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Biomedical subjects

M Farris

Publications and source records attributed to M Farris.

At least 19 recordsLinked to original sources
PubMed2006

[Emergency contraception].

A specific formulation has been approved for use in Italy for emergency contraception (EC) in 2000. As expected, marketing of this levonorgestrel (LNG) only formulation has been accompanied by an increased interest and, often, controversies leading to even strong opposition on the part of those ethically opposed to the use of any method that may act after fertilization. At present, several trials on the exact mechanism of action and safety have been conducted, giving good reason for simplifying access, providing it free or over the counter, in several European countries. EC, also known as ''the morning after pill'' or postcoital contraception, is a modality of preventing the establishment of an unwanted pregnancy after unprotected intercourse and thus, probably, of reducing the number of voluntary pregnancy terminations. Two different forms are available: the hormonal and the intrauterine. Hormonal estrogen only EC was first proposed in the 60s and in 1974 Yuzpe following his studies proposed for the first time his combined regimen, that showed better efficacy and lower side effects. More recently, a new regimen, consisting of LNG, administered alone at the dose of 1.5 mg, was introduced and found in clinical trials to be more effective than the Yuzpe regimen, if taken as early as possible, within 72 h, thereby replacing the latter in common use. Mechanism of action of both hormonal preparations used for EC is inhibiting or delaying ovulation, therefore a prefertilization action. No effect has been reported on the process of implantation nor on an ongoing pregnancy. The WHO have developed a third regimen based on the use of the selective progesterone receptor modulator (antiprogestin) Mifepristone and conducted trials with different dosages, reporting similar efficacy and safety compared to LNG. Intrauterine EC was first proposed by Lippes in 1976. It has the advantage of being effective if inserted within 5 days after unprotected intercourse and the disadvantage of a greater complexity. In addition, this modality is truly interceptive, acting by preventing implantation. Pregnancy rates reported following EC using a device >300 mm2 of copper are consistently low (0.1-0.2%).

Contraception Behavior↗
PubMed2006

[Infertility: a global perspective].

Infertility has always existed; however, today it has a different meaning because the possibility exists, not only to treat it in some three quarters of all cases, but also, in a number of instances, to prevent it. At the same time, this improved scenario created a number of important new issues concerning public health policies and the social impact of infertility; these issues can be summarized with two words: equity and ethics. Indeed, there are intolerable differences in access to infertility care, depending on the social-economic status, as well as the country in which a couple lives. It is generally believed that, overall, in the general population a persistent form of infertility affects some 7-8% of all couples; in Europe the prevalence of infertility has been estimated at around 14%. There are important regional differences in the incidence and causes of sterility. Whereas the best known factor in western countries is an increase in the age in which women attempt to conceive, in Africa, the most important cause is represented by sexually transmitted infections. Over the last fifty years there have been major break-throws in the diagnosis and treatment of infertility, although it must be stressed that the importance and validity of therapy must be in all cases evaluated against expectant management. This is because in couples without clear signs of functional or organic pathology, conception will occur spontaneously in between 80 and 90% of the cases. At the same time, if attempts to conceive fail over a period of three years, even in women 30 years or younger, the probability of pregnancy decreases to about 40%. Finally, it must be stressed that advances in assisted reproductive technology have created not only important successes, but also significant ethical problems: on the one hand, the debate is open on the limits of artificial interventions in the field of reproduction; on the other the possibility exists that a partner may ''impose'' an infertility on the other.

Female↗
PubMed2005

Reasons for requesting emergency contraception: a survey of 506 Italian women.

OBJECTIVE: To evaluate the reason for requesting emergency contraception (EC), previous use of contraceptive methods and provision route in a Family Planning Clinic in Italy. METHODS: Women requesting EC were interviewed, through a questionnaire containing questions on demographic characteristics, about their reasons for requesting EC, their prior contraceptive use, their reasons for not using an effective contraceptive method (or possible reasons for its failure) and specifically about the so-called 'provision route' (i.e. whether and where they had previously requested EC receiving a negative response). RESULTS: Almost 70% of all women requesting EC were aged between 18 and 25 years. Some 80% of all women were in a stable relationship with their partner, with fewer than 20% having had an occasional intercourse. The vast majority of women (83%) reported prior use of a modern contraceptive method, i.e. 64% with a condom, 27% for combined oral contraceptives and 1.1% for the intrauterine device (IUD). In addition, 15% of the women had used more than one method (oral pills and condoms). Concerning the reasons for requesting EC, condom breakage or slipping was the most frequently cited (64%), followed by totally unprotected intercourse (28%), failed withdrawal (5%) and forgetting one or more pill (only 1.1%). CONCLUSIONS: More than one-third of the women interviewed had previously used an emergency contraceptive modality; although no one did so more than four times. Therefore, it can be inferred that-at least in the present series-EC had not been used as a routine contraceptive method. Finally, it seems clear that in Italy, even in large cities, information about the availability, proper usage and mechanism of action is lacking. This seems due to information being spread by word of mouth between peers and friends, with more formal communication channels lagging behind.

Adolescent↗
PubMed2004

Why a consensus conference on hormone replacement therapy and the cardiovascular system?

A recent randomized, placebo-control study of a combination of conjugated estrogens (0.625 mg) and medroxyprogesterone acetate (2.5 mg) known to bring considerable advantages to post-menopausal women, has concluded that the risks associated with its use outweigh the benefits. On the strength of these data the manufacturer began recommending that physicians consider alternatives to their product to treat post-menopausal symptoms. Since women take hormone replacement therapy (HRT) for compelling health reasons, it is important, not only to evaluate the new evidence, but also to translate it into terms which can be understood by women and their physicians. Although the focus of this conference is on the cardiovascular system, in order to place the present controversy in its proper perspective, it is necessary to consider also other adverse effects that frighten women, first and foremost, a possible increased risk of breast cancer. For several years it has been reported that there is an increased risk of invasive breast cancer with increased duration of HRT use, similar to what has been found for oral contraceptives. The situation is however, entirely different when addressing HRT and risk of cardiovascular diseases (CVD). Here, a large body of evidence has, for years, pointed to a protective effect. Therefore, in the case of cardiovascular risk, we must proceed very cautiously and weigh the evidence, before concluding that HRT has indeed a negative effect on cardiovascular diseases. To properly do so, we must evaluate the validity and applicability of the findings presented in the latest study, since evidence indicates that the results of the study may not be applicable to women seeking HRT at the time of menopause. We also need to try and outline an overall "risk-benefit profile" for the use of HRT and we must aim at establishing a true dialogue between all parties concerned. Finally, we must obtain information, or state the lack of it, on possible different effects among the various estrogens, routes of administration and dosages, as well as possible different actions of the various progestins, their dosages and routes of administration.

Cardiovascular Diseases↗
PubMed2004

Clinical profile of contraceptive progestins.

The term progestogen has been widely utilized to indicate the general class of agents that includes both progesterone and its synthetic analogs, whereas the term progestin refers only to synthetic progestational steroids. The development of progestins has been influenced in a major way by the search for orally active hormonal contraceptives, since it is likely that hormonal contraceptives will continue to utilize a progestin, the only possible alternative being represented by the utilization of antiprogestins. Synthetic progestogens in clinical use today belong to three main chemical families: progesterone derivatives (progesterone, retro-progesterone, 19-norprogesterone and 17alpha-hydroxyprogesterone); gonane and 19-nortestosterone derivatives (norethisterone, levonorgestrel, desogestrel, gestodene, norgestimate); a spironolactone derivative. Biological potency of progestogens varies depending on the end-point measured, usually ovulation inhibition and endometrial transformation; with both these tests, the most active compounds are all gonane derivatives, with a potency over a 100 times that of the natural hormone. When administered in adequate doses, a progestin inhibits fertility by inhibiting ovulation. This action is mainly exerted at the hypothalamic level where, physiologically, progesterone decreases the number of LH pulses. When progestogens are delivered directly to the uterine cavity, their action seems to be purely local. It has been amply proven that--even when administered in doses that do not constantly inhibit ovulation--a progestin can still remain effective as a contraceptive by acting at the level of the cervical mucus and, at least in part, of the endometrium. Progestogens utilized today differ largely in their pharmacokinetics. In general, after intake, these compounds are rapidly absorbed and distributed so that peak serum concentrations are reached between 1 and 4 h. Third-generation progestins (desogestrel, gestodene, norgestimate) have common characteristics: a higher affinity for progesterone receptors than their predecessors, a lower affinity for androgen receptors, a higher selectivity of action, a higher central inhibitory activity, a higher potency at the level of the endometrium, and an overall metabolic neutrality, in terms of effects on lipid and carbohydrate metabolism. In general, progestins can induce two types of adverse effects: changes in lipid metabolism and bleeding irregularities. Whereas the newer compounds seem to have overcome the first of these adverse effects, the second remains untouched: to this day, proper cycle control can only be achieved with combined hormonal contraceptives.

Contraceptive Agents↗
PubMed2003

Public health policy and infertility.

In assisted reproductive technology, three main areas are relevant from a health policy perspective: first, the technical excellence of the services rendered; second, a licensing and monitoring system to control all practitioners and the premises in which they work; and third, legislation to avoid abuse, prevent possible damage to the mother and the child and outlaw techniques unacceptable in a given cultural setting, including mechanisms to ensure the adherence by all to ethical and deontological principles. No one refuses the need to ensure that services offering assisted reproductive technologies adhere to technical excellence and everyone agrees that technical guidelines should exist and should be thoroughly enforced. When it comes to legislating about assisted reproductive techniques and, more specifically, to ruling in favour of limiting the use of existing technology to certain groups and not to others, or to ban altogether individual methods, views are sometimes totally divergent. In countries where legislation is fairly liberal, usually both physicians and the public view legislation with favour; conversely, where a number of restrictions exist, many complain that legislation impairs their ability to offer proper services. The solution seems to be a simple, well-defined, legislative act setting clear principles and providing for the creation of an Authority capable of resolving the myriad of individual problems that invariably arise from applying assisted reproductive techniques. Homo sum et nihil humanum a me alienum puto I am a human being and therefore cannot consider alien to me anything that helps another human being.

Female↗
PubMed2001

Proteomic detection of PhoPQ- and acid-mediated repression of Salmonella motility.

Salmonella adaptation to low pH is a critical survival response and essential for virulence. Here, we show that another key virulence-associated process, flagella-mediated cell motility, is co-regulated by low pH via the PhoPQ signal transduction system. Using a proteomic approach, we found that phase 1 and phase 2 flagellin were specifically down-regulated when acid-adapted (pH 5.0) Salmonella SL1344 cells were exposed to pH 3.0. Decreased flagellin expression and cell motility was dependent on activation of the PhoPQ pathway, which directly or indirectly negatively regulated transcription of the flagellin gene fliC. In contrast, the general stress sigma factor RpoS (sigma s) positively regulated flagellar gene expression. Low external pH had no effect on the level of H-NS protein, a further regulator of flagellar gene expression. We suggest that flagellar repression at low pH conserves ATP for survival processes and helps to limit the influx of protons into the cytosol. These results highlight the power of proteomics to reveal unanticipated links between relatively well-characterised regulatory systems in bacteria.

Adaptation, Physiological↗
PubMed2001

'Eloquent chaos' in the oral discourse of killing fields survivors: an exploration of atrocity and narrativization.

If "narrative" implies a form of discourse in which sequenced events are meaningfully connected, an "anti-narrative" is a chaotic discourse form "of time without sequence, telling without mediation, and speaking about oneself without being fully able to reflect on oneself" (Frank 1995: 98). This paper examines narratives and anti-narratives in the oral discourses of survivors of the Cambodian killing fields. Through an extended analysis of two cases, we demonstrate the internal logic and "eloquence" of anti-narratives--i.e., the ways in which anti-narrative patterns vividly express and reveal a survivor's complex and continuing experience of atrocity.

Adaptation, Psychological↗
PubMed2001

Association between polycystic ovary and fibrocystic breast disease.

OBJECTIVE: The aim of this study was to assess whether or not there was an association between a polycystic ovary (PCO) and fibrocystic breast disease based on ultrasound findings, both pelvic and mammographic. DESIGN: Prospective case-control study. POPULATION: Women aged between 18 and 30 years not using oral contraceptives attending the outpatient ultrasound clinic from January 1996 to December 1998. MAIN OUTCOME: Confirm the association between PCO and fibrocystic breast disease. RESULTS: According to the ultrasound findings, women were allocated to three groups: 351 out of 456 showed normal-appearing ovaries (group A), 93 had polycystic-appearing ovaries/PCO (group B) and 12 had PCO syndrome (group C). In group A, 24 (6.83%) women showed breast pathology. In group B, there was an association between PCO and breast pathology in 53 (56.98%) women, while in group C it was noted in 11 out of 12 (91%). CONCLUSION: This study showed a significant association between PCO and benign pathology. This should encourage the performance of a screening breast sonography on women with PCO.

Adolescent↗
PubMed2000

The analysis of microbial proteomes: strategies and data exploitation.

Microbes present special opportunities for proteomic analysis that are not yet available for other types of organisms, due mainly to the relative abundance of information on their genomes, their low levels of functional redundancy and their experimental tractability. They are also being used to develop and validate powerful new experimental approaches that surmount some important current limitations in this field. The review surveys the different proteomic procedures that are available and considers the advantages and disadvantages of different experimental strategies. The ways in which microbiologists - and others - can exploit proteomic data are also discussed.

Animals↗
PubMed2000

[Incidence of fibrocystic disease of the breast in women with polycystic ovary. Clinico-instrumental study].

BACKGROUND: The aim of this study was to assess whether or not there was an association between polycystic ovaries (PCO) and fibrocystic breast disease. It is known that hyperestrogenism and anovulation are involved in the etiology of the fibrocystic breast disease; we evaluated the incidence of this disorder in women with PCO or Polycystic Ovary Sindrome (PCOS) based on ultrasound findings both pelvic and mammographic. METHODS: From January 1995 to December 1997 we performed in our outpatient ultrasound service (I Divisione I Istituto di Clinica Ostetrica e Ginecologica, Università di Roma "La Sapienza") pelvic standard scan on 980 women. Patients between 18 and 30 years of age, not using oral contraceptives, both with Normal Appearing Ovariest (NAO) or with PCO Polycystic Appearing Ovaries (PAO) enrolled in the study, informed and agreed to undergo ultrasound mammography. All the subject were examined using an Aloka SSD ZOOO and Esaote AU3 ultrasound equipment with 3.5 MHz and 10 MHz probes for pelvic and mammographic scan respectively. The relationship between pelvic and mammographic scan findings were studied and the chi 2 analysis was used to examine them. RESULTS: Women by the US findings were allocated into three groups: 203 over 264 showed NAO (group A); 54 had PAO/PCO (group B) and 7 had PCOS (group C). In group A (6.83%) women showed breast pathology. In group B there was association between PCO and breast pathology in 30 (56.98%) women, while in group C on 6 over 7 (91.66%). CONCLUSIONS: This study showed a significant association between PCO and benign pathology. This should encourage the performance of a screening breast sonography in women with PCO.

Adult↗
PubMed1998

BipA: a tyrosine-phosphorylated GTPase that mediates interactions between enteropathogenic Escherichia coli (EPEC) and epithelial cells.

We report the functional characterization of BipA, a GTPase that undergoes tyrosine phosphorylation in an enteropathogenic Escherichia coli (EPEC) strain. BipA mutants adhere to cultured epithelial cells but fail to trigger the characteristic cytoskeletal rearrangements found in cells infected with wild-type EPEC. In contrast, increased expression of BipA enhances actin remodelling and results in the hyperformation of pseudopods. BipA appears to be the first example of a new class of virulence regulator, as it also controls flagella-mediated cell motility and resistance to the antibacterial effects of a human host defence protein. Its striking sequence similarity to ribosome-binding elongation factors suggests that it uses a novel mechanism to modulate gene expression.

Amino Acid Sequence↗
PubMed1998

[Use of intrauterine device by nulliparous women. Prospective study and preliminary data].

BACKGROUND: The aim of the study, that is still on the way, was to evaluate the negative effects of an intrauterine device, used for more than 2 years, on future fertility of young women who due to medical or personal reasons couldn't use hormonal contraceptives. METHODS: A prospective study was started in 1987 in a group of 515 nulliparous healthy women (age 20-30) using an intrauterine device (Nova T, Schering, Multiload Cu 275 Organon) as contraceptive method. Two hundred and twentyfour women wished to become pregnant following the IUD extraction. RESULTS: Within 12 months, 221 (98.7%) of them became pregnant demonstrating the harmlessness of the contraceptive method on future fertility. All pregnancies had a normal course, except one abortion at the 8th week of gestational age. There hadn't been pregnancies during the observation period, 25 (4.8%) women requested the IUD be removed before the end of the study because of side effects. DISCUSSION: IUD did not cause a reduction in fertility or an increase in ectopic pregnancy in our group of patient.

Adult↗
PubMed1998

[Risk factors for ectopic pregnancy. Case-control study].

BACKGROUND: To analyze risk factors for ectopic pregnancy in an Italian population. METHODS: A retrospective case-control study has been carried out on 213 cases of ectopic pregnancy and 213 controls. The control subjects were women who delivered spontaneously at the same time and in the same hospital of the cases considered. RESULTS: Smoking more than 10 cigarettes/die doubles the risk of ectopic pregnancy. IUD causes an increased risk in women using this contraceptive method for less than two years. A history of abdominal surgery was associated with about a double risk of ectopic pregnancy. The risk was higher in cases of cesarean section and pelvic surgery. CONCLUSIONS: Abdominal surgery (particularly pelvic surgery and cesarean sections), use of IUD for less than two years and cigarette smoking are the risk factors found to be a cause for ectopic pregnancy in the population studied. It was not possible to evaluate the history of pelvic inflammatory disease because there were not enough data. For this reason it is suggested it will be possible in the future to compile a register data, collecting all the cases of ectopic pregnancy as a part of a prevention campaign.

Abdomen↗
PubMed1997

The proteome of Salmonella enterica serovar typhimurium: current progress on its determination and some applications.

Salmonella typhimurium (official designation Salmonella enterica serovar Typhimurium) is an enteric pathogen and a principal cause of gastroenteritis in humans. A comprehensive description of the proteins of Salmonella and their patterns of expression under different environmental conditions would greatly increase our understanding of the virulence of this organism at the molecular level and provide insights into many other aspects of Salmonella biology. While a variety of two-dimensional studies of Salmonella have been previously carried out to address specific questions, little systematic information is available at the protein level on the numbers of Salmonella polypeptides that have homologues in other organisms, their abundance, and the frequency of post-translational modifications. To test the feasibility of determining the proteome of Salmonella, the identities of 53 randomly sequenced cell envelope proteins have been determined by N-terminal sequencing of spots from two-dimensional gels. In addition to confirming the existence of previously hypothetical proteins predicted from genomic sequencing projects, we found that approximately 20% of the proteins had no matches in sequence databases. The results suggest that proteome analysis is an efficient way to identify novel proteins from prokaryotes and that the analysis provides a useful approach to the study of Salmonella virulence.

Amino Acid Sequence↗
PubMed1997

Effects of a skill-based intervention to encourage condom use among high risk heterosexually active adolescents.

OBJECTIVES: In this article we describe the development and testing of three behavioral interventions to reduce the risk of contracting HIV/AIDS and other sexually transmitted diseases among heterosexually active adolescents. METHODS: The interventions include a comic book, a videotape, and a group skill training curriculum that emphasize skill development--for communicating and negotiating condom use with partners, in addition to providing basic information. Participants included 228 youths sampled in juvenile detention and 168 youths sampled from public health STD and other similar clinics. The samples included both young men and women, and were comprised of African American and European American adolescents, ages 14-19. RESULTS: Examination of the relative efficacy of the interventions at three and six months following intervention show very few differences among conditions, despite the fact that the interventions contained most of the elements that previously have been defined as essential for effective interventions. CONCLUSIONS: In the discussion, we consider possible reasons for this outcome and make recommendations for future research.

Adolescent↗
PubMed1997

[Causes for transfer of obstetric patients to an intensive care unit (1990-19960].

BACKGROUND: In order to have an updated review of the causes for transferring patients from our Institute to Intensive Care Unit (ICU), a study has been conducted on patients admitted from 1990 to 1996. METHODS: Of the 28 women transferred, one underwent dilatation & curettage of uterine cavity after abortion, 3 had a normal delivery and 24 underwent a cesarean section. RESULTS AND CONCLUSIONS: The complications were as follows: respiratory failure (5 cases); suspected or confirmed lung embolism (1); cerebral ischemia (1); septic complications (1); cardiocirculatory complications (19 cases; 7 of them were due to DIC; 6 due to cardiocirculatory failure; 6 due to haemorrhagic shock). These patients were divided into 3 groups, those with pre-existing pathologies which worsened (2 cases); those due to deterioration of pathology arose during pregnancy (17) and, finally, complications during delivery (9). In total the cases of mortality were 7, all of them following cardiocirculatory complications.

Abortion, Induced↗