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Biomedical subjects

O Triolo

Publications and source records attributed to O Triolo.

At least 19 recordsLinked to original sources
PubMed2005

Colposcopy vs Hybrid Capture II assay in detection of cervical human papilloma virus infection.

PURPOSE OF INVESTIGATION: Considering the relationship between high-risk human papillomavirus types and the presence or subsequent development of cervical high-grade preinvasive lesions, the aim of the study was to determine if the Hybrid Capture II test can be used to triage women with atypical colposcopic findings. METHODS: The study was carried out on 100 patients with suspicious colposcopy findings (suggestive of human papillomavirus infection) who underwent a cervical smear for human papillomavirus testing DNA Hybrid Capture II and direct biopsies for histopathological analysis. RESULTS: Sixteen patients were negative for human papillomavirus. Of the eight patients positive for high-risk HPV type, seven presented an abnormal transformation zone grade 2 (high-grade squamous intraepithelial lesion of the cervix at histopathology). There was a significant positivity of medium-high risk virus types in the cases with more abnormal colposcopy (chi2 = 7.44; p < 0.005). Histopathological findings of high-grade squamous intraepithelial lesions were registered in the patients positive for medium-high risk human papillomavirus types (chi2 = 7.66; p < 0.025). CONCLUSIONS: Based on these results it can be concluded that if a diagnosis of a high-grade squamous intraepithelial lesion has been made on the basis of colposcopic and histopathological findings, there is a high probability that the infection was due to one or more types of human papillomavirus. There are necessary further studies to interpretate both the advantages and disadvantages of intermediate triage procedures, like Hybrid Capture II testing, compared with immediate colposcopy.

Adolescent↗
PubMed2005

Hysteroscopic findings of endometrial carcinoma. Evaluation of 104 cases.

PURPOSE OF INVESTIGATION: Retrospective evaluation of hysteroscopic findings in the accurate diagnosis of endometrial carcinoma. METHODS: A retrospective monocentric study from January 1995 to December 2004. One hundred and four patients with hysteroscopic aspects evocative of endometrial carcinoma confirmed by endometrial biopsy during diagnostic hysteroscopy, by surgical hysteroscopic resection pieces or by hysterectomy specimen were included. RESULTS: Among the 104 patients, diagnostic hysteroscopy pointed out endometrial features suggestive of endometrial carcinoma in 102 cases. In two women diagnostic hysteroscopy failed to diagnose endometrial malignancy which was identified on pieces of polyps by surgical hysteroscopic resection. DISCUSSION: Polypoid proliferations cerebroid in appearance, with ulceration and necrosis, friable and with irregular vessels, represent endometrial findings highly indicative of malignancy. The diagnosis may be missed in cases of focal neoplasias, within endometrial polyps or in conditions of unsatisfactory endouterine visualization.

Aged↗
PubMed2005

Postmenopausal bleeding and vaginal nodules as the first presenting sign of adenocarcinoma of the gallbladder.

Vaginal submucosal nodules were observed in a 67-year-old woman, with ultrasonographic features of an advanced uterine neoplasm. On biopsy, light microscopy suggested that the lesions might be metastatic foci from an extragenital cancer, with a prevalent tubular growth pattern. Parallel immunohistochemical reactions revealed a diffuse, strong CA 19-9 positivity in both the cell membrane and cytoplasm. Subsequently, high serum levels of such tumor marker were also found, and an extragenital cancer was suspected of pancreatic or biliary origin. A mass in the gallbladder fossa was then detected by computed tomography and a primary gallbladder adenocarcinoma was confirmed on ultrasound-guided biopsy.

Adenocarcinoma↗
PubMed2005

Hysterectomy: benefits of clinical performance indicators in the evaluation of healthcare facilities.

PURPOSE: The aim of our study was to verify, by applying clinical performance indicators, the quality of healthcare given to hysterectomy patients and the benefits on their adoption in healthcare facilities. METHODS: The different surgical approaches and indications for surgery were evaluated in 534 patients analysing postoperative short-term complications and triggered clinical performance indicators (CPIs). RESULTS: Surgery was performed by the abdominal (80.9%) and vaginal route (19.1%). Postoperative complication rate was 13.5% and CPIs were triggered 108 times overall: 42 in benign conditions (10.3%) and 30 in malignancy (23.4%) (p = 0.001). In patients operated on for benign conditions the different approaches, abdominal or vaginal, showed differences in postoperative period (p = 0.4). In 10.9% of malignant and in 2.9% of benign conditions hospital stay was triggered (p = 0.001). Vaginal surgery showed a shorter average stay than laparotomy (p = 0.001). CONCLUSION: The use of CPIs may determine a refinement of clinical performance with positive effects on health, patient satisfaction, postoperative morbidity hospitalisation and healthcare cost savings.

Adult↗
PubMed2004

The role of transvaginal ultrasonography and serum CA 125 assay combined with age and hormonal state in the differential diagnosis of pelvic masses.

PURPOSE OF INVESTIGATION: To evaluate the ability of CA 125 and echography, alone and in combination with clinical parameters (age over 50 years and post-menopausal state), in the diagnosis of a malignant pelvic mass. METHODS: 125 women were enrolled and underwent echography and CA 125 assay. For each methodology, positive and negative predictive value, sensitivity, specificity, diagnostic accuracy, pre- and post-test probability and likelihood ratios were calculated. RESULTS: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy (DA) and positive likelihood ratio were identical for echography and CA 125 considered alone. Paired with the patient's age, the CA 125 assay showed better results than the associations echography-age (LR+ 26.9 vs 10.1) or CA 125-echography (LR+ 26.9 vs 17.8). Furthermore the combination of the postmenopausal state with CA 125 obtained the best result of a positive likelihood ratio (LR+ 29.7). CONCLUSION: Our study pointed out that, in the prediction of a malignant adnexal mass, the best results were obtained from the association between CA 125 and menopause, probably because in this period there is a lower incidence of benign diseases related to this marker so that an increase of CA 125 level is more likely associated with a malignant mass.

Adolescent↗
PubMed2004

Term angular pregnancy with placenta accreta. A case report.

A 27-year-old primigravida, with two prior adnexal operations, had retained placenta with postpartum haemorrhage following an uncomplicated vaginal delivery. Laparotomic removal revealed placental accretism. Pharmacological treatment (oxytocin and sulprostone) and right cornual resection failed to control profuse bleeding. In the end, subtotal hysterectomy was unavoidable.

Adult↗
PubMed2004

Primary ovarian leiomyosarcoma. Proliferation rate and survival.

OBJECTIVE: A case of Stage IIA primary ovarian leiomyosarcoma (LMS) with an unfavorable outcome 24 months after total abdominal hysterectomy with bilateral salpingo-oophorectomy, despite chemotherapy treatment, is described. Eighteen months from surgery the patient showed peritoneal spreading with ascites, liver and lung metastases. The present study was aimed to compare tumor growth fraction with cell density, lesion stage and clinical course. METHODS: The surgical specimens were evaluated by histological, histochemical, and immunocytochemical methods. Under microscopy, mitotic index (MI) was estimated, as a ratio of mitotic figures per 1000 tumor cells. Immunohistology was also carried out to reveal some intermediate-type filamentous proteins, as histogenetic markers, and the MIB1 monoclonal antibody was used to assess the percent of MIB1-positive nuclei (MIB1 labeling index). RESULTS: The histologic findings and immunohistology of the assayed intermediate filamentous proteins substantiated a diagnosis of LMS, with associated coagulation necrosis and not rare mitotic figures. A dual tumor component was observed, representing both the pleomorphic and myxoid LMS-variants. On the basis of the quantitative findings, a MI of 10.9 and a MIB1-LI of 23.1 were calculated, on average. CONCLUSIONS: The proliferation indices in the described variant of ovarian LMS, denote a fast growing malignancy. They agree with the tumor stage at operation and the subsequent fatal outcome.

Aged↗
PubMed1999

Screening for gestational diabetes in Sicily.

OBJECTIVE: To establish the prevalence of gestational diabetes in a universally screened population living in Messina, Sicily, as the first step in evaluating the cost: benefit ratio of screening for carbohydrate intolerance in pregnancy. STUDY DESIGN: Between October 1989 and March 1995, 1,000 pregnant women underwent screening for gestational diabetes with a 50-g, one-hour glucose challenge test. All the risk factors were registered. RESULTS: Two hundred sixty subjects had a value of > or = 135 mg/dL and underwent a full three-hour oral glucose tolerance test. Of them, 46 (4.6%) met the Carpenter-Coustan diagnostic criteria for gestational diabetes. CONCLUSION: The apparent incidence of gestational diabetes (1.2%) prior to screening was only 25% of the incidence determined with the protocol of universal screening (4.6%). If we assume that timely diagnosis and treatment of gestational diabetes provides an important opportunity to improve obstetric outcome and reduce perinatal morbidity, and since women with gestational diabetes are at increased risk of developing diabetes later, the knowledge that the true prevalence is almost four times that previously reported is a determinant of a future evaluation of the cost:benefit ratio of screening universally for gestational diabetes.

Adult↗
PubMed1997

[Therapeutic abortion intrauterine fetal death in the second trimester. Treatment with a gemeprost-sulprostone combination].

UNLABELLED: This study reports the results obtained in the medical introduction of abortion during the second trimester of pregnancy in 52 patients following intrauterine fetal death or the diagnosis of fetal malformations. METHODS: The protocol consisted of the alternate use of intravaginal suppositories of gemeprost and intramuscular injections of sulprostone. The results were analysed using statistical methods and evaluated in relation to the different parameters present (intrauterine fetal death or therapeutic abortion, maternal age, gestation period and parity). RESULTS: It was seen that the time required to induce abortive labour was significantly shorter in patients with IFD compared to patients with live fetus. The comparison between patients with a gestation period < or > 18 weeks revealed shorter induction times in the former group without reaching statistical significance. CONCLUSIONS: Maternal age (under and over 30) and parity (P = 0 and P > or = 1) did not influence the results obtained.

Abortifacient Agents↗
PubMed1996

[Preclinical lymph node metastasis in ovarian cancer. Report of a case].

The involvement of inguinal lymph nodes in the spread and metastatic process of ovarian cancer is not common and has been reported in a very small percentage of cases (1-3%) and at relatively advanced stages. This paper examines the case of a patient in whom lymph node metastasis at inguinal level became manifest at quite an early stage in the form of a swelling, initially mistaken for a crural hernia, and preceding by about one year the onset of papilliferous serous cystoadenocarcinoma which subsequently developed in the right ovary. This case, which to the authors' knowledge represents the second observation of this kind reported in the literature, aims to draw attention to the need to examine and monitor these patients more carefully and accurately (at both instrumental and biochemical levels) in order to intervene as rapidly and appropriately as possible.

Aged↗
PubMed1994

Renal function evaluation in an adult female with cat-eye syndrome.

Cat-eye syndrome is a rare congenital anomaly involving the kidney. It is rarely reported in literature, while renal function has never been studied up to now. Shown here are the morphofunctional renal alterations observed in a female patient affected by cat-eye syndrome.

Abnormalities, Multiple↗
PubMed1993

[The hand-foot-uterus syndrome. A report of a case with recessive autosomal inheritance].

The authors report a new case of hand-foot-uterus syndrome, an infrequent and peculiar clinical condition characterized by skeletal anomalies of the extremities associated with alterations in the development of Mullerian derivation structures. The female patient in fact present morphological and skeletal anomalies to the extremities and a bicornate, twin-necked uterus with double vagina. This genetic condition is normally transmitted with a autosomal dominant pattern. The consanguinity of the parents and the absence of other like cases in the family led the authors to suppose that this is an even rarer form with a recessive autosomic-type inheritance. The importance of an accurate diagnosis is underlined not only to ensure better management, but above all for a more appropriate examination of their reproductivity.

Abnormalities, Multiple↗
PubMed1993

[Familial ectodermal dysplasia with agenesis of the breasts and the external urethral sphincter. Description of a case].

The Authors report a case of athelia and amastia observed in a 28-year-old woman. The association of severe dental alterations, nail dystrophies and irregular cutaneous hyperpigmentation with normal sweating, make it possible to catalogue the anomaly in the hydrotic ectodermal dysplasia, an autosomal dominant hereditary disease. The syndrome, transmitted by the father, is also present in two brothers of the patient: the association of sphincter urethrae agenesis, responsible for urinary incontinence unsuccessful treated with two surgical operations, is to be considered quite fortuitous.

Abnormalities, Multiple↗
PubMed1991

Testicular regression syndrome. A case report.

Testicular regression syndrome occurred in a 20-year-old, white, phenotypic female with a 46,XY karyotype. The basal levels of serum gonadotropins were elevated, while the testosterone was in the normal range. Estrogens were undetectable. At laparotomy no gonadal rudiments or müllerian or wolffian derivatives were found. The logical diagnosis was late embryonic testicular regression with a specific testicular insult 62-63 days after fertilization.

Adult↗
PubMed1990

A 45,X male with molecular evidence of a translocation of Y euchromatin onto chromosome 1.

A 45,X complement was found in lymphocyte and fibroblast cultures of a male infant with severe growth and mental retardation and mild dysmorphism. Lymphocyte DNA from this patient was found to contain Yp chromosome sequences. In situ hybridization (ISH) with the 50f2 probe led to a clear assignment of euchromatic material on the short arm of chromosome 1. This observation and others from the literature argue in favour of the conclusion that all 45,X males are probably either the result of undetected mosaicism or are carriers of Y translocated material.

Child, Preschool↗
PubMed1990

[Spontaneous abortion and advanced maternal age].

A retrospective analysis of pregnancy outcome after demonstration of a live fetus in the first trimester was carried out in 387 patients to establish a background loss rate and evaluate the safety of chorionic villus sampling. The present study proves an increased risk of spontaneous abortion with increasing maternal age, and a miscarriage rate (9.81%) higher than chorionic biopsy (4.4), probably because the therapeutic abortions and the sonograms were performed after bleeding.

Abortion, Spontaneous↗