-hCG titrations. RESULTS: Threatened pregnancies had statistically significantly higher CA 125 serum values than non-threatened pregnancies, especially those with a negative outcome (P < 0.01). The CA 125 levels in the threatened pregnancies were positively correlated with the tropho-decidual hematoma volume (r=0.839, P < 0.0001). The CA 125-beta-hCG association showed a higher prognostic value (sensitivity 78.9%, specificity 96.5%) in assessing pregnancy outcome than CA 125 or 0-hCG alone (sensitivity 78.9% and 57.9%, respectively; specificity 75.8% and 86.2%, respectively). CONCLUSIONS: Our findings are in accordance with the hypothesis of a tropho-decidual origin of this marker, suggesting its possible usefulness in the prognostic evaluation of first trimester threatened abortion.

Abortion, Threatened↗
PubMed1994

[Diagnostic possibility in neonatal bacterial infections].

Bacterial infections in neonates may be acquired in utero, as is the case in congenital syphilis, or after delivery, such as late onset B streptococcal meningitis. Although some infections remain localized and may even be self-limiting, the majority of neonatal bacterial infections require speedy diagnosis and immediate and appropriate treatment. Severe invasive bacterial infections are rare but catastrophic; they are more common in intensive care wards. Neonatal, maternal, and environmental factors favoring bacterial infections are discussed together with their main clinical features. Useful diagnostic parameters are examination of the placenta, leukocyte counting, erythrocyte sedimentation rate, and C-reactive protein. If a bacterial infection is suspected in a baby that is sick or in poor general condition (low birth weight, therapies, environmental conditions) a "septic therapeutic approach" must be adopted which includes examination and culture of blood, cerebrospinal fluid, and urine, as well as of any other suitable material according to clinical and laboratory findings. Pathogens most frequently involved in neonatal infections (streptococci, staphylococci, Listeria, gram-negative enteral bacteria) can be presumptively identified by comparatively simple laboratory tests. The valid interpretation of the results of these tests is dependent upon the degree to which the laboratory personnel is familiar with techniques of identification and assessment of sensitivity, as well as on the close cooperation between clinical department and laboratory from the start and all along the course of the disease.

Bacterial Infections↗
PubMed1993

[The pharmacological options for an immediate intervention in threatened premature labor].

The following preparations, with different mechanism of action, have been comparatively tested for induction of immediate tocolysis in case of threatened preterm labour: Hyoscine butylbromide, ritodrine, ketoprofen and the association of ritodrine with ketoprofen. Hyoscine butylbromide was found to be very easy to handle, but its myolytic effect is modest. Ritodrine and ketoprofen have shown a high and quantitatively similar tocolytic power. But even better results have been achieved with the association of ritodrine with ketoprofen which has shown a total myolytic effect. The authors suggest some hypotheses concerning the mechanism of action of these drugs, and some precautions for their correct clinical use.

Adolescent↗
PubMed1993

[Clinical evaluation of DHEA-S plasma levels and possible therapeutic value of the hormone in the third trimester].

Three groups of women were studied. The first included women without obstetric or systemic pathology; in these, plasma concentrations of progesterone, E, and DHEA-S were assayed at 30-40 weeks of pregnancy. The second group comprised women after physiological first delivery at term, and in these the plasma levels of the same hormones were assessed. In the third group, comprising women at 38 weeks of pregnancy with unripened cervix and DHEA-S plasma levels that were by 1-2 weeks below those of women with ripened cervix of the same gestational age, the effect of repeated perfusion with DHEA-S was examined.

Adult↗
PubMed1993

Progesterone immunosuppressive levels and luteal steroid profiles in the cycles induced with clomiphene citrate.

Several studies have focused their attention on the possible interferences of the endocrine with the immunity system; these interrelations have been summoned to explain some aspects of the implantation. It has already been demonstrated that progesterone could play an immunosuppressive role, allowing the implantation of allotransplantation. However, the individual plasmatic levels of the substance needed to produce that effect still unknown. With the aim of determining the certain immunosuppressive progesterone levels in women with normal ovulatory function, and in order to determine if the other principal steroids might also have immunosuppressive effects, in 47 women affected by sine causa infertility, treated with 100 mg. die of Clomiphene Citrate (from day 3 to day 7) we evaluated the plasma levels of progesterone, 17-OH-Progesterone and 17 beta-Estradiol. The assays were made on the 7th, 11th and 14th post-ovulation days both in women who conceived (immunosuppressive effect present) and in women who did not achieve pregnancy (immunosuppressive effect absent). The results achieved showed a significant difference only in the progesterone values, while those of the other steroids were not significantly different, indicating thus that progesterone is the main element responsible for the immunosuppressive phenomenon and that the seriated evaluation in the luteal phase of this steroid could be used as a marker of achieved implantation.

17-alpha-Hydroxyprogesterone↗
PubMed1993

[An increase in the median plasma values of progesterone in luteal deficiencies treated with clomifene citrate in the early follicular phase].

A clinical study performed during 265 cycles in 63 normo-ovulating and normo-menstruating patients, of whom 27 with a luteal phase defect (LPD), assessed by morphological, hormonal, echographic and clinic criteria. These were given Clomiphene Citrate, 100 mg per day from the second to sixth day of the cycle, for a total of 108 cycles. The other 36 patients, without any luteal abnormality, were utilized as a control group during 156 cycles. At the end of the study there were no significant differences in hormonal, echographic and morphological parameters between the two groups.

Clomiphene↗