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Biomedical subjects

N Fortunato

Publications and source records attributed to N Fortunato.

12 recordsLinked to original sources
PubMed2001

Chemicals with sweet aroma descriptors found in Portuguese wines from the Douro region: 2,6,6-trimethylcyclohex-2-ene-1,4-dione and diacetyl.

2,6,6-Trimethylcyclohex-2-ene-1,4-dione (TMCHD), a norisoprenoid with a sweet honey aroma descriptor, is reported for the first time as a minor constituent of single-varietal table and fortified wines from the demarcated Douro region. Olfactory gas chromatography (GC-O) of a volatile wine extract, previously isolated by preparative gas chromatography, indicated the presence of a zone containing an intense honey descriptor. The targeted odor compound was identified by GC-MS, GC-O, and Kovats index. Quantitative analysis using a selected characteristic ion (m/z 96) indicated that young Douro fortified wines from the 1997 vintage contained up to 4 microg/L TMCHD. The sweet honey sensory threshold limit for TMCHD in a model Port wine solution was found to be 25 microg/L. TMCHD is therefore only likely to contribute as a collective element to Port wine aroma. The wine volatile diacetyl was identified as a strong contributor to the sweet caramel aroma descriptor often associated with Port.

Chromatography, Gas↗
PubMed2000

Tamoxifen effects on endometrium.

BACKGROUND: To evaluate the effects on the endometrium of a long term treatment with Tamoxifen in postmenopausal patients, asymptomatic for gynecologic disorders, surgically treated for breast cancer. METHODS SETTING: Outpatient menopausal clinic and endoscopic unit. PATIENTS AND INTERVENTIONS: 45 patients (Group I) were treated with 20 mg of Tamoxifen daily for a mean of 23.4 months. Seven patients (Group II) represented the control group and did not receive Tamoxifen. A transvaginal ultrasonography and a hysteroscopic guided biopsy were performed in all patients. RESULTS: Sagittal sonograms showed abnormal endometrial thickening (range 8-32 mm, mean 13 mm) in 17 patients (35.4%) of Group I and in 1 patient of Group II. Pathology on endometrial tissue sampling obtained at the time of hysteroscopy showed hyperplastic endometrial polyps in 3 patients (6.25%), endometrial hyperplasia in 16 patients (33.4%), while 1 patient had an endometrial polyp cancer on a background of hyperplasia and 1 had a superficial endometrial cancer (4.1%). Out of the 7 patients of Group II, one had an endometrial polyp, while 6 had no relevant endometrial abnormalities. CONCLUSIONS: Our study confirms that Tamoxifen treatment is associated with an increased incidence of proliferative and neoplastic endometrial changes. No obvious correlation was found between the length of Tamoxifen exposure time and occurrence of endometrial pathologies. It is mandatory to undertake twice per year gynecological evaluations for patients treated with Tamoxifen to promptly identify and correctly manage endometrial changes.

Aged↗
PubMed1998

Effects of tibolone on the breast.

OBJECTIVE: to evaluate the effect of hormone replacement therapy and tibolone on the breast. STUDY DESIGN: prospective, controlled, randomized study. SETTING: Outpatient Menopause Clinic of the Second University of Naples. PARTICIPANTS: forty four women in spontaneous menopause without any risk factor for breast cancer were randomly allocated to three groups: 15 patients (group A) were treated with transdermal oestrogens 50 microg, 2 patches/week for 3 weeks per month, plus acetate nomegestrolo per os 5 mg/die for 12 days per cycle, 17 patients (group B) were treated with tibolone 2.5 mg/die. Twelve patients not given any medication represented the control group (group C). METHODS: at the time of recruitment and after at least 12 months of therapy the patients were subjected to a questionnaire aimed at quantifying the slight, moderate or severe presence of the tension/mastodynia symptoms and to a mammographic test to assess the parenchymal pattern according to a quantitative method: type 1 (less than 25% of mammary gland covered by dense tissue), type 2 (from 25% to 75% of total glandular area covered by dense tissue), type 3 (more than 75% of mammary parenchyma covered by dense tissue). Statistical analysis was carried out by means of Fisher's exact test. RESULTS: after at least 12 months of treatment in Group A 5 out of 15 patients (33%) showed a trend of increase in mammographic density not statistically significant (P=0.22) when compared with group B in which one patient showed a swift from type 1 to type 2 and another from type 2 to type 3. The analysis of tension/mastodynia symptoms revealed a significantly difference between the two groups (P=0.02): in group A mastodynia appeared in three previously asymptomatic women and increased in five women, with a total increase in the symptomatology in 8 out of 15 patients (53.3%), in group B only in one case (5%) mastodynia turned from slight to moderate. CONCLUSION: in postmenopausal women oestroprogestogenic replacement therapy may be associated with an increase in mammographic density and with the onset or increase in mastodynia. On the contrary tibolone does not seem to affect normostructured mammas and may be considered a first-rate replacement therapy in case of mammas showing particular density or benign mastopathies.

Anabolic Agents↗
PubMed1998

Preoperative GnRH analogue in hysteroscopic metroplasty.

OBJECTIVE: To evaluate the effectiveness of Gonadotropin-Releasing Hormone analogue when administered preoperatively in hysteroscopic metroplasty. DESIGN: Prospective, comparative study. PATIENTS AND MAIN OUTCOME MEASURES: Sixty patients undergoing hysteroscopic metroplasty for septate uterus who were randomly allocated to pretreatment with two injections monthly of Gonadotropin-Releasing Hormone analogue or to no pretreatment. To assess the outcome of surgery three parameters were used: operative time (minutes), fluid adsorption (ml) and intraoperative bleeding. RESULTS: No significant differences in the operating time (21.9 vs 22.9 min), fluid adsorption (395 ml, range 200-550 vs 515 ml, range 250-650), intraoperative bleeding and failure rate were found between pretreated patients and controls. CONCLUSIONS: Preoperative treatment with Gonadotropin-Releasing Hormone analogue showed no advantage in hysteroscopic treatment of mullerian defects, but only an improvement, not statistically significant, in term of reduced operative time and fluid adsorption.

Adult↗
PubMed1998

Time length of negativization of hCG serum values after either surgical or medical treatment of ectopic pregnancy.

OBJECTIVE: The aim of this study was to compare the time length until the human chorionic gonadotropin titer became negative after medical or surgical treatment of ectopic pregnancy. EXPERIMENTAL DESIGN: Prospective, randomized study. PARTECIPANTS AND INTERVENTIONS: We compared time to resolution in 30 cases of tubal pregnancies successfully treated, 15 underwent laparoscopic linear salpingostomy (group 1) and 15 medical treatment with single-ose methotrexate (group 2). The patients of both groups had no meaningful differences of age, gestational age and human chorionic gonadotropin mean values. MEASURES: During the follow-up human chorionic gonadotropin serum values were obtained every two days until the titer was negative. RESULTS: The time to resolution was 33.6 +/- 6.6 days in group 1, 31.5 +/- 7.8 in group 2 with no statistically meaningful differences. CONCLUSION: The data, comparable with results obtained by laparoscopic treatment, suggest that human chorionic gonadotropin value becomes negative independently of type of treatment and residual trophoblast.

Abortifacient Agents, Nonsteroidal↗
PubMed1996

Serum and peritoneal CA-125 levels as diagnostic test for endometriosis.

OBJECTIVE: To evaluate the clinical utility of CA-125 in the diagnosis of endometriosis and to compare the sensitivity of the serum and the peritoneal test as indicator of disease. STUDY DESIGN: Peritoneal fluid was obtained at laparoscopy. The quantitative determination of CA-125 in serum and in peritoneal fluid was performed by IRMA-mat CA-125 'two-step method', a two-site immunoradiometric assay, using 35 and 60 U/ml as cutoff. SETTING: Second Department of Gynecology and Obstetrics, Second University of Naples, Italy. PARTICIPANTS: A total of 26 women infertile undergoing diagnostic laparoscopy that exhibited endometriosis in 14 patients, normal pelvis in 12 patients (control group). INTERVENTIONS: None. RESULTS: CA-125 levels in peritoneal fluid were higher than those found in serum and were significantly elevated (P < 0.05), when compared with the control group, both in women with endometriosis stage I-II and stage III-IV. In serum, CA-125 levels increased only in advanced stage of endometriosis. CONCLUSIONS: Levels of CA-125 in peritoneal fluid seem to be a more sensitive indicator of disease than serum levels (0.86 vs. 0.36), especially in early stage endometriosis (0.80 vs. 0.20) which tends to be overlooked by the CA-125 serum test.

Ascitic Fluid↗
PubMed1996

Relevance of CA-125 in the evaluation of endometriosis.

To evaluate the clinical utility of CA-125 in the diagnosis of endometriosis and to compare the sensitivity of the serum and the peritoneal test as indicators of disease, the quantitative determination of the antigen in serum and in peritoneal fluid was performed by the IRMA-mat "two-step method", a two-site immunoradiometric assay. A total of 28 women undergoing diagnostic or operative laparoscopy with endometriosis stage I-II (10 patients), endometriosis stage III-IV (8 patients) or other benign gynecological diseases (10 patients) were studied. The results were compared with a sample of 12 women with a normal pelvis (control group). CA-125 levels in the peritoneal fluid were higher than those found in the serum and were significantly elevated (p < 0.001) when compared with the control group, both in women with endometriosis stage I-II and stage III-IV. In the serum CA-125 levels increased only in advanced stages of endometriosis. Levels of CA-125 in peritoneal fluid seemed to be a more sensitive indicator of disease than the serum test (0.88 vs 0.44), especially in early stage endometriosis (0.80 vs 0.20) which tends to be overlooked by the CA-125 serum test.

Ascitic Fluid↗
PubMed1995

Heterotopic pregnancy following administration of human menopausal gonadotropin and following in vitro fertilization and embryo transfer: two case reports and review of the literature.

We report two cases of heterotopic (combined intra- and extra-uterine) pregnancy in women treated for infertility. In the first case the patient conceived following administration of human menopausal gonadotropin. In the seventh week of gestation she had a spontaneous abortion and in the eighth week required urgent laparotomy for acute abdomen due to the rupture of pregnant right tube. In the second case the patient conceived from IVF-ET; in the eighth week a salpingectomy was made. The intrauterine pregnancy continued regularly until term and the patient was delivered of a healthy baby by caesarean section. We reviewed the literature and we found that heterotopic pregnancy is an insidious disease with a constant increase of incidence, especially in infertile women submitted to therapy for ovulation induction or assisted reproductive techniques. All the patients who have risk factors should be submitted to careful controls in early pregnancy, including an ultrasound transvaginal scan.

Adult↗
PubMedDate not supplied

[Reproductive outcome of hysteroscopic lysis of intrauterine adhesions].

OBJECTIVE: To analyze the reproductive outcome in women undergoing hysteroscopic lysis of intrauterine adhesions, according to their localization and severity. STUDY DESIGN: Retrospective study. MATERIALS AND METHODS: Fifty-three patients affected by intrauterine adhesions of different degree, subdivided according to localization and morphologic aspect: three isthmic, thirteen marginal, fourteen central, moreover twenty were complex and three complete. All the interventions were performed by means of the resectoscope. RESULTS: Hysteroscopic surgery restored an acceptable menstrual cycle in almost all the patients affected by intrauterine isolated adhesions, in 52% of women affected by complex incomplete adhesions, and in none of the three patients with entirely obliterated cavity. Concerning fertility, while in isolated, isthmic, central or marginal synechias we observed a pregnancy rate of 73.3% (22 out of 30) with a pregnancy rate to term respectively of 63.3% (19 out of 30 cases) and of 86.3% (19 out of 22 total pregnancies), in case of complex but not complete adhesions we reported, on 20 cases, 5 pregnancies (25%) with only two gone to term. We had no pregnancy in three cases of complex synechias. CONCLUSIONS: The basic parameter to define the functional and reproductive prognosis of the hysteroscopic lysis of intrauterine adhesions is not the menstrual profile or the histological characteristic of the lesions, but rather their extension.

Adult↗