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Biomedical subjects

M Marchini

Publications and source records attributed to M Marchini.

At least 19 recordsLinked to original sources
PubMed1997

Dietary habits, reproductive and menstrual factors and risk of dysmenorrhoea.

In order to analyze risk factors for dysmenorrhoea, we conducted a case-control study. Cases were 106 women (median age 27 years) with moderate or severe dysmenorrhoea lasting 12 months or more. Controls were 145 women (median age 26 years) without dysmenorrhoea, admitted for routine gynecological examination at the outpatient gynecological services of the same clinic where cases had been identified. In comparison with women reporting short menstrual cycles (every 25 days or less) the relative risk (RR) of dysmenorrhoea was 2.0 and 2.6, respectively, in those reporting their menstrual cycles of 26-30 days and of 31 days or more, and the RR was 3.6 (95% confidence interval (CI): 1.0-13.4) for women reporting totally irregular menstrual cycles. The estimated RRs were, in comparison with women reporting menstrual flows lasting 4 days or less, respectively 2.2 and 1.9 in those reporting menstrual flows lasting 5 and 6 days or more. Fourty-four (58%) cases but only seven (5%) controls reported heavy menstrual flows (RR in comparison with women reporting slight or normal menstrual flow 12.6, 95% CI: 5.0-32.1). As regards dietary factors, no associations emerged between the various food items, with the exception of cheese and eggs, which tended to be more frequently consumed by cases than controls. The results of this study suggest that the risk of dysmenorrhoea is higher in women with irregular, long and heavy menstrual flows. No association emerged between reproductive history and dysmenorrhoea. Likewise, no clear relationship emerged between intake of several dietary factors and risk dysmenorrhoea.

Adult↗
PubMed1996

Vaginal cabergoline in the treatment of hyperprolactinemic patients intolerant to oral dopaminergics.

OBJECTIVE: To evaluate the effectiveness and tolerance of vaginal cabergoline in hyperprolactinemic patients intolerant to oral dopaminergics. DESIGN: Case reports. SETTING: University hospital endocrinological outpatient clinic. PATIENTS: A 35-year-old primipara woman with idiopathic hyperprolactinemia and a 22-year-old female with primary amenorrhea harboring macroprolactinoma. INTERVENTIONS: Treatment with vaginal cabergoline (0.5 mg two and five times a week). MAIN OUTCOME MEASURES: The serum PRL levels and side effects were assessed before and during treatment. RESULTS: A single vaginal dose of 0.5 mg cabergoline reduced serum PRL levels by approximately 50% to 85% of basal values over a period of 4 to 5 hours. In the patients with idiopathic hyperprolactinemia, serum PRL levels normalized during long-term treatment, whereas in the one with macroprolactinoma they remained above the normal values (79 ng/mL [conversion factor to SI unit, 3.180]) despite resumption of menses and marked tumor shrinkage (70% reduction). No side effects were reported. CONCLUSIONS: Vaginal cabergoline is a safe and effective method of therapy for hyperprolactinemia and it avoids the adverse events of oral administration.

Adult↗
PubMed1996

Residual uterine septum of less than 1 cm after hysteroscopic metroplasty does not impair reproductive outcome.

The objective of this study was to ascertain if incomplete correction leaving a residual uterine septum of < or = 1 cm affects fertility outcome. Reproductive outcome in 17 women with a residual septum of between 0.5 cm and 1 cm after hysteroscopic metroplasty was compared to that in 51 women with no residual septum or one of < 0.5 cm. Septal lysis was performed with microscissors or resectoscope. One month after operative hysteroscopy, abdominal ultrasonography was performed on all the women and those with a residual septum of > 1 cm then underwent a second operative hysteroscopy to complete the lysis. The cumulative pregnancy and birth rates were calculated and the curves compared using the log-rank test. The cumulative 18 month probability of becoming pregnant was 44.5% in the patients with residual septum and 52.7% in those with no residual septum (not significantly different), and the cumulative 18 month probability of giving birth to a child was 27.5 and 36% respectively (also not significant). The presence of a residual uterine septum of between 0.5 and 1 cm as shown by ultrasonography appears not to worsen the reproductive prognosis compared with that in women in whom the septum has been completely or almost completely corrected.

Abortion, Habitual↗
PubMed1996

Carboplatin monochemotherapy in elderly patients with nonoperable transitional cell carcinoma of the bladder: a two-stage, phase II study.

Elderly patients with nonoperable transitional cell carcinoma of the bladder need a rather active, but less toxic treatment than full-dose polychemotherapy. This study was designed to determine whether the cisplatin-analogue carboplatin (which is less nephrotoxic and less neurotoxic than the parent compound) has sufficient activity against T2-T4 neoplasms (both nonmetastatic and metastatic) to warrant further development in phase III trials. Carboplatin dose was adjusted according to creatinine clearance, with a maximum dose of 300 mg/m2. The patient selection for this screening for activity was adjusted by the use of the 'optimal' two-stage design. Seventeen patients were enrolled, with a median age of 78 years (range: 70-85), a median performance status of 80% (range: 70-90%); 13 patients were lymph node-negative (10 T2, 2 T3, 1 T4) and 4 had locoregional or distant node metastases. Nine patients had a complete response (3 in the first, 9-patient, stage, and 6 in the second, 8-patient, stage), demonstrating that carboplatin had sufficient activity (at the 'desirable' target level of 35%); almost all responses were observed in T2 patients. Six patients had stable disease, and 2 had disease progression during treatment. The toxicity was acceptable, with only 41% of patients having grade II-III hematologic toxicity. More than 30% of patients were estimated to be free from progressive disease (54% alive) at 24 months. In our opinion carboplatin is suitable to be tested-in a phase III testing versus full-dose radiation therapy-as adjuvant after initial transurethral resection of the prostate in elderly patients with T2 transitional cell carcinoma of the bladder considered radically nonoperable for medical problems.

Aged↗
PubMed1996

Ultrastructural aspects of endometrium in infertile women with septate uterus.

OBJECTIVES: To evaluate the endometrial surface morphology in patients with septate uterus and primary infertility in an attempt to throw light on the question of whether endometrial anomalies are involved in the pathogenesis of infertility in women with mullerian malformations. DESIGN: Endometrial biopsies were performed in eight women with septate uterus and primary infertility during hysteroscopy scheduled in the preovulatory phase of the cycle (when a follicle > 17 mm was identified by ultrasonography and E2 levels were >200 pg/mL [conversion factor to SI unit, 3.671]). Two samples were obtained from each patient, one from endometrium covering the septum and the other from endometrium lining the lateral wall of the uterus. All specimens were examined by scanning electron microscopy. MAIN OUTCOME MEASURES: The number of glandular ostia, the ciliated:nonciliated cell ratio, and the number of cilia on ciliated cells were analyzed in endometrial specimen from both the covering of the septum and the corresponding uterine lateral wall. RESULTS: In five patients septal endometrium showed the following defective preovulatory changes with respect to endometrium of the lateral uterine wall: a reduced number of glandular ostia, irregular nonciliated cells with rare microvilli, incomplete ciliogenesis on ciliated cells, and decrease in the ciliated:nonciliated cell ratio (1:52 +/- 11 versus 1:21 +/- 8). CONCLUSIONS: Our results indicate a decrease in the sensitivity of endometrium covering the septa of malformed uteri to preovulatory hormonal changes. This could play a role in the pathogenesis of primary infertility in patients with septate uterus.

Adult↗
PubMed1996

Superovulation and intrauterine insemination vs. superovulation alone in the treatment of unexplained infertility. A randomized study.

OBJECTIVE: To assess whether intrauterine insemination (IUI) improves the fertility rates in women with unexplained infertility. STUDY DESIGN: We recruited 68 women with unexplained infertility and allocated them randomly to treatment with three to five cycles of superovulation plus IUI (36 patients) or superovulation alone (32 patients). Superovulation was obtained with clomiphene citrate, human menopausal gonadotropins and human chorionic gonadotropins. RESULTS: The cycle fecundity rate was 10% in patients who underwent superovulation alone and 19% in those treated with superovulation plus IUI (P < .05). CONCLUSION: Our results demonstrate that superovulation plus IUI is more effective than superovulation alone in the treatment of unexplained infertility.

Adult↗
PubMed1995

Mitogen-induced lymphocyte proliferation and peripheral blood mononuclear cell beta-endorphin concentrations in primary dysmenorrhoea.

Dysmenorrhoea is a recurrent painful disease which causes physical and psychological stress. The purpose of the present study was to investigate whether there was a measurable derangement of immune cells and immune responses in women with severe primary dysmenorrhoea. On day 26 of one cycle and on days 1 and 3 of the following cycle we measured polyclonal, mitogen-induced lymphocyte proliferation and beta-endorphin concentration in peripheral blood mononuclear cells obtained from 16 infertile women with normal pelvis, of whom eight had and eight did not have the disorder. In women with dysmenorrhoea, polyclonal mitogen-induced lymphocyte proliferation was lower than in controls on all 3 days considered, but the difference was statistically significant only on day 26 (43,605 +/- 9876 micrograms/ml versus 67,305 +/- 15,249 micrograms/ml; P < 0.01). Monocyte beta-endorphin concentrations in the patients with dysmenorrhoea were significantly elevated on day 3 compared to controls (67.8 +/- 24.3 pg/10(6) cells versus 29.7 +/- 6.9 pg/10(6) cells; P < 0.05). Our results demonstrate that immune responses are modified in patients with primary dysmenorrhoea. These effects are independent of circulating hormone concentrations and are consistent with the role of dysmenorrhoea as a stressful event.

Adult↗
PubMed1995

Tight underpants and trousers and risk of dyspermia.

The association between the wearing of tight underpants and trousers and risk of dyspermia has been analysed using data from a case--control study. Cases included infertile men with a diagnosis of unexplained dyspermia. Normospermic men of infertile couples were eligible as controls. In comparison with men usually wearing loose underpants, the odds ratio (OR) of dyspermia was 1.9 (95% confidence interval, CI, 0.9-4.1) in those wearing tight underpants. Likewise, the OR of dyspermia was 1.6 (95% CI 0.9-3.0) in men reporting usually wearing tight trousers (including jeans), in comparison with those wearing loose trousers.

Adult↗
PubMed1995

Histological impact of medical therapy--clinical implications.

The medium- and long-term effects of gestrinone and danazol on the endometrium were examined in 36 patients with endometriosis. Endometrial biopsies were taken from each patient before treatment and after 3 and 6 months of treatment with 600 mg danazol daily (n = 17) or with 2.5 mg gestrinone twice weekly (n = 19). Endometrial samples were analysed by light, scanning and transmission electron microscopy. At 3 months' treatment the endometria of patients treated with danazol appeared more atrophic than those of the women treated with gestrinone; some cell organelle involution was evident in all patients. After 6 months of treatment a marked atrophy was observed in patients of both treatment groups. A complete involution of cytoplasmic organelles with cytoplasmic collapse and a shift of nucleoplasmic ratio in favour of the nucleus occurred in patients treated with danazol; the cytoplasmic organelle involution was less marked in patients treated with gestrinone. Compared with gestrinone, danazol induces more rapid endometrial atrophy, with greater impairment of the cytoplasm and cell secretory activity.

Adult↗
PubMed1995

Comparative efficacy of diclofenac dispersible 50 mg and ibuprofen 400 mg in patients with primary dysmenorrhea. A randomized, double-blind, within-patient, placebo-controlled study.

Sixty female out-patients suffering from moderate to severe primary dysmenorrhea, aged 14-40 years (mean 27 years), entered this randomized, double-blind, 3-period, within-patient study, evaluating the efficacy and tolerability of diclofenac dispersible 46.5 mg (equivalent to 50 mg of diclofenac sodium), ibuprofen 400 mg and placebo taken up to 4 times daily for a maximum of 3 days. Pain relief was evaluated on a verbal rating scale (0 = none, 1 = slight, 2 = moderate, 3 = considerable, 4 = complete) at 0.5, 1,2,3,4,5 and 6 hours after the first dose; the weighted sum of pain relief scores over the 6-hour observation period was also investigated (TOTPAR-6). Pain intensity was assessed on a verbal rating scale (0 = nil, 1 = mild, 2 = moderate, 3 = severe) at baseline and at the above mentioned time points; the weighted sum of pain intensity differences at each time point was also analyzed (SPID-6). A rescue medication was permitted 1 hour or more after the intake of the test drug: in such cases the last value of pain intensity/relief scores was carried forward and used for the analysis. A global evaluation of efficacy and of trial medication as compared to her usual medication was performed by the patient at the end of each treatment period. Finally, adverse experiences were recorded throughout the study period. Analysis of covariance and Koch's adaptation of the Wilcoxon-Mann-Whitney rank sum test were used, where appropriate, for statistical analysis. Mean TOTPAR-6 values for diclofenac dispersible, ibuprofen and placebo were 16.5, 17.8 and 14.7, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Cartilage type II collagen fibrils show distinctive negative-staining band patterns differences between type II and type I unfixed or glutaraldehyde-fixed collagen fibrils.

The cross striation of native and reconstituted collagen fibrils is believed to conform to a unique D-band pattern independently of the genetically distinct types of fibril-forming collagens. This investigation focuses on type II native collagen fibrils, whose negative-staining patterns are shown to differ from the usual banding exhibited by type I collagen fibrils. Negative staining with phosphotungstic acid, pH 7.4, was carried out on a) unfixed and b) glutaraldehyde-fixed collagen fibrils isolated from bovine hyaline cartilages. The band patterns obtained and their microdensitograms were compared to similarly processed type I collagen fibrils isolated from bovine fibrous tissues. Only minor differences were observed in unfixed fibrils. In the intraperiod light zones of type II fibrils, two dark bands (interbands X2-Y4 and Y4-Y2) showed different intensities with respect to their homologous bands in type I fibrils. In contrast, a marked difference was shown by glutaraldehyde-fixed fibrils. In comparison with type I fibrils, the greater stain exclusion capacity of type II fibrils yielded both the appearance of supernumerary bands, which altered banding in two intraperiod regions, and differences in the intensity of several bands in three intraperiod regions where the band distribution was similar. This stain exclusion pattern may be accounted for by molecular extradensity. The possibility that it depends on linkage with a higher number of glutaraldehyde residues and/or the persistence of cross-linked collagenic or non-collagenic proteins is discussed. To refer to the glutaraldehyde-induced band patterns in negatively stained type II and type I collagen fibrils, the terms "bands GA(II) 1-12" and "bands GA(I) 1-15," respectively, are proposed.

Animals↗
PubMed1994

Cigarette smoking, alcohol consumption, and risk of primary dysmenorrhea.

We analyzed the relation between cigarette smoking, alcohol consumption, and risk of dysmenorrhea using data from a case-control study in Milan, Italy. With never-smokers as the reference category, the relative risk (RR) of dysmenorrhea was 1.9 [95% confidence interval (CI) = 0.9-4.4] for women smoking 10-30 cigarettes per day. The risk of dysmenorrhea increased with duration of smoking in women who smoked for less than 10 years (RR = 1.3, 95% CI = 0.6-2.6) and in those who smoked for 10-20 years (RR = 2.8, 95% CI = 1.3-6.2). In comparison with teetotalers, the age-adjusted RR of dysmenorrhea was 0.8 (95% CI = 0.4-1.5) for alcohol drinkers.

Adolescent↗
PubMed1993

Vaginal patterns during danazol and buserelin acetate therapy for endometriosis: structural and ultrastructural study.

OBJECTIVE: To evaluate histologic and ultrastructural changes of the vaginal mucosa in patients given buserelin acetate or danazol treatment for endometriosis. DESIGN: Controlled clinical study. SETTING: Infertility clinic of an academic unit. PATIENTS: Infertile women with endometriosis randomized to receive buserelin acetate or danazol and undergoing vaginal biopsies during treatment were selected. INTERVENTIONS: Buserelin acetate was administered IN 400 micrograms three times per day and danazol orally 600 mg/d. Vaginal biopsies were performed baseline and at 3 and 6 months of treatment, and specimens were examined by light microscopy and scanning electron microscopy. 17 beta-Estradiol and P levels were determined in each patient at the time of each biopsy. MAIN OUTCOME MEASURE: Structural and ultrastructural patterns of vaginal mucosa after 3 and 6 months of treatment. RESULTS: Buserelin acetate treatment induced early, marked hypotrophy of the vaginal mucosa with aspects typical of the menopause. The modifications caused by danazol occurred mainly in the intermediate layer, which was weakly hypotrophic only at the end of the treatment. CONCLUSION: Vaginal mucosa undergoes constant and well-defined modifications during both buserelin acetate and danazol treatment for endometriosis. The modifications are compatible with the biological effects of the drugs.

Biopsy↗
PubMed1993

Fertility after conservative surgery for adenomyomas.

Reproductive performance was evaluated after conservative surgery for uterine adenomyoma in a prospective, observational study. Twenty-eight women with histologically proven adenomyomas had conservative surgery in the period 1985-1990. Eighteen patients wanting children were regularly followed for a mean +/- SD period of 53.2 +/- 23.5 months. Crude and cumulative pregnancy rates were calculated after the operation. Thirteen (72.2%) women conceived, for a total of 18 pregnancies: nine (50%) ended in term deliveries, seven (38.8%) in spontaneous abortions, one (5.6%) in ectopic pregnancy and one (5.6%) in a pre-term delivery with neonatal death. The cumulative pregnancy rate at 36 months of follow-up was 74.7%. This analysis of a small series indicates that conservative surgery for adenomyomas is associated with a good reproductive prognosis.

Adenomyoma↗